Nearly 40% of teenagers who used e-cigarettes went on to smoke real cigarettes, new research published in JAMA Pediatric has revealed.
The American researchers found that 38% of e-cigarette users had started smoking traditional cigarettes within a year of starting, compared to only 10% who had not used an e-cigarette.
Recent research has suggested that vaping could be a way of breaking the habit and could save the NHS millions.
Yet the US study indicates that as e-cigarettes deliver nicotine more slowly than traditional cigarettes, users advance to cigarette smoking as they become tolerant of nicotine side effects.
Dr Brian Primack of the University of Pittsburgh said: “E-cigarettes are not subject to many of the laws that regulate traditional cigarettes, such as age limits on sales, taxation and labelling requirements.
“They also come in youth-oriented flavourings that laws have limited in traditional cigarettes, such as apple bubble gum and chocolate candy cane.”
Professor of pediatrics Dr James Sargent at the Geisel School of Medicine at Dartmouth added: “It also is notable that electronic cigarettes are marketed on television.
“This represents the first time in more than 40 years that a smoking-related device has been advertised on this medium, which has tremendous reach and could drive appeal of these products among youth.”
The study was the first to assess this relation in a national US sample of nearly 700 non-smokers aged 16-26. All participants were deemed to be 'non-susceptible' to starting traditional cigarette smoking at the beginning of the study, because they had responded 'definitely no' when asked if they would try a cigarette offered by a friend or believed they would smoke a cigarette within the next year.
However, 12 months later 38% of the baseline e-cigarette users had started smoking traditional cigarettes compared to only 10% of the youths who were not e-cigarette users.
“These differences remained statistically significant,” Dr Primack said.
The first set of surveys took place in 2012 and 2013 – before e-cigarette use rocketed. Latest figures from the US Centers for Disease Control and Prevention indicate that 13.4% of high schoolers are now using e-cigarettes, compared to just 4.5% in 2013.
The authors have urged the FDA to regulate the e-cigarette industry.