Teens who use e-cigarettes are more likely to smoke combustible tobacco. As a result, governments have to strictly regulate vaping products to prevent children from progressing to a deadly cigarette habit.
This is the much-ballyhooed vaping-to-smoking “gateway” many tobacco-control advocates have warned about for years.
“Young people who had ever used e-cigarettes had seven times higher odds of becoming smokers one year later compared with those who had never vaped,” The Truth Initiative declared in January 2021. “The link between vaping and future cigarette use serves as a stark warning for the need to regulate all nicotine products to protect youth…”
Although this gateway hypothesis remains popular, it’s hindered by one critical detail: it’s wrong. Recent research shows that the few teenagers who experiment with vaping do not become regular cigarette smokers, undermining the campaign to further restrict adult access to nicotine vaping products.
A phony gateway effect
To understand the flaw in this gateway idea, we need to distinguish between experimenting with cigarettes and regular smoking. Many studies have looked at the association between teen vaping and later smoking initiation, and some of them have indeed shown that youth who try e-cigarettes do start smoking.
But how many of those teens continue to smoke? That’s the crucial follow-up question the authors of a new study published by JAMA Network Open answered. The researchers analyzed the vaping and smoking behavior of 8,671 adolescents, between 12 and 17 years old, from 2015 to 2019.
As previous studies had found, this one also showed that youth who tried vaping were more likely to try cigarettes. However, the authors concluded, “few adolescents are likely to continue smoking after initiation regardless of baseline e-cigarette use.” Overall, they added, “few adolescents started smoking cigarettes … and even fewer continued smoking …”
Regardless of vaping status, just over four percent of teens started smoking cigarettes and less than 2.5 percent continued smoking. Two previous studies, one from 2012 and another from 2019, also found “that few youth experimenters become regular or established smokers.” In an ideal world, no teenagers would vape or smoke; nonetheless, the new study points to an important conclusion, according to its authors:
“Although a positive association between e-cigarette use and cigarette initiation has been reported by many studies, at the population level, the prevalence of past 30-day cigarette smoking among youth and young adults has steadily decreased in the era of e-cigarettes.” [emphasis mine]
The smoking-to-vaping diversion
Put another way, as vaping has grown more popular, the rate of teen smoking has continued to drop. Other recent research has shown that the relationship between vaping and smoking goes in the opposite direction; the few teenagers who vape were smokers before they tried e-cigarettes. The authors of a January 2021 study summarized this “diversion” effect as follows:
“Not only does the current study demonstrate that actual data are much more consistent with a diversion effect than a catalyst effect, but the magnitude of this effect is somewhat large … This is consistent with other recent research showing that declines in cigarette use have accelerated after the introduction of ECs.”
Putting this research together leads to a clear conclusion. The vaping-to-smoking “gateway” doesn’t exist. It’s a myth propped up by misleading statistics, nothing more.