Health & Studies

Teenage Rates On The Slide

E-cigarettes act as a ‘gateway’ to smoking tobacco for U.S. teens, a self-proclaimed expert warns, but this runs contrary to findings showing American teens' use of tobacco has dropped to a record low

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A study from the Children's National Hospital in Washington D.C., in which it refers to the authors as “experts”, warns that vaping is a gateway for American teens into tobacco use. Unfortunately for them, the findings fly in the face of what is actually happening in the real world as shown by other recent studies.

Speaking about her new study in the anti-vaping journal Pediatrics, lead author Doctor Olusegun Owotomo, said: "Research is showing us that adolescent e-cigarette users who progress to cigarette smoking are not simply those who would have ended up smoking cigarettes anyway. Our study shows that e-cigarettes can predispose adolescents to cigarette smoking, even when they have no prior intentions to do so.

Abstinence from e-cigarettes can protect teens from becoming future smokers and should be framed as a smoking prevention strategy by all concerned stakeholders. Paediatricians are best positioned to educate patients and families on the clinical and psychosocial consequences of e-cigarette use and should support education campaigns and advocacy efforts geared to discourage adolescent e-cigarette use.”

A paper by Rafael Meza, Evelyn Jimenez-Mendoza, and David T. Levy, says differently. Published this month, the trio’s work looked at the actual impact of vaping between 2011 and 2019.

Smoking rates for 12th-grade boys showed a 17% decline between 2012 and 2019. As a result, rates of teens smoking on a daily basis has plummeted to just 2% of the population.

David Levy said: “This is an astoundingly low rate, and our goal from a public health perspective should be to keep smoking at this rate or lower.”

Rafael Meza added: "While the increases in e-cigarettes are indeed concerning and is something we need to address and reverse, the decreases in other tobacco products, in particular, cigarettes, the most concerning form of tobacco use, are accelerating.

So, I think the good news is that the rapid increase in e-cigarette use has not yet resulted in a reversal of the decreasing trends of cigarette smoking and smokeless tobacco use, and if anything, those trends have accelerated.”

The paper attempts to distance vaping from the fall in rates but does note they “closely follow the introduction of e-cigarettes into the market and their increase in prevalence and at least suggest that the recent increase in e-cigarette use has not slowed the decrease in smoking prevalence among youth.”

Yet again, zero evidence of a gateway effect no matter what the Children's National Hospital in Washington D.C would have you believe. Vaping has been a huge intervention for teens who would otherwise have experimented with tobacco products – something America really ought to start celebrating – and has done more to combat lifetime addiction and tobacco-related disease than decades of traditional tobacco control interventions and policies.


  • Smoking Intention and Progression From E-Cigarette Use to Cigarette Smoking”, by Owotomo et al. – [link]
  • Trends in Tobacco Use Among Adolescents by Grade, Sex, and Race, 1991-2019” by Meza, Jimenez-Mendoza, and Levy – [link]

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Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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