New research suggests that teenagers who tried an e-cigarette were almost four times more likely to start smoking a conventional cigarette within a year, when compared to classmates who had not.
The research published in the Tobacco Control journal raises questions about the role e-cigarettes may play in the progression adolescents make to smoke their first cigarette.
Vaping – or the use of e-cigarettes – is widely accepted as a safer option for people who are already smoking.
The study, which involved a collaboration of academics including from Manchester Metropolitan, surveyed 2,836 adolescents from 20 schools in England. Some had tried tobacco but the vast majority were non-smokers. A third had used an e-cigarette.
They were re-surveyed a year later. Among the adolescents who had never smoked but had tried an e-cigarette, 34% reported smoking at least one cigarette over the year. Among the group who had not smoked and never used an e-cigarette, the figure was just under 9%.
Professor Mark Conner, an applied social psychologist at the University of Leeds and lead investigator, said: “The findings suggest that among the teenagers who had never smoked, the use of e-cigarettes was a strong predictor that within 12 months they would have tried a conventional cigarette.
“It is impossible to say if these young people were just experimenting with cigarettes or were becoming more regular smokers.”
The scientific paper raises the question that the adolescents who tried e-cigarettes would have tried smoking anyway, whether e-cigarettes were available or not.
If that was true, the researchers say they would have expected the adolescents at the lowest risk of starting to smoke – those with no friends who smoked – to have shown a weak association between e-cigarette and tobacco use.
But the data suggested the opposite.
The survey data revealed that e-cigarette use was a greater risk factor for starting smoking in those with no smoking friends than for those who had a friendship network where most smoked.
Professor Sarah Grogan, from Manchester Metropolitan University and a co-author on the study, said: “Adolescents who have used e-cigarettes and who initially have no friends who smoke may be at particular risk of starting to smoke cigarettes.
“This is particularly interesting as it runs contrary to the suggestion that adolescents who try e-cigarettes would have been likely to try smoking anyway due to factors such as peer pressure from friends who smoke.
“Further work is now needed to understand fully the mechanisms behind this effect.”
The researchers say it is also plausible that the use of e-cigarettes ‘normalises’ smoking or leads to nicotine addiction.
Kamran Siddiqi, Professor in Public Health at the University of York and another co-author, 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."
From October 2015, it has been illegal in the UK for retailers to sell e-cigarettes or vaporising liquids to anyone under the age of 18.
NOTES FOR EDITORS
The paper, Do electronic cigarettes increase cigarette smoking in UK adolescents? Evidence from a 12-month prospective study, was published in Tobacco Control.
For more information or to access a copy of the paper, contact Chris Morris, Senior Press Officer, Manchester Metropolitan University. Email: email@example.com. Tel: 0161 247 2184, or David Lewis, University of Leeds press office. Email: firstname.lastname@example.org. Tel: 0113 343 8059.