E-Cigarettes Could Serve as Gateway to Traditional Tobacco Products

High school students who use electronic cigarettes are more than twice as likely to progress to smoking conventional tobacco products, according to a study published Tuesday in the Journal of the American Medical Association, Modern Healthcare reports.

Researchers at the University of Southern California in 2013 surveyed about 2,500 ninth graders from 10 Los Angeles-area high schools who said they had never smoked tobacco. Of those surveyed, 222 had tried e-cigarettes.

Researchers conducted follow-up surveys six months and one year later and found that:

• After six months, 31% of those who used e-cigarettes had tried tobacco, compared with 8% of those who had never used e-cigarettes; and
• After one year, 25% of those who used e-cigarettes had smoked tobacco in the six months prior, compared with 9% of those who had never used e-cigarettes (Robeznieks, Modern Healthcare, 8/18).

Students who used e-cigarettes were about twice as likely over the course of the study to report smoking cigarettes, three times as likely to report smoking hookah and five times as likely to report smoking cigars (Rapaport, Reuters, 8/18).

Study leader Adam Levanthal said a "disproportionate number of smokers were e-cigarette users" first, but he noted that the study could not conclude if e-cigarettes were what led the students to try other tobacco products (Mickle, Wall Street Journal, 8/18).

Study Counters E-Cig Smoking Cessation Argument

Some proponents of e-cigarettes have said they could be useful as a smoking cessation tool.

However, a JAMA editorial accompanying the study noted the findings show that such an argument does not apply to adolescents. The editorial argued that advertising for e-cigarettes directed at teens should be prohibited (Modern Healthcare, 8/18).

Calif. Lawmakers To Consider E-Cig Legislation

The study comes as lawmakers during a special session reintroduced:

• SB 151, which would raise the smoking age in the state to 21 years old; and
• SB 140, which would regulate e-cigarettes in the same way as other tobacco products (White, "Capitol Alert," Sacramento Bee, 8/16).

Lawmakers also have renewed efforts to add a $2 per pack tax on cigarettes, which would result in an estimated $1.5 billion annually for health care programs.

Deborah Hoffman, a spokesperson for the Brown administration, said, "As tobacco use has a significant impact on health care costs, it's an appropriate discussion to have" (Megerian/McGreevy, Los Angeles Times, 8/15).