E-cigarettes are expanding nicotine addiction in England, too

One of the arguments coming from Public Health England and the other e-cig cheerleaders there is that youth use is very low.

A new study using data collected in the UK between June 2015 and April 2016 of schoolchildren (mean age 14.1, n=499) shows that, like everywhere else, a substantial number of kids using e-cigarettes have never smoked cigarettes.  In fact, at 52.6%, this is the highest fraction of never smokers reported by adolescent e-cig users. 

This observation, combined with the substantially stronger gateway effect for smoking McNeill and colleagues reported in their longitudinal study of UK youth, may be another reflection of the likelihood that all the enthusiasm for e-cigs among much (but not all) of the British health establishment is recruiting kids to a lifetime of nicotine addiction.

The new paper is “More than half of adolescent E-Cigarette users had never smoked a cigarette: findings from a study of school children in the UK” by Fulton E, Gokal K, Griffiths S, Wild S ( Public Health. 2018 Jun 2;161:33-35. doi: 10.1016/j.puhe.2018.04.014. [Epub ahead of print]).

Here is the abstract:

OBJECTIVES:  Electronic cigarettes (ECs) are known for their use as a smoking cessation aid; however, experimental use in adolescence is a growing international concern. The proportion of adolescent EC users who have never used tobacco is rising. EC use is associated with later tobacco initiation in young people. Understanding adolescent beliefs about ECs is needed to inform public health campaigns and school education regarding the EC and the associated risks.

STUDY DESIGN:  A cross-sectional questionnaire-based design was used.

METHODS:  As part of a larger study, questionnaires to assess beliefs about ECs and current use were distributed to 499 school pupils aged 11-16 years in a county in England, UK.

RESULTS:  More than half of EC users had never used tobacco (52.6%), a substantially greater proportion than previously reported in the literature. Adolescents were aware that ECs were less harmful than tobacco but many were unaware that they contain nicotine and the subsequent risk of addiction could lead to later tobacco use.

CONCLUSIONS:  Given the possible association of EC use and later smoking initiation, education in schools may warrant greater emphasis on ECs, the role of nicotine and the risk of addiction associated with experimentation. Young people who deem ECs as a 'safe' option, and may otherwise have never experimented with tobacco, could be at risk of later tobacco use.

The paper is available here.