Are E-Cigarettes Displacing the Real Thing?

As more teenagers vape, fewer smoke.


Survey results released last week indicate that use of electronic cigarettes by American teenagers continues to rise, even as their use of conventional cigarettes continues to fall. You might think these diverging trends would give pause to critics who worry that e-cigarettes are "reglamorizing" the old-fashioned, combustible kind. Yet opponents of vaping seem undeterred by reality's failure to match their predictions. Longtime anti-smoking activist Stanton Glantz recently told USA Today "there's no question that e-cigarettes are a gateway to smoking."

If e-cigarettes were "a gateway to smoking," you would expect to see people try them first, then move on to traditional cigarettes. But according to a recent review in the journal Addiction, "Regular use of [e-cigarettes] by non-smokers is rare, and no migration from [e-cigarettes] to smoking has been documented." Such migration would not necessarily show that vaping encourages smoking, since people predisposed to smoke may be especially likely to try e-cigarettes. But if Glantz were right, this sequence would be common.

Furthermore, if Glantz were right, the rising popularity of e-cigarettes would be accompanied by increased consumption of conventional cigarettes. But except for one study showing vaping and smoking rising in tandem among Polish teenagers, there seems to be no evidence this is happening. It certainly is not happening in the United States, where smoking rates among teenagers have reached record lows as more and more of them have tried e-cigarettes.

This year the government-sponsored Monitoring the Future (MTF) Study, which has been asking teenagers about their drug use since 1975, asked them about e-cigarettes for the first time. It found that "more teens use e-cigarettes than traditional, tobacco cigarettes or any other tobacco product." Specifically, MTF numbers published last Tuesday show that 8.7 percent of eighth-graders, 16.2 percent of 10th-graders, and 17.1 percent of 12th-graders reported using e-cigarettes in the previous month.

By comparison, the National Youth Tobacco Survey (NYTS), sponsored by the U.S. Centers for Disease Control and Prevention (CDC), last year put the prevalence of past-month e-cigarette use among all high school students at 4.5 percent. Although the two surveys are not directly comparable, the gap suggests that past-month e-cigarette use by teenagers, which according to the NYTS tripled between 2011 and 2013, continues to climb. We will have a clearer idea of the trend when the 2014 NYTS data are released next year.

"The numbers are stunning," Matthew Myers, president of the Campaign for Tobacco-Free Kids, told The New York Times. The increase in the percentage of teenagers reporting e-cigarette use is indeed dramatic. But Michael Siegel, a professor of public health at Boston University who blogs about tobacco policy, points out that past-month use may be little more than experimentation. In a 2013 survey of high school students in Hawaii, 18 percent reported past-month use, but only 2 percent reported daily use.

In any case, higher vaping rates are not associated with higher smoking rates. The prevalence of past-month e-cigarette use in the Hawaii survey was four times the nationwide rate indicated by the 2013 NYTS. Yet the past-month smoking rate among teenagers in Hawaii was just 7 percent, about half the national average.

In the MTF survey, the "stunning" rates of past-month e-cigarette use that worry Matthew Myers coincided with the lowest past-month smoking rates seen in the history of the study: 4 percent among eighth-graders, 7.2 percent among 10th-graders, and 13.6 percent among 12th-graders. Daily smoking also was less common than ever before. It was reported by 6.7 percent of high school seniors, down from 26.9 percent in 1975, when the study started, and 12.3 percent in 2007, when e-cigarettes were first marketed in the United States. The NYTS and the CDC's National Youth Risk Behavior Survey show similar downward trends in smoking.

Although activists like Glantz and public health officials like CDC Director Tom Frieden worry that e-cigarettes "could become a gateway for young people to take up real cigarettes," notes New York Times science reporter Sabrina Tavernise, "that does not seem to be happening." Far from showing that e-cigarettes are training teenagers for the real thing, the fact that vaping and smoking rates are moving in opposite directions suggests that e-cigarettes may be replacing combustible cigarettes among people who otherwise would be smoking.

The MTF data provide some additional support for that hypothesis. Among the 12th-graders who said they had ever smoked a cigarette, for example, 17.5 percent said they had used only cigarettes in the previous month, 16.7 percent said they had used only e-cigarettes, 21.5 percent said they had used both, and 44.3 percent had used neither. This pattern suggests that e-cigarettes may be helping some adolescent cigarette smokers cut back or quit. Even when teenagers try e-cigarettes first, some of them might otherwise have smoked the conventional kind. The upshot in both cases would be the same: less smoking and less tobacco-related disease, something anti-smoking activists like Glantz ought to welcome.

As Tavernise notes, "most experts agree that e-cigarettes are far less harmful than traditional cigarettes." That is why the crucial question, when it comes to assessing the public health impact of e-cigarettes, is whether they compete with tobacco cigarettes or somehow expand the market for them. The evidence so far indicates that more vaping means less smoking, not the other way around.

This article originally appeared at Forbes.com.

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  1. Moderately off topic… I’m a recreational hookah smoker. Bare minimum, once a day. Sometimes more than that. One of my smoking buddies started hookah and cigarettes at the same age. Within a year, he quit cigarettes because he could already tell a difference in his health. He said he’ll give up the pipe when he also notices health effects. That was almost 10 years ago.

    Anecdotal, I know, but I felt it was worth mentioning. The e-cig trend has been interesting to follow even though I’m not a user.

    1. I did hookah on occasion through college. Definitely a different effect than cigs. The only long term effect of hookah was that I would be extra thirsty the next morning. I smoked a grand total of 1 cig before saying “fuck that” and never smoking again. It was dirty, tasted terrible, and I felt horrible the next day. I was blitzed at the time, and the experience seared itself into my memory. I hardly remember the weekend, except for that awful cigarette.

  2. Survey results released last week indicate that use of electronic cigarettes by American teenagers continues to rise, even as their use of conventional cigarettes continues to fall.

    Great. We finally start getting teens off the tobacco through our hip PSA’s and and even hipper sin taxes and e-cig pushers come along and give them a new addiction!

    1. They’ll all be sexting each other and playing video games filled with loose women before you know it!

  3. “… seem undeterred by reality’s failure to match their predictions.”

    Alex, what are AGW proponents?

  4. Longtime anti-smoking activist Stanton Glantz recently told USA Today “there’s no question that e-cigarettes are a gateway to smoking.”

    Again with the “gateway”.

    Obviously mothers’ nipples are to blame for most of these oral fixations.

    1. “Obviously mothers’ nipples are to blame for most of these oral fixations.”

      Big breast-feeding is to blame!

      1. Yep. Can you believe there are those who would allow it in *public*?!

      2. ” Big breast-feeding”

        Go on…

  5. Given the Anti-Tobacco Crusaders’ propensity for hysteria, hyperbole, and outright lying, I wouldn’t trust any statement they make about vaping, e-cigarettes, teen smoking, or whether the sun will rise in the morning. Certainly nothing published after the mid-1970’s, which is when they seem to have gone completely off the rails.

    Since smoking is illegal for teenagers, why do we trust any survey that claims to track it? Why would they tell any authority figure the truth, if they were breaking the law? From the reports I get on how public school functionaries behave I have to say that by high school I expect any but the most sheeplike students (who aren’t likely to smoke) will have learned the lesson that you NEVER TRUST THE MAN. THey will have been told so many times that “Answers are confidential” only to have those answers come back to haunt them that they will simply tell the surveyors ether A) what they think the surveyors want to hear or B) what they think thy can get away with that will screw with the system.

  6. Yeah I saw this bozo from U Michigan on a HuffPo live who did this study and he said, “we just don’t know how many kids are going to move from e-cigs to regular cigs in the future because e-cigs are new. There is a strong concern that this will be a gateway for our children.”

    I am biased against cigarettes, but I don’t know any right-minded person who would switch from e-cigs to cigarettes, at least not permanently. I do know many people who done the reverse. You’re not even allowed to smoke cigarettes anywhere.

    1. I do know many people who done the reverse. You’re not even allowed to smoke cigarettes anywhere.

      Yeah that would be me. I started vaping when they first hit the USA. Even then with crappy products you could only get online, it was better. Now, with local stores and quality products… my thirty year cig habit is becoming a distant memory.

      Some days I really miss the feeling of coughing and hacking, running out of air, spitting up phlegm, and the bonus of being able to identify my clean clothes by smell. Great times…

  7. “there’s no question that e-cigarettes are a gateway to smoking.”

    I think he has that backwards. Cigarette smoking is clearly a gateway to vaping.

    1. No, he doesn’t have that backwards. That would imply that he made a mistake. He’s an Anti-Smoker; he is saying anything he can think of to keep the Crusade alive. Think of him as a spokeman for the Anti-Saloon League; any lie, any fBrication, is justified if it further’s The Cause.

      Not that that attitude is unique to the Anti-Smokers.

      1. Which is why crusaders like this aren’t really concerned about stopping smoking, they are concerned about their own power, influence and livelihoods.

        The urge to save humanity is almost always a false front for the urge to rule.

        H. L. Mencken

        1. I will grant the Anti-Tobacco nut this much grace; I don’t think they realize that their stated motives are a false front for a thirst for power. They have convinced themselves that The Know Better, and are just doing what they do For Our Own Good.

          Whether that makes them better or worse than the run-of-the-mill power-grabber, I leave to history.

          1. I will grant the Anti-Tobacco nut this much grace; I don’t think they realize that their stated motives are a false front for a thirst for power.


            There will come a time when Stanton Glantz and those like him are surrounded by stupid and/or morally filthy people whom they despise and they will either wonder how it came to this and bail out or realize where it’s going and double-down.

            There are/were parts of the AGW movement that were similar. Scientists who were varying levels of practical about realizing that their ‘science’ was no more sound than any given economic or political model that stood in contrast/opposition.

      2. Search this;
        “Tobacco settlement board warns against complacency”

        Checko said;
        “We have to stay vigilant and continue to have programs that prevent and control.”

        Referring to autonomy choices imposed on others in deliberate ignorance of their human rights?

        A fanatic once entitled will never give up their 15 minutes of fame at least not willingly, until their irrelevance and insanity becomes the topic of normal discussion. With remedial actions or medications to cure those irrational behaviors, now evolving as the more imperative activity, to serve the common good.

        Tick Tock…

  8. The sooner society stops listening to Stanton Glantz the better off society will be.

    Fuck that guy.

  9. $6370 , I didnt believe that my brother was realy earning money in there spare time at their computer. . there moms best frend had bean doing this for less than seventeen months and by now repayed the loans on their cottage and got a brand new Porsche 911 .
    navigate to this site ==—-==—- http://www.jobsfish.com

  10. Help me out, please.

    Can an e-cig be used to consume anything else? I saw a caffine vape thingies, with no nicotine or tobbacco. I am also aware of marijuana infused “e-cigs” etc.

    What else is there, and are they interchangable?

    1. I’ve been told that some meth users about an hour west of us have made a meth/vape. I’ve heard rumors of THC being liquified.

      I’ve never actually seen anything like that though. It’s always a rumor told by a friend of a friend of a friend.

      I think if it were true, it’d be common knowlege.

  11. What is so important to these Public Health agencies, crusaders, religious zealots [of what the define as science and not politics] and US Government departments; that they would all exchange their own personal autonomy rights and recognition in law, that they are cognizant and coherent, all priceless possessions, given away willingly, just for the success of this, openly admitted financially corrupted agenda?

    Nothing will re-glamorize smoking, more significantly, than the race to the bottom, perpetrated by fanatics being paid with tax dollars to lie. Or the payola scandal that exists in government agencies, utilizing public funds to purchase hate campaigns, promoting snake oil, in the form of gummy patchy medications.

  12. Start working from home! Great job for students, stay-at-home moms or anyone needing an extra income… You only need a computer and a reliable internet connection… Make $90 hourly and up to $12000 a month by following link at the bottom and signing up… You can have your first check by the end of this week…….


  13. I used to smoke, now I vape. It tastes better, and I know exactly how much nicotine is in the liquids. I can step down my intake until I am buying liquids that have 0 nicotine in them. It is a great alternative to smoking. Besides, there is no residual side-effects (bad breath, smelly clothes…).

  14. just before I saw the receipt which said $5461 , I didnt believe …that…my mom in-law woz like they say actually bringing in money in their spare time at there labtop. . there sisters roommate has been doing this 4 only about twenty months and by now paid the mortgage on there house and purchased themselves a Audi Quattro . this link………..www.netjob70.com

  15. Yea your not going to see me move to vaping to smoking! That is just crrrrayyyzie. I really hope they don’t ban e-liquid. I am addicted. Oh no I better not say that. Oh wait I can. I don’t use nicotine. I enjoy the flavors. Uh oh it is bubblegum I am vaping on! I am not a little kid though that don’t make sense lol Some of these articles are so wack.

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