Teenagers who smoke electronic cigarettes may smoke in later life
Teens who start vaping are nearly three times more likely to go on to smoke cigarettes than their peers who don't use any type of tobacco product, a new study finds. The results are alarming for both medical experts - who would rather kids not smoke - and for the e-cigarette industry, which is increasingly marketing its products as smoking-cessation tools for adults.
Today's study, published in the journal JAMA Network Open, couldn't say whether vaping caused the kids to go on to smoking. But the study authors did find some pretty strong associations between vaping and later cigarette smoking, particularly for kids who would normally be considered "low risk" for substance use: the ones that aren't big on thrill-seeking, drinking, or misusing prescription drugs. The findings are especially timely in light of the Food and Drug Administration's recent announcement that 3.6 million high school and middle school students used e-cigarettes in 2018.
The paper comes on the heels of a major clinical study that showed e-cigarettes helped a small proportion of adult smokers quit cigarettes. The back-to-back publications show the tightrope on which regulators and the e-cigarette industry are walking: on one hand, e-cigarettes may wind up being a useful tool for helping adults stop smoking. On the other hand, there's a growing body of evidence that they act as what FDA commissioner Scott Gottlieb has called an "on ramp" to the more dangerous, combustible kind of cigarette.
"These two papers highlight the conundrum public health policymakers are faced with," says Gideon St. Helen, a tobacco researcher at the University of California, San Francisco who was not involved in the research, in an email to The Verge.
There are a few limitations, including that the study looks at a window of time before Juul really took off, says Michael Ong, a professor of medicine and public health at UCLA who didn't participate in the study. That means the results aren't a perfect window into the e-cigarette market of today.