A study found an association between smoking
and e-cigarette use among adolescents but didn't answer a pressing
public-health question on whether e-cigarettes acted as a gateway to smoking.
Published in JAMA Paediatrics, the study found that among
those who have smoked, adolescents who also used e-cigarettes were less likely
to have given up smoking than those who did not use e-cigarettes.
The authors of the study, Lauren Dutra and Stanton Glantz, a
prominent opponent of e-cigarettes, concluded that the "use of
e-cigarettes does not discourage, and may encourage, conventional cigarette use
among US adolescents."
about school kids using e-cigarettes
Critics say the results do not support such a conclusion.
Correlation but no
Dr Michael Siegel, a professor of community health sciences
at Boston University School of Public Health who has spoken publicly in favour
of e-cigarettes, said that while the study draws a correlation between smoking
and e-cigarette use, there was no evidence to prove e-cigarettes led to
"The authors seem to have an axe to grind," he
said. "I could equally argue that what this study shows is that people who
are heavy smokers are attracted to e-cigarettes because they are looking to
may not be gateway to smoking
The study was funded by the National Cancer Institute and
conducted by the University of California San Francisco's Centre for Tobacco
Control Research and Education.
It comes as the US Food and Drug Administration prepares to
gain regulatory control over e-cigarettes, which generated sales of nearly $2
billion last year, and which some analysts believe could eventually exceed the
$80-billion tobacco market.
The aim of the study was to further understand the
relationship between e-cigarette use, conventional cigarette use and quitting
among US adolescents.
What came first?
It relied on data from some 40 000 adolescents who completed
the 2011 and 2012 National Youth Tobacco Surveys carried out by the Centres for
Disease Control and Prevention.
The authors said that since the study did not follow its
subjects over time, they couldn't determine whether most youths began smoking
conventional cigarettes before moving to e-cigarettes, or vice versa.
Adult smoking rates have fallen to 18% from 43% in 1965.
Even so, more than 3 200 young people a day under the age of 18 try their first
cigarette, a recent government report found, and the use of e-cigarettes by
young people doubled between 2011 and 2012.
E-cigarettes are battery-powered cartridges that look like
cigarettes and contain a nicotine liquid that, when heated, creates an
inhalable vapour. This vapour, advocates say, is less dangerous than
traditional cigarette smoke since it does not contain lung-damaging tar.
itself is considered relatively benign compared with cigarettes, but data on
the long-term safety of e-cigarettes, which contain a variety of chemicals, is
That uncertainty has led a number of cities, including New
York, Chicago, Boston and, most recently, Los Angeles, to restrict the use of
e-cigarettes in restaurants, bars, nightclubs and other public spaces.
companies selling addiction?
can damage the lungs
that e-cigarettes may lead to tobacco use