Is Vaping a Gateway Drug?

The electronic cigarette has taken the world by storm as a vehicle to quit smoking. But is it really working the way it should be?

Back when you were a teenager, cigarettes may have lured you. A friend might have been smoking one behind the high school gym or maybe an actor was smoking one on the big screen. As you began to grow older, some of the people you knew might have experimented with other drugs or even narcotics.

California has instilled higher cigarette taxes and some cities have banned smoking altogether — hurdles that would hopefully decrease the number of smokers. But as the state thought it was progressing as the number of teens smoking cigarettes dropped, an alternative solution to smoking was introduced: vaping.

With the introduction of vaping, a “safer” alternative to a cigarette, it was easy to perceive that the long-term problem of smoking was slowly turning into a problem of the past. But is vaping really helping? Or is it causing a new problem?

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A new USC study debunks the popular belief that electronic cigarettes are merely a substitute for cigarettes. Instead, the study suggests that some teens who never would have smoked cigarettes are now vaping.

The National Youth Tobacco Survey has reported a long-term decline in teen smoking rates, followed by a leveling off between 2014 and 2015.

The USC study found that the number of 12th-graders in Southern California who had smoked in the past 30 days dropped from 19 percent in 1995 to about 9 percent in 2004 and then leveled off, with the rate of smoking just under 8 percent in 2014.

But when cigarettes and e-cigarettes were combined, some 14 percent of high school seniors in 2014 said they had smoked or vaped in the last 30 days, which is nearly an astounding 60 percent increase in the past decade.

“If teenagers who vape are using e-cigarettes instead of cigarettes, we would have expected to see the decline in smoking rates continue through 2014,” said Jessica Barrington-Trimis, lead author and a postdoctoral scholar research associate in the Department of Preventive Medicine at the Keck School of Medicine of USC. “But what we’ve seen is a downward trend in cigarette use from 1995 to 2004 but no further decrease in cigarette smoking rates in 2014. The combined e-cigarette and cigarette use in 2014 far exceeded what we would have expected if teens were simply substituting cigarettes with e-cigarettes. The data suggest that at least some of the teens who are vaping would not have smoked cigarettes.”

Cigarette use is the largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans annually, according to the Centers for Disease Control.

“An important question in the rapidly evolving landscape of youth tobacco product use is whether e-cigarettes are replacing cigarettes,” said Rob McConnell, the study’s senior author and professor of preventive medicine at Keck Medicine of USC. “However, use of e-cigarettes by youth who would not otherwise have smoked results in exposure to the hazards of inhaled vaporized liquids and flavorings in e-cigarettes and may result in exposure to nicotine that can damage the adolescent brain.”

“Because e-cigarettes are perceived as less harmful and less dangerous than combustible cigarettes, another concern is that teens may be introduced to nicotine use via e-cigarettes,” Jessica Barrington-Trimis said. “In California, where smoking rates are among the lowest in the country, the increase in vaping, possibly followed by increases in smoking, could erode the progress that has been made over the last several decades in tobacco control.”

Is your child having a problem with vaping? There are new smoking cessation programs to help. Schedule an appointment with your primary care physician to learn more.

If you are in the Los Angeles area and are looking for a new primary care physician, be sure to schedule an appointment by calling (800) USC-CARE (800-872-2273) or by visiting

By Leonard Kim