Teens and young adults who indulge in vaping, or using e-cigarettes, are more likely to go on to smoking traditional tobacco cigarettes, a study indicates.
The finding comes amid efforts by the U.S. Food and Drug Administration to move toward regulation of e-cigarettes, which adolescents can purchase more easily than traditional cigarettes.
Younger people also find e-cigarettes more attractive than traditional cigarettes, authors of the study appearing in JAMA Pediatrics point out.
"E-cigarettes are not subject to many laws that regulate traditional cigarettes, such as age limits on sales, taxation and labeling requirements," says lead author Brian A. Primack of the University of Pittsburgh. "They also come in youth-oriented flavorings that laws have limited in traditional cigarettes, such as apple bubble gum and chocolate candy cane."
In a trial that followed 694 young people ages 16 to 26, 37.5 percent of those who were e-cigarette users started smoking traditional cigarettes one year after the trial began, while only 9.6 percent of the study participants who were not e-cigarette smokers took up the habit.
This is despite the fact that at the beginning of the trial, the e-cigarette smokers said they definitely had no interest in smoking traditional cigarettes.
Public health advocates have long expressed concern that e-cigarettes could introduce young people to nicotine, which, in turn, could act as a gateway to traditional tobacco-based smoking.
"The real concern is that if it does indeed move these adolescents in the direction of smoking cigarettes, it's going to turn around the two-decade-long decline in teen smoking that we've seen," says study senior author Dr. James Sargent of Dartmouth College. "The government needs to get off the pot on this. They need to act."
Proponents of e-cigarettes criticized the study, saying the sample size was too small to draw any accurate conclusion about vaping leading to tobacco use.
However, Primack called the study's findings statistically significant.
"It's one more bit of evidence in emerging data in this area," he says. "It's not conclusive, but it certainly is cautionary, and points toward the need for an effective regulatory structure in this country for these new products."
Sargent said he agrees e-cigarettes encourage conduct that could push young people toward traditional cigarettes.
"They're practicing all of the parts of the behavior except lighting up that they would need to use a cigarette," he says.
The FDA has issued a rules proposal that would grant it the authority to regulate the e-cigarette industry.