University of Southern California experts say E-cigarettes ARE a gateway to smoking

Teenagers who use e-cigarettes are more likely to go on to smoke tobacco, new research suggests.

The findings, based on more a study of more than 3,000 15-year-olds in the US, last night fuelled a bitter row about whether the devices can provide a ‘gateway’ to smoking.

Many public health experts are keen to promote e-cigarettes as a quit-smoking aid.

But others stress that the devices are too often marketed as a lifestyle accessory – and some believe they can even promote smoking among the young.

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Teenagers who use e-cigarettes are more likely to end up becoming heavy smokers of cigarettes, new research suggests

It is illegal to sell the devices to under-18s in the UK – but their use among teenagers is growing.

The number of schoolchildren who have ever smoked tobacco is at an all-time low, at 18 per cent, but the numbed who have ever tried e-cigarettes exceeds it, at 22 per cent.

The new research, led by the University of Southern California Keck School of Medicine, suggests that the more often children use e-cigarettes, the more often they will be smoking tobacco a few months later.

The researchers surveyed 3,084 teenagers, who had an average age of 15.5, in the autumn of 2014, asking how often they had used e-cigarettes and tobacco cigarettes in the previous 30 days.

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They returned six months later, in spring 2015, and repeated the survey.

The researchers, whose work is published in the JAMA medical journal, wrote: ‘In this study of adolescents, vaping more frequently was associated with a higher risk of more frequent and heavy smoking six months later.’

They found that of those who never vaped at the beginning of the study, only 0.9 per cent were occasional smokers six months later, and only 0.7 were frequent smokers.

But of those who were frequent vapers at the beginning of the study, defined by as having used e-cigarettes more than three times in the last month, 11.6 per cent were occasional smokers six months later and 19.9 per cent were frequent smokers.

A study found adolescents smoked tobacco more often if they frequently vaped previously

The authors stressed that more work is needed, writing: ‘The role of nicotine and generalizability of these results to other locations and ages, longer follow-up periods, and non-self-report assessments are unknown and merit further inquiry.’

But they added: ‘The transition from vaping to smoking may warrant particular attention in tobacco control policy.’

British scientists met the report with scepticism, insisting that the authors had not proved that the e-cigarettes had caused the take-up in smoking.

E-CIGARETTES AS BAD ON THE HEART AS TOBACCO

Using electronic cigarettes could be as bad for the heart as smoking tobacco, research suggested earlier this year.

Scientists found inhaling nicotine vapour damages key blood vessels, raising the risk of heart disease.

The team monitored participants’ hearts while smoking a conventional cigarette for five minutes and using an e-cigarette for half an hour, which they said was the most accurate comparison of typical use. 

Professor Paul Aveyard, an expert in behavioural medicine at the University of Oxford, said: ‘This study could not tell us if it is something about the young people that vape that predisposes them to smoking or that vaping itself makes smoking more likely.

‘Showing that one behaviour precedes another is not enough.’

Professor John Britton, director of the UK Centre for Tobacco Alcohol Studies at the University of Nottingham, added: ‘This doesn’t tell us whether vaping caused these young people to start smoking, or whether they would have started smoking anyway; or whether vaping prevented some young people who would otherwise have become smokers from progressing to tobacco smoking.

‘Children who live with a parent or sibling who smokes are around twice as likely to become smokers as those who do not.’

But many others accept that e-cigarettes may act as a gateway to tobacco.

New laws introduced by the EU earlier this year banned TV advertising of e-cigarettes precisely because of the risk to children.

The European Tobacco Products Directive said: ‘Electronic cigarettes can develop into a gateway to nicotine addiction and ultimately traditional tobacco consumption, as they mimic and normalise the action of smoking.

New laws introduced by the EU earlier this year banned TV advertising of e-cigarettes precisely because of the risk to children

‘For this reason, it is appropriate to adopt a restrictive approach to advertising electronic cigarettes and refill containers.’

The European Court of Justice reiterated this risk when it dismissed a legal challenge in May, ruling the new rules would ‘mean that consumers — not least young people who are particularly sensitive to advertising — are confronted with fewer commercial inducements to purchase and consume electronic cigarettes with the result that they are less exposed to the identified or potential risks to human health to which those products could give rise’.

E-cigarettes contain a liquid form of nicotine that is heated into vapour to be inhaled, avoiding the harm caused by tobacco smoke.

While most experts are agreed that vaping is far safer than smoking tobacco, many are concerned about unresolved safety concerns.

The World Health Organisation last week called for a global ban on using e-cigarettes in public places.

The WHO warned of the dangers of ‘passive vaping’, which growing evidence has linked to lung damage, heart complications and stillbirth in pregnant women.