Researchers have been hypothesizing for months that e-cigarettes are just a “gateway” to traditional cigarette use. But a study published this morning in Nicotine & Tobacco Research calls this theory into question, and finds that what we thought was causation may just be correlation: it’s possible that the demographic of person who takes up vaping, due to a number of cultural and institutional forces, is the same kind who would have taken up cigarettes anyway, had vaping not existed.
Researchers arrived at this brand-new theory by looking at 14 “shared risk factors” among teens who pick up vaping and cigarette smoking. Those include things like how often teens reported taking risks and being disciplined; exposure to health warnings about cigarettes; previous alcohol and drug use; and comfort being around smokers. Before controlling for those factors, teens who vaped appeared 36 times more likely to become regular cigarette smokers. But when accounting for the 14 risk factors, researchers found no statistically significant causation rate. Vaping as a teen still increases a likelihood of trying a cigarette, but that doesn’t appear to increase a person’s odds of becoming a current, regular smoker.
The research is highly at odds with the “gateway theory” that vaping is a slippery slope to using other tobacco products. Previous studies, like one VICE reported on in late October, point to a strong correlation between using flavored products and higher rates of tobacco and nicotine use.
Arielle Selya, the study’s lead author, told CNN that this study questions a theory that has the power to influence policy. “Most of the public health community thinks that e-cigarettes act as a ‘gateway’ to nicotine use, and attract new populations of users,” Selya told CNN, and her study shows that may not be actually true. “It’s really important to hold off on making policies on e-cigarettes until we have a more solid understanding of its effects.”
Selya told CNN she worries that the moral panic around vaping, particularly the knee-jerk reactions to the rash of lung illnesses across the country, are going to send teens to cigarettes, which are definitely known to be bad for public health. The science on e-cigarettes remains less clear. So far the research on vaping’s health risks has been polarized, with the respective sides arguing “vaping is bad for you, period,” versus “vaping is a lesser of two evils.” (For those keeping score: The science is still largely on the side of vaping probably being bad.) This is to be expected when a product is relatively new and little is known about its long-term health effects, but the public conversation about how to regulate something that may or may not be bad (or “not so bad,” relative to cigarettes) for people isn’t helping make things any less complicated, either.
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