Many anti-e-cigarette advocates believe that e-cigarettes may serve as a gateway to smoking. A study titled "Smoking Intentions and Progression from e-Cigarette Use to Smoking" claims that the use of e-cigarettes among adolescents who had no prior intention to smoke is associated with an increased risk of future smoking.
Currently, research is being conducted to measure the gateway effect by examining the relationship between electronic cigarette use and overall smoking rates among young people, including non-smokers. If there is indeed a gateway effect, then the change in smoking rates among those who are associated with smoking should increase in tandem with the use of electronic cigarettes. However, the authors of the study found no statistically significant correlation between the use of electronic cigarettes and regular smoking among participants aged 16 to 24.
These research findings indicate that we can rule out the previously reported large gateway effect, especially in the 18 to 24 age group. However, we cannot rule out smaller gateway effects, and we have not studied younger age groups. If the estimates are correct, we estimate that around 7,000 out of 74,000 16 to 17-year-old e-cigarette users in England will become regular cigarette smokers due to e-cigarette use. At the same time, an estimated 50,000 smokers quit smoking each year due to e-cigarette use," said lead researcher Dr. Emma Beard.
In countries and regions where e-cigarettes are recognized, there is no evidence that they are creating a gateway effect.
According to the findings of these investigations, countries such as the UK and New Zealand, which support the use of e-cigarettes as a means of quitting smoking, not only report low smoking rates, but also do not have an increased proportion of teenagers using e-cigarettes. Reports from these countries are consistent with previous studies on these patterns, and a recent article titled "Does the Gateway Theory Justify the Prohibition of Nicotine E-Cigarettes in Australia?" has once again refuted the gateway theory.
Comment authors Colin Mendelsohn and Wayne Hall point out that a more reasonable explanation as to why young people who vape are more likely to smoke is attributed to personality factors. This means that teenagers who vape are more likely to be risk-takers, and therefore more prone to smoking, drinking alcohol, using cannabis and other substances, as well as engaging in unprotected sex. This argument has been emphasized by other experts in several studies.
The major findings reviewed by Mendelsohn and Hall are as follows:
Smoking usually precedes the use of electronic cigarettes. At least 70-85% of teenage smokers try using electronic cigarettes after starting to smoke. Most teenage electronic cigarette users are experimental and regular use of electronic cigarettes among non-smokers is rare. In Australia and international surveys, the proportion of non-smokers who regularly use electronic cigarettes is usually 1% or less. Many teenage electronic cigarette users only use flavorings and do not use nicotine. Nicotine addiction is rare among electronic cigarette users who do not smoke. In the United States, less than 4% of non-smoking youth who use electronic cigarettes have symptoms of nicotine dependence. Some teenagers use electronic cigarettes to quit smoking. Since the introduction of electronic cigarettes, teenage smoking rates have declined rapidly in the United Kingdom and the United States, making it unlikely that electronic cigarettes will increase teenage smoking. Electronic cigarettes are more likely to steer some high-risk teenagers away from smoking and towards safer alternatives.
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