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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And the truth is, going into the final 4 days of the year we still needed to raise $TK to hit our $350,000 goal and start 2021 on track. It's nerve-wracking, wondering if the big spike we normally see at the end of December is going to be another thing that doesn't go as planned in 2020, or worse, if, now that Donald Trump is set to leave the White House (for longer than a taxpayer-funded golf trip to a property he owns), folks might be pulling back from fighting for the truth and a democracy and think the hard work is done.

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