Thursday 10 March 2022

The gateway effect myth that will never die

Vaping probably isn’t a gateway to smoking 
You mean people don't take up vaping and then suddenly decide to do something that is ten times more expensive and a thousand times more dangerous? Who'd a thunk it?

Young people who try vaping are more likely to later start smoking – but a new analysis of trends in nicotine use in England suggests that the so-called gateway theory of vaping isn’t the explanation.

The real reason for the link could be that teens who start vaping are the same ones who are likely to try smoking, regardless of whether they ever have an e-cigarette.

Indeed. This is the common liability theory. People with a propensity for risk-taking tend to take more risks than people who are risk-averse. This has always been the obvious explanation for the statistical correlation, such as it is, between vaping and smoking. 
Equally obvious is the fact that the rise of vaping has not led to a rise in smoking - quite the reverse. If a nonsmoking vaper is four times as likely to become a smoker - as one oft-cited study claimed - then the USA, in particular, should have seen a dramatic rise in teen smoking. Instead, it has seen a dramatic decline. 

So whilst it is perfectly possible that somebody somewhere started on e-cigarettes and then switched to tobacco, there are far more people who would have smoked but vape instead. 
And while it is impossible to prove there is no gateway effect, it is easy to show that any such effect is not worth worrying about. The authors of this new study looked at 16-24 year olds in the UK and found no association between vaping prevalence and smoking prevalence. 

For some reason, the New Scientist felt the need to ask an obese flat-earther what he thought about the study.

The findings may not convince all critics of e-cigarettes. “I don’t see this study as refuting the extensive evidence that already exists for a gateway effect,” says Martin McKee at the London School of Hygiene & Tropical Medicine. “Following up individuals is the most appropriate way to answer this question.”

Isn't public health supposed to be all about populations?

Meanwhile, in Massachusetts, lots of vapers have been switching to cigarettes thanks to a ban on e-cigarettes. 

In response, 231 vapers – nearly 40 percent -- said they switched or increased use of other products as a result of the ban.  Since there is minimal smokeless tobacco use in Massachusetts, it is likely that the “other products” were cigarettes. 

Converting 40 percent of smoke-free product users to smokers is an important and unfortunate result, for which ban architects must be held partially responsible. This was predictable and predicted. When will tobacco control activists ever own the foreseeable harmful consequences of their actions?

They won't.

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