Does e-cigarette use among young people lead to smoking, or vice versa?

Young people who use e-cigarettes are more likely to start smoking tobacco. However, the reverse is also true, according to a new study published today in the international scientific journal Tobacco Control: young people who smoke tobacco are more likely to start using e-cigarettes. The study was conducted by Maastricht University in collaboration with the Dutch National Institute for Public Health and the Environment (RIVM) and IVO Research Institute, and was funded by the Dutch Research Council (NWO).

Gateway theory

In the light of previous studies, e-cigarettes are often said to be a gateway to tobacco smoking among young people, but this new study paints a more nuanced picture. Young people who start smoking tobacco are also more likely to go on to use e-cigarettes. ‘One explanation could be that a certain group of young people are more likely to try different substances (such as e-cigarettes and tobacco) and that the order of trying the substances doesn’t necessarily matter,’ Thomas Martinelli of the Research Institute IVO, who is the lead author of the scientific paper.

Discouraging e-cigarettes recommended

‘On the basis of our results, we can’t say with certainty that e-cigarettes are the cause of young people starting to smoke tobacco,’ says the study’s project leader Professor Gera Nagelhout of Maastricht University and IVO Research Institute. Nevertheless, the authors strongly recommend discouraging the use of e-cigarettes among young people. E-cigarette vaping is harmful to health and (like tobacco smoking) is not compatible with a healthy lifestyle.

The study was conducted at ten secondary schools in total, eight in the Netherlands and two in Belgium. More than 2,800 young people took part. In 2018 and 2019, they completed a questionnaire three times with six months in between on the use of e-cigarettes, tobacco and other substances. In the analysis, the researchers adjusted for a wide range of characteristics of the young people and their social environment.

In the video below, the authors explain more about the study and its results:

Also read

  • Patients admitted to hospital due to a severe COVID-19 infection exhibit no evidence of brain damage caused by the disease. This is the conclusion of an extensive study led by Maastricht University.

  • Sten van Beek

    Cold shivers?

    Due to the Western lifestyle with a high fat diet combined with little exercise, more and more people in the Netherlands are overweight or even obese. This causes an increased risk of type II diabetes. What can be done about this besides a healthier lifestyle? The answer comes from an unexpected...

  • Marlou-Floor Kenkhuis

    Quantity and Quality

    Survivors of colon cancer often have symptoms associated with the cancer or treatment for years after treatment, such as fatigue and tingling in fingers and feet. This has a great impact on the perceived quality of life. Whereas current lifestyle advice is mainly aimed at prevention of (colon)...