Is Vaping a Gateway to Tobacco?

Welcome to week 9 of our Knowledge is Power blog series. This week we will be looking the argument around vaping as a gateway to smoking. Medical News Today1 defines the gateway hypothesis as “the idea that less deleterious substances can lead to use and addiction of more harmful drugs.” Do we actually know if vaping leads to smoking traditional cigarettes? Join me as we look at what we do know.

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The World Health Organization (WHO)2 published a Report on Regulation of E-cigarettes in which they stated “E-cigarettes have been marketing in almost 8,000 different flavors, and there is concern they will serve as a gateway to nicotine addiction and, ultimately, smoking, particularly for young people. Experimentation with e-cigarettes increased rapidly among adolescents.” The Food & Drug Administration (FDA)3 posed the same concern in the form of a question in their policy statement regarding Electronic Cigarettes “It is not known whether e-cigarettes may lead young people to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death.” As agencies tasked with the public’s health and well-being, these are valid questions to be addressed. The Centers for Disease Control and Prevention (CDC)4 conducted Youth E-Cigarette Study which concluded “The data shows that youth who had never smoked conventional cigarettes but who used e-cigarettes were almost twice as likely to have intention to smoke conventional cigarettes as those who had never used e-cigarettes. Among non-smoking youth who had ever used e-cigarettes, 43.9% said they have intentions to smoke conventional cigarettes within the next year, compared with the 21.5% of those who had never used e-cigarettes.” Based on this study, it appears as though vaping does lead youth to intend to smoke traditional cigarettes, which everyone agrees would be a bad thing. However, is that the whole story?

The Wall Street Journal5 in an article titled The E-Cigarette Gateway Myth, counteracted the claims above, “There is no evidence that the few nonsmoking youths who experiment with e-cigarettes subsequently progress to cigarette smoking. Cigarette smoking among young people, whom public-health experts are rightfully focused on protecting from use of either product, continues to decline. The CDC’s national youth risk behavior survey shows that teenage smoking has dropped over the last several years, falling to 15.7% in 2013 from the 18.1% found in 2011. The smoking rate among U.S. high school students in 2013 was the lowest level since the survey began in 1991. Meanwhile, experimentation with e-cigarettes among high-school students doubled from 2011 to 2013. Meaning, the gateway hypothesis is a myth. The evidence shows that very few nonsmokers ‘vape’. The primary reason people use e-cigarettes is to quit or cut back on smoking conventional cigarettes.” In addition, Health Day6 published an article E-Cigarettes May not be a Gateway stating “In just one year, the number of kids in grades 6-12 who said they’d never tried an e-cigarette more than doubled, rising from 3.3% to 6.8% Among the those who said they were current e-cigarette users, more than ¾ said they also smoked regular cigarettes. Given the overlap, many health experts worried that e-cigarettes might be acting like a gateway drug. A new study suggests that may not be the case. Overall, 43 students said their first nicotine product was an e-cigarette. Of that group, only one person said they 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.” These seem directly to contradict the study listed by the CDC above and the negate the concerns of the WHO and the FDA, but why is there such a discrepancy of information?

New Scientists Health7 addressed this discrepancy in their article E-cigarette users are young, heavy smokers trying to quit in which they found “One of the big concerns around the use of e-cigarettes, or ‘vaping’, is that they tempt people who don’t already smoke, getting them hooked on nicotine. Research published earlier this year by the CDC found that the use of e-cigarettes in US middle and high school students was associated with a higher likelihood of also smoking real cigarettes. But this study doesn’t show whether those people already smoked before they tried e-cigarettes, which makes it impossible to say whether vaping really is a gateway to smoking.” Meaning, the original study was missing a key component, whether the youth in question were already using traditional cigarettes when they started using the e-cigarette. The American Vaping Association (AVA)8 published AVA criticizes CDC report on e-cig use by teens  to dispute the CDC’s published study stating “The recent study by the CDC and its accompanying press release are just plain deceptive. The reported result is flawed because teens who answered ‘probably not’ when asked if they intended to smoke in the future were counted as likely future smokers instead of unlikely future smokers. The CDC failed to disclose this in its press release, which led to hundreds of news sources identifying e-cigarettes as a gateway to cigarettes. A growing number of studies have shown that e-cigarettes help smokers safely and effectively quit the habit and are not gateways to tobacco smoking. There is no evidence e-cigarettes are gateways to smoking, and in fact, for millions of Americans they are anti-tobacco products.” Meaning that, in addition to not taking into consideration the youth who were already using traditional cigarettes, the report was also skewed.

In summary: the study references in each of these articles regarding the concerns of vaping as a gateway to traditional cigarettes, published by the CDC, was found to be flawed upon closer examination by other sources. Studies conducted since have shown that concerns of transitioning from vaping to traditional cigarettes is not founded. Aside from the scientific studies, the idea of transitioning from vaping flavors like honeydew melon, caramel coffee, or apple pie to smoking analog cigarettes with their burnt dirt flavor seems unlikely to me.

As always, I encourage everyone to educate themselves. Read the studies and information listed in the references below, and learn more about the realities and misconceptions surrounding the subject of vaping as a gateway to tobacco. Come back next week when we look at the subject of Legislation, we want some, but how much is too much? Until then, we look forward to your questions and comments. Vape on!

Written by: Michelle Harnden

  1. Medical News Today ‘E-cigarettes may be a gateway
  2. World Health Organization (WHO) ‘Report on Regulation of E-Cigarettes
  3. Food & Drug Association (FDA) ‘Electronic Cigarettes
  4. Centers for Disease Control and Prevention (CDC) ‘Youth E-Cigarette Use Study
  5. The Wall Street Journal ‘The E-Cigarette Gateway Myth’ http://on.wsj.com/1s6lG8i
  6. Health Day ‘E-Cigarettes May not be a Gateway’ http://bit.ly/1cpNAUX
  7. New Scientists Health ‘E-cig users are young, heavy smokers trying to quit
  8. American Vaping Association (AVA) ‘AVA criticizes CDC report on e-cig use by teens
Tim Mechling

Tim is Mt Baker Vapor's resident creative weirdo. He writes, composes music, draws, designs, produces podcasts, investigates, and blows the trumpet for the Common Man.

  • Cheryl C. says:

    Vaping is no more of a gateway to tobacco than coca cola is a gateway to alcohol. I quit a 42 year tobacco habit (1 year now) with e-cigs. As for the flavors….. I am 57 years old and one of my favorite flavors is admiral berry crunch. I may be old but that doesn’t mean I don’t like a variety. The last flavor I want is tobacco.
    I am all for age limits on e-cigs. All of the shops I go to will not sell to minors. Maybe some parents need to be a little more aware of what their kids are up to.

  • Mark A. says:

    I could not agree more with Cheryl C. I mean the hype seems all about children well first of all children will do what they are going to do no matter what they are after all children and yes parents should know what their kids are up to. I was that kid myself a long, long time ago I am now 52 and been cig free for 7 Months with Nic level from 12% to 3% and planning on zero mostly for RDA method.
    I am all about the rights issue, now they are trying to ban smoking in a Mass. town. Listen if that is what you choose to do then it is your right, if you choose to vape that should be your right as well. We should not be stripped of our rights just because of the H.O. says so!
    Now where it becomes contradictive is they want to ban cigarettes and Ecigs; but in the same hand they want to legalize a drug called pot. BTW causes cancer no different than a traditional cigarette. Your still burning, there is ash and smoke and has chemicals along with THC.
    So where is the logic in that? There is none! The H.O. just want’s control over our own decisions that we are entitled to make for ourselves, our freedom and our rights! All just because people are dying from cancer, HEY news flash cigarettes are not the only thing that causes cancer!! There are foods, beverages, environments etc. etc. the list goes on that can cause all kinds of cancers not to mention the sun!!! So what’s next we move underground and eat soilent green, seriously? There will always be risks and what is life if you do not take some risks or gambles, this is part of our human existence and nature of who we are.
    If one is so worried about risks etc. then maybe they should live in a plastic bubble or shelter your children in a protective box from the world so then nothing will be learned or experienced or gained. Nothing will be gained from all this of what they want, just more issues and problems.

  • Rebecca says:

    Vaping is quickly becoming put in the same category as smoking. I have recently gone on two cruises and vaping is limited to smoking areas also. It is not the same and I find it very discriminatory! Vaping is not allowed in your own cabin or on your own balcony at the risk of a $250 fine. We are restricted to the casino and nightclub an a few of the upper decks on one side on the ship! This angers me and wish it could be addressed!

  • Trevor says:

    Vaping did actually lead me to smoking though. I mean, I halfways started vaping about a year ago and I’ve only ever been able to find really horrible tanks so I just went to cigarettes instead.

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  • It is absurd to even suggest that vaping is a gateway to smoking because vaping and smoking are two separate kettles of fish.

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