E-cigarette use in young adults not associated with regular smoking, study finds

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There was evidence for no association between the prevalence of e-cigarette use and regular smoking among the youth population in England, a major study has found.

Using data from the Smoking Toolkit Study, which has surveyed around 300 households per month since 2006, researchers at the University College London has found that 30.5 per cent of 16 to 24-year-olds were regular smokers while just 2.9 per cent used vapes.

The study, published in the journal Addiction, rejects previous research findings that suggested strong association between initiation of e-cigarette use and later use of cigarettes.

“The findings from this study contribute to the debate on whether e-cigarettes could act as a gateway into smoking, and are consistent with a recent population time trend analysis which showed a reduction in smoking initiation during the period of e-cigarettes ascendance in the United States,” the research report states.

“If a gateway effect exists, our results suggest that it is likely to be smaller than estimated previously.”

The study however does not rule out small associations, particularly for 16–17-year-olds, but added that findings are not conclusive.

“It remains plausible that a third unmeasured confounding variable may simultaneously be driving up ever regular smoking prevalence and e-cigarette use in the population, creating an artificial association. For example, it may be that increasing misperceptions around the harms of e-cigarettes are driving users into smoking,” the report noted.

The study, which collected data on 37,105 participants aged 16–24 between January 2007 and December 2018, estimates approximately 7200 additional ever regular smokers aged 16–17 in 2018 as a consequence of e-cigarette use, whereas the e-cigarette users in this age group numbered approximately 74,000.

“This needs to be weighed against the 50,000–70,000 smokers who are estimated to quit smoking each year as a consequence of using e-cigarettes during a quit attempt. These numbers are also much smaller than those proposed by previous evidence for gateway effects,” the study added.