By Steve Birr
A leading expert in the field of tobacco harm reduction is criticizing a wave of recent studies claiming electronic cigarettes are a “gateway” to smoking as “bad science in service of bad theories.”
The media is currently saturated with headlines decrying alternative smoking technologies as “gateway” products that are hooking a new generation on combustible cigarettes. The hysteria is being fueled by tobacco control researchers with, “blind commitment to a bad theory,” says Dr. Carrie Wade, harm reduction policy director for the R Street Institute, in an editorial for Real Clear Science.
The ideological motivations behind anti-vaping zealots are, “negatively affecting the pursuit of improved public health,” according to Dr. Wade, and hampering what should be a united effort by public health officials to transition millions of smokers off deadly combustible tobacco products.
The recent studies claiming vaping leads to smoking only prove that youths experiment, and they cannot show the true cause behind teen smoking, which is at a record low.
“Hypotheses based on the gateway effect are rarely supported, and a rudimentary examination of what would be required to show that certain substances are gateways indicate that it’s nearly impossible to do so,” Dr. Wade says in the Real Clear Science editorial. “There are ways to minimize the initiation of risky behaviors, but prohibiting one product in hopes of decreasing the use of another should not be one of them. …At worst, people who would otherwise benefit from the reduced harm posed by the alleged gateway product – like e-cigarettes – are put at risk of relapsing to a more dangerous product – like their combustible counterparts.”
The “gateway” theory on vaping was previously debunked in a collaborative study by researchers at the University of Stirling and Public Health England; however, tobacco control crusaders continue to push the myth.
A recent study published in the journal Pediatrics by researchers at Yale University School of Medicine makes the bold claim that a teen who uses vape products within a 30 day period is seven times more likely to use combustible cigarettes than their peers. The study, conducted over a two year period, shows that while teens will experiment with a range of substances and products, no definitive link can be made between vaping and future cigarette use.
In fact, over the course of two years of observation, “the strength of the association between e-cigarettes and combustible cigarettes decreased,” contradicting the premise pushed by Yale researchers that e-cigarettes are a gateway product. Meanwhile, previous use of combustible cigarettes continued to be the strongest indicator of future smoking for teens.
“Unfortunately, we are not deprived of misleading research that threatens to steer users away from reduced-harm products, like e-cigarettes, and toward readily available yet more dangerous tobacco products,” Dr. Wade says in the editorial. “What no study can capture – and this study is no exception – is the population of youth that would smoke combustible cigarettes regardless of e-cigarette availability. Therefore, no study can demonstrate that e-cigarette use is necessary or sufficient to future combustible cigarette use.”
Dr. Brad Rodu, a professor of medicine at the University of Louisville, similarly called out researchers at the University of California San Francisco (UCSF) in a post on Tobacco Truth Jan. 3, saying they misrepresent the results of their recent federally funded study on vaping to give the impression the devices are luring teens to cigarettes.
The study used an analysis of the Population Assessment of Tobacco and Health (PATH) survey for 2013 to 2014 to analyze the habits of 9,909 young adults. The UCSF researchers followed up with the teens a year later to see how their tobacco and nicotine use changed.
Of the 9,909 young adults surveyed after one year, only 219 smoked cigarettes within 30 days of being asked by researchers. Of the 219 people who smoked after one year, 175 had not used hookahs, smokeless tobacco or vaping devices at the beginning of the survey, according to Dr. Rodu.
The vast majority of cigarette smokers after one year, according to the UCSF study pushing the “gateway” narrative, had not previously used an alternative smoking product.
“When the overwhelming majority of research does not support such a hypothesis, and the research that does draws weak conclusions, it would be egregiously irresponsible for us to craft public policies against the weight of evidence,” argues Dr. Wade. “We simply cannot let bad science in service of bad theories support public policies.”
Amid all the alarmism about teen use of e-cigarettes, as Dr. Wade points out, youth smoking is plummeting to record lows. The U.S. National Institute on Drug Abuse (NIDA) and the University of Michigan’s annual Monitoring the Future Survey released Dec. 14 shows that reported cigarette use among 12th graders fell to 4.2 percent this year, down from 24.6 percent in 1997, even as the number of youth experimenting with vaping devices increased.
Despite the onslaught of misinformation in the media on the supposed threats posed by vapor products, millions of former smokers in the U.S. are transitioning to the harm reduction tools and quitting combustible cigarettes. Roughly 2.62 million former smokers were using a vape in 2016.