Teenagers who use electronic cigarettes are four times more likely to go on to smoke tobacco, researchers have found.
The study is the first UK evidence that ‘vaping’ may act as a ‘gateway’ to smoking – a finding that will fuel the ongoing row about the benefits and dangers of e-cigarettes.
E-cigarettes contain a liquid form of nicotine that is heated into vapour to be inhaled, avoiding the harm caused by tobacco smoke.
Around 3million adults in Britain have used e-cigarettes in the decade or so that they have been on the market.
The study is the first UK evidence that ‘vaping’, pictured, may act as a ‘gateway’ to smoking – a finding that will fuel the ongoing row about the benefits and dangers of e-cigarettes
Health experts agree that the devices are much safer than smoking tobacco – and the gadgets are thought to have helped 22,000 people quit smoking each year.
Public health experts in the UK view the devices as a crucial tool in the fight against tobacco, and plans are in place to eventually make them available on prescription through the NHS.
But others are concerned about unresolved safety concerns and are particularly worried about their use among young people.
These fears have been inflamed by a series of studies from the US which have warned many teenagers use the gadgets, attracted by the exotic flavours on offer – and that they are more likely to ‘graduate’ to smoking tobacco later.
Doctors in the UK have repeatedly insisted there is no evidence this is also the case in this country.
But the new study, published in the BMJ journal Tobacco Control, suggests for the first time that the ‘robust association’ between vaping and smoking exists in this country as well.
The study is the first UK evidence that ‘vaping’ may act as a ‘gateway’ to smoking – a finding that will fuel the ongoing row about the benefits and dangers of e-cigarettes, pictured
Experts led by the University of Leeds examined survey responses from 2,836 pupils from 20 schools in England at the age of 13 and 14, and again a year later, when they were 14 and 15.
Among those who had never smoked but had tried an e-cigarette, 34 per cent tried smoking tobacco over the year.
Among the group who had not smoked and never used an e-cigarette, only 9 per cent tried tobacco.
The researchers, however, pointed out that they only asked whether the pupils had experimented with tobacco – meaning some of them may have only tried it once.
Study leader Professor Mark Conner of the University of Leeds said: ‘The findings suggest that among the teenagers who had never smoked, the use of e-cigarettes was a strong predicator that within 12 months they would have tried a conventional cigarette.
The study is the first UK evidence that ‘vaping’ may act as a ‘gateway’ to smoking – a finding that will fuel the ongoing row about the benefits and dangers of e-cigarettes, pictured
‘It is impossible to say if these young people were just experimenting with cigarettes or were becoming more regular smokers.’
Among those who had already tried tobacco at the beginning of the study, those who had also tried e-cigarettes were more likely to increase the frequency of their smoking, although the scientists stressed that these results were too weak to be classed as statistically significant.
The scientists said it is ‘plausible’ that the use of e-cigarettes ‘normalises’ smoking or leads to nicotine addiction – although, as of yet, there is no evidence of that.
It has been illegal in the UK to sell e-cigarettes or vaporising liquids to anyone under the age of 18 since October 2015.
Professor Kamran Siddiqi of the University of York, who also worked on the study, said: ‘Our study highlights the value of regulating marketing and sale of e-cigarettes to adolescents. The UK has introduced strong regulatory measures in this regard. It is important to enforce these measures effectively and remain vigilant by closely monitoring e-cigarette use in minors.’
Other experts last night stressed the research had only demonstrated a trend – not proven that e-cigarettes lead to tobacco used.
Professor Linda Bauld of the University of Stirling, said: ‘This study does not provide evidence that using e-cigarettes causes young people to become smokers.
‘It simply shows that some teenagers who try an e-cigarette might go on to try tobacco, and on both occasions it could be just once.
‘If e-cigarettes were causing smoking, then the steady decline in youth smoking we’ve seen in national surveys in recent years would be reversed. But it’s not – smoking amongst young people in the UK is at an all-time low.’
Rosanna O’Connor of Public Health England said: ‘While young people’s experimentation with e-cigarettes has been going up, smoking rates have been falling fast. In US studies claiming similar findings, the actual numbers of young people who go from vaping to smoking are very small.
‘New UK research will be published later this year bringing together multiple UK studies. All these studies find that while experimentation with vaping by young people is not uncommon, regular use is rare with the great majority being current or ex-smokers.’