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December 16, 2017

New Study: Teens Who Use E-Cigarettes Might Transition To Real Tobacco (or will they?)


A new Study, funded by the National Institutes of Health and conducted by University of Southern California researchers, supposedly shows a clear link between teens who use electronic cigarettes and those who eventually move on to the traditional cigarettes. Though this “link” is not clearly established by said research, it does not seem to matter: the existence of the study is already prompting new calls for e-cigarette regulations at state and federal levels. The study, published last month by the Journal of the American Medical Association, tracked 2,500 American teenagers during their ninth-grade year, reporting on their experimentation with e-cigarettes, traditional cigarettes, cigars and other forms of smoking (i.e. hookah).

The University of Southern California’s press release of the study boasted a headline stating the research shows “teenagers who use e-cigarettes may be transitioning to tobacco products.” The release itself goes even further, claiming their research team:

has found, for the first time, that using or ‘vaping’ of electronic cigarettes is associated with a propensity to start smoking cigarettes or other, harmful tobacco products.

Anti-smoking groups have been on the attack against the e-cigarette industry for a while, arguing that vaping is going to attract more people to the idea of smoking, particularly kids, and that using e-cigarettes could be just as harmful as traditional combustion-based cigarettes. Except e-cigarettes are really an entirely different entity. They use a battery to power a vaporizer that turns a nicotine-water solution into an inhale-able vapor; hence the word “vaping”. Likewise, e-cigs don’t contain any of the negative side effects, like tar and smoke, that come from traditional cigarettes.

A true causal link between the use of e-cigarettes by minors and future use of other, potentially less healthy, tobacco products would be a big blow to tobacco companies’ claim that e-cigarettes are a legitimately better-for-you alternative.

Is this study that link?

No, says Joel Nitzkin, a policy analyst for R Street Solutions, a free market think tank based in Washington, D.C., who has followed the ongoing national e-cigarette debate. Nitzkin stated the study is flawed because it assumes teens who tried e-cigarettes would never have moved on to traditional cigarettes or other tobacco products without vaping first. But in the real world, that’s not how things work. In one of his articles, “E-cigarettes and recruitment of teens to nicotine addiction” he expressed the following:

These data show that those inclined to experiment with a chemical substance are more likely to initiate e-cigarette use than those not inclined to such experimentation. In other words, the data reported in this study do not support the suggestion that preventing use of e-cigarettes by minors would in any way influence the number of teens experimenting with nicotine delivery products.

Even the authors of the USC study admit that shortcoming in their research. They say the study does not conclusively prove a causal link between e-cigarette use and later tobacco use, and they point out the study focused solely on smoking initiation, and further research is needed to assess whether e-cigarette use is associated with an increased risk of ongoing, frequent combustible tobacco use.

Adam M. Leventhal, associate professor at USC and the primary author of the study, in a statement provided by the National Institutes of Health stated:

While we cannot conclude that e-cigarette use directly leads to smoking, this research raises concerns that recent increases in youth e-cigarette use could ultimately perpetuate the epidemic of smoking-related illness

The researchers might recognize the limitations on their research, but the anti-smoking crowd has not. The Wall Street Journal, in reporting on the study this week, predicted it

…is likely to escalate calls for regulators to treat the devices as traditional cigarettes.

It’s not as if teens are able to readily purchase e-cigarettes right now. According to the National Conference of State Legislatures, there a currently 46 states that have banned the sale of e-cigarettes to minors. Only Maine, Massachusetts, Michigan and Pennsylvania lack such bans, though a bill to impose one is pending in Michigan. Anti-smoking groups are pushing for stricter regulations in many states, including higher taxes and bans on the use of e-cigarettes in any place where smoking is also banned.

The big target, though, is at the federal Food and Drug Administration, where anti-smoking advocates are hoping for a total ban on advertising for e-cigarettes that matches the existing blackout for traditional cigarettes and other tobacco goods.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, told the Journal the USC study should put more pressure on the FDA because it shows”

…never-smoking youth will go on to use tobacco products.

It doesn’t say that, of course, and other studies have already shown e-cigarettes can actually help existing smokers kick their cigarette habit and otherwise improve public health by cutting down on liter and second-hand smoke. By helping smokers quit, e-cigarettes might even save Medicaid from bankruptcy.


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