Over the past few decades, adolescent cigarette smoking has shown a marked decline, largely due to effective public health campaigns, rising education levels, and decreased parental smoking. However, this progress may now be at risk due to the rising popularity of e-cigarettes (vaping) among teenagers.
This study, based on three UK birth cohorts from 1958, 1970, and 2001, explored the relationship between vaping and cigarette smoking across generations. While earlier cohorts reflected a natural decline in youth smoking over time, the youngest cohort, born in 2001 and exposed to vaping during adolescence, displayed a concerning trend: a significant increase in smoking likelihood among current vapers.
In fact, current vapers in this group showed a 33% probability of smoking — similar to the 32% rate in the 1974 cohort, when smoking was at its peak and anti-tobacco policies were minimal. Even experimental vapers were at notably higher risk (12.7%) compared to never-users (1.4%). These findings suggest that vaping may act as a gateway to cigarette smoking, potentially reigniting patterns of nicotine addiction among youth.
While various risk factors such as low school engagement, early alcohol use, and externalizing behaviors continued to correlate with higher smoking rates across all cohorts, vaping stood out in the most recent generation as the strongest individual predictor of cigarette use.
Although the study design does not allow definitive conclusions about causality, the strength of association between vaping and smoking raises serious public health concerns. If left unaddressed, vaping could reverse decades of progress in reducing adolescent smoking. These findings emphasize the need for targeted prevention strategies and stricter regulation of e-cigarette marketing and accessibility among youth.
