E-cigarettes may be a gateway to smoking for teens, researchers say

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And they say policy experts may need to more aggressively try to stop teens from using products like e-cigarettes in the first place. Using the Population Assessment of Tobacco and Health (PATH) study population consisting of youth ages 12 to 17 years, the investigators studied use of noncigarette tobacco products among youths who had never used cigarettes at baseline, and assessed ever and past 30-day use of cigarettes one year later.

The findings are also important because some of the novel tobacco products have especially high rates of use among adolescents in vulnerable populations. Teens who used a combination of these products were nearly four times as likely to have smoked a cigarette by the following year. Their most frequent contacts included: signing up for email alerts; reading articles or watching videos online;, using a smartphone to scan a QR (Quick Response ) code about tobacco products to enter a sweepstakes or drawing from a tobacco company; and visiting a tobacco company website.

The research also showed that teens who used more than one tobacco product were more likely to move on to traditional cigarettes.

Relevant Reading: Assessing 30-day quantity-frequency of US adolescent cigarette smoking as a predictor of adult smoking 14 years later. Although teens trying other tobacco products were more likely to smoke, the majority of new smokers after one year came from the group that had not tried tobacco at baseline.

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Even though fewer teens are smoking cigarettes, vaping is growing increasingly popular, with 17 percent of 12th-graders reporting using some sort of vaping device (either with nicotine, a flavored liquid or marijuana) past year, compared to 13 percent in 2016, according to the Center for Tobacco Control Research and Education, based at the University of California-San Francisco.

Cigarette use reported in the followup survey was higher among youths who had ever used e-cigarettes (19 percent); hookahs (18.3 percent); non-cigarette combustible tobacco (19.2 percent) or smokeless tobacco (18.8 percent), the researchers found. About 4 percent of teens had vaped at the start of the study, followed by 3 percent who had smoked a hookah, or water pipe, researchers report in JAMA Pediatrics. Polyuse of two or more noncigarette tobacco products was associated with greater odds of cigarette smoking. Similar results were obtained for past 30-day cigarette use, and for both former and past 30-day use of each noncigarette tobacco product.

"It's not surprising that products like e-cigarettes and cigars have become popular with kids when they are sold in sweet flavors like gummy bear and cherry dynamite", said Vince Willmore, vice president of communications for the Campaign for Tobacco-Free Kids, which was not involved in the research.

Smoking cessation researcher Scott McIntosh, PhD, of University of Rochester Medical Center, New York, told MedPage Today that the data examining the usefulness of e-cigarettes for smoking cessation are mixed.

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