Feb. 26, 2019—When curious kids experiment with tobacco, they're most likely to start with e-cigarettes, a new study shows. And when that experimentation starts with vaping, kids' odds of moving on to traditional cigarettes jump.
The study looked at more than 6,000 children ages 12 to 15. None of them had used cigarettes, e-cigarettes or other tobacco products. Over the course of two years, researchers checked in about their tobacco use.
Vaping's gateway effect
Most kids—about 83 percent—had still never used a tobacco product at the study's end. But over the two years of the study, about 17 percent used tobacco for the first time. Their first tobacco products were:
- E-cigs (8.6 percent).
- Other non-cigarette products like smokeless tobacco (5 percent).
- Traditional cigarettes (3.3 percent).
Kids who vaped were four times more likely to move on to cigarettes than those didn't use any tobacco product before lighting up. This adds to concerns that vaping is a gateway for smoking, the researchers said.
While the study suggests other tobacco products are also a pathway to smoking, e-cigs may be the key culprit because of their popularity, the researchers cautioned.
Surprisingly, vaping's gateway effect was strongest in kids considered to be at low risk for smoking. Those who first tried e-cigs—but initially said they had no interest in lighting up and were generally risk averse—were the most likely to smoke cigarettes later.
That kids who thought they'd never smoke often do after trying e-cigs is especially troubling, the researchers said. It suggests vaping may renormalize smoking and erode decades of progress in reducing smoking rates.
The study appeared in JAMA Network Open.
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