Organizations that oppose electronic cigarettes, such as the CDC and FDA, and anti-smoking advocates who oppose these products, like Dr. Stanton Glantz, have been arguing that electronic cigarettes are a gateway to youth smoking. The CDC has gone so far as to claim that its own survey demonstrates that youth are starting with electronic cigarettes and then moving on to smoke real tobacco cigarettes. The CDC has warned the public that e-cigarettes lead to a lifetime addiction to smoking among our nation's children.
Fortunately, there is a simple way to evaluate this hypothesis, at least on a preliminary basis, prior to waiting for the results of longitudinal studies. Enough youth are experimenting with electronic cigarettes, and the increase in youth e-cigarette use has been dramatic and sustained enough, that if the gateway hypothesis were correct, we would be starting to see an increase in smoking prevalence among youth due to the many new smoking initiates that were converted from e-cigarette experimentation to smoking.
The Rest of the Story
The rest of the story is that new data from the CDC itself show that the smoking rate among U.S. high school students dropped significantly in 2013, reaching the lowest level in the history of the survey (the Youth Risk Behavior Survey), which began in 1991.
Despite the tremendous proliferation of e-cigarette experimentation among youth, with a doubling of use from 2011 to 2012 alone, the CDC data show that youth smoking prevalence (among high school students) fell dramatically, from 18.1% in 2011 to 15.7% in 2013. This is a 13.3% decline in smoking prevalence over a two-year period. It is also the largest drop in youth smoking prevalence measured by this survey over the past decade.
These data all but destroy the gateway hypothesis. They demonstrate that at the current time, the evidence simply does not support the assertion that the proliferation of e-cigarette use among youth is leading to increased smoking initiation. Electronic cigarettes are not leading to a lifetime addiction to cigarette smoking among our nation's youth.