With the Food and Drug Administration recently opting to regulate e-cigarettes, one cannot but wonder about the health risks of using these devices, not to mention their role as a gateway to using other smoking products like tobacco cigarettes. Barrington-Trimis et al. (10.1542/peds.2016-0379) wondered about these questions as well and share the results of a prospective cohort of 11th and 12th graders using e-cigarettes as well as non-smokers (matched by gender, grade, and ethnicity) who were followed for almost a year and a half to determine if tobacco cigarette use ensued more from e-cigarettes than non-e-cigarette users.
Even when confounders were well controlled for, the use of e-cigarettes was an extremely powerful risk factor for using not just tobacco cigarettes but other smoking products including hookahs, cigars, and pipes—when a legal age was reached to buy these products. Most worrisome were those teens who at the start of the study said they had no intention to smoke, and then tried e-cigarettes only to move on to tobacco products
compared to non-smokers who did not try these products and never turned to tobacco in the next year and a half. If you are not asking your teens about their exposure to or use of e-cigarettes, this study is worth reading and sharing with your teen patients as a means of hopefully reducing their desire to experiment with e-cigarettes during their adolescence. Smoke out the information contained in this study—you’ll be glad you did.