Cause and effect with vaping and smoking

Browsing through my colleague David McGeorge's latest round-up of research into young people and health (https://sheu.org.uk/resl), I came across a paper about how e-cigarettes and tobacco cigarettes may be adopted by young people (https://sheu.org.uk/content/how-effect-adolescent-e-cigarette-use-smokin...).
The message from the manufacturers has been that e-cigarettes are intended only to help adult smokers of tobacco cigarettes to quit.  Nonetheless, there have been concerns that e-cigarettes are being adopted by young people who don't use tobacco cigarettes, and might even be a route to trying tobacco cigarettes later.  This has now been shown to happen, and this latest research is a contribution to our understanding of how this works in at least one group of young people.
What can we learn from SHEU surveys?
A question that we have tried in a couple of local authority surveys is this one:

11. Have you ever tried vaping or smoking?

Vaping - includes using an electronic cigarette, e-cig, shisha pen, hookah pen 
Smoking - includes roll-ups & ready-made cigarettes.
Please select one answer

(_) Both
(_) Smoking
(_) Vaping
(_) Neither

(and if they answer Both...)

12. Smoking and Vaping: Which did you try first?

(_) Vaping
(_) Smoking
(_) I tried smoking and vaping at about the same time
(_) I don't remember

 
This relies on self-report and memory, so is not as good as a longitudinal study of the sort we have just seen, but the answers are interesting nonetheless.

The results looked like this:

    Vaping first      Smoking first I tried smoking and vaping
at about the same time
Other responses/
missing
Area 1 Year 8 20% 44% 7% 29%
  Year 10 22% 59%   7% 11%
Area 2 Year 8 45% 12% 0% 43%
  Year 10 49% 22% 4% 25%

The mix of causes and effects and possible pathways cannot be shown here, but some important points are:

  • where a student has used both e-cigarettes and tobacco, vaping can precede tobacco use (both areas)
  • vaping can precede tobacco use more often than the other way around (area 2 only)
  • young people in different communities may have very different patterns of adoption

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Author: 

DrDave