A new study from the University of Hawaii in Honolulu may help settle the swirling debate on the public health benefits of e-cigarettes and their impact on teen smokers. Research findings published online Jan. 25 in the journal Tobacco Control showed e-cigarettes do not help teens break the smoking habit. In fact, the research team found that teens who vape are three times more likely to try traditional cigarettes than those who don’t use e-cigarettes.
The results “provide support of the hypothesis that e-cigarette use may promote initiation of smoking,” the study authors wrote. “These findings should be considered for policy discussions about the availability of e-cigarettes to adolescents.”
For the study, researchers led by Thomas Wills, PhD, interim co-director of the Cancer Prevention and Control Program at the University of Hawaii Cancer Center, surveyed 2,338 freshmen and sophomores from seven high schools in the Honolulu area about their use of electronic and regular cigarettes. Participants were asked about the frequency of their e-cigarette and tobacco use, ranging from never, to a few times a year, to daily.
The students were also questioned about other factors known to influence the initiation of smoking, including home environment, parental education, and degree of rebelliousness. The initial survey was conducted in 2013 and then followed up again a year later.
According to a Jan. 25 news release, findings showed that those teens who used e-cigarettes in 2013 were almost three times more likely to have started smoking traditional cigarettes a year later than those who had never vaped at the time of the first survey. Overall, 31 percent of the survey participants had used e-cigarettes in 2013 and 15 percent owned up to smoking regular cigarettes. By 2014, vaping increased to 38 percent and smoking to 21 percent.
When the researchers took other variables into account, they found that the probability of smoking tobacco was 5 percent if a teen never used e-cigarettes and 14 percent if an e-cigarette had been used at least once. For regular vapers, the probability increased to 19 percent.
In addition, the research team found that white and native Hawaiian students were more likely to become smokers than Asian Americans. There was also the perception among 68 percent of the polled students that e-cigarettes were safer than regular cigarettes.
Perhaps the study’s most important finding was the lack of evidence that e-cigarette use helped teens stop smoking. High school vaping had no association with a decrease in cigarette smoking between 2013 and 2014, noted the authors in their report.
The study authors acknowledged that the exact reasons vaping leads to cigarette smoking are not clear. However, they offered several explanations in the study: “One is that some e-cigarettes mimic the look and feel of cigarettes, and the inhaling and exhaling of e-cigarette aerosol produces some of the same sensory experiences as smoking a cigarette,” they wrote.
“Additionally, nicotine exposure via e-cigarettes, even at lower levels, may sensitize adolescents to its effects. If adolescents begin to experience mild physiological effects from nicotine they may be inclined to shift to cigarettes to get a bigger ‘kick,’” added the authors.
The study authors concluded that “e-cigarette use among adolescents is not without behavioral costs.”