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Young vapers are almost five times more likely to try real cigarettes

The study suggests that e-cigarettes could contribute to a new generation of real smokers

Younger people who have tried e-cigarettes but had never previously smoked are nearly five times more likely to try tobacco cigarettes, suggesting vaping may play a role in instigating smoking.

Researchers from the University of Bristol’s Tobacco and Alcohol Research Group (TARG) worked with the city’s Medical Research Council’s Integrative Epidemiology Unit and the National Institute for Health Research’s Bristol Biomedical Research Centre to combine 17 studies into whether e-cigarette smoking was associated with subsequent cigarette smoking.

While existing studies suggest that smoking e-cigarettes, also known as vaping, is less harmful than smoking cigarettes and can be an effective quitting tool, concerns have circulated over whether they can present a ‘gateway’ into smoking.

This latest study found that young people who had never previous smoked but had tried vaping were four-and-a-half times more likely to go on to smoke.

Lack of hard evidence

However, the researchers are reluctant to conclude that vaping is causing young people to start smoking, as the results rely on the participants’ self-reported smoking history.

Without biochemical verification, they would be unable to reliably check whether a participant had never previously smoked a cigarette.

“Policymakers have used the findings of studies, including the studies we reviewed in this research, to support the heavy regulation of e-cigarettes, including restrictions on flavours and even total bans, but the evidence that e-cigarette use might cause young people to take up smoking is not as strong as it might appear,” said Jasmine Khouja, a PhD student in TARG based in the School of Psychological Science.

None of the studies were able to provide stronger evidence whether the association of early vaping with later smoking was casual, and much of their evidence also failed to consider the nicotine content of e-liquids.

This makes it difficult to conclude whether nicotine was the mechanism driving the association, the report, published in journal Tobacco Control, claimed.

Derailing efforts to quit

A separate study from the Ohio State University College of Public Health in December warned that knee-jerk reaction bans on e-cigarettes could derail the efforts of millions of people trying to stop smoking traditional nicotine cigarettes.

The US Centres for Disease Control and Prevention (CDC) had reported 48 deaths and 2,291 cases of serious lung injury linked to smoking e-cigarettes, also known as vaping, as of 3 December, prompting the American Medical Association to call for a blanket ban.

Amy Fairchild, dean of The Ohio State University College of Public Health, said that while the alarm was justifiable, the response needed to acknowledge the “powerful evidence” supporting the availability of legal nicotine products.

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