Tejal Somvanshi
Young people who vape face three times higher risk of becoming cigarette smokers later, according to a major new study from researchers at the University of York and London School of Hygiene and Tropical Medicine.
The comprehensive review, published in the journal Tobacco Control, analyzed 56 reviews covering 384 studies on youth vaping – making it the largest global assessment of its kind. Researchers found consistent evidence linking e-cigarette use in teens with not just future smoking but a range of other health concerns.
“The consistency in the evidence is striking,” says Dr. Su Golder, Associate Professor in Health Science at the University of York. “Across multiple studies, young people who use e-cigarettes are more likely to smoke in the future.”
Beyond just starting to smoke, teens who vaped were found to smoke more frequently and intensely when they transitioned to cigarettes. The study also revealed connections between vaping and respiratory problems including asthma, coughing, and airway irritation.
Mental health impacts were another significant finding. The research pointed to associations between vaping and depression, anxiety, and suicidal thoughts in teens, though experts say more research is needed to fully understand this relationship.
The review also found that teen vaping often precedes use of other substances. “Vaping in young people often is followed by alcohol and marijuana use,” note the researchers. Many young vapers reported signs of nicotine dependence, including cravings and difficulty quitting.
Dr. Greg Hartwell, Clinical Assistant Professor at LSHTM, explains the significance: “Our review provides the most comprehensive picture to date on the range of risks vaping poses to young people. We found consistent evidence around transitions to smoking which, in turn, opens the door to the multitude of harms that conventional cigarettes bring.”
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While the researchers acknowledge more work is needed to establish direct cause-and-effect relationships, they argue the findings make a strong case for stricter policies to protect teens.
“These findings support stronger public health measures to protect teens from the risks associated with vaping,” says Dr. Golder, who called for marketing restrictions targeted at young people.
The UK government has announced plans to ban disposable vapes, with experts stressing the need for more comprehensive approaches including better enforcement, education, and support for young people already dependent on nicotine.
Industry representatives maintain that vaping products are intended solely for adult smokers as a less harmful alternative to tobacco. Dr. James Murphy from British American Tobacco disputes the gateway effect evidence, stating that vaping “has helped millions of adults move away from cigarettes.”
As Dr. Rebecca Glover, senior author of the study and Assistant Professor at LSHTM, notes: “Vaping is having a detrimental impact on the health of young people globally and vaping appears to be a gateway to other substances.”
Researchers are now calling for more long-term studies on vaping’s effects on brain development, cardiovascular health, and oral health to provide a fuller picture of potential harms.
