E-cigarette use by teens linked to later tobacco smoking: study

TORONTO Teenagers who use electronic cigarettes are at risk of graduating to tobacco smoking, a large Canadian study suggests.

The study of more than 44,000 Grade 9 to 12 students in Ontario and Alberta, published Monday in the Canadian Medical Association Journal (CMAJ), shows a “strong and robust” linkage between so-called vaping and subsequent tobacco use.

“We found that youth that had used e-cigarettes were significantly more likely to start smoking a year later,” said lead researcher David Hammond, a professor in the school of public health at the University of Waterloo.

“They’re more likely to try smoking and they’re more likely to become daily smokers.”

The big question, said Hammond, is whether it’s the use of e-cigarettes that is making some young people smoke.

“A lot of what we’re seeing in our study and a lot of other studies out there is a simple fact, and that is the kids who do risky things, the ones that are more likely to try e-cigarettes are also more likely to try smoking,” he said from Waterloo, Ont.

“And guess what? They’re also more likely to try alcohol and marijuana. It’s all to do with the fact that kids who are susceptible are going to try different things.

“We’ve had something like two million Canadian youth try e-cigarettes and we’d be foolish if we weren’t concerned about kids trying nicotine products at an earlier age than they typically try smoking.”

The research, known as the COMPASS study, looked at ecigarette use among students in 2013/14, with a follow-up a year later. Students were classified into six categories: current daily smokers, current occasional smokers, former smokers, experimental smokers, puffers; and those who had never tried smoking.

Those teens who vaped in the 30 days prior to the start of the study were more likely to start smoking cigarettes and to continue smoking after one year, researchers found.

“Youth may be trying e-cigarettes before smoking because they are easier to access,” said Hammond, noting that tobacco cannot be sold to minors.

Rob Cunningham, senior policy analyst for the Canadian Cancer Society, said vaping by young people is of significant concern.

“Certainly nicotine is addictive and we don’t want e-cigarettes to be a mechanism whereby youth get addicted to nicotine,” he said.