Vapes Are Not A Smoking Gateway

With multiple attacks being launched on vaping and the concept of tobacco harm reduction, there are a number of people claiming that action needs to be taken to prevent youths from trying vaping and progressing on to using tobacco products. The truth is that the evidence from independent research is clear – there is no gateway effect – and experts have come out to reaffirm that this is clear.

Who conducted the research?
The study was carried out by Francesca Pesola, Anna Phillips-Waller, Emma Beard, Lion Shahab, David Sweanor, Martin Jarvis and Peter Hajek, led by Queen Mary University of London. It was funded by the National Institute of Health and Care Research.

How did the team describe the research?
The independent academics said it was, “the most comprehensive study to date investigating whether e-cigarettes are a gateway into or out of smoking”.

What did they look at?
The researchers compared the sale and use of vapes with smoking rates and cigarette sales. The results from the United Kingdom were compared with the United States (where vapes are still legal) and Australia (where nicotine ecigs are banned).
They also considered results looking at the sale and use of heated tobacco products in South Korea and Japan and the sale and use of tobacco-free oral nicotine products in Sweden.

What did they find?
Where vapes are freely available (the UK), a rise in sales can be mapped against a drop in smoking, whereas where they are restricted (Australia) the decline in smoking is much less – leading the team to say that allowing ecig products to be sold “seems to have been linked with lowered rather than increased rates of smoking”.

Professor Peter Hajek commented on the findings: “The results of this study alleviate the concern that access to e-cigarettes and other low-risk nicotine products promote smoking. There is no sign of that, and there are some signs that they in fact compete against cigarettes, but more data over a longer time period are needed to determine the size of this effect.”

Professor Lion Shahab added: “This comprehensive analysis provides reassurance that countries which have adopted a more progressive stance towards e-cigarettes have not seen a detrimental impact on smoking rates. If anything, the results suggest that – more likely than not – e-cigarettes have displaced harmful cigarettes in those countries so far.”

Dr Jamie Hartmann-Boyce was not part of the research project but is a recognised expert in this area of research. She commented: “This is a well-conducted study that is consistent with some other studies in this area which suggest that – at a population level – e-cigarettes do not appear to increase smoking rates and may possibly decrease them.”

Scientists need huge levels of evidence in order to categorically state there is no gateway effect, so they couch their terms to illustrate a relative level of confidence. In plain English, there is no evidence supporting claims of a gateway effect and strong evidence to say there isn’t.