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Recent findings indicate that U.K. adolescents who vape have a 33% greater likelihood of smoking cigarettes

Adolescents who frequently utilize e-cigarettes are just as likely as their counterparts from the 1970s to initiate cigarette smoking, despite a significant decline in teen cigarette usage over the past half-century, as indicated by a study co-directed by the University of Michigan.

Researchers from U-M, alongside colleagues from Penn State University and Purdue University, determined that teenagers who had never used e-cigarettes had roughly a less than 1 in 50 probability of smoking cigarettes weekly, while those who had previously vaped faced more than a 1 in 10 likelihood. Notably, adolescents who reported regular e-cigarette usage had nearly a 1 in 3 probability of also declaring current conventional cigarette use.

This study highlights trends in youth cigarette usage over time and how e-cigarettes influence these patterns. The findings were compiled from three longitudinal studies gathered by the Centre for Longitudinal Studies at University College London, which followed teens from three distinct U.K. birth cohorts.

The research appeared in the journal Tobacco Control and was funded by the National Cancer Institute, a segment of the National Institutes of Health, along with a seed grant from the Criminal Justice Research Center at Penn State University. The Centre for Longitudinal Studies received financial support from the Economic and Social Research Council for data collection.

“The surge in e-cigarette use and its spread have truly disrupted those positive trends and advancements. Among youngsters who have never tried e-cigarettes, we still observe those historical drops in risk,” remarked Jessica Mongilio, a research fellow at the U-M School of Nursing and one of the primary investigators of the study. “However, for those who engage in e-cigarette use, it seems as though all those policies and societal perceptions have had little effect, and they face a significantly high risk of smoking cigarettes.”

Over recent decades, the act of smoking cigarettes has transitioned from a once-glamorized status symbol to an undesirable and socially disapproved behavior, as per the researchers. This transformation was largely influenced by vigorous campaigns that branded cigarette smoking as a public health threat.

By the late 1990s and early 2000s, smoking was systematically and socially stigmatized, enshrined in national federal regulations and health policies. Subsequent research from the Centers for Disease Control indicates that youth cigarette smoking has declined to unprecedented lows in recent years.

Commonly known as vapes, e-cigarettes—often marketed in vibrant designs and fruity flavors—have rapidly gained traction as a perceived “safer” alternative to traditional cigarettes. According to researchers, they pose a challenge to decades of advocacy, health policy, and cultural aversion to smoking in both the U.K. and the United States.

The Millennium Cohort Study, or MCS, examined teens born in England, Scotland, Wales, and Northern Ireland during 2000 and 2001, who were children when e-cigarettes first hit the market. The British Cohort Study followed individuals born in 1970, who were teenagers in the 1980s when smoking was prevalent and in their 40s when e-cigarettes became available. Lastly, the National Child Development Study traced individuals born in 1958, who were young children at the peak of cigarette cultural acceptance.

“We analyzed data from various cohorts, essentially different generations living in the U.K., to assess their likelihood of weekly cigarette usage based on well-known risk and protective factors,” Mongilio explained. “For the most recent cohort, we also investigated how e-cigarette use influenced those probabilities.”

Mongilio and her associates emphasized it remains uncertain whether e-cigarette usage directly leads to cigarette use, but a strong correlation between the two is evident. The MCS cohort will continue to be monitored over time to explore how e-cigarette use during critical teenage developmental years may impact long-term health outcomes.

Ultimately, through the outcomes of this study, the researchers aim to illustrate the significant influence of e-cigarettes on contemporary youth as a means to advocate for impactful legislative, social, and economic reforms.

“The more evidence you accumulate—the larger the body of support—the more challenging it becomes to overlook. This will pave the way for policy reforms and stricter regulations regarding e-cigarettes and their manufacturers,” Mongilio stated. “I believe we are at a juncture where change is possible, and we must enhance regulations and ensure that those regulations are enforced for companies producing e-cigarettes.”

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