A Colorado State University faculty member was involved in a new study showing that teens who use e-cigarettes are more likely to start smoking combustible types of tobacco products, like cigarettes, cigars and hookah.
Nathaniel Riggs, an associate professor in the Department of Human Development and Family Studies, co-authored a paper about the study that appeared on Aug. 18 in the Journal of the American Medical Association.
That study, “Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence,” focused on 2,530 14-year-old students at 10 public high schools in Los Angeles who had never tried combustible tobacco. The researchers separated the students into two groups: 222 who acknowledged using e-cigarettes in the past and 2,308 who said they’d never tried them. Six months later, about 31 percent of the group that had reported using e-cigarettes said they had used a combustible tobacco product, while only 8 percent of the non-users had tried combustible tobacco.
“Sure enough, the kids who had used e-cigarettes were more likely to start using combustible tobacco,” said Riggs, a co-investigator who collaborated on the research design and data analysis for the project. “Results provide support for the hypothesis that e-cigarettes can be a stepping stone to combustible tobacco use.”
Growing health concern
Riggs said that while the use of e-cigarettes in Colorado is sometimes overshadowed by the legalization of marijuana, they represent an emerging public health concern.
“The perception is that e-cigarettes are less harmful because they contain fewer known carcinogens,” he said. “But they still contain nicotine, the addictive chemical which contributes to dependence. We are particularly concerned with adolescent nicotine use because the adolescent brain appears to be more susceptible to addiction than the adult brain.”
Exacerbating the problems with the growing popularity of e-cigarettes is that they can be flavored, making them even more appealing to youth.
Riggs, whose research expertise is in understanding adolescent brain development and its role in risk-taking behavior, said the study does not definitively mean that e-cigarettes caused the kids to start smoking, because other factors could be involved. But it’s a strong indication that e-cigarettes can act as a gateway.
He said one logical next step for the researchers is to examine the causal pathways linking e-cigarette use to combustible tobacco use.
“What is it about these youth, or their environments, that makes them more likely to transition to combustible use?” he asked.
The study was part of a larger project called the Health and Happiness Study, a five-year $3.5 million research grant funded by the National Institute of Drug Abuse. The principal investigator on the study was Adam Leventhal of the Department of Preventive Medicine at the University of Southern California.
Riggs has an appointment in the Colorado School of Public Health. The Department of Human Development and Family Studies is in CSU’s College of Health and Human Sciences.