March 17, 2020

expert reaction to study on gateway effect of e-cigarettes

A study, published in the journal Tobacco Control, reports on the gateway effects of e-cigarette use.

Prof John Britton, Director of the UK Centre for Tobacco & Alcohol Studies and Consultant in Respiratory Medicine, University of Nottingham, said:

“These findings confirm an earlier analysis¹ of the US National Youth Tobacco Survey indicating that most American young people who use e-cigarettes tried cigarettes before vaping, suggesting that vaping is for them a rational health choice rather than a dangerous gateway into smoking.

“Although much has been made of the rapid increase in vaping among young people in the US there has been very little analysis of the relation between vaping and smoking. This study is an important demonstration that in the US, as in the UK, vaping by young people is probably helping to reduce, rather than increase, the probability of developing a lifelong and lethal addiction to tobacco.”

¹ https://www.qeios.com/read/article/384

Prof Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London (QMUL), said:

“The study suggests that those young people who find nicotine rewarding (‘nicotine seekers’) and who would normally proceed to smoking can be deflected from picking up smoking if e-cigarettes, which are much less risky and much less addictive, are available.  

“The title of the press release does not reflect the findings of this study accurately. The data do not show that e-cigarettes provide only a small gateway effect into smoking – there was in fact a significant effect going in the opposite direction. As the authors cautiously point out, ‘E-cigarettes were unlikely to have acted as an important gateway towards cigarette smoking, and may, in fact, have acted as a gateway away from smoking for vulnerable adolescents’.  The prevalence of regular smoking among young people in the USA has decreased dramatically since e-cigarette use increased.” 

‘Association of initial e-cigarette and other tobacco product use with subsequent cigarette smoking in adolescents: a cross-sectional, matched control study’ by Lion Shahab et al. was published in Tobacco Control at 22.30 hours UK time Tuesday 17 March 2020.

DOI: 10.1136/ tobaccocontrol-2019-055283

Declared interests

Prof Hajek: No conflict of interest.

Prof Britton: None to declare