E-cigarettes could undo decades of progress made by anti-smoking efforts, based on a recent study that found youths starting with e-cigarettes are four times as likely to use cigarettes within two years compared to those who never tried e-cigarettes. Findings were published in JAMA Network Open and highlight the public health threat that e-cigarettes pose to America’s youth.
Using data from a national survey study, this analysis looked at smoking trends among children aged 12 to 15 years. The goal was to see how many children who never tried tobacco eventually use e-cigarettes, cigarettes and other tobacco products.
Smoking is the leading cause of preventable death in the United States, causing nearly 6 million deaths per year. Over the past few decades, we’ve made significant progress in reducing smoking rates among both children and adults. However, the recent adoption of e-cigarette use raises red flags for public health.
E-cigarettes are battery-operated devices that heat up liquid nicotine into a vapor that can be smoked. While they don’t contain tobacco, they are not considered a “safe” alternative to cigarettes since they can contain addictive nicotine and other dangerous chemicals.
In the recent study, 6,123 children were surveyed about cigarette and tobacco use at three points between 2013 and 2016. Participants were between 12 and 15 years old and had never used any tobacco products at the start of the study.
Although most participants never tried any form of cigarettes or tobacco over the two-year study period, those who did were most likely to try e-cigarettes as their first tobacco product. Overall, 8.6% of participants reported e-cigarettes as their first tobacco product, while 5% reported using another non-cigarette tobacco product and 3% reported using cigarettes first.
Unfortunately, researchers found that trying e-cigarettes led to future tobacco cigarette use, even among low-risk participants.
Participants who tried e-cigarettes were more than four times as likely to use cigarettes and nearly three times as likely to currently smoke cigarettes by the end of the two-year period. When applied to a population level, researchers estimate that e-cigarettes were to blame for 180,000 adolescents trying cigarettes and 45,000 adolescents actively smoking cigarettes from 2013–2016.
Researchers note that use of non-cigarette products also increased odds of future cigarette use, although the association wasn’t quite as strong.
The take-home message, according to authors, is that use of non-cigarette products could be a gateway for future cigarette use.
Data shows that high school students who said they had used e-cigarettes within the last 30 days rose from 1.5% to 21% between 2011 and 2018. Given these trends, the link between e-cigarette and cigarette use could undo or even reverse progress we’ve made in cutting smoking rates.
As a result, experts call for stricter regulation of e-cigarettes, as well as increased efforts to reduce any form of cigarette or tobacco use among children and teens.