The trio wanted to assess “how changes in the prevalence of e-cigarette use among young adults have been associated with changes in the uptake of smoking in England between 2007 and 2018.”
It’s an important issue as, “policymakers have cited a gateway from e-cigarette use to cigarette smoking as a key motivation for various regulations to heavily restrict e-cigarettes.”
The authors were unable to run a randomized controlled trial (offering vapes and cigarettes to various groups) for ethical reasons, so they conducted a time–series analysis of population trends, looking at “the association between the prevalence of e-cigarette use among young adults with uptake of smoking generally and among never smokers in particular.”
They used the monthly Smoking Toolkit Study (STS) data set for England that is collected by University College London, covering 37,105 participants aged 16–24 between January 2007 and December 2018.
The team concluded: “The increase in prevalence of e-cigarette use in England among the entire sample does not appear to have been associated with an increase in the uptake of smoking among young adults aged 16–24. In stratified analyses, large positive associations could also be ruled out for those aged 16–17 and 18– 24”.
Lead author and behavioural scientist Doctor Emma Beard said: “These findings suggest the large gateway effects reported in previous studies can be ruled out, particularly among those aged 18 to 24. However, we cannot rule out a smaller gateway effect and we did not study younger age groups.
“If the upper estimates are true, we would estimate that of the 74,000 e-cigarette users aged 16 to 17 in England, around 7,000 would become ever regular smokers as a consequence of e-cigarette use. At the same time, approximately 50,000 smokers are estimated to quit per year as a consequence of e-cigarette use.”
Senior author and health psychologist Professor Lion Shahab continued: “These findings are important given the contrasting advice given by health bodies and governments in different countries.
“Research to date supports the argument that e-cigarettes are less harmful than tobacco and help smokers to stop smoking. Although some harm from vaping relative to never vaping cannot be ruled out, this study suggests there is little evidence of a substantial gateway effect into smoking.”
- Association of quarterly prevalence of e-cigarette use with ever regular smoking among young adults in England: a time–series analysis between 2007 and 2018 - https://onlinelibrary.wiley.com/doi/10.1111/add.15838