Are Vapes a Gateway to Smoking?

Selya says that electronic nicotine delivery systems (vapes) offer “a substantial harm reduction opportunity for adults who smoke and are unlikely to quit.”

However, she goes on to state, there are those who harbour major concerns about vaping and the use of vapes by non-smoking teens. This comes as no surprise given the basis of the Tobacco and Vapes Bill is set around combatting teen vaping. In particular, she says, opponents are concerned about the potential for vaping to act as a “gateway”, leading non-smoking youths to cigarette smoking. 

“Evidence for the gateway hypothesis can be interpreted in alternative ways”, she adds, pointing out that it can be argued that non-smoking teens who initiate vaping were probably already predisposed to risky behaviours and would likely have begun smoking anyway – a “common liability” explanation.

In her paper, Arielle Selya aims to provide an evaluation of the gateway hypothesis that is accessible by a lay audience – i.e. us. 

“This paper first reviews and evaluates the evidence interpreted as supporting the gateway hypothesis. Important alternative explanations (i.e., common liability) are discussed, as are different types of evidence (i.e., population-level trends) that can help differentiate between these competing explanations,” she writes.

Arielle says that evidence for the gateway hypothesis, “is based on the finding that youth who [vape] are more likely to also smoke cigarettes. However, this evidence suffers from an important flaw: these studies fail to fully account for some youths’ pre-existing tendency to use products containing nicotine, and inappropriately interpret the results as [vaping] causing some youth to smoke. Common liability studies suggest that [vaping] does not, in and of itself, directly cause youth to later smoke cigarettes, beyond their pre-existing tendency to use products containing nicotine. Population-level trends show that youth cigarette smoking declined faster after [vaping] became common, which contradicts the central prediction of the gateway hypothesis (i.e. that youth smoking would be more common following [vapes] uptake, than otherwise be expected).”

At the end of the comprehensive piece, Arielle concludes that the evidence offered up in support of the gateway hypothesis by those opposed to vaping and tobacco harm reduction does not establish that taking up vaping is the cause of teens going on to initiate smoking.

“Instead,” she says, “this evidence is better interpreted as resulting from a common liability to use both [vapes] and cigarettes. Population-level trends are inconsistent with the gateway hypothesis, and instead are consistent with (but do not prove) [vapes] displacing cigarettes. Policies based on misinterpreting a causal gateway effect may be ineffective at best and risk the negative unintended consequence of increased cigarette smoking.”

Arielle Selya works for Pinney Associates. 

On its website, the company highlights: “Our clients have successfully switched numerous products that make a difference in people’s lives, and ensured important OTC products have remained available to consumers.

“At the same time, we’ve smoothed the path to regulatory acceptance for clients in the prescription medicines sector; dietary ingredients and supplements category; and in tobacco harm reduction.”

Rather than focussing on the evidence Pinney Associates employees have produced, the Bloomberg funded Tobacco Tactics website focuses on sources of funding.

The paper is very accessible for those interested in finding out more about the arguments surrounding the gateway arguments and can be found at the link below.

References:

• The “Gateway” hypothesis: evaluation of evidence and alternative explanations - https://link.springer.com/article/10.1186/s12954-024-01034-6

Photo Credit:

• Photo by Rae Tian on Unsplash

Dave Cross

Journalist at POTV

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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.