A new published research from the University at Buffalo and the University of Michigan says using E-cigarettes is not a likely a gateway to smoking.
Lynn Kozlowski - the paper's lead author and a professor of community health and health behavior in UB's School of Public Health and Health Professions - says research shows that as the use of e-cigarettes, or vaping, has increased, overall smoking rates have decreased.
"Our analysis focused on the risks of moving from e-cigarettes to cigarettes," said Kozlowski. "There is little evidence that those who have never smoked cigarettes or never used other tobacco products and first try e-cigarettes will later move on to cigarette usage with great frequency or daily, regular smoking."
The paper says many studies use misleading measures for what is considered smoking.
"Measures of 'at least one puff in the past six months' can mean little more than the experimenting vaper was curious how cigarettes compared," Kozlowski said.
According to co-author Kenneth Warner - the Avedis Donabedian Distinguished University Professor of Public Health in Michigan's School of Public Health - none of the studies followed up smoking intensity. He says all the participants said they only smoked one or two cigarettes in the past 12 months.
The study says e-cigarette flavorings are also important to note. Many young people say they vape with only flavorings and no nicotine.
Kozlowski and Warner say other studies have also failed to look at smokeless tobacco or paid attention to confounding issues, like alcohol and drug use and mental health issues. Researchers say youth who are experimenting with other substances are more likely to try e-cigarettes and combustible cigarettes.
"The evidence from the prospective studies is weak at best," said Warner. "All that it demonstrates is that there is a connection between kids who vape and future experimentation with smoking. But we know that these kids are different from those who do not vape. Even if there is a small gateway effect, it is totally swamped by the overall trend toward less and less smoking."
Both authors agree that the public deserves better, accurate information on the health risks of e-cigarettes versus cigarettes.
"From the best evidence to date, e-cigarettes are much less dangerous than cigarettes," said Kozlowski. "The public has become confused about this."
"The persistent focus on the potential risks to kids has caused adults' understanding of the risks of e-cigarettes to worsen over time," said Warner. "This is likely discouraging adult smokers from using e-cigarettes as a smoking cessation tool."