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Study Finds Teens Who Vape, Chew Tobacco More Likely To Later Smoke Cigarettes

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Teens who use e-cigarettes, hookah, chewing tobacco and other cigarette alternatives are almost twice as likely to eventually smoke cigarettes than teens who never use those alternatives. That’s according to a new study out Tuesday in the Journal of the American Medical Association.

In Kentucky, a sizable portion of teenagers already smoke cigarettes, according to a state government survey published in 2017. A little more than 14 percent of Kentucky high schoolers reported smoking cigarettes, while about the same percentage reported vaping, which is similar to e-cigarettes.

For the new JAMA study, authors set out to find out if using e-cigarettes and similar products eventually led teens to smoke cigarettes. That’s important because cigarette smoking rates have gone down in teens, which could be seen as a win by health advocates. But for many teenagers, e-cigarettes have taken the place of traditional cigarettes, according to a University of Michigan study from 2014.

“Any use of all forms of non-cigarette tobacco was independently associated with greater risk of future cigarette smoking,” the JAMA study authors concluded.

And they say policy experts may need to more aggressively try to stop teens from using products like e-cigarettes in the first place.

The researchers asked 10,384 teens between 12 and 17-years-old if they’d ever used e-cigarettes, hookah, dissolvable tobacco and other similar products. Then they asked if the teen had ever smoked a cigarette. They followed up with the same teens a year later to ask again if they'd smoked a cigarette in the previous 30 days or year.

Teenagers who used e-cigarettes, moist snuff, snus, cigarillos, pipes and other similar products were around twice as likely to have smoked cigarettes a year later. Teens who used a combination of these products were almost four times as likely to have smoked a cigarette by the following year.

Foundation for a Healthy Kentucky President Ben Chandler said these products basically fall into the same camp as cigarettes because both lead to future cigarette use. About 90 percent of adult smokers first tried cigarettes by the time they turned 18, according to the study.

“Products like e cigarettes are essentially gateways to smoking cigarettes,” Chandler said. “There’s no question about it after this study.”

Marketing To Teens

E-cigarettes and vaporizers are commonly marketed as products that have fewer health effects than using tobacco, and as a way to wean users off cigarettes. The Kentucky Smoke Free Association, whose membership consists of vaping, e-cigarette and other smokeless product makers, writes on its website that these products ‘lower the health risks associated with using tobacco or nicotine.’

But health advocates have said that doesn't apply to teenagers. That’s because any tobacco use is harmful to the body, and the new study now draws a clear link to future cigarette smoking.

The study notes that flavorings in these smokeless products — like bubble gum, strawberry and chocolate cake — should be banned. The majority of teens who use these products buy vapes and e-cigarettes with these kinds of flavorings, according another study from the University of Michigan in 2016.

“The estimated health risks of non-cigarette tobacco products should include the additional health consequences of future cigarette use,” study authors wrote.

Lisa Gillespie is WFPL's Health and Innovation Reporter.

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