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Gateway Myth: Does Vaping Really Lead to Smoking?

It’s been three years since director of the Centers for Disease Control and Prevention (CDC), Thomas Frieden, voiced his concerns about the number of kids vaping, starting what has come to be known as the ‘gateway theory’. His worry was that by vaping these young people will be persuaded to try out conventional cigarettes, an opinion which has been echoed across the country ever since, and has no doubt influenced the harsh rulings the FDA has imposed on the e-cigarette and vaping industry.

For some time now, one of the leading arguments of e-cigarette alarmists in their crusade against electronic alternatives is that vaping is a gateway into the world of smoking. Much focus has been on the likelihood that impressionable teens or other curious non-smokers will be influenced by the appealing flavours and cool cultural appearance of vaping.

But where is the evidence to back up Frieden’s scary accusation?

The model of “gateway” substances was first applied in the fifties when it was claimed, erroneously, by drug enforcement agencies that smoking marijuana would result in fatal heroin addictions, something we now know is just not true. Similarly, research data today on the correlation of previous non-smoking vapers and subsequent tobacco addiction is murky at best, and not in any way substantial enough to warrant the torch and pitchfork approach the CDC are taking towards the e-cigarette industry.

In a 2015 study in JAMA, 2,530 14-year-old students were tracked for a one year period, none of whom identified as using any form of traditional tobacco product at the outset, although 222 had tried electronic alternatives. At the end of the period, a quarter of the e-cigarettes smokers said they had tried at least one puff of an ordinary tobacco product, whilst only 9% of the non-e-cigarette smokers confirmed this.

The problem with this kind of data, and others like it is, as Professor of Health Behaviour at University of Buffalo Lynn T Kozlowski states, it is flawed in the way it is collected, “While studies attempt to different degrees to control contextual and personal factors that could be linked to smoking, this is easier said than done. The study from Leventhal et al does try to control for the use of alcohol, marijuana and smokeless tobacco (another nicotine product), but uses only one two-level measure of “any use” versus “no use” of all these products. Blunt tools lead to cruder results.”

When these cloudy findings are presented as a certainty, this contributes to the skewed perception the American public has on vaping and e-cigarettes. In a 2011 survey, around 13% of Americans identified e-cigarettes as being as harmful as ordinary tobacco products, but by 2015, this figure had increased to nearly 40%, despite e-cigarettes generally accepted as being less harmful; British health officials announced this year that e-cigarettes were 95% less harmful than the traditional varieties, and whilst across the Atlantic there is still hot debate on vaping as a long-term solution to tobacco use, there seems to be more of a push to accept e-cigarettes as a viable alternative.

The insistence that research is undoubtedly telling us that e-cigarettes will result in more tobacco addicts sounds silly, because it is- the Saddleson e-cigs study reported that a high percentage of those they spoke to seemed to be using e-cigarettes as a method of tobacco cessation, which suggest the majority of e-cigarette users are not non-smokers who are potentially going to have their head turned but existing smokers who are looking to stop smoking. 

 New York Times science reporter Sabrina Tavernise has highlighted a worry that attitudes in America will be detrimental to public health overall, “A growing number of scientists and policy makers say the relentless portrayal of e-cigarettes as a public health menace, however well intentioned, is a profound disservice to the 40 million American smokers who could benefit from the devices,”.

Smoking kills more than 480,000 yearly in the United States, and is the leading cause of preventable death, and whilst tobacco use was previously inclusive and widespread, today use is most prevalent in those who are least likely to be able to deal both financially and mentally with any subsequent disease their habit could result in, such as the under privileged, less educated or mentally ill.

Do you think e-cigarettes are acting as a gateway to traditional tobacco product use? Did you smoke ordinary cigarettes before becoming a vaper? Share your thoughts in the comments below, or on social media!



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