As e-cigarettes spread like wildfire around the country, medical experts have expressed concern about whether e-cigarettes actually discourage users from moving on to cigarettes, but a new study finds that e-cigarettes are not a gateway to regular smoking.
E-cigarettes are growing rapidly among the high school population in the United States. Previous research has indicated that in just one year, e-cigarette usage by high school students doubled from 4.5 percent to 10 percent. Apart from e-cigarettes, hookah is also starting to take off in popularity, which is why researchers included it as a category in the new study.
With an explosion of tobacco products, researchers have found it difficult to determine causation. In other words, do emerging tobacco products (ETPs) like e-cigarettes and hookah encourage users to start smoking regular cigarettes, or do ETPs actually reduce overall rates of smoking?
“One of the biggest concerns about e-cigarettes is that they will serve as a gateway drug to lifelong nicotine dependence and all of the harms we know result from cigarette smoking,” said Michael Fiore, tobacco researcher from the Centers for Disease Control, according to Radio Iowa.
County after county has jumped into the regulatory fray to ban minors from accessing e-cigarettes, owing to health concerns and the fact that e-cigarettes have entered the market so quickly. Some experts are unsure aren’t yet sure what to think, although the general tone so far has been relatively optimistic. E-cigarettes have the potential to dramatically reduce conventional smoking rates.
Using a sample size of 1,304 students with an average age of 19.4 years at a public university in Oklahoma, researchers conducted an online survey to determine what tobacco products student had tried before and how frequently they used them.
To start, 79.5 percent of the sample was composed of non-users, which were mostly white and female. And 49 percent of all students reported that they had tried a tobacco product at least once. Another 20 percent either daily or occasionally consume tobacco products.
The main finding? Youths who first used hookah or e-cigarettes are less likely to become frequent smokers of regular cigarettes, compared to those who first tried conventional cigarettes. The students who first tried conventional cigarettes were three more times likely to become poly tobacco users than those who first tried e-cigarettes. Poly users are those who use three or more tobacco products.
Out of the sample, only one student who first started with an ETP ended up becoming a daily user of tobacco products. In contrast, 10 percent of users who first started with conventional cigarettes now smoke daily.
“Though this finding should be interpreted with caution, it potentially indicates that current ETPs are not necessarily strong gateways to regular tobacco use,” the researchers noted.
However, the study does have some noteworthy limitations. The first is most important: the study is cross-sectional, meaning it did not track users over time. Second, the researchers relied on self-reported data instead of biochemical indicators of smoking. This means that while the research is promising, it by no means is conclusive.
“Despite these limitations, the present investigation helps to identify the gateway potential of various tobacco products in a rapidly expanding tobacco market,” the authors concluded.