E-cigarette use as a predictor of cigarette smoking

Listen to a recent BMJ interview with Richard Miech for a discussion on young vapers and cigarette smoking.


Current opinions on teen vaping run the gamut from harmful to protective. Miech and colleagues use national data in the US to ask a fairly simple question: When 12th graders vape, are they more or less likely to have smoked cigarettes a year later?


First the researchers looked at 12th graders who had never smoked cigarettes and divided them into those who had vaped in the last 30 days and those who hadn’t. The teens who had vaped were over 4 times more likely to have smoked one or more cigarettes a year later.


Next the researchers looked at 12th graders who had smoked cigarettes in the past but were not smoking at the time of the survey, with the question whether vaping could entice these former smokers back to cigarettes. One year later the 12th-grade vapers were 2 times more likely than non-vapers to have smoked again.


Finally, could vaping help kids quit smoking? High school seniors who smoked at least one cigarette a day at survey time and who vaped were no more likely than non-vapers to have quit smoking a year later.


The Monitoring the Future study, used here, also asks 12th graders how much people risk harming themselves if they smoke one or more packs of cigarettes a day. The researchers in the current study wondered if kids might become more vulnerable to cigarette smoking by seeing less harm in smoking. To assess the role of vaping, they looked at 12th graders who had never smoked cigarettes and who said smoking posed great risk of harm. They divided this group into those who vaped around survey time and those who didn’t. Those who vaped were 4 times more likely to change their view of smoking harm to a lower risk a year later.


These results have policy implications. To regulate youth access to vaping liquids and devices, we don’t need to wait for decades of research showing physical harm from vaping. The findings here point to the rationale that vaping leads to cigarette smoking among youth and that regulation can help reduce harm from cigarettes among young people.


Hear the interview. Read the UM press release. Or access the article in Tobacco Control journal.


Monitoring the Future is funded by the National Institute on Drug Abuse.