Teenagers vape are more likely to smoke cigarettes later

A new study shows that teenagers who start taking vapors are almost three times more likely to smoke cigarettes than their peers who do not consume any type of tobacco product. The results are alarming for both medical experts – who would prefer that children do not smoke – and for the e-cigarette industry, which is increasingly marketing its products as smoking cessation tools for women. adults.

Today's study, published in the journal JAMA Network open now, I can not say if the vaping caused children to smoke. However, the authors of the study found strong badociations between vaping and subsequent smoking, especially among children who would normally be considered to have a "low risk" of substance use: those who do not like much thrills, drink or consume drugs. The findings are particularly timely in light of the recent Food and Drug Administration announcement that 3.6 million high school and college students were using electronic cigarettes in 2018.

This document is part of a major clinical study that showed that e-cigarettes helped a small proportion of adult smokers quit smoking. Back-to-back publications show the tightrope on which regulators and the e-cigarette industry are evolving: on the one hand, e-cigarettes can prove to be a useful tool to help adults to stop smoking. In addition, there is growing evidence that they are acting like what FDA Commissioner Scott Gottlieb has called a "ramp" to the more dangerous and more combustible type of cigarette.

Today's study adds a new link in this disturbing correlation chain. "These two articles highlight the issues facing public health policymakers," says Gideon St. Helen, a tobacco researcher at the University of California, San Francisco, who has not participated in the research. The edge. The are some limitations, including the fact that the study looks at a window of time before Juul has really taken off, said Michael Ong, professor of medicine and public health at UCLA, who did not participate in the study. This means that the results are not a perfect window into the current e-cigarette market. Nevertheless, he says, "This study probably gives us the best estimates to date of what we would expect in terms of people using e-cigarettes during their youth and what could happen to them."

The Bulk Study on the Evaluation of the Tobacco and Health Population (PATH) – a long-term national survey on the use of tobacco products – provided data from the United States. ;study. Researchers led by Andrew Stokes, badistant professor of global health at Boston University, badyzed responses to more than 6,100 surveys between 2013 and 2016, between 2013 and 2016, who answered questions about their families , their risk tolerance and their nature. loved smoking or vape. About 8.6% reported that the first tobacco products used were electronic cigarettes, 5% first tried other tobacco products such as hookah or cigarillos, and 3.3% started smoking.

At the end of the study, the percentage of children having tried at least one or two puffs of cigarettes had risen to 20.5%. Children who started trying e-cigarettes were about four times as likely to continue to try cigarettes, and almost three times more likely to have used cigarettes in the last 30 days than their clbadmates who did not smoke or smoke. The probabilities were the same for other tobacco products other than cigarettes, but they were less likely to be marketed.

The link between the use of the e-cigarette and the possible use of the cigarette was particularly strong in low-risk children. These are children who are not very thrill-seekers, who do not drink or take prescription drugs without a prescription, and who think they would say no if their friends are giving them smoking. "This is remarkable in itself," says St. Helena. Even more surprisingly, this link was not true for children who started with other types of tobacco, such as narghile or cigarillos: all children, from low to high risk, were nearly as likely to try the cigarette. . "There seems to be something unique in the e-cigarette that brings with it a heightened risk of initiation to smoking among low-risk youth," says Ste Helen.

The authors of the study do not understand why this could be. Perhaps starting with vaping nicotine in low-risk children or perhaps normalizing smoking for cigarettes to extinguish it later. But researchers make indicate how their results could be disrupted in the United States. They estimate that more than 43,400 young cigarette smokers would have started using e-cigarettes over a two-year period, between 2013 and 2016.

This badumes, however, that the link is causal, which the study can not say with certainty. (This is one of the main limitations of the study.) Moreover, the survey did not ask for which The children used electronic cigarettes. Researchers therefore did not know whether certain types of electronic cigarettes predisposed children to use it later. And even if it was, the results are already exceeded, because Juul began to dominate the market. after the investigation has begun. Future studies will have to study how the rise of Juul has modified these results, says Ong. In the meantime, he said: "We are all concerned that this would lead to increased use, as they will become more addicted, as the amount of nicotine in a Juul capsule equals about 20 cigarettes. "

The medical community is eagerly awaiting these results, giving regulators another reason to try to curb the appeasement of young people, says Ong. "The difficult thing is that there will always be this counterweight to" Is there value for these products? "" Helen confirms. Today's study is a "well-done and rigorous badysis" that highlights the difficult balance that the FDA has to strike in deciding how to regulate the growing cigarette sector. electronic.