Children who regularly vape are three times more likely to become smokers later in life, a bombshell report has claimed.
Figures have long shown how the proportion of kids using e-cigarettes has exploded amid the decline of traditional smoking, with more than a third of 16 to 18-year-olds now regularly inhaling them.
For comparison, less than one in ten were doing so a decade ago.
But British researchers now believe the gadgets could pose a worse threat to children than thought.
In the largest global review on vaping in young people to date, experts from the University of York and the London School of Hygiene and Tropical Medicine (LSHTM), found that vapers were also more likely to smoke more frequently and intensely.
Regularly using e-cigs could also increase the odds of respiratory illness and substance abuse, the scientists said.
However, other experts urged caution over the findings noting many of the studies assessed were merely observational and could not prove that vaping alone caused such health issues.
In the research, the scientists analysed 56 reviews on 384 youth vaping studies.
Britons are taking up vaping in unprecedented numbers, with roughly one in ten adults estimated to be hooked on the habit
Of these, 21 looked at use of e-cigarettes among young people and later cigarette smoking.
Writing in the journal Tobacco Control, the authors said the data available ‘consistently indicated a significant association between e-cigarette use and later cigarette smoking in young people’.
They said it was difficult to ‘infer causality’ from their review, but the ‘repeated strong associations in prospective cohort studies are consistent with a causal relationship’.
The analysis also suggested an increased risk among young people who vape of developing asthma or asthma exacerbation, they added.
Other harmful outcomes linked to youth vaping included pneumonia, bronchitis, lower total sperm counts, dizziness, headaches and migraines.
There was also a link identified between depression and suicidal thoughts among young vapers.
Dr Su Golder, associate professor in health science at the University of York, said: ‘The consistency in the evidence is striking.
‘Across multiple studies, young people who use e-cigarettes are more likely to smoke in the future. These findings support stronger public health measures to protect teens from the risks associated with vaping.’
Dr Greg Hartwell, clinical assistant professor at LSHTM, said: ‘We found consistent evidence around transitions to smoking which of course, in turn, opens the door to the multitude of harms that conventional cigarettes bring.
‘As the UK Government’s chief medical officer states, marketing vapes to children is always unacceptable, and our review shows exactly why further restrictions on the tobacco industry, who control the vaping market, are so important.’
Dr Rebecca Glover, senior author of the study, assistant professor at LSHTM, added: ‘Vaping is having a detrimental impact on the health of young people globally and vaping appears to be a gateway to other substances.
‘Our study provides the strongest evidence to date that young people globally face a serious range of physical and psychological harms from vaping and are at higher risk of transitioning to smoking.’
But other experts today, who weren’t involved in the research, labelled the findings ‘overspeculation’ and warned the studies analysed were observational or low quality.
Professor Ann McNeill, an expert in tobacco addiction at King College London, said: ‘It reported on 56 systematic reviews of which 53 were rated critically low or low quality, meaning authors should be extremely cautious before making any conclusions.
‘The authors reported that the reviews found consistently that vaping was associated with subsequent smoking.
‘This replicates the findings of many previous reviews and indeed research I have been involved in.
Campaigners have long blamed predatory manufacturers for the ever-growing crisis, claiming they are intentionally luring kids in with colourful packaging, compared to highlighter pens, and child-friendly flavours such as bubblegum and cotton candy
‘However, the authors incorrectly state that this supports “a causal relationship”.
‘in other words that vaping causes smoking—the so-called ‘gateway’ effect. It is well-established that consistency does not mean causality.’
Meanwhile, Dr Emma Beard, an associate professor in statistics and quantitative methods at University College London, said: ‘The conclusion that vaping acts as a “gateway” is an overspeculation, especially when the paper notes that at a population level, smoking rates have generally fallen as vaping has risen.
‘While protecting youth is vital, this review clearly shows the current evidence base on this topic has some significant weaknesses.’
E-cigs allow people to inhale nicotine in a vapour—which is produced by heating a liquid, which typically contains propylene glycol, glycerine, flavourings, and other chemicals.
Unlike traditional cigarettes, they do not contain tobacco, nor do they produce tar or carbon—two of the most dangerous elements.
Nicotine’s effect on the brain is well known—within 20 seconds of inhalation, it triggers the release of chemical messengers such as dopamine, associated with reward and pleasure.
But it also increases heart rate and blood pressure and makes blood vessels constrict. This is because nicotine triggers the release of the hormone adrenaline.
Despite NHS chiefs insisting it is safer than smoking, vaping is not risk-free. E-cigarettes can contain harmful toxins and their long-term effects remains a mystery.
Experts are also concerned the high nicotine content might increase blood pressure and cause other heart problems.
Last year, in world-first guidance setting out possible interventions to help people stop using tobacco products, the World Health Organization labelled the evidence around e-cigarettes as ‘complex’.
Vapes could not be recommended as way to stop smoking as too little is known about the harms and benefits, the UN agency said.
In June, in a bid to tackle the surge in youth vaping, it was made illegal for businesses to sell or supply single-use vapes, such as Elf bars and Lost Mary, in shops and online.
Only devices considered reusable—with a rechargeable battery and replaceable coil—are now allowed.
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