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E‑Cigarettes Are a Gateway to Cigarettes for Non‑Smoking Teens: Study

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Nov 10, 2020

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Teens who smoke e-cigarettes are at a higher risk of transitioning to cigarette smoking, says new research published in Pediatrics.

“Research is showing us that adolescent e-cigarette users who progress to cigarette smoking are not simply those who would have ended up smoking cigarettes anyway,” says Dr. Olusegun Owotomo, Ph.D., M.P.H., the study’s lead author and a pediatric resident, said in a statement. “Our study shows that e-cigarettes can predispose adolescents to cigarette smoking, even when they have no prior intentions to do so.”

This has significant implications for health and public policy, as e-cigarettes were created to curb smoking amid those with nicotine dependencies but now influence smoking behaviors. Data pulled from more than 8,000 adolescents aged 12 to 17 between 2014 and 2016 shows that adolescents who did not intend to smoke cigarettes in the future, but had used e-cigarettes, were far more likely to start smoking one year later than teens who didn’t use e-cigarettes at all.


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India is currently home to one of the largest tobacco smoking populations, second only to China. Around 270 million adults currently use smoking or smokeless tobacco products, according to the Global Adult Tobacco Survey (2016-2017). In the interest of public health, India banned the production, import, and sale of vaping products in 2019, but still allows personal consumption. This ban put in place as a response to the growing fear of vaping sickness in late 2019, even when only a small proportion of Indians used e-cigarettes (0.02%). Yet, Indian authorities are still working to undo the e-cigarette black market in the country — existing both in local-scale paan shops and online.

The researchers write, “With the proliferation of e-cigarettes among adolescents, the absence of smoking intention may no longer be sufficient to prevent cigarette smoking. Abstinence from e-cigarette use is also necessary to reduce the likelihood of conventional cigarette smoking. It is essential that health care providers, parents, and education campaigns emphasize the dangers associated with e-cigarette use, including the risk of progressing to cigarette smoking that remains even without an intention to smoke conventional cigarettes.”

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Written By Aditi Murti

Aditi Murti is the senior culture writer at The Swaddle, with an interest in cultural analysis, environment, and the science of mental health.  Write to her using aditi@theswaddle.com, or find her on social media @aditimurti.

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