Study Finds Vaping is Not A Gateway to Smoking

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The largest investigation to date shows no signs at the population level that vaping serves as a gateway into cigarette smoking. The comprehensive analysis led by Queen Mary University of London compared smoking rates and patterns in countries with contrasting e-cigarette regulations.

Researchers discovered that the decline in smoking has accelerated faster in the UK, where vaping is embraced, than in Australia which bans nicotine e-cigarettes. There are also early indications that switching to vaping is hastening the demise of combustible cigarettes.

Vaping Boom Not Driving Smoking Rates

The study funded by the National Institute of Health and Care Research aimed to settle the debate on whether rising youth vaping rates lead more adolescents to smoke. Anti-vaping advocates have warned of a “gateway effect” hooking kids.

However, researchers analyzed smoking prevalence data from the UK, US and Australia from 2001 to 2018. They found no population-level evidence that increased e-cigarette access prompted more smoking initiation in either the UK or US.

In fact, smoking declined faster among young people and disadvantaged groups in countries where vaping is more prevalent. Rates of decline were also impacted by heated tobacco and oral nicotine products in other nations reviewed.

“The results alleviate concern that e-cigarettes promote smoking,” said lead author Professor Peter Hajek of Queen Mary University’s Health and Lifestyle Research Unit. “There are even signs they displace cigarettes, but more data over longer periods is required to determine the size of this substitution effect.”

Australian Ban Slowed Smoking Decline

A key contrast came between the UK, where vaping prevalence approached 6% by 2018, and Australia where nicotine vaping products cannot be sold legally. Smoking prevalence declined more slowly down under over the last decade, especially among youth.

“This analysis provides reassurance that progressive e-cigarette regulations haven’t detrimentally impacted smoking rates,” said co-author Professor Lion Shahab of University College London’s Tobacco and Alcohol Research Group. “If anything, these alternatives seem to be displacing far more lethal cigarettes.”

However, researchers emphasized that with people often using both products concurrently, longer-term monitoring is needed to quantify to what extent vaping specifically replaces smoking over time.

Heated Tobacco Accelerating Cigarette Decline

The analysis also revealed that as heated tobacco products gained market share in Japan and South Korea since 2014, cigarette sales markedly declined. The rapid uptake of these devices which heat refined tobacco rather than burning it was accompanied by more Japanese smokers switching completely away from cigarettes.

Professor Hajek says these international findings point to the potential public health gains on offer from cigarette alternatives: “Alternative nicotine products appear to be accelerating the demise of smoking in countries where they are popular. But ongoing tracking is essential to confirm the size of this substitution effect.”

Matthew Ma