Teenagers who vape are four times more likely to try smoking, finds controversial study

Teenagers who had vaped when they were 13 or 14 were about four times more likely to have tried a tobacco cigarette a year later than those who had not, according to a new study designed to help work out whether ecigarettes act as a “gateway” to smoking.

The issue is controversial as a major report by the Royal College of Physicians last year concluded that ecigarettes were much less harmful to health and smokers should be encouraged to use them.

Another expert, commenting on the new study, said vaping had been previously associated with a fall in teenage tobacco smoking.

However, there is concern that ecigarettes’ better image could encourage people who had never smoked to try them, then develop a nicotine habit that leads them to cigarettes.

And while the new research found an association between vaping and later trying at least one cigarette, the academics stressed they had not established a causal link.

They found 9 per cent of 13 and 14-year-olds who had not tried ecigarettes reported trying a tobacco cigarette a year later, they reported in the journal Tobacco Control.

However, among those who had tried an ecigarette, the figure for tobacco use a year later rose to 34.4 per cent.

“We showed that ever use of ecigarettes is associated with initiation of cigarette use; an effect that remains when controlling for various predictors of smoking,” the researchers wrote. “Our study in UK adolescents found patterns similar to those reported in longitudinal studies among adolescents aged 13 to 14 years and older in the USA.

“A significant minority of adolescents try ecigarettes first (19.9 per cent here) and later initiate cigarette use.

“Our findings also indicated that the association between ever use of ecigarettes and initiation of cigarette use was particularly strong among adolescents with no friends who smoked, a group usually considered to be less susceptible to smoking initiation.”

However they added: “While acknowledging that a causal relationship may be plausible, we cannot confirm this, based on our findings and the trends observed over the same period in the UK.

“Given the lack of clarity regarding the mechanism linking ecigarette and cigarette use, we need to be cautious in making policy recommendations based on our findings.”

Other experts said any suggestion that ecigarettes were acting as a “gateway” to tobacco cigarettes for teenagers appeared to be contradicted by falling rates of smoking among that age group.

Professor Linda Bauld, an expert in health policy at Stirling University, said: “This study does not provide evidence that using ecigarettes causes young people to become smokers.

“It simply shows that some teenagers who try an ecigarette might go on to try tobacco, and on both occasions it could be just once.

“If ecigarettes were causing smoking, then the steady decline in youth smoking we’ve seen in national surveys in recent years would be reversed. But it’s not – smoking amongst young people in the UK is at an all-time low.”

And Professor Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary University of London, said: “People who drink white wine are more likely to also try red wine than teetotallers and kids who like superhero comics also try superhero films, whether their friends do the same or not.

“Common sense would not suggest that this shows gateway effects.

“To be fair, the authors seem aware that the obvious explanation of their finding is that kids who try smoking are the same kids who also try vaping and the other way round, whatever their friends are doing.

“The finding that vapers with no smoking friends were more likely to try smoking later on than those whose friends smoke is most likely because among the latter, those who wanted to try smoking had tried one of their friends’ cigs already.”

He said other data had showed experimenting with vaping was “accompanied by a decline, not an increase, in smoking in young people”.

“Rather than leading to smoking, access to vaping seems more likely to deflect some adolescents who would have otherwise smoked and help those who already smoke to switch to a much less risky alternative,” Professor Hajek said.