Vaping News

US Gateway Closed

New study by researchers at University College London finds that vaping is not proving to be a gateway to smoking in the United States

Share on:
A cross-sectional, matched control study by researchers at University College London (UCL) has been published in the journal ‘Tobacco Control’. It looked to see if there was an association of between vaping and subsequent progression on to smoking, and also factored in other tobacco product use with smoking in American adolescents.

Lion Shahab, Emma Beard, and Jamie Brown conducted the study using data from 78,265 adolescents in the American National Youth Tobacco Survey.

The authors write: “There is considerable debate about the impact of e-cigarettes on youth smoking. A contentious point is whether e-cigarettes act as a gateway and increase the likelihood of subsequent cigarette smoking. A large number of studies have shown that e-cigarette experimentation is longitudinally associated with uptake of cigarettes.”

But they continue to point out that there are two major problems with the previous work claiming to demonstrate the so-called gateway effect: “First, most studies have considered the impact of e-cigarettes on ever use of cigarettes—that is, initiation—but ignore their effect on continued use.”

They explain that this means the studies do not “allow for a more nuanced analysis of the impact of e-cigarette use on smoking trajectories and health implications, as only regular cigarette use will result in subsequent premature death and disability.”

Secondly, they point out: “a causal association between e-cigarette use and subsequent cigarette smoking cannot be tested directly; it would be unethical (and impractical) to conduct a randomised controlled trial allocating non-smoking adolescents to receive e-cigarettes or not to see whether this leads to uptake of smoking.”

The team concluded: “The NYTS showed a continuing decrease in both cigarette smoking prevalence and in the use of any tobacco product, despite a concurrent increase in e-cigarette use between 2014 to 2017. This suggests that any gateway effect of e-cigarettes, if present, must be small. Further, despite e-cigarettes being more commonly used than any other product from 2015 onwards, cigarettes remained the most prevalent initiation product in 2014 and 2015, followed by other combustibles.”

<1% of adolescents trying an e-cigarette first became established cigarette smokers

The current cross-sectional matched control study estimated that around a quarter of e-cigarette initiators go on to try cigarettes subsequently. However, <1% of adolescents trying an e-cigarette first became established cigarette smokers, significantly fewer than in any other product category.”

The current analysis suggests that the association of e-cigarette initiation with subsequent smoking is largely explained by shared vulnerability such that those who try an e-cigarette first would have gone on to smoke cigarettes anyway.”


  • Association of initial e-cigarette and other tobacco product use with subsequent cigarette smoking in adolescents: a cross-sectional, matched control study” by Shahab, Beard, and Brown – [link]

Photo Credit:

Dave Cross avatar

Dave Cross

Journalist at POTV
View Articles

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.

Join the discussion

Vaping News

Harm Reduction For The Rich

The United Kingdom risks becoming a harm reduction country only for the wealthy, according to Michael Landl of the World Vapers’ Alliance

Vaping News

CAPHRA Highlights Tobacco Control Flaws

The Coalition of Asia Pacific Tobacco Harm Reduction Advocates highlights the flaws in tobacco control which has led to the rise of black market in Australia

Vaping News

A Missed Opportunity at COP10

The Smoke Free Sweden movement says that COP10 was a missed opportunity to save millions of lives

Vaping News

COP10: Promote Tobacco Harm Reduction

Experts with Smoke Free Sweden are emphasising the urgent need for a Tobacco Harm Reduction approach at COP10