“Even if the evidence for a
gateway hypothesis were
stronger, it would not justify
a ban on the sale of nicotine
vaping products to adults”
The vaping to smoking gateway effect only makes sense if young
people are vaping nicotine e-liquid. However, research cited in
the evidence review found that many teen vapers used nicotinefree
e-liquid or vaped other things such as cannabis which could
not fairly be labelled as ‘vaping’ in this context.
But the big takeaway from the review is that vaping is far more
likely to be a gateway out of smoking than into it.
Mendelsohn and Hall cite a 2017 survey, which found that twothirds
of 12 to 17-year-olds who had ever vaped tried cigarettes
first. Meanwhile, the 2013-2016 US Population Assessment
of Tobacco and Health (PATH) study found that 85 percent of
current smokers aged 12 to 15 had not vaped before they tried
cigarettes.
Meanwhile, youth smoking rates have declined since vaping
became popular in 2014.
The gateway effect has been used to justify bans across the US,
particularly with regards to flavours and nicotine content.
Co-authors Colin Mendelsohn and Wayne Hall asked a
straightforward question: ‘Does the gateway theory justify a ban
on nicotine vaping in Australia?’
A 2019 study published in the journal Tobacco Control
aggregated smoking data from five different countries. It found
that the decline in past 30-day tobacco-use accelerated as much
as four-fold in teens and young adults.
In England which supports vaping for harm reduction, smoking
prevalence among 16 and 17-year-olds fell by 60 percent
between 2015 and 2019, according to the cited Smoking Toolkit
Study from 2019.
Gateway theory suggests that e-cigarette use leads to tobacco
use. However, the authors argued that the link could instead be
explained by a common liability model.
Mendelsohn and Hall concluded: “Even if the evidence for a
gateway hypothesis were stronger, it would not justify a ban on
the sale of nicotine vaping products to adults.
It’s pretty straightforward. Think back to your school days and
the kids your parents warned you about. Big Barry at the bike
sheds wasn’t just smoking cigarettes. He was drinking down
the park with his mates at weekends and engaging in some light
vandalism, too. He was just more of a risk-taker.
The researchers wrote: “Regular vaping by never-smokers is rare
and the association is more plausibly explained by a common
liability model.
“If there is a gateway effect, it is small at the population level
because smoking prevalence has continued to decline despite an
increased uptake of vaping in countries that allow it.”
“More proportionate regulatory policies could minimise youth
uptake while allowing adult smokers to access these products
for cessation or as a lower risk substitute for cigarette smoking.”
Regardless of what the experts say, Aussie vaping advocates
still face an uphill battle. The country’s historic distrust of the
tobacco industry has created scepticism of harm reduction
initiatives coming from adjacent industries.
The vaping gateway effect has been debunked by numerous
European experts. But if the US situation has taught us anything
it’s that expertise from within a nation’s own borders carries the
most weight when it comes to public policy.
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