With electronic cigarette (e-cig) use on the rise, there are public health concerns that e-cig use may serve as a “gateway” product causing e-cig users to begin smoking cigarettes, especially among young people. Rather than e-cigs causing subsequent cigarette use, it may be that individuals who are likely to try e-cigs are also more likely than others to try cigarettes and other risky activities like marijuana use or heavy alcohol drinking.
[Photo: Ms. Megan Saddleson]
In a study recently published in Drug and Alcohol Dependence, researchers from the University at Buffalo’s School of Public Health and Health Professions, department of community health and health behavior (CHHB), examined factors associated with current and future e-cig use as well as the relationship between e-cig use and susceptibility to future tobacco cigarette smoking. Their findings show that involvement in risky health behaviors, such as tobacco use, marijuana use, and/or alcohol use, are associated with both trying e-cigs and with susceptibility to use e-cigs in the future. When investigating the possibility of e-cig use leading to future cigarette smoking, findings suggest the importance of considering other factors that may predict future cigarette smoking, such as previous use of non-cigarette nicotine or other tobacco products (i.e. cigars, hookah, snus), and participation in other risky health behaviors, such as alcohol and marijuana use.
“For this study, we considered factors (aside from e-cig use alone) that may lead e-cig users to start smoking. In addition, we were interested in influences associated with the use of e-cigs and what might lead non- e-cig users to begin using these products,” said Ms. Megan Saddleson, a doctoral candidate in CHHB.
The study reports low levels of daily smoking, just nine percent of current smokers smoked every day (one percent of the entire sample). Fifteen percent of students were current (past 30-day) e-cig users, 32 percent were currently using other tobacco products (non-cigarette), 53 percent binge drank in the past 30 days and 26 percent used marijuana in the past 30 days.
“We know that many people are concerned that use of e-cigarettes will cause people who would not otherwise have become smokers to start smoking. Our results suggest experimentation with multiple products and are supportive of a ‘common liability model,’ rather than a causal gateway model. A common liability model argues that individual characteristics are linked with risky behaviors and that certain individuals are at greatest risk to use multiple substances,” said Ms. Saddleson.
Researchers used data collected from a 2013 web-based survey from a sample of college students enrolled in introductory psychology courses across four universities in Upstate New York.
In addition to Ms. Saddleson, co-authors from the Department of CHHB at the UB School of Public Health and Health Professions include Dr. Lynn Kozlowski, Dr. Gary Giovino, and Dr. Gregory Homish. Co-authors outside of the Department of CHHB include: Dr. Larry Hawk, Department of Psychology at the University at Buffalo; Dr. Martin Mahoney, Departments of Medicine and Health Behavior at Roswell Park Cancer Institute in Buffalo, New York; Dr. Maciej Goniewicz, Division of Cancer Prevention and Population Sciences at Roswell Park Cancer Institute; Dr. Jill Murphy, SUNY Cortland’s Health Department; Dr. Brian Wrotniak, Center for Health Behavior Research at D’Youville College in Buffalo, New York; and Dr. Michael MacLean, Department of Psychology at Buffalo State College.