There may be a “strong association” between vaping and smoking in adolescents, according to a report looking at the consequences of electronic cigarette (e-cigarette) use released Oct. 11 by CNA, a nonprofit research and analysis organization.

The report analyzed survey data from nearly 130,000 middle-school and high-school students and compared National Youth Tobacco Survey data from the years before the arrival of e-cigarettes to more recent years.

Results showed that there is a “very strong correlation” between vaping and tobacco use. The researchers also found a “very low rate of cigarette use among those who have never tried vaping” and note that this “raises the possibility that in the absence of e-cigarettes, smoking by schoolchildren might be falling more dramatically.” Further, “e-cigarette users were two-and-a-half times more likely to be smoking or chewing tobacco” than their statistical model had predicted.

“We found that not only were vapers more likely to smoke than expected, they also smoked a significantly greater number of cigarettes per day than fellow smokers who had never tried e-cigarettes," says Elizabeth Clelan, PhD, lead author and CAN research scientist. "One potential implication is that e-cigarettes could be a gateway drug for the use of tobacco," concludes Justin Ladner, PhD, co-author and CNA research analyst.

“We still don’t know the degree of harm that is caused by vaping itself, but this study provides a strong indication that e-cigarettes do lead to tobacco usage, which is a major detriment to public health," adds Mary Norine Walsh, MD, FACC, president-elect of the ACC. "We hope regulators, young people, and their parents, are not taken in by the arguments that e-cigarettes are safer than tobacco products. We do not want to erode the great progress we’ve made in reducing heart disease and other diseases by allowing a new generation of smokers to start.”

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