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Are E-cigarettes A ‘Gateway’ To Teen Smoking? A New Study Investigates

Are E-cigarettes A ‘Gateway’ To Teen Smoking? A New Study Investigates

By Amina Khan, Los Angeles Times (TNS)

LOS ANGELES — Even though teenage smoking rates have plunged in recent decades, teen use of electronic cigarettes has been on the rise in the last few years. Now, a new study involving more than 2,500 students at 10 Los Angeles schools has found that teens who began using e-cigarettes were far more likely than their peers to start smoking traditional cigarettes and other combustible tobacco products.

Although they don’t establish a causal link, the findings published in the Journal of the American Medical Association have some experts worrying that e-cigarettes might lead more young people to take up the habit.

“What is extremely worrisome is that these findings further indicate that e-cigarette use by our nation’s youth, which is a major concern in itself, may also be a gateway to smoking,” American Heart Association Chief Executive Nancy Brown said in a statement. “This new study truly underscores just how dangerous of a habit e-cigarette use can be, especially if it is leading to teens taking up additional tobacco products.”

E-cigarettes heat a liquid laced with nicotine and other chemicals to generate a vapor that can be inhaled. That method, known as “vaping,” presumably sounds better than traditional combustible tobacco products, which are burned to produce a smoke filled with chemicals, many of which are known to cause cancer. The problem is, there isn’t enough evidence yet to say whether, on balance, the devices are helpful or harmful, scientists say.

“E-cigarettes raise many questions for which there are few answers,” Dr. Nancy Rigotti of Massachusetts General Hospital, who was not involved in the paper, wrote in an editorial. “The evidence base is limited because e-cigarettes entered the marketplace without being regulated as either drugs or devices.”

Many think that e-cigarettes might allow smokers to transition away from traditional cigarettes, which contain cancer-causing substances. Others argue that e-cigarettes, which often appear to be marketed to youths, could act as a sort of “gateway device” into smoking traditional cigarettes, full of those carcinogenic materials.

That’s a serious matter, given that nearly 90 percent of adult cigarette smokers first started smoking before age 18, according to the Centers for Disease Control and Prevention. A recent study showed that the number of high school smokers tripled from 2013 to 2014, and another showed that teens who vaped also smoked regular cigarettes.

But such studies have looked at a snapshot of these two behaviors, and have not watched to see how they change over time _ which would better describe the relationship between the two activities.

So for this study, a team led by researchers at the University of Southern California’s Keck School of Medicine tracked the behavior of 2,530 students attending L.A. high schools who said they had never before used any combustible tobacco products. The scientists focused on high school freshmen, given that ninth-graders, fresh out of middle school and now exposed to new pressures and older adolescents, are at a critical turning point in their lives.

“The first year of high school is a vulnerable period for initiating risky behaviors,” the JAMA study authors wrote.

The researchers asked the students whether they had ever tried e-cigarettes _ 222 had already tried e-cigarettes at that time. Then they followed up six months later and 12 months later to see if they had ever smoked regular cigarettes or other tobacco products (including cigars and hookah) during the previous six months.

The scientists found that 30.7 percent of students who had ever used e-cigarettes at the start of the study had also used combustible tobacco products at the six-month mark. In the same time period, only 8.1 percent of those who had never used e-cigarettes at the start of their freshman year had smoked tobacco. This pattern held at the 12-month mark as well.

The findings show a link between the two habits, but not a cause. That means it’s possible that there’s some other underlying factor that might be contributing to both behaviors. And the results can’t distinguish between students who may have just tried a few cigarettes and those who ended up as regular smokers, Rigotti noted.

“The latter is the greater concern, and the current study cannot determine whether e-cigarette exposure was associated with that outcome,” she wrote. “Similarly, the single exposure measure, lifetime e-cigarette use, did not permit the authors to look for a dose-response relationship between the degree of prior e-cigarette use and subsequent smoking, which could have strengthened a causal inference.”

Further work will be needed to determine whether there is a cause-and-effect relationship between vaping and smoking, the study authors said.

Regardless, experts said, this doesn’t mean that children should be taking up e-cigarettes at all. But many e-cigarette products appear to be marketed toward youths, they added.

“Knowing the long-term consequences of tobacco use, it is mind boggling to think that anyone would assume e-cigarette use is acceptable among children, when for many it can function as an entry drug,” Dr. Kim Allan Williams, president of the American College of Cardiology, said in a statement. “This research provides one more piece of evidence that what common sense tells us is likely true: inhaling an addictive chemical is not good for anyone.”

Brown, of the American Heart Association, urged the federal government to take action to regulate the products.

“These findings are yet another wake-up call to the Food and Drug Administration that final regulations are needed now to protect our kids from tobacco,” Brown said in a statement.

(c)2015 Los Angeles Times. Distributed by Tribune Content Agency, LLC.

Study: Many Teens Who Use E-Cigarettes Also Smoke Regular Cigarettes

Study: Many Teens Who Use E-Cigarettes Also Smoke Regular Cigarettes

By Karen Kaplan, Los Angeles Times (TNS)

Public health experts fear electronic cigarettes — with their colorful designs and array of sweet flavorings — will induce young people to start smoking. But are those fears justified? A new study from Wales offers mixed results.

Researchers found that 5.8 percent of preteens surveyed said they had used e-cigarettes, and nearly two-thirds of them had tried the battery-powered devices only once. By comparison, fewer than 2 percent of the 10- and 11-year-olds in the same survey had tried regular cigarettes, with about half of them describing themselves as current smokers, according to a report published Wednesday in the journal BMJ Open.

Although the overwhelming majority of kids in this age group had never smoked anything, there was a concerning overlap among kids who had tried electronic and traditional cigarettes. For instance, compared with those who had never smoked traditional cigarettes, those who had were 16 times more likely to have tried e-cigarettes as well. Likewise, the small number of kids who were current smokers were 17 times more likely than their nonsmoking counterparts to have used e-cigarettes too.

Both types of smoking were more popular among an older group of students between the ages of 11 and 16. In this group, 12.3 percent had tried electronic cigarettes and 1.5 percent used them at least once a month. In addition, 12.1 percent had used regular cigarettes, including the 5.4 percent who were current smokers.

Once again, researchers found a link between use of electronic and tobacco cigarettes. Four out of five of those who used e-cigarettes regularly had also tried traditional cigarettes. And compared to nonsmokers, current tobacco smokers were more than 100 times more likely to smoke e-cigarettes as well.

Still, even in this older age group, 43.2 percent of kids and teens who described themselves as regular users of e-cigarettes said they were not current tobacco smokers. And among the kids and teens who had used e-cigarettes just “a few times,” 72.1 percent were not current tobacco smokers.

The study was based on data from two different surveys — one involving 1,601 primary school students who were 10 or 11 years old and another that included 9,055 secondary school students between the ages of 11 and 16.

When all the data was put together, a pattern emerged: Electronic cigarettes were more popular than traditional cigarettes up through the ages of 15 and 16, when the kids were in school-year 11. After that, tobacco smoking became more common.

In school-years 6, 7, and 8 — when kids were between the ages of 10 and 13 — the majority of those who had tried e-cigarettes had not tried tobacco. School-year 9 (ages 13 and 14) was the tipping point, with half of those who had used e-cigarettes at least once saying they had also used traditional cigarettes at least once. Among older teens, the majority of those who had used e-cigarettes had also used tobacco.

One thing seemed quite clear from the data: Teens were not using e-cigarettes to help them kick their tobacco habit. The fact that current smokers were just as likely to use e-cigarettes as were people who had smoked just a few times “indicates that young people are not adopting e-cigarettes as an effective means of quitting tobacco,” the researchers wrote.

(c)2015 Los Angeles Times, Distributed by Tribune Content Agency, LLC

Photo Credit: AFP/Jim Watson

Smoking May Increase Suicide Risk, Study Says

Smoking May Increase Suicide Risk, Study Says

By Monte Morin, Los Angeles Times

LOS ANGELES — It’s well-known that cigarettes are bad for your health, but does smoking make you more likely to kill yourself too?
In a paper published this week in the journal Nicotine & Tobacco Research, authors argued that smoking and suicide may be more closely related than previously thought.

The researchers analyzed suicide rates in states that aggressively implemented anti-smoking policies from 1990 to 2004 and compared them to suicide rates in states that had more relaxed policies.

Those states that imposed cigarette excise taxes and smoke-free air regulations had lower adjusted suicide rates than did states with fewer anti-smoking initiatives, authors wrote.

“There does seem to be a substantial reduction in the risk for suicide after these policies are implemented,” said lead study author Richard Grucza, a psychiatric epidemiologist at Washington University School of Medicine in St. Louis.

“For every dollar in excise taxes there was actually a 10 percent decrease in the relative risk for suicide,” Grucza told Washington University BioMed Radio. “The smoke-free air policies were also very strongly associated with reduced suicide risk.”

Study authors said that states with lower taxes on cigarettes and more lax policies on public smoking had suicide rates that were up to 6 percent greater than the national average.

This is not the first study to document a correlation between cigarette smoking and suicide, but it is among the first to suggest smoking and nicotine may be specific factors.

Up until now, researchers believed smoking coincided with suicide because people with psychiatric problems or substance abuse problems were more likely to smoke as well as to commit suicide.

“Markedly elevated rates of smoking are found among people with anxiety disorders, alcohol and drug dependence, schizophrenia, and other diagnoses, in both clinical and general studies,” authors wrote. “However, it is also possible that smoking is not merely a marker for psychiatric disorders, but rather directly increases the risk for such disorders, which in turn increases the risk for suicide.”

Grucza said that the imposition of anti-smoking rules presented the researchers with a naturally occurring experiment. However, the authors did note that there were limitations on their research.

In particular, they said that since they considered state-imposed anti-smoking efforts only, their research would not account for local-level policies aimed at smoking behavior.

“While further studies may be required to establish a compelling weight of evidence, this study provides strong epidemiological support in its favor of the proposition that smoking is a casual risk factor for suicide,” authors wrote.

Photo: DucDigital via Flickr

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Cigarette Giant Reynolds American In Talks To Acquire Rival Lorillard

Cigarette Giant Reynolds American In Talks To Acquire Rival Lorillard

By Andrew Khouri, Los Angeles Times

Cigarette-maker Reynolds American Inc. said it’s in talks to acquire Lorillard Inc., a deal that would combine the nation’s second- and third-largest tobacco firms.

After months of unconfirmed reports, the two cigarette makers acknowledged the talks Friday. If completed, the deal would create a tobacco behemoth, one with a strong foothold in the increasingly popular electronic cigarette market.

The companies, two of the nation’s oldest, had more than $13 billion in combined sales last year.

Reynolds American, the nation’s second-largest tobacco company, produces the Camel and Pall Mall cigarette brands. Greensboro, N.C.-based Lorillard owns Newport, the popular menthol brand. And it has a strong presence in e-cigarettes with its blu and Skycig brands.

Reynolds, of Winston-Salem, N.C., also owns the e-cigarette brand Vuse.

The companies said there was no guarantee a deal would be reached.

If they combine, Reynolds, founded in 1875, and Lorillard, in 1760, would likely prove a strong challenger to Altria, the nation’s largest tobacco maker and parent of Philip Morris.

Also on Friday, the United Kingdom’s Imperial Tobacco Group said discussions are underway with Reynolds and Lorillard to acquire some of its brands and assets.

AFP Photo/Daniel Barry

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