A University of California, Los Angeles study found that American teenagers who use electronic cigarettes are more than six times as likely to smoke cigarettes when they reach the legal age to buy tobacco.
The study contrasts the longstanding belief that e-cigarettes help people reduce cigarette use and overcome tobacco addiction.
Vaping involves inhaling and exhaling the vapor produced by e-cigarettes. The device vaporizes a solution typically made of nicotine, flavorings and other chemicals. Despite government regulations preventing the sale of electronic cigarettes to minors, their popularity among teenagers keeps growing.
UCLA researchers surveyed 298 high school students in Southern California to examine whether e-cigarette use in adolescence increases the risk for cigarette initiation. About half the participants smoked only e-cigarettes, while the other half never smoked e-cigarettes or tobacco cigarettes.
The study found that 40.4 percent of e-cigarette users started smoking tobacco cigarettes after an average of 16 months from an initial evaluation on smoking habits. About 10 percent of never users began smoking cigarettes post follow-up.
“Adolescents who had never smoked but who had used e-cigarettes were substantially more likely to begin smoking combustible cigarettes over the next year,” said study lead author Jessica Barrington-Trimis.
Researchers noted that the association between e-cigarette use and smoking initiation was stronger for those who expressed no interest in starting to smoke during their initial evaluation.
Among participants with no intention to smoke tobacco cigarettes, 36.2 percent of e-cigarette users and 6 percent of never e-cigarette users started smoking. These findings indicate that e-cigarettes may lead teens to start smoking during the transition to adulthood, even for those with low risk factors.
“The increase in e-cigarette use, which may be followed by increases in cigarette use, could result in an erosion of the progress that has been made over the last several decades in tobacco control,” Barrington-Trimis said.
Multiple studies found a link between e-cigarettes and the subsequent use of tobacco cigarettes among students.
A University of Southern California study surveyed ninth-grade students who had never smoked tobacco cigarettes prior to the evaluation. Researchers discovered that e-cigarette users were 1.75 times more likely to convert to cigarette users within a year and 2.73 times more likely to use any combustible tobacco products such as cigars, hookah or pipes.
The University of Hawaii Cancer Center surveyed teenagers in grades nine and 10 about e-cigarette use and found results similar to past studies. The study revealed that e-cigarette users were 2.87 times more likely to become tobacco cigarette smokers.
In 2015, University of Pittsburgh researchers surveyed teens and adults aged 16 to 26 years. They concluded that e-cigarette users were more susceptible to regular cigarette use despite their intention to never smoke. The researchers were concerned that e-cigarettes may contribute to the development of a new wave of cigarette smokers.
The FDA announced a new rule in May 2016 extending its authority to all tobacco products, including e-cigarettes. It aims to reduce tobacco exposure and use among teenagers.
“As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap. All of this is creating a new generation of Americans who are at risk of addiction,” U.S. Secretary of Health and Human Services Sylvia Burwell said.
Prior to the update, it was legal for people under 18 to purchase e-cigarettes, hookah tobacco and cigars. The FDA now requires retailers to verify the customer’s age before selling these products.
Retailers will no longer be able to sell tobacco products in vending machines or distribute free tobacco-related samples.
The FDA will further require retailers to:
“This final rule is a foundational step that enables the FDA to regulate products young people were using at alarming rates, like e-cigarettes, cigars and hookah tobacco, that had gone largely unregulated,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products.