30-07-2025
Study finds vaping leads to smoking for one in three teens
By Stephen Beech
Teenagers who vape are just as likely to start smoking cigarettes as young people 50 years ago, according to new research.
Despite a massive fall in the number of youngsters smoking over the past half-century, scientists found that UK teens who are current vapers are as likely to take up smoking now as 1970s teenagers.
The likelihood of starting to smoke cigarettes among teenagers who don't vape today is less than one in 50 (1.5%), suggests the long-term study.
But that figure soars to one in three (33%) among teens who do vape, according to the findings published in the BMJ journal Tobacco Control.
American researchers drew on data from three nationally representative groups of UK teens born in 1958, 1970 and 2001, respectively
The National Child Development Study (NCDS) follows people born in 1958 who were children when cigarette smoking was at its historic peak.
The British Cohort Study (BCS) follows children born in 1970, who were teens in the 1980s when cigarette smoking among young people was relatively widespread, and who were in their 40s before e-cigarettes were introduced.
The Millennium Cohort Study (MCS) follows teens who were born in 2000–01 and who were children when e-cigarettes were introduced.
The prevalence of teen smoking was assessed in 1974 among 11,969 NCDS participants, in 1986 among 6,222 BCS participants, and in 2018 among 9,733 MCS participants.
The odds of smoking among 16- and 17-year-olds were estimated, based on a common set of childhood risk and protective factors; teen vaping was included as a predictor in the MCS.
Factors included whether they had ever drunk alcohol by age 16 or 17; how engaged they were with education at school; and parental occupation, education, and smoking habits.
Analysis of the data revealed a "steep" decline in the prevalence of cigarette smoking among teenagers, falling from 33% in 1974 to 25% in 1986, and to just 12% in 2018.
Around half of the MCS participants hadn't vaped by the time they were 17, while 41% said they had previously vaped, and 11% reported current vaping.
The researchers suggest that the decline in prevalence of teen smoking is down to a mix of tobacco control legislation, better public understanding of the health consequences of smoking, and a shift away from the perception of smoking as socially acceptable.
They pointed out that risk factors also changed over time. For example, the percentage of teens who had started drinking by the age of 16 or 17 fell from 94% in the NCDS to 83% in the MCS.
The average age at which mothers left education also rose from 15.5 in the NCDS to 17 in the MCS.
The prevalence of parental smoking also fell from above 70% in the NCDS to 27% in the MCS; and fewer mothers continued smoking while pregnant in the MCS than in the two younger groups.
But many factors for teen smoking remained similar across the groups, including boozing before the age of 17.
To illustrate the likelihood of cigarette smoking for an "average" teenage 16 or 17 over time, the researchers worked out predicted probabilities of cigarette smoking with all risk factors included from the intergenerational data.
This probability was 30% in the NCDS and 22% in the BCS.
Among those who had never vaped in the MCS group, it was only around 1.5%, but 33% for the teens who reported current vaping.
Study author Dr. Jessica Mongilio, of the University of Michigan, said: "This probability is especially concerning given the recent increases in e-cigarette use prevalence among UK youth, despite some initial assurances that e-cigarettes would have little appeal to them."
The research team acknowledged that they were unable to account for some socio-demographic characteristics, including race and ethnicity.
But Dr. Mongilio said: "While our research shows that the historic decline in the likelihood of youth cigarette smoking has continued in this recent cohort of UK youth, overall, we find that this is not the case among e-cigarette users.
"Youth who had never used e-cigarettes had an estimated less than one in 50 chance of reporting weekly cigarette use at age 17, while those who had previously used e-cigarettes had over a one in 10 chance.
"Youth who reported current e-cigarette use had an almost one in three chance of also reporting current cigarette use.
"As such, the decline in the likelihood of cigarette smoking is waning for youth who have used e-cigarettes-about half of our sample -and has reversed for those currently using e-cigarettes."
She added: "Among contemporary youth, efforts to reduce cigarette smoking should focus both on those who are currently using e-cigarettes and on the prevention of e-cigarette use among youth, to maintain the promising declines in youth nicotine use in years to come."
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