Vaping has become extremely popular among teens. While it has been shown to help cigarette smokers kick their habit, a 2016 survey shows that teens who vape are more likely to smoke traditional cigarettes if they use an e-cigarette or a vape pen.
Postdoctoral researcher and lead study author Jessica Barrington-Trimis told ABC News:
“Historically most adults who are smoking started smoking early in life.”
Barrington-Trimis said that most people who now smoke started before the age of 18, but the findings still came as a shock. She explained:
“We really weren’t expecting to see that much uptake. We found pretty high rates of initiation amongst e-cig users.”
University of Southern California (UCLA) researchers followed two groups of high school juniors and seniors, about 300 in all, who had never smoked before. There were few differences between the groups, except that one group vaped and the other did not. Approximately 16 months later, 40% of the vapers had started smoking traditional cigarettes, compared to just 10% of non-vapers.
The study also found that vapers were more likely to use hookahs, pipes, or cigars.
When the study began, the researchers asked the students if they were firmly committed to not smoking cigarettes. Of the students who said they were committed, those who vaped were more likely to start smoking cigarettes.
“These kids are expressing a pretty firm commitment not to smoke. E-cigarettes may be eroding this intention not to smoke, or introducing the kids to nicotine. But more research is needed; we don’t really have enough data to sort it out.”
She told CBS News:
“The increase in e-cigarette use, which may be followed by increases in cigarette use, could result in an erosion of the progress that has been made over the last several decades in tobacco control.”
She said the study didn’t examine whether the teens who reported trying cigarettes were just experimenting, or will go on to become regular smokers.
Gregory Conley, president of the nonprofit American Vaping Association, pointed out that teens are smoking less, and suggested that vaping is helping to keep kids from smoking traditional cigarettes.
He told ABC News:
“The fact that there is an association between a willingness to try a vapor product and later experimentation with smoking is neither new information nor particularly helpful in evaluating the public health impact of vaping. The bottom line is that as more teens have experimented with vapor products, youth smoking has experienced massive and unprecedented declines that no one predicted just five years ago.”
Cynthia Cabrera, executive director of the Smoke-Free Alternatives Trade Association, questioned the study’s results. She noted the continued decline in teen smoking and suggested that the researchers’ findings were wrong.
“The [methodology] is flawed and the data does not prove that e-cigarette use among teens prompted smoking with the study’s own authors concluding that the risk between vaping and smoking is unknown. The fact is there is no gateway effect between the two since the National Institute of Health’s Monitoring the Future (MTF) survey actually found decreases in teen smoking and e-cig use over the last two years, and just a few days ago, the CDC reported that smoking among teens has hit dramatic lows over the past two years.”
Other findings from the survey included:
- The risk of e-cigarette use may vary by age.
- New high school graduates face enormous social changes (jobs, college, adulthood), and have legal access to tobacco products. Teens who are vaping at the end of high school are 6 times more likely to use tobacco products by age 18.
The researchers concluded that follow-up is required to determine if e-cigarette use among young people will eventually lead to more established smoking patterns and increases in smoking-related diseases. Former CDC director Tom Frieden wrote:
“Current cigarette smoking is at an all-time low, which is great news. However, it’s troubling to see that students are engaging in new risk behaviors, such as using e-cigarettes. We must continue to invest in programs that help reduce all forms of tobacco use, including e-cigarettes, among youth.” 
In May of 2016, the FDA announced that e-cigarette products and other tobacco products, including hookahs and premium cigars, would be regulated in the same way as traditional cigarettes and smokeless tobacco. That includes making it illegal to sell e-cigarette products to people under 18. In California and New York City, the current smoking age is already 21.