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Lisa Black

While cigarette smoking has been dropping in popularity among teenagers over the past couple decades, smoking remains a leading preventable cause of disease and death in the United States. Nicotine dependence keeps many adult smokers from quitting, and nicotine dependence from vaping is a reason why many teenagers start smoking, according to a new study, “Smoking Intention and Progression from E-Cigarette Use to Cigarette Smoking,” in the December 2020 Pediatrics (published online Nov. 9). In the study, among adolescents who had no intention of ever smoking, e-cigarette users were four times more likely to start smoking. Researchers studied 8,661 adolescents, ages 12-17, who reported never smoking cigarettes before they participated in the Population Assessment of Tobacco and Health Study, a U.S. nationally representative study of tobacco use. The study compared participant vaping and interest levels in smoking, among other factors, in 2014-2015 against smoking in 2015-2016. Researchers found that, of adolescents who reported that they had no intention of ever smoking in 2014-2015, 9.71% of e-cigarette users, compared to 1.51% of kids who said they would never vape, progressed to cigarette smoking a year later. Among adolescents who said that they had considered smoking in the future, 17.36% of e-cigarette users, compared to 10.04% of non-vapers, had started smoking by the next year. Researchers concluded that these findings are instructive for future adolescent smoking prevention efforts, because teenaged vaping can cause a teenager to start smoking, even when they have no prior intentions to do so, but that more research is needed to understand how e-cigarette vaping  progresses to cigarette smoking.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

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