Study: Teens Who Use E-Cigarettes More Likely to Smoke Tobacco

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The National Institutes of Health has released the findings of a recent study on teen use of e-cigarettes. The study, published in The Journal of the American Medical Association (JAMA), shows that students who have used electronic cigarettes by the time they begin the ninth grade are more likely than others to start smoking traditional cigarettes and other combustible tobacco products within the next year.
E-cigarettes, explains the NIH, deliver nicotine to the lungs by heating the liquid solution that contains nicotine and other chemicals to produce an aerosol that the user inhales, a process called “vaping.”
The study compared tobacco use startup among 222 students from 10 public high schools in Los Angeles who had used e-cigarettes but not combustible tobacco products, and 2,308 who had neither used e-cigarettes or combustible tobacco products when initially surveyed at the start of the ninth grade. During the first six months after being surveyed, 30.7% of those who used e-cigarettes started using combustible tobacco products such as cigarettes, cigars, and hookahs, compared to 8.1% of those who had never used e-cigarettes. Over the following six months leading into 10th grade, 25.2% of e-cigarette users had used combustible tobacco products compared to 9.3% of nonusers.

“While teen tobacco use has fallen in recent years, this study confirms that we should continue to vigilantly watch teen smoking patterns,” said National Institute on Drug Abuse (NIDA) Director Nora D. Volkow, M.D. “Parents and teens should recognize that although e-cigarettes might not have the same carcinogenic effects of regular cigarettes, they do carry a risk of addiction.”

The study found a link between e-cigarette use in teens and an increased chance of smoking other products at a later time, but it did not establish a cause-and-effect relationship between them, according to Adam Leventhal, an associate professor of preventive medicine and psychology at the Keck School of Medicine of the University of Southern California in Los Angeles and a co-author of the study. Cari Nierenberg, writing for LiveScience, reports that the study’s researchers explained that while e-cigarettes may be viewed as a valid method to help adult smokers cut down or quit the habit, vaping for kids is actually a gateway to real tobacco smoking. 
Dr. Nancy Rigotti, director of the Tobacco Research and Treatment Unit at Massachusetts General Hospital in Boston, in an editorial accompanying the study, also published in the Aug. 18 issue of JAMA, wrote:

“[The report] is the strongest evidence to date that e-cigarettes might pose a health hazard by encouraging adolescents to start smoking conventional tobacco products.” 

Rigotti has proposed protections for young people which include FDA regulations for e-cigarettes with the same restrictions applied to the sale, marketing, and use of conventional tobacco products. Leventhal added that recreational use of nicotine may be attractive to teens because of e-cigarettes’ sleek styling, high-tech look, and enticing flavors like bubble gum. Also, it is relatively easy for minors to purchase them.
According to Leventhal, adolescence is a period when the brain is still developing making it sensitive to the effects of nicotine. Teen years are also a time when young people are more likely to take risks.
The study’s one limitation, writes LiveScience, was that it did not ask the participants to enumerate the amount of smoking that was occurring or the frequency of their smoking.

“A major concern is that the increasing population of adolescent e-cigarette users may eventually lead to future generations that smoke harmful tobacco products,” Leventhal said.

Approximately 2 million middle- and high-school students tried e-cigarettes in 2014 – three times as many as those who smoked in 2013, reported the CDC in April of this year. Reuters’ Lisa Rapaport writes that big tobacco companies like Altria Group, Inc., Lorillard Tobacco Co [LO.UL], and Reynolds American, Inc., are all developing e-cigarettes.
The Cochrane Review published research that showed that the devices could assist smokers who were trying to quit, but showed that existing information on the effects of e-cigarettes was relatively small.

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