Another Study Refutes The Gateway Theory Stating The Opposite is True

A new study led by Queen Mary University of London and funded by the National Institute of Health and Care Research (NIHR)reiterated that on the contrary to what the “Gateway Theory” claims, if anything vaping acts as a gateway out of not into smoking.

A recent research letter published in JAMA Internal Medicine explored smoking and vaping patterns in young adults, offering insights into the relationship between the two behaviors. Led by researchers at the Medical University of South Carolina (MUSC) who analyzed data from the Population Assessment of Tobacco and Health (PATH) Study, the study revealed a significant shift in tobacco use among young adults, with more individuals initiating nicotine intake through vaping rather than traditional cigarettes.

Discussing the study, Dr. Sarah Jackson, Principal Research Fellow at the UCL Tobacco and Alcohol Research Group, emphasized the concern about vaping acting as a potential gateway to smoking among young individuals. However, recent studies suggest a different trend, indicating that vaping may be actually displacing smoking, steering those who might have chosen smoking towards a less harmful option.

The research letter highlighted that in the last decade, a significant proportion of young adults have consumed nicotine. However in recent years, there has been a noticeable shift away from smoking tobacco: a highly lethal habit, towards vaping, which science has shown us poses only a fraction of the risks associated with smoking. Dr. Jackson suggests that this shift could have net public health benefits.

An increase in the number of vapers who have never smoked
The data also highlighted an increase in the proportion of young adult vapers who were never established smokers. Professor Peter Hajek from Queen Mary University of London said that the study’s findings refute the common concern that e-cigarettes act as a gateway to smoking. Instead, they suggest that vapes may divert young people from more risky smoking behaviors, leading to a proportional decrease in smoking rates.

Professor Caitlin Notley from the University of East Anglia noted that the study aligns with evidence from England, where historically low tobacco smoking rates coincided with increased vaping among young people. This trend corresponds with the widespread availability of disposable vapes and nicotine-salt based e-liquids.

The reduction in smoking is seen as a positive development for public health, emphasizing the importance of clearly communicating that vaping is a reduced harm alternative to smoking. However, added Professor Notley, there is widespread confusion across the US, partly stems from the fact that vapes are incorrectly classified as tobacco products. This naturally leads to misperceptions about the relative harms of vaping compared to smoking.

Countless previous studies have come to the same conclusion, however claims about an alleged gateway to smoking and/or substance use, have never stopped resurfacing. Another recent study, is the most comprehensive to date on the topic. In order to carry out an investigation at the population level, the research team examined associations of vape use and sales, with smoking rates and cigarette sales across different age and socioeconomic groups. The researchers then proceeded to compare smoking prevalence over time in countries with contrasting regulations of these products, such as the UK and the US, versus Australia.

A gateway out of, not into, smoking
In line with previous findings, the results indicated that not only was there no gateway to smoking, but also that vaping products have actually facilitated smoking cessation and led to decreased smoking rates in countries where they are endorsed. In fact, as the rise in sales of heated tobacco products in Japan has coincided with a reduction in cigarette sales.

Moreover, the decrease in smoking prevalence in Australia appears to have slowed down in comparison to countries which have endorsed tobacco harm reduction. This deceleration is particularly evident among young individuals and in lower socioeconomic groups, and is significant when compared to both the UK and the US. Finally, cigarette sales have declined at a much quicker rate in the United Kingdom than in Australia.