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Research: Gateway Perceptions

Researchers from Switzerland Surveyed Teens About A Gateway To Smoking.

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The so-called ‘gateway effect’ has been debated for as long as electronic cigarettes have existed. For harm reductionists, vaping offers a single gateway – and that’s one away from the grips of tobacco smoking and the related diseases. An ever-decreasing band of objectors have sought to paint a gateway going in the other direction despite the lack of evidence to support their case. Two Swiss researchers have investigated what young people think.

Christina Akre and Joan-Carles Suris work at the Institut Universitaire de Médecine Sociale et Préventive, at Lausanne University Hospital in Switzerland. They have undertaken a qualitative study looking at “Adolescents and young adults’ perceptions of electronic cigarettes as a gateway to smoking”. The paper has been published in this month’s Health Education Research journal, but is behind a paywall.

“Electronic cigarettes acting as a gateway to smoking traditional cigarettes is a growing public health concern of electronic cigarette use among youths,” heralds beginning to the paper. Of more concern to vapers will be how anyone can claim the gateway effect is a growing concern in public health circles. The UK and the USA have been demonstrating drops in the rates of teen smoking, year on year, for the last ten years – there has been absolutely no indication that vaping is feeding a growing demand for cigarettes among adolescents.

Akre references her own work as evidence that there is a soaring teen vaping rate, and justification for public health concern comes from them citing Stanton Glantz. At this point it’s clear what kind of researchers this pair are and what they hope to prove with their study.

Where the researchers are probably correct is when they state: “there is a gap in understanding the relationship between electronic cigarettes and tobacco smoking among young people from their own perspective.”

The study involved taking a smattering of subjects, just 42 in this case, and split into eight groups: “4 with current electronic cigarette users, 2 with tobacco cigarette users, 1 with non-users, and 1 with mixed consumption types.” The subjects were recruited from the Internet and at the university. Each group took part in a ninety-minute chat – and then everybody got paid 40 Swiss Francs (£32).

The participants were asked set questions from an interview guide: “it included questions about consumption modes (context of use, flavours, price etc.), electronic cigarette onset reasons and modes, reasons to use or not to use electronic cigarettes, and differences between electronic cigarettes and with tobacco cigarettes (in terms of health, image, preference etc.). Participants were also asked if they believed that electronic cigarettes could act as a gateway to smoking.”

From the study’s initial 42, 31 were either vapers or (much beloved of Glantz and his peers) “ever used” - this means the adolescents could have taken one puff a number of years previously. There are no prizes for guessing what the finding was regarding a gateway effect, it was obvious from the outset: “Overall, participants identified a significant risk of electronic cigarettes easing the access to tobacco cigarettes and acting as a gateway to TC use among adolescents.”

They cite an anonymous 23-year-old male dual-user saying, “I believe that it’s an open door to start smoking cigarettes, clearly.”

It is typical that such a study follows the Glantz model of being hidden away from prying eyes rather than being open for inspection and debate. There are so many questions rising from it, such as the ethical aspect of paying the participants and why there were no adolescents cited in the results – just adults aged 18 or over. It will certainly feature in the references of the next paper to come out of California, but adds nothing but smoke and mirrors to the body of scientific knowledge.

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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