The gateway myth of vaping

Most anti-vaping arguments fail to take into account the fact that e-cigarettes target tobacco consumers....

An argument commonly made is that vaping would be a gateway towards smoking or in other words: due to vaping people would start smoking en masse again. The EU Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) final report on e-cigarettes made this claim again just recently. Unfortunately, the report is based on weak data, it ignores crucial scientific evidence, experience from consumers and the expert opinions received in the consultation period. If one looks a bit deeper into the topic it becomes clear that vaping is a gateway away from smoking and not vice versa. 

The correlation between the introduction and the higher popularity of vaping and declining smoking rates suggests that vaping is an important innovation to help people quit smoking. The 2018 U.S. National Academies of Sciences, Engineering, and Medicine Report found that the smoking rate has decreased overall more rapidly since vaping became more prominent in the United States. The researchers concluded: “The inverse relationship between vaping and smoking was robust across different data sets for both youth and young adults and for current and more established smoking.” 

Moreover, the claim that non-smokers would get introduced en masse to smoking due to vaping seems not to be supported by data from the newest Action on Smoking and Health (ASH) UK report. It states that “only 0.3% of never-smokers are current vapers (amounting to 2.9% of vapers), down from 0.8% in 2019”. 

Colin Mendelsohn and Wayne Hall found in a recently published review in the Journal of Drug Policy that at least 70-85% of all adolescents try vaping after having already started smoking and that regular vaping is very rare amidst teenagers. The authors conclude furthermore that “contrary to the gateway hypothesis, vaping appears to divert a subset of youth at high risk of cigarette smoking away from smoking.

In the UK, Public Health England, an agency of the Ministry of Health, is actively recommending smokers to switch to e-cigarettes, and accordingly very progressive frameworks for vaping have been introduced. Due to these policies the UK sees better results in reducing smoking compared to more restrictive countries. In the UK approximately 25% fewer people smoke today compared to 2013 when vaping became popular, while for example Australia, one of the countries with the toughest vaping regulations, saw a decline of only 8% in the same period. France, Canada and New Zealand followed an approach more similar to the UK and is seeing positive results. 

In conclusion, e-cigarettes are a gateway out of smoking rather than being a path towards smoking, as has been widely claimed. The anti-vaping narrative plays to the advantage of policymakers who seek to paternalise consumers and to limit their choices. Such an approach is disastrous and detrimental to the health of heavy smokers for whom vaping has become a life-saving tool.
Most anti-vaping arguments fail to take into account the fact that e-cigarettes target tobacco consumers. This is similar to sugar consumption by people who suffer from diabetes: sugar substitutes are not a gateway to sugar because it is because of the harmful effects of sugar that they had to switch. Sugar substitutes are not blamed for increased sugar consumption, and e-cigarettes that serve a similar purpose should be equally endorsed. We call on policymakers to reconsider their approach to vaping. Despite many voices seeking to undermine vaping as a gateway out of smoking, the evidence is sound: vaping saves lives.