E-cigarette use among youth leads to smoking as adults finds study

By Dr. Ananya Mandal, MDDec 11 2017

E-cigarettes and vaping is considered to be a harmless version of the real thing with many manufacturers selling them to the youth. There are candy and a host of other flavoured e-cigarettes that are being sold to the youth. A new study from the University of Pittsburgh has found that use of these among the youth raises the risk of their smoking cigarettes later in life. The study was published this week in the American Journal of Medicine.

University of Pittsburgh researcher Brian Primack, director of Pitt’s Center for Research on Media, Technology and Health, and Dean of Pitt’s Honors College, and his colleagues from Pitt, Dartmouth and the VA Pittsburgh Healthcare System, looked at a group of 915 participants who were 18- to 30-year-old non-smokers in March of 2013. They looked at these individuals again 18 months later. They analyzed the use of e-cigarettes and cigarettes among this population. Of the 915 participants in the survey, 16 had tried e-cigarettes initially of which 6 went on to smoke cigarettes later. The other 899 who had never smoked any form of cigarettes, 80 took up cigarette smoking. Results showed that 47.7 percent of those who had used e-cigarettes earlier would go on to try and smoke cigarettes. Compared to this, only around 10.2 percent of those who had not tried e-cigarettes went on to smoke cigarettes at a later date. They matched this finding with the standard US population to arrive at these percentages.

Dr. Primack explained that there have been studies that show a raised risk of taking up smoking among the youth who experiment with vaping. He added that “experience puts them at a higher risk of later on transitioning.”

There have been critics of this study too. Bill Godshall, executive director of Smokefree Pennsylvania for example did not agree with these findings. He said, “In order for e-cigs to be a ‘gateway’ to cigarette smoking, a person’s regular use of e-cigarettes must cause (not merely precede) a person’s regular cigarette smoking.” He added that the statistics show an all time low in smoking rates in the United States since 2010. Dr. Primack however says that smoking e-cigarettes is not the only factor associated with cigarette smoking but several other factors are responsible. Rebelliousness, for example, he said, could be one reason, but no significant association could be made between rebelliousness and trying e-cigarettes and later smoking.

Dr. Primack admitted that this was a difficult study to conduct and correlate because it was difficult to find an 18 year old that had never had a single cigarette or tried an e cigarette. Back in 2013, e cigarettes were less popular too. This means that the sample of participants they looked at was small. To overcome this hurdle, the team had to adjust the findings to the general American population statistics.

He explained that three are around 800,000 Americans who have used e-cigarettes but never smoked. If around half of these people take up smoking, the numbers come to a whopping 400,000 people he explained. Primack said more research is needed to establish this theory but for now this is significant.