Updated 05 November 2013

E-cigarettes may not be gateway to smoking

A study has shown that parents whose teens are experimenting with e-cigarettes should be reassured that it doesn't necessarily set them up for a lifetime of addiction.


E-cigarettes don't appear to entice teens to try smoking tobacco, a new study says.

The researchers noted that the findings didn't mean that e-cigarettes were risk-free, but it should reassure parents that teens who tried the devices might simply be doing so for the novelty and weren't necessarily setting themselves up for a lifetime of nicotine addiction.

The US Centers for Disease Control and Prevention warned last month that "vaping," or inhaling the nicotine vapours from e-cigarettes, might be a dangerous new fad that could set teens up for smoking.

In just one year, the number of kids in grades six to 12 who said they'd ever tried an e-cigarette, more than doubled, rising from 3.3% to 6.8%. Among the 2.1% who said they were current e-cigarette users, more than three-quarters said they had also smoked regular cigarettes.

Given that overlap, many health experts worried that e-cigarettes might be acting like a gateway drug, sucking kids more deeply into nicotine addiction and law officials urged the US Food and Drug Administration to regulate e-cigarettes as tobacco products.

Tobacco and nicotine use

The new study suggests that may not be the case.

Researchers surveyed 1 300 college students about their tobacco and nicotine use. The average age of study participants was 19.

"We asked what the first tobacco product they ever tried was and what their current tobacco use looked like," said researcher Theodore Wagener, an assistant professor of general and community paediatrics at the University of Oklahoma Health Sciences Centre, in Oklahoma City.

Overall, 43 students said their first nicotine product was an e-cigarette. Of that group, only one person said that he went on to smoke regular cigarettes. And the vast majority who started with e-cigarettes said they weren't currently using any nicotine or tobacco.

"It didn't seem as though it really proved to be a gateway to anything," said Wagener, who presented his findings at a meeting of the American Association for Cancer Research, in National Harbor, Maryland.

Study findings presented at medical conferences are considered preliminary since they haven't been carefully reviewed by outside experts for publication in a medical journal.

E-cigarettes, which use a heating element to vapourise a liquid nicotine solution, are relatively easy for teens to purchase.

Unknown risks

While federal rules block the sale of regular cigarettes to anyone under the age of 18, there are currently no such rules for e-cigarettes. About half of states prohibit the sale of e-cigarettes to minors, but they can also be bought online.

The devices are advertised on TV and popular YouTube videos. They come in sweet flavours that appeal to teens like green apple, watermelon and bubble gum.

"The use of these products is increasing dramatically," while little is known about the risks, said Scott Leischow, who co-leads the cancer prevention and control program at the Mayo Clinic in Scottsdale, Arizona.

"It seems like we're in the midst of a national experiment," he said during a news conference.

Wagener agreed. He said that most teens and adults who use e-cigarettes seem to be using them to stop smoking or at least to reduce the harm from smoking tobacco.

But he says that parents should be sure to let kids know that e-cigarettes still carry some risk.

"I think parents should be vigilant and talk to their kids and let them know that this not a 100% safe product. It's not water vapour. It's nicotine. It has carcinogens in it," he said.

"It might be less than regular cigarettes, but at the end of the day, they're still putting something that has carcinogens and toxins into their system," Wagener said.

More information

For information on electronic cigarettes, head to the US Food and Drug Administration.

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