New research has found that the overall effect of youth vaping is to lead more adolescents AWAY FROM regular smoking than towards smoking ie that vaping has a net effect as a gateway OUT OF smoking.
The study by leading UK researchers analysed data from the 2014-2017 US National Youth Tobacco Survey and was published today in the journal Tobacco Control.
The study found that only 1% of teens who used an e-cigarette first became *established smokers. They were 85% less likely to go on to be established smokers than those who smoked first (OR 0.15 CI 0.12-0.18).
They were also less much likely to become established smokers than similar, matched teens who had not tried vaping (OR 0.76 CI 0.62-0.93).
This suggests vaping has a protective effect in reducing the risk of an adolescent becoming a smoker
The likely explanation is that many teens who would have smoked if vaping was not available were diverted from progressing to smoking.
Overall positive effect from teen vaping
This is in stark contrast to the conventional narrative that vaping is leading young people who would not otherwise have smoked to become smokers.
This research suggests that any gateway effect from vaping to smoking must be small and is outweighed by a much larger effect of diverting youth away from smoking, ie a ‘reverse gateway’
This is consistent with the rapid decline in youth smoking rates in the US. According to the Monitoring the Future study, the smoking rate of 12th graders fell by an unprecedented 21% in 2018 and 25% in 2019.
The current analysis suggests that the association of e-cigarette initiation with subsequent smoking is largely explained by shared vulnerability such that those who try an e-cigarette first would have gone on to smoke cigarettes anyway.
The study used a statistical analysis called propensity score matching which reduces the risk of confusion from common risk factors (confounders) and provides a less biased result.
This protective effect of vaping calls into question the ban on youth vaping. Vaping may be having an overall positive effect on public health
* Unlike most other studies, this study examined the impact of vaping on established smoking rather than ‘ever smoking’. This is important because most ‘ever users’ do not go on to regular smoking. Only regular or established smoking will result in subsequent premature death and disability.
Media release. Observed ‘gateway’ effect of e-cigarettes
among teens ‘likely to be small’ 17 March 2020