Do you know anyone who has tried hookah? E-cigarettes? Chances are, you do. Recent reports indicate that the use of emerging tobacco products (ETPs) such as the ones mentioned above is steadily on the increase, particularly among youth. And while the general use of traditional tobacco products has been on the decline for many years, a study by the Centers of Disease Control (CDC) found that among high school students, ETP use doubled from 4.7% in 2011 to 10% in 2012.
First, let’s get it clear. Emerging tobacco products are not quite the same as their traditional counterparts. These products contain a solution that is heated to make a vapour. Some contain nicotine, some don’t.
As ETPs have gained more popularity, the vape industry has come under a lot of scrutiny. Many groups argue that “vaping,” or the use of ETPs, is a “gateway to tobacco use”. However, this is not a new argument. We’ve heard it before with marijuana. Anti-cannabis groups proclaimed that the use of “soft” drugs such as marijuana would lead to use of harder, more dangerous drugs. However, during the last few years, many studies have disproven this argument over and over again. Since the use of ETPs is relatively new, many groups are preaching caution, mostly based on assumption.
Dr. Thomas Frieden, Director of the CDC commented recently in his interview with Medscape magazine, “What we are doing first is tracking, and we are seeing some very concerning trends. The use of e-cigarettes in youth doubled just in the past year, and many are starting out with e-cigarettes and then going on to smoke conventional cigarettes.” It appears that anti-vaping proponents seem to be using the same tactics as traditional anti-tobacco marketing: frighten the public.
According to the British Medical Association, more than 100,000 deaths are linked to the use of traditional tobacco products. With such numbers, it is no wonder that the increased usage of ETPs, especially the skyrocketing success among the youth, has people wondering about their effects. Should we be worried about this new trend? With 85% of adults stating that their first tobacco product tried was before the age of 18, it begs the question: Do ETPs lead users to use traditional tobacco products?
According to researchers at Oklahoma State University, the answer is no.
The Facts Revealed
A study conducted by Oklahoma State University investigated tobacco use among undergraduate students. This study, conducted in January 2015 and detailed in the American Journal of Preventive Medicine, evaluated the habits of 1,304 non-tobacco and recreational smokers, to understand the relationship between first tobacco product tried and current tobacco use. They wanted to know if the use of certain products increased the chances that students would become more frequent tobacco users.
What researchers found was pretty interesting.
Of the 1,304 participants, 49% reported having used a tobacco product. Of the non-frequent users, hookah was the most frequently tried, with 38% percent of participants reporting use. Traditional cigarettes ranked in second, with 32% of participants stating previous use. Electronic cigarettes came in last, with 29% of participants citing usage.
Researchers also found that of the 59 participants who reported electronic cigarettes as the first product tried, only one participant moved on to smoking traditional cigarettes daily.
Among the 78% of students who tried e-cigarettes as their first tobacco products, only one was still occasionally using electronic cigarettes at the time of the study.
Students who reported ETPs or hookah as their first tobacco product reported occasional, or social use. However, those who first tried cigarettes reported occasional or daily use of traditional cigarettes or smokeless tobacco products such as chewing tobacco. Nearly 25% of individuals who tried cigarettes as their first tobacco products were current or frequent smokers. More than 40% of students who used smokeless tobacco products such as snuff or chewing tobaccos were current users. Less than 4% of those whose first tobacco product was an ETP were current ETP or tobacco users.
The Final Word
The study indicates that the first product tried did not predict the current tobacco use and non-use among students. Additionally, people who use ETPs are not very likely to move on to more frequent use of either ETPs or traditional tobacco products. Students who used hookah or an ETP as their first tobacco products were pretty unlikely to move on to using cigarettes, and only moderately likely to become recreational users of any tobacco products. This is a pretty important point, since most students who tried traditional cigarettes first became regular or daily users.
Clearly, there is more room for additional research on the topic. However, in the meantime, it seems that there isn’t much validity to the argument of ETPs as a gateway to smoking or more frequent tobacco use.