Who vapes, who mutates into a smoker?



Young people who use e-cigarettes are more likely to use tobacco, it is said. The evidence is missing, but there is new evidence. They show that it is time to better protect teenagers.


Will the e-cigarette replace the glow stick in the long term? How dangerous is it to live as a steamer? And is the device perhaps not just the healthier alternative and therefore the solution for all smokers, but rather drives young people into nicotine addiction in the first place?

Answers to these questions abound - they are often as contrary as possible. Also because perspective is important; namely whether you measure the e-cigarette on the tobacco variant or abstinence. Even studies have so far not provided clear results. Anyone who cites a publication will immediately be told the opposite position. The alarm determines the discussion, not reason.


A current study now confirms what others have already hinted at: If you vape as a teenager, you will sooner use tobacco. The next round of debates is now open - a good thing. Because a stricter law is needed to protect teenagers.


200 million euros in sales of e-cigarettes


Electronic cigarettes produce a nicotine vapor instead of tobacco smoke. According to the Association of E-Cigarette Trade (VdeH), the number of German e-smokers has increased tenfold in the past five years from 300,000 to three million. The industry's turnover in 2014 was around 200 million euros. The market is still tiny compared to the traditional tobacco industry, but it is growing. And with it the concern that e-cigarettes are the new, big health risk for teenagers in Germany.

So far, children and adolescents have been allowed to buy e-cigarettes in this country. The products are not regulated by law, which health researchers, politicians and the VdeH criticize equally. In spring 2014, the European Parliament adopted a new tobacco directive to change that. The government must transpose it into national law by May 2016. The directive only covers nicotine-containing e-cigarettes, but the ban in Germany should be more comprehensive. The risks of steaming are too unpredictable, says Federal Minister of Family Affairs Manuela Schwesig.


According to the Association of E-Cigarette Trade, the number of German e-smokers has increased tenfold in the past five years from 300,000 to three million in 2015. At the same time, more than 18 million people still smoke tobacco cigarettes regularly. Around 110,000 of them die each year from the consequences.

There are still no representative data showing that e-cigarettes encourage adolescents to start smoking cigarettes. Rather, previous studies show that mostly smokers or former smokers use e-cigarettes ( see Meier et al., 2015 ). Evidence of vaping as an introduction to nicotine addiction is increasing ( Hughes et al., 2015 ). For example, this week in the JAMA magazine: "Teenagers who use e-cigarettes are more likely to start smoking" (Leventhal et al., 2015).

Preventive medicine doctor Adam Leventhal from the University of Southern California and colleagues interviewed students at ten public high schools in Los Angeles. A total of 2,530 young people should say how often and in what form they consume nicotine. At the beginning of the study, none of the 14-year-olds had smoked or vaped, six months later there were 222 e-cigarette users who would have used tobacco even more in the following six months than those who only used cigarettes would have decided.


In this case, the authors themselves emphasize that they do not provide an answer simply because of the study design, but only a contribution to an important debate. The team writes that anyone who gets to know e-cigarettes early on is at greater risk of becoming a smoker. According to medical doctor Nancy Rigotti from Harvard Medical School in Boston, it is "the strongest evidence so far that e-cigarettes could encourage adolescents to start smoking" (Rigotti, 2015).