study, conducted in Hawaii, used a longitudinal approach to look at the impact of the e-cigarette. The study looked at awareness of e-cigarettes, smoking status (tobacco and electronic cigarettes), parental support & education, rebelliousness and sensation seeking. As you might have thought, this study caused a little stir.

The findings showed that there was a link between students that had used e-cigarettes in the first year of the study (2013) and an increase of students who smoked tobacco cigarettes a year later (2014). Analysis of the data also showed that age, ethnicity, low parental education and support, high rebelliousness and the view that e-cigarettes are healthier were all contributing factors to the uptake of e-cigarettes in the first year of the study.

But what does this all mean for us? It’s understandable to see why some might say that this is proof that e-cigarettes are a gateway to tobacco cigarettes. Others might argue that this is just one study that indicates a link, but no proof. The latter is what’s being argued online.

This opinion piece argues that this study doesn’t show vaping causes smoking. The piece argues that we may be reading too much into the findings because we aren’t able to track those who have tried tobacco cigarettes after e-cigarettes and whether they will continue to be long-term smokers. This is a fair counter statement. The only way we’ll able to identify whether e-cigarette use could create long-term smokers is to conduct a longitudinal study over several years, maybe even decades. However, we could send a follow-up survey to those teenagers every year asking for their views and smoking status.

Methodological approach aside, the main point of the piece argues that just because teenagers use e-cigarettes before tobacco cigarettes doesn’t prove that e-cigarette use causes tobacco use. This was compared to marijuana use argued as a gateway to heroin, with the article stating that while it is true that marijuana users are more likely to use heroin in comparison to individuals that have never used marijuana, it does not mean that trying marijuana causes heroin uptake. The author goes on to argue that characteristics are more important in having an impact on heroin uptake rather than marijuana uptake status.

I agree that characteristics do have a role to play in the uptake of any substance, or in this case, e-cigarettes and tobacco cigarettes. However, type of thinking is not progressive in addressing issues that crop up. It would be ideal to identify what causes behaviours; however, we aren’t able to establish this due to the complexities of behaviours. The study in question looked at some areas that could be related to the uptake of e-cigarettes, but did state that they were limited in the types of influences examined and there is room for more in future research.

But this is beside the point. While tobacco smoking rates have seen a decline in recent years, e-cigarette consumption has shot up – there’s no way around this. Turning an eye to this behaviour could be costly. While e-cigarettes aren’t as harmful as tobacco cigarettes ( so we are told, but this is also debatable) we aren’t aware of the long-term health consequences associated with e-cigarettes. Due to the lack of regulation, e-cigarettes are still being marketed and sold to children and young people. E-cigarettes are also going to be introduced by the NHS as an option for those wishing to quit smoking, which raises questions about whether this might have a negative effect on smokers wishing to quit by sustaining the behaviour of smoking.

Over the past two years, we have conducted research with teenagers and adults on smoking and e-cigarettes. Awareness and ever-use of e-cigarettes has always come out higher than tobacco cigarettes with many teenagers stating that they have tried e-cigarettes because of the variety of flavours as well as being influenced by peers and family members. We are keen to keep researching this area. Shortly we will be publishing all the evidence in one place to allow professionals to see all the evidence. To find out how we can help you in understanding more about smoking and e-cigarette use in your local area, contact us and a member of our team will get back to you.