Vaping may get teens to try cigarettes, but it doesn't increase their chances of becoming smokers, according to a study of 12,000 middle and high school students in the US.
The study reviewed previous studies that found a link between e-cigarettes and smoking. But experts are still divided on the results. Many praised the findings, describing them as new evidence in a growing and conflicting field.
The new study, published in the journal Nicotine and Tobacco Research last Friday, suggests the link between teen vaping and smoking can be attributed to shared influences from tobacco — for example, whether the person drinks alcohol or is around smokers.
Older studies, such as a 2018 study from the University of California, San Francisco, suggested that vaping leads to smoking in teens. But the new study has a simple explanation for that link: vapers tend to have some similarities to smokers.
Researchers use complex statistical methods to explain differences among youth. They consider information such as race, gender, and behavioral information such as disciplinary and misdemeanor rates.
Before controlling for these characteristics, e-cigarette use increased the odds of becoming a smoker by 36 times. But that effect disappeared when the researchers added dozens of similar risks. Vaping still led teens to try cigarettes, but it didn’t necessarily turn them into regular smokers.
“This is an important study that uses an innovative evidence-based approach,” said Professor Nicholas Chadi, assistant professor of pediatrics specializing in addiction medicine at the University of Montreal.
But Professor Chadi, who was not involved in the study, also said “some existing studies show a correlation between e-cigarette use and future smoking, those results need to be superseded.”
Study uses “sophisticated data research” but has limitations
Arielle Selya, the study's lead author and an assistant professor at Sanford Health in South Dakota, said her study undermines the hypothesis that vaping leads to smoking.
“The majority of the public health community believes that e-cigarettes are a gateway to nicotine use and attract new users,” Selya said. In her report, she cited a 2018 study in the National Academies of Sciences, Engineering, and Medicine that “suggested that e-cigarettes may accelerate the transition to traditional cigarettes among adolescents.”
Professor Selya, who led the study
But new data do not support this conclusion, Selya said, and “It is important that we pause on e-cigarette legislation until we know more about its effects.”
Dr. Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children's Hospital, said the study used “sophisticated data analysis strategies” but added, “however, I am still skeptical about the results.”
The study doesn't address the issue of “what we know about addiction and the problem,” she said, “like when someone is addicted to a substance, they want to use it in whatever form they can find.”
New data may lead to new conclusions.
Chadi, the University of Montreal professor, also noted that the study used data from 2015 and 2016, "which is around the time that rates of vaping among minors began to increase dramatically."
Another limitation, which Selya acknowledged in his paper, is that his study did not follow adolescents closely. It relied on surveys that asked adolescents to recall when they used tobacco. For those who use both e-cigarettes and vapes, it can be difficult to remember which one they used first.
Salya called that a major limitation of her study, but added, “most studies tell us that kids start with e-cigarettes first.” She found that many teens were able to start smoking shortly after completing the survey, highlighting the need for studies that can follow young people over time.
Source: CNN
