More data link vaping to smoking

Last month, a study highlighted the potential dangers of using electronic cigarettes, or “vaping.” It showed that Los Angeles high school students who vaped were more likely to start smoking conventional cigarettes than were kids who didn’t. Now, a second study comes to a similar conclusion.

Brian Primack is a doctor and researcher at the University of Pittsburgh School of Medicine in Pennsylvania. He led the new study. He and his colleagues followed nearly 700 people from the United States for a year. All were 16 to 26 years old at the start of the study. And as with the L.A. study, he notes, the new one showed “young people who use e-cigarettes are more likely than [non-vapers] to progress to regular cigarette smoking.”

But unlike the earlier study, the new one recruited only people “who said they were not interested at all in cigarette smoking,” he notes. Indeed, to be included in the study, each had to have said he or she “definitely” had no intention of smoking in the next year. All also said they’d refuse to try a cigarette if offered one by a friend.

Over the course of the next year, though, some of the participants did start to smoke. And those who had been vaping before the study began took up smoking at a much higher rate. The study’s findings appeared online September 8 in JAMA Pediatrics.

The new study was small. Even smaller was the number of vapers at the start: 16 people. Yet 11 of them changed their minds about avoiding cigarettes over the course of the year. That’s at least three and a half times the rate seen among the nonvapers.

Six of the vapers (37.5 percent) started smoking tobacco cigarettes. That’s nearly four times the percentage seen among the non-vapers.

Studies have shown that e-cigarettes can help some tobacco give up using conventional cigarettes. But for nonsmokers, Primack’s group says, e-cigarettes may do the opposite: They might “contribute to the development of a new population of cigarette smokers.”

Nicotine is an addictive stimulant in tobacco. It’s what keeps smokers coming back for more. Vaping also delivers nicotine but more slowly. As such, Primack’s team says, e-cigarettes “may serve as a ‘nicotine starter,’” for young people. A new user can then advance to cigarette smoking after any initial adverse effects become tolerable.

Despite the study’s small size, its authors emphasize that “we found consistently significant results.” That means the results were strong enough to suggest they were not due to chance.

The new study provides strong “evidence that e-cigarette use leads to smoking, most likely owing to nicotine addiction,” says Jonathan Klein. A doctor, he works for the American Academy of Pediatrics, based in Elk Grove Village, Ill. He wrote a commentary that appears with the new study. He argues that it’s now time to “act on the evidence.” What type of action? The U.S. Food and Drug Administration needs to assert its authority over vaping products, he says. That means regulating e-cigs to keep them out of the hands of minors.

Power Words

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addiction  (adj. addictive) The uncontrolled use of a habit-forming drug or uncontrolled and unhealthy habit (such as video game playing or phone texting). It results from an illness triggered by brain changes that occur after using some drugs or engaging in some extremely pleasurable activities. People with an addiction will feel a compelling need to use a drug (which can be alcohol, the nicotine in tobacco, a prescription drug or an illegal chemical such as cocaine or heroin), even when the user knows that doing so risks severe health or legal consequences. (For instance, even though 35 million Americans try to quit smoking each year, fewer than 15 out of 100 succeed. Most begin smoking again within a week, according to the National Institute on Drug Abuse.)

e-cigarette  (short for electronic cigarette) Battery-powered devices that disperse nicotine and other chemicals as tiny airborne particles that users can inhale. They were originally developed as a safer alternative to cigarettes that users could use as they tried to slowly break their addiction to the nicotine in tobacco products.

Food and Drug Administration  (or FDA) A part of the U.S. Department of Health and Human Services, FDA is charged with overseeing the safety of many products. For instance, it is responsible for making sure drugs are properly labeled, safe and effective; that cosmetics and food supplements are safe and properly labeled; and that tobacco products are regulated.

minors    Children and adolescents below an age that would make them legally adults.

nicotine  A colorless, oily chemical produced in tobacco and certain other plants. It creates the ‘buzz’ effect associated with smoking. It also is highly addictive, making it hard for smokers to give us their use of cigarettes. The chemical is also a poison, sometimes used as a pesticide to kill insects and even some invasive snakes or frogs.

pediatrics A field of medicine that has to do with children and especially child health. A doctor who works in this field is known as a pediatrician.

tobacco A plant cultivated for its leaves. Dried tobacco leaves are burned in cigars, cigarettes, and pipes. Tobacco leaves are also sometimes chewed. The main constituent of tobacco leaves is nicotine.

vaping  A new slang term for the use e-cigarettes, because these devices emit vapor, not smoke. People who do this are referred to as vapers.