Study identifies link between e-cigarette and tobacco use in school children

A new study, published in the journal Tobacco Control has found a link showing that school children who use e-cigarettes are more likely to try tobacco within a year.

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Using e-cigarettes or vaping is generally accepted as a safer alternative for people who already have the habit of smoking. However, there are concerns that these forms of smoking will be used as a gateway to smoking with cigarettes.

In order to investigate the role of e-cigarettes in adolescents’ progression to smoking their first cigarette, a collaboration of researchers led by the University of Leeds surveyed 2,836 adolescents from 20 schools in England.

The vast majority of these participants were non-smokers, while a few had already tried tobacco. One-third of them were identified as e-cigarette users.

One year later, they were surveyed again and were asked if they had tried smoking a conventional cigarette. From those who had tried, the details on the frequency of cigarette use were also collected.

Out of 343 non-smokers of conventional cigarettes but who had tried an e-cigarette, 118 students (34 %) reported smoking at least a cigarette during the year; also, among 1383 students who were non-smokers and had not tried e-cigarettes, 124 (9 %) had since tried at least a cigarette.

According to Prof. Mark Conner, an applied social psychologist and the lead investigator of the study, the findings suggest e-cigarette use as a strong predicator of trying cigarettes among teenagers who had not smoked before.

It is impossible to say if these young people were just experimenting with cigarettes or were becoming more regular smokers"

Prof. Mark Conner.

Contrary to popular opinion, the findings also showed that for those who did not have friends who smoked, the use of e-cigarettes was a better predictor of starting smoking, making a student five and a half times more likely to start smoking, as compared to a friendship group where most smoked where e-cigarettes were only one and a half times more likely to start smoking.

According to Prof. Sarah Grogan from Manchester Metropolitan University, a co-author of the study, further research is needed to understand the mechanisms behind the above mentioned effect completely.

The researchers, in order to find if there is any link between increased use of tobacco and e-cigarette, had also analyzed teenagers who had already smoked a minimum of one cigarette at the beginning of the survey. Out of the 248 participants who had tried an e-cigarette, 60 children (24%) were identified with an increase in cigarette smoking, while 9 out of the 70 children (13%), who had not tried an e-cigarette the same.

Even though there is a lack of proper evidence, the chance of normalization of smoking or nicotine addiction or chance of building up friendship networks with smokers, etc., by the use of e-cigarettes is indicated by the researchers.   

Kamran Siddiqi, Professor in Public Health at the University of York and another co-author, said that the study points out the importance of regulating sales and marketing of e-cigarettes to adolescents. According to him, although the UK had introduced strong control measures for non-conventional smoking, effective enforcement of the same is vital. Also, it is important to remain observant by close monitoring of the use of e-cigarettes in minors.

As the data was acquired as a part of an observational study, instead of finding the cause o r effect, it highlights the likely association between the various factors responsible. Yet, the findings of the study were supported by similar studies from the US where it was found that the use of e-cigarette is linked with cigarette use.

Since 2015, the UK has made it illegal for the retailers to sell e-cigarettes or vaporizing liquids to minors.

The research also underlines the availability of a new generation e-cigarette devices which more closely mimic the conventional cigarettes. The need of more research to know whether this has any impact on young people in taking up smoking is put forth by the researchers.

As per the official statistics, among young people, there is an increase in the usage of e-cigarettes and decrease in the usage of cigarettes; this is contradictory to the findings of this study, says Prof. Conner.