E-Cigarettes May or May Not Be a Gateway Drug. (But Probably Not.)

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Are e-cigarettes a gateway drug to traditional cigarettes? There’s a new study out that suggests they might be:

The study focused on ninth-graders at 10 public schools in Los Angeles who had tried e-cigarettes before the fall of 2013. Researchers surveyed those students in the spring of 2014 and fall of 2014, and discovered that they were about 2½ times as likely as their peers to have smoked traditional cigarettes.

This is a classic case of correlation which may or may not also be causation (something the authors acknowledge). Did more of the e-cigarette kids take up smoking because e-cigarettes gave them a taste for it? Or do the kids who are most likely to take up smoking in the first place simply start with e-cigarettes? There’s no way to tell just from this study.

That’s not to say it’s worthless, though. If the study found no correlation, then you could be pretty sure that e-cigarettes don’t lead to cigarette smoking. That would be worth knowing. But since it did find a correlation, we need more research to know if there’s causation here.

One way to get a tentative read on this is to look at total cigarette smoking among teens. If it’s up, then e-cigarettes might be leading more kids to cigarettes. If it’s not up, then e-cigarettes are probably just temporarily replacing cigarettes for kids who were going to take up smoking anyway. So which is it?

As it happens, we know the answer to this: cigarette smoking has plunged among teenagers over the past four years. On the other hand, total cigarette use among teens (cigarettes + e-cigarettes) has gone up. The cigarette plunge makes it unlikely that e-cigarettes are a gateway to traditional cigarettes. But the increase in total cigarette use suggests that e-cigarettes really are creating a new market. It’s complicated.

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DEMOCRACY DOES NOT EXIST...

without free and fair elections, a vigorous free press, and engaged citizens to reclaim power from those who abuse it.

In this election year unlike any other—against a backdrop of a pandemic, an economic crisis, racial reckoning, and so much daily crazy—Mother Jones' journalism is driven by one simple question: Will America will move closer to, or further from, justice and equity in the years to come?

If you're able to, please join us in this mission with a donation today. Our reporting right now is focused on voting rights and election security, corruption, disinformation, racial and gender equity, and the climate crisis. We can’t do it without the support of readers like you, and we need to give it everything we've got between now and November. Thank you.

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