Does vaping lead to cigarette smoking?

Study shows increased risk of "real" smoking for users of eletronic tobacco products

A new study reveals that electronic cigarettes, hookahs, non-cigarette combustible tobacco or smokeless tobacco were associated with conventional cigarettes usage within a year in adolescents, with a higher chance of use for consumers of multiple non-cigarette tobacco products.

A team of University of California scientists looked into the use of electronic cigarettes, hookahs and other presentations of combustible or smokeless tobacco. In the research, Ph.D. Benjamin Chaffee and his coauthors gathered data through a US-specific national questionnaire of 10,384 individuals between 12-17 years old, who reported no prior use of a conventional cigarette at baseline (2013-2014) and conducted a one-year follow-up (2014-2015).

The research occurs with the rising popularity of non-cigarette tobacco products amongst adolescents. Moreso, with the diversification of such product formats (which include electronic cigarettes, hookahs, non-cigarette combustible tobacco and smokeless tobacco) it has become increasingly relevant to understand whether they encourage conventional cigarette smoking.

In this cohort study, the researchers used statistics to control for some of the differences between groups that could explain the study findings. However, while the study accounted for known risk factors of youth smoking, other unknown factors may have influenced study results.

Despite these observational study challenges, it was possible to determine that while electronic cigarettes are the most common form of non-cigarette tobacco used by young people, all forms of non-cigarette tobacco usage were associated with a greater risk of future conventional cigarette smoking. It was also observed that adolescents starting tobacco usage coupled with non-cigarette products were more likely to smoke conventional cigarettes within one year than those who had never used tobacco. Finally, adolescents using multiple tobacco products were more likely to start smoking conventional cigarettes.

These findings shed light on the rising need to update or design legislative and public health strategies currently centered on tobacco products. Extending these to the diversifying formats of non-cigarette tobacco products can contribute to the prevention of young groups use of conventional cigarettes.

Watkins SL, Glantz SA, Chaffee BW. Association of Noncigarette Tobacco Product Use With Future Cigarette Smoking Among Youth in the Population Assessment of Tobacco and Health (PATH) Study, 2013-2015. JAMA Pediatr. Published online January 02, 2018. doi:10.1001/jamapediatrics.2017.417

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