While concerns about vaping as a potential gateway to smoking persist, a recent study reiterated that there is no evidence supporting this claim. Instead, data suggest that as vaping rates rise, youth smoking continues to decline.
A recent study published in Addiction reviewed existing research on whether vaping increases the likelihood of smoking among individuals under 29. While vapes have been marketed as a safer alternative to cigarettes, concerns persist about their potential role in encouraging smoking initiation. One of the key concerns is whether vaping serves as a gateway to smoking, either by introducing non-smokers to nicotine or encouraging occasional smokers to develop a regular habit.
Conducted by a number of renowned researchers in the field of public health, the current study systematically reviewed 126 research papers, including: 27 population-level studies (16 of which had serious bias) and 99 individual-level studies, of which 40 had more than 5,000 participants—but all carried a high risk of bias. The research team examined how vaping affects smoking rates, including its role in smoking initiation, progression, and cessation.
The higher the vaping rates, the lower the smoking rates
While conflicting evidence exists, with some studies suggesting that vaping helps smokers quit, while others indicate that vapers have lower odds of quitting smoking altogether, no significant evidence was found to suggest that vaping leads to higher smoking rates among young people. In fact, an increased availability of vapes correlated with higher vaping rates but lower-than-expected smoking rates in youth. However, studies linking vaping to reduced smoking rates were limited by serious bias.
The study also found that young people who vape are more likely to try smoking or increase their smoking over time. However, this does not confirm a direct causal relationship, as other factors may influence this trend. In fact, a number of studies have identified and discussed such factors, including a personality type that would make one likely to experiment with or try multiple substances, including vapes and cigarettes.
In light of the above findings, the authors concluded that current evidence remains highly uncertain. While some studies suggest vaping may predict later smoking, none provide strong causal proof. Population-level data hint at a decline in smoking as vaping rates rise, but individual-level studies often suggest the opposite.
Consistent findings across the globe
In line with the above, a recent study by Australian and Kiwi THR experts, reaffirmed that there is no evidence of a gateway effect from vaping to smoking. In fact, youth smoking rates reached record lows in 2023—0.3% in Australia and 1.2% in New Zealand—suggesting that vaping has not led to smoking uptake and may have even steered young people away from cigarettes.
Similarly, the 2022 National Health Interview Survey (CDC) from the U.S., found that rather than acting as a gateway to smoking, vaping products are among the most commonly used smoking cessation tools. The study analyzed smoking cessation trends among 27,651 U.S. adults, focusing on those who successfully quit for at least six months and those who attempted but did not succeed.
Among other findings, the survey reported that nicotine-based methods were the most common, used by 53.9% (1.5 million people), with vapes playing a significant role. A total of 40.8% of the participants (1.2 million) combined them with other methods, while 26.0% (0.7 million) used e-cigarettes alone.
A gateway out, not in
In conclusion, all the literature available on the topic not only reinforces growing evidence that vaping does not act as a gateway to smoking, but also highlights that it helps reducing smoking rates, particularly among young people. While further research is needed, current data suggest that regulated vaping access could support smoking cessation efforts and contribute to public health improvements worldwide.