Landmark Study Fails To Find Gateway

Posted 20th February 2019 by Dave Cross
The Journal of the National Cancer Institute has published a huge study looking at youth vaping and how this is a predictor for later cigarette smoking behaviour – otherwise known as the ‘gateway effect’. Despite claiming that ever-vaping predicts future smoking, people have been quick to point out that absolutely no evidence has been provided.

Researchers from the Food and Drug Administration, Roswell Park Cancer Centre, National Institutes for Health, the Truth Initiative, and the John Hopkins Bloomberg School of Public Health combined to produce the study.

In “Longitudinal e-cigarette and cigarette use among US youth in the PATH Study”, the team lays out its bias at the outset: “Evidence is accumulating that youth who try ENDS (e-cigarettes) may go on to try cigarettes.”

The group looked at data obtained from almost 12,000 youths and used regression models to identify a gateway effect. They concluded: “Ever ENDS [Electronic nicotine delivery systems] use predicts future cigarette smoking and frequency of ENDS use has a differential impact on subsequent cigarette smoking uptake or reduction. These results suggest that both cigarettes and ENDS should be targeted in early tobacco prevention efforts with youth.”

Dr Michael Siegel is a Professor at the Boston University School of Public Health. He has worked in the field of tobacco control and harm reduction for over thirty years and is widely respected as being an expert in the area. He was quick to respond to the paper’s claimed findings.


“Buried deep within the article is the rather startling, but most critically relevant finding of the entire study,” he said. “The investigators were unable to report a single youth out of the 12,000 in the sample who was a cigarette naive, regular vaper at baseline who progressed to become a smoker at follow-up. Why? Because the number of these youth was so small that it was impossible to accurately quantify this number.”

Siegel has performed his own analysis of the data and pulled up that there were only 21 non-smoking teen vapers who progressed to smoking. On top of that, he noted that this tiny group were exceptionally casual users of vape equipment.

“They literally could have tried an e-cigarette once 30 days earlier. It is possible that vaping was not a gateway to smoking for any of these 21 youth, but even if it was, they represent just 0.2% of the youth population,” he added.

“The bottom line is that despite the widespread claims that vaping is a gateway to smoking initiation among youth, the most definitive study to date of this issue fails to provide any evidence to support that contention. If anything, it provides evidence suggesting that vaping acts as a kind of diversion that can keep some youth away from cigarette smoking.”




 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker