Editor's Note:
A British research report published in "Tobacco Control" on August 20th has sparked widespread attention. The report found that children who frequently use e-cigarettes are three times more likely to become smokers in the future compared to others. The research team reviewed 384 studies on adolescent e-cigarette use and compiled 56 reviews.
After the release of this conclusion, it was quickly reported and shared by mainstream media in the UK, Ireland, and other countries, highlighting the high level of alertness in society regarding the risks of e-cigarettes for teenagers.
The following content is translated by 2Firsts from the Daily Mail.
According to a report by the Daily Mail on August 20th, a UK study found that children who frequently use e-cigarettes are three times more likely to become smokers in the future compared to others.
Long-term data has shown that while traditional smoking rates have been declining, the proportion of children using e-cigarettes has increased dramatically. Currently, more than one-third of adolescents aged 16 to 18 regularly use e-cigarettes.
Ten years ago, this proportion was less than one-tenth.
However, British researchers now believe that these devices may pose a greater threat to children than previously thought.
In the largest global review to date on youth e-cigarette use, experts from York University and the London School of Hygiene and Tropical Medicine (LSHTM) found that those who use e-cigarettes are more likely to smoke more frequently and in larger quantities in the future.
Scientists say that frequent use of e-cigarettes may increase the likelihood of developing respiratory diseases and drug abuse.
However, other experts are cautious about these findings, pointing out that many of the studies evaluated are purely observational and cannot prove that simply using e-cigarettes will lead to these health problems.
In this study, scientists analyzed 56 reviews of 384 studies on e-cigarette use among adolescents.
Among them, 21 articles discussed the relationship between adolescent e-cigarette use and future smoking.
The authors of the study wrote in the journal "Tobacco Control" that existing data "consistently indicate a significant association between youth e-cigarette use and subsequent smoking.
They stated that it was difficult to "infer causality from their review," but that the strong associations repeatedly seen in prospective cohort studies are consistent with causality.
They added that the analysis also indicated that adolescents who use e-cigarettes have an increased risk of developing asthma or worsening asthma.
Other harmful consequences related to teenagers using e-cigarettes include pneumonia, bronchitis, decreased sperm count, dizziness, headaches, and migraines.
Research has also found a connection between teenagers using e-cigarettes and experiencing depression and suicidal thoughts.
Dr. Su Golder, Associate Professor of Health Sciences at York University, stated, "In numerous studies, adolescents who use e-cigarettes are more likely to smoke in the future. These findings support the implementation of stronger public health measures to protect young people from the risks associated with vaping e-cigarettes.
Dr. Greg Hartwell, Clinical Assistant Professor at the London School of Hygiene and Tropical Medicine, stated, "We have found consistent evidence about the transition to smoking, which in turn brings multiple harms similar to traditional cigarettes. As the Chief Medical Officer of the UK government has said, promoting e-cigarettes to children is always unacceptable. Our review clearly indicates how important it is to further restrict the tobacco industry that controls the e-cigarette market.
Dr. Rebecca Glover, an assistant professor at the London School of Hygiene & Tropical Medicine and a senior author of the study, added: "The use of e-cigarettes is having a detrimental impact on the health of young people worldwide. Our research provides the most compelling evidence to date that global youth are facing a range of serious physical and mental health harms from using e-cigarettes, with an increased risk of transitioning to smoking.
However, other experts who were not involved in the study have called these findings "speculative" and warned that the research analyzed is either observational or of low quality.
Professor Ann McNeill, a tobacco addiction expert at King's College London, stated, "The study reported on 56 systematic reviews, with 53 of them being rated as very low or low quality, which means that authors should be extremely cautious before drawing any conclusions. The authors reported that these reviews consistently found an association between e-cigarette use and subsequent smoking. This is consistent with many previous reviews and the results of studies I have been involved in. However, the authors incorrectly suggest that this supports a 'causal relationship'. In other words, that using e-cigarettes leads to smoking - the so-called 'gateway effect'. It is well known that consistency does not imply causation.
Meanwhile, Dr. Emma Beard, Associate Professor of Statistics and Quantitative Methods at University College London, said: "The conclusion that vaping is a 'gateway effect' is speculative, especially when the paper points out that on a population level, smoking rates are generally decreasing as the number of e-cigarette users increases. While it is crucial to protect young people, this review clearly indicates that there are significant weaknesses in the existing evidence base on this topic.
The impact of nicotine on the brain is well known - within 20 seconds of inhalation, it triggers the release of dopamine and other neurotransmitters associated with reward and pleasure.
However, it also causes an increase in heart rate and blood pressure, and constricts blood vessels. This is because nicotine triggers the release of adrenaline.
Although officials from the UK National Health Service claim that e-cigarettes are safer than smoking, vaping is not without risks. E-cigarettes may contain harmful toxins and the long-term effects are still not fully understood.
Experts are also concerned that high levels of nicotine may raise blood pressure and lead to other heart issues.
In 2024, the World Health Organization referred to the evidence regarding e-cigarettes as "complex" in its first-ever guidelines on interventions that may help people quit smoking.
The United Nations agency stated that due to a lack of understanding regarding the harms and benefits of e-cigarettes, it cannot recommend them as a method to quit smoking.
In June 2025, in response to the sharp increase in teenage e-cigarette use, the sale or provision of disposable e-cigarettes (such as Elf bar and Lost Mary) in stores and online was officially declared illegal.
Currently, only devices deemed to be reusable are allowed - devices equipped with rechargeable batteries and interchangeable coils.
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