E-cigarettes could lead young users to daily cigarette use, research suggests

Vaping while still smoking regular cigarettes may not cut risk of cardiovascular disease. Image: Getty Images/Neydtstock via AFP Relaxnews

Youngsters who experiment with vaping before the age of 18 could be three times as likely to become daily cigarette smokers in the future, according to research from the United States studying the evolution of tobacco consumption and addiction among adolescents and young adults.

A team of researchers at the University of California San Diego Herbert Wertheim School of Public Health and Human Longevity Science analyzed data from the Population Assessment of Tobacco and Health (PATH) study of tobacco use and its effects on health, based on a nationally representative sample of 12 to 24-year-olds in the U.S. between 2013 and 2014.

Participants were re-interviewed annually for four years to determine whether experimenting with 12 tobacco products, including e-cigarettes, had led to daily tobacco use.

“In these data, e-cigarettes are a gateway for those who become daily cigarette smokers. The start product has changed from cigarettes to e-cigarettes, but the end product has stayed the same. When users become dependent on nicotine, they are converting to cigarette smoking,” explains professor John P. Pierce, the study’s first author.

Published in the online edition of Pediatrics, the research reveals that young people age 12 to 24 who used e-cigarettes were three times as likely to become daily cigarette smokers in the future. The researchers add that the age of the first experimentation and the number of tobacco products tested also increased addiction risk. Among participants who said they used a tobacco product of any kind, daily use increased with age through age 28. Daily cigarette smoking nearly doubled between 18 to 21-year-olds (12%) and 25 to 28-year-olds (21%).

More precisely, nearly half of participants (45%) reported using at least one tobacco product in their lifetime during the first year of the study. This rose to 62% in the fourth year of the study, and among those, 73% had tried cigarettes, 72% had tried e-cigarettes, over 50% had tried hookahs and cigarillos, and just over 10% had tried traditional cigars or pipes.

By the fourth year of the study, 12% of participants reported using tobacco products daily, 50% of whom became daily users after the first year. Nearly three quarters of these daily users (70%) smoked cigarettes, and 63% used cigarettes exclusively. Plus, among the 17% of daily users who reported vaping every day, almost half were also non-daily cigarette smokers.

“Trying e-cigarettes and multiple other tobacco products before the age of 18 is also strongly associated with becoming daily cigarette smoking. We know that e-cigarette use among high school seniors, most under the age of 18, increased from 38% in 2016 to 45% in 2019,” said senior author, professor Karen Messer.

These results suggest that recent rapid growth in adolescent e-cigarette use will lead to increased daily cigarette smoking among young adults in the United States, reversing decades of decline in cigarette smoking,” she concluded. JB

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