Study: E-cigarettes increase smoking risk fivefold in adolescents

New research published in a leading public health journal shows that Australian teenagers who have used e-cigarettes are much more likely to then try smoking, with Australia’s youngest adolescents the most at risk.

Health experts say it’s a sobering reminder of the need for state, territory and federal governments to work together to fully implement and enforce Australian’s new e-cigarette reforms and protect young people.

The new study used Generation Vape survey data from over 5,100 teenagers in a retrospective cohort analysis that was published today in the Australian and New Zealand Journal of Public Health.

Lead Author Sam Egger from the Daffodil Centre, a joint venture between Cancer Council NSW and the University of Sydney, says the study is the first of its kind in Australia, using data collected in 2023, prior to recent e-cigarette reforms coming into effect.

“It’s the first Australian study to look at the relationship between teenage vape use and smoking over time, and across different ages. Even after accounting for other factors that could influence the likelihood that a young person would try vapes or tobacco, we found that teenagers aged 12-17 who had vaped are five times more likely to start smoking in the future than those who had not.

“The link was strongest for adolescents at the younger end of the 12 to 17 age range. The younger a person started using vapes, the higher their increased risk that they would subsequently try smoking. We found that 12-year-olds who had vaped were 29 times more likely to go on to try smoking than 12-year-olds who had not vaped.”

Associate Professor Becky Freeman, study supervisor from the University of Sydney, says that the study reinforces why the national e-cigarette reforms introduced this year were urgently needed and now need to be strongly enforced.

“When it comes to teenage smoking, up until recently Australia was an international success story. Our Australian teenage ever-smoking rates dropped from 58% in 1996, to 14% in 2023. But recent data has suggested a possible increase in teenage smoking over the same time period that e-cigarette use has exploded.

“Public health experts have warned that teenage e-cigarette uptake has the potential to undo the positive progress Australia has made in reducing smoking. This latest study shows how real that threat is.

“Young people don’t want to smoke. They’ve grown up seeing graphic health warnings on expensive cigarette packs and think smoking is unattractive and something from their parent’s generation. They view e-cigarette use as an entirely different behaviour to smoking and don’t know that they are more likely to take up smoking if they use e-cigarettes.”

Adjunct Professor Terry Slevin, CEO, Public Health Association of Australia, says that while public health experts have enthusiastically welcomed the Federal Government’s e-cigarette reforms, positive change won’t happen overnight.

“We strongly and enthusiastically welcomed the Federal Government’s e-cigarette reforms that passed Parliament in June this year, but the job is not done yet.

“We need to make sure that state and territory governments are harmonising their local legislation and enforcement with the Federal reforms. All levels of government will need to work together to protect young people.”

References:

The association between vaping and subsequent initiation of cigarette smoking in young Australians from age 12 to 17 years: a retrospective cohort analysis using cross-sectional recall data from 5114 adolescents” by Sam Egger, Michael David, Christina Watts, Anita Dessaix, Alecia Brooks, Emily Jenkinson, Paul Grogan, Marianne Weber, Qingwei Luo & Becky Freeman will be published in the Australian and New Zealand Journal of Public Health on 11 September 2024.

All articles are open access and can be found here: https://www.journals.elsevier.com/australian-and-new-zealand-journal-of-public-health