Vaping obtained a terrible reputation last year when quite a few young adults became ill after vaping. While it was later found that 98 percent of those who became ill did so after using illegal products, the media failed to share this information widely as they did with the illnesses and hospitalizations. Today, experts speak of the dangers of vaping and the gateway effect. This refers to the likelihood that young adults who vape are more likely to begin smoking. However, two recent studies suggest that young adults who vape aren’t more likely to smoke. Why is this of importance?
What is the Gateway Effect?
Research studies show that vaping comes with fewer risks than tobacco products. In fact, countless individuals find they quit smoking for good with the help of vaping. Nevertheless, people continue to assume young adults who take up this habit move on to traditional cigarettes. In fact, some individuals in the past claimed adults who tried vaping would also move on to smoking at some point. They expressed concern that declining rates of smokers would increase again thanks to the introduction of these products. This led to many people being hesitant to ask for help finding vape deals.
The Meta-Analysis
Fortunately, science continues to advance, and those working in this field remain focused on this topic to get accurate information. Researchers in one study did a meta-analysis of the results from 17 previously conducted studies. They wanted to determine whether the use of e-cigarettes by young adults would encourage them to move to traditional tobacco cigarettes. They calculated an odds ratio for each of the studies they looked at, and every study they reviewed examined the link between the use of e-cigarettes and subsequent smoking.
During this meta-analysis, the researchers found that young adults who never smoked traditional cigarettes but used e-cigarettes were four-and-a-half times more likely to pick up traditional tobacco cigarettes at a later date. They question the results, however, because they found several issues with the studies included in the meta-analysis. They feel the results they got may not be accurate because of these issues.
The National Youth Tobacco Survey
A second study reviewed data obtained through the United States National Youth Tobacco Survey over the three-year period between 2014 and 2017. This data brought together responses from roughly 40,000 teens in the United States. As part of this survey, the researchers asked teens about their traditional cigarette use. They wanted to know how many teens tried a tobacco cigarette, even if they did nothing more than take one puff. They categorized anyone who answered yes to this question as “ever smokers.”
If the teen smoked one or more cigarettes in the 30 days prior to taking part in the survey, the researchers placed them in a separate category. The third group consisted of teens who had smoked over 100 cigarettes since picking up the habit. They placed these teens in a group referred to as “established smokers.”
The researchers quizzed participants on their combustible and non-combustible tobacco use as well as their e-cigarette use. Combustible tobacco products for the purpose of this survey included tobacco cigarettes, hookahs, cigarillos, cigars, and pipes while the non-combustible products category included items such as chewing tobacco. Researchers took this a step further and adjusted the teens in terms of their demographic, social, and behavioral characteristics.
Once they placed the teens in the appropriate categories, the researchers looked to see who tried combustible and non-combustible products first and who tried e-cigarettes first. The researchers found traditional tobacco cigarettes served as the most popular starter product. Other combustibles came in second, followed by e-cigarettes, and lastly non-combustible tobacco products. They found that this remained consistent even with the increase in popularity of e-cigarettes starting in 2015, when they became the most popular of these items. Researchers also discovered boys are more likely to try any of these products than girls, and teens are more likely to experiment the older they get.
What Does This Mean?
Policymakers continue to push for heavy regulation of e-cigarettes and vape products, stating they are dangerous and lead to tobacco use. In fact, certain areas of the country now restrict or outright ban the sale of flavored vape juice to discourage teen use. They continue to do so even when the research doesn’t support the restrictions or bans.
The researchers feel additional studies need to be conducted for a variety of reasons. For example, they feel the evidence they reviewed lacked biochemical verification. They obtained information gathered solely through self-reports, and these aren’t always accurate. Additionally, the studies used no negative controls, which impacts the question of causality. Finally, the studies never assessed nicotine content, and the researchers believe nicotine could play a role in the behaviors and associations.
According to the researchers, additional studies must be carried out to eliminate these issues and get a more accurate picture of e-cigarette use and its association with later tobacco use. Areas they feel need to be addressed in future studies include biochemical analyses to verify self-reports, an examination of nicotine content in the products used and its relation to behaviors and associations, and implementing a variety of statistical analyses.
This issue has yet to be resolved, as suggested by the latest information. While one study found that young vapers are four times more likely to smoke tobacco cigarettes at a later date, more research needs to be done with better techniques being used in the studies to determine if there is an association between the two.
The second study found that young teens who used e-cigarettes before trying tobacco products were less likely to pick up tobacco. Kids who used tobacco alternatives first were most prone to picking up a cigarette than those who vaped. Additionally, less than one percent of those who tried an e-cigarette became established smokers. This figure comes in lower than seen with any other category. Of those who vaped first, only 2.7 percent went on to be established smokers. Nine percent of those who started with combustible tobacco products ended up as established smokers, and 16 percent of those who first started with non-combustible tobacco products became established smokers.
Again, more research need to be conducted and these studies need improvements in terms of their methodology. However, at this time, it appears cigarettes remain the most important gateway for a young adult becoming a tobacco smoker. In fact, vaping may serve as a gateway away from smoking, and the experts must consider this before restricting or banning the use of these products.