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Young adolescent smokers who also vape or use e-cigarettes may be more likely to frequently smoke tobacco later in their teens, according to a new study published in Tobacco Control.
The researchers say the findings support the ‘entrenchment hypothesis’, which suggests that e-cigarette use deepens early patterns of tobacco smoking, rather than steering users away.
US and UK have different vaping regulations
The researchers wanted to look at whether different vaping regulations and marketing in the UK and USA affected the results, so they used two large-scale, nationally representative cohorts from both countries (UK: n=1090, USA: n=803).
Participants from both cohorts were regularly surveyed about their use of vapes and how often they smoked conventional cigarettes up to the age of 17.
In total, more than half (57%) of the UK teens said they vaped as well as smoking, while a similar number (58%) of US teens said the same.
Vaping linked to more persistent and heavier smoking in late teens
The researchers found that the odds of later adolescent smoking were significantly higher among e-cigarette users relative to those who had not used e-cigarettes.
Among UK participants 61% of early vapers were smoking in their late teens compared with 50% of non-vapers. While for US participants, 42% of vapers continued smoking in their late teens, compared with just 24% of non-vapers.
This means the odds of continuing to smoke for early teen vapers were 45% higher than they were for non-vapers in the UK, and 119% higher than they were for non-vapers in the US.
Furthermore, frequent smoking (more than six cigarettes a week) in late teens was almost twice as common in UK early vapers compared to non-vapers, and three times as common in the US groups.
Policymakers should target early smoking youth in prevention campaigns
The study’s authors say the results suggest that e-cigarette use in early adolescence, both in the UK and in the US, increases the likelihood of tobacco cigarette smoking in late teens.
However, the researchers note that since the study is observational, it cannot establish a cause. Furthermore, since the study relied on person recall, it may be subject to bias.
Even so, they are now encouraging policymakers in the UK and the US to introduce tougher e-cigarette regulations which target early smoking youth.
“Although a great deal of attention has centred on restricting e-cigarettes so that they do not serve as a pathway into tobacco initiation among youth, our results highlight that considering their impacts on youth who initiate smoking at an early age remains important as well,” they write.
“The results indicate comprehensive steps must be taken to reduce adolescent access to e-cigarettes, particularly to reduce the likelihood of entrenchment among youth who initiate smoking early,” they add.