Vaping's Gateway Effect: E-cigarette vapor transforming into cigarette smoke on a college campus.

Vaping's Gateway Effect: How E-Cigarettes Can Lead to Cigarette Use in Young Adults

Jordan Keane in Health & Wellness August 2025 • 4 min read.

"New Research Reveals the Link Between Exclusive E-Cigarette Use and Increased Risk of Cigarette Initiation Among College Students."

The rise of e-cigarettes, or electronic nicotine delivery systems (ENDS), has been a significant trend in recent years, particularly among young adults. While some view them as a less harmful alternative to traditional cigarettes, concerns have grown about their potential to lead non-smokers to start smoking. Research has been inconsistent, and there's been limited examination on the risk differences between exclusive ENDS users and those who use them alongside other tobacco products.

A new study published in Addictive Behaviors, Alexandra Loukas, C. Nathan Marti, Maria Cooper, Keryn E. Pasch & Cheryl L. Perry sought to clarify this issue by investigating whether exclusive e-cigarette use predicts cigarette initiation among college students. The researchers aimed to determine if young adults who had never smoked cigarettes but used e-cigarettes were more likely to start smoking compared to non-e-cigarette users.

This article breaks down the study's findings, explaining how e-cigarette use can act as a gateway to cigarette smoking for young adults. It explores the implications of these results and what they mean for future prevention and policy efforts.

E-Cigarettes as a Launchpad: Understanding the Risks

Vaping's Gateway Effect: E-cigarette vapor transforming into cigarette smoke on a college campus.

The study followed 2,558 cigarette-naïve students aged 18-25 from 24 Texas colleges over 1.5 years. Key findings from this research:

The study used four waves of data collection, spaced six months apart, to track when and how students initiated cigarette use. Researchers created sophisticated statistical models to predict cigarette initiation and weed out alternative explanations.

Overall, 11% of the students started smoking cigarettes by the end of the study.
A significantly higher percentage of e-cigarette users (20.1%) began smoking cigarettes compared to non-e-cigarette users (8.4%).
Exclusive e-cigarette users showed a greater likelihood of starting to smoke cigarettes than non-users.
If students used other tobacco products already, the likelihood for cigarettes remained constant.

These findings highlight a crucial distinction: the increased risk of cigarette initiation primarily applies to those who initially only use e-cigarettes. For young adults already experimenting with other tobacco products, e-cigarettes don't appear to further increase the risk of starting to smoke.

Implications and the Bigger Picture

This study's conclusion adds to a growing body of evidence suggesting that e-cigarettes can be a gateway to cigarette smoking, particularly for young adults who are not already using other tobacco products. This has significant implications for how we approach prevention and regulation.

The research underscores the need for targeted prevention programs, especially within the college environment. These programs should focus on the specific risks associated with e-cigarette use and correct misperceptions about their safety compared to traditional cigarettes.

Ultimately, these findings support the implementation and enforcement of FDA regulations regarding the marketing and availability of e-cigarettes, especially concerning flavors that appeal to young people. Limiting access to these products and communicating the risks effectively are essential steps in protecting young adults from nicotine addiction and the dangers of smoking.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.addbeh.2017.08.023, Alternate LINK

Title: Exclusive E-Cigarette Use Predicts Cigarette Initiation Among College Students

Subject: Psychiatry and Mental health

Journal: Addictive Behaviors

Publisher: Elsevier BV

Authors: Alexandra Loukas, C. Nathan Marti, Maria Cooper, Keryn E. Pasch, Cheryl L. Perry

Published: 2018-01-01

Everything You Need To Know

Does vaping with e-cigarettes really increase the risk of starting to smoke cigarettes, especially for young adults?

The research indicates that college students who exclusively use e-cigarettes are more likely to start smoking traditional cigarettes compared to their peers who don't use e-cigarettes. Specifically, the study revealed that a significantly higher percentage of e-cigarette users (20.1%) began smoking cigarettes compared to non-e-cigarette users (8.4%). This suggests that e-cigarette use can be a gateway to cigarette smoking for young adults.

Does the increased risk of cigarette smoking apply to everyone who uses e-cigarettes, or just certain groups?

The study's findings primarily apply to young adults who are not already using other tobacco products. The increased risk of cigarette initiation was most pronounced among exclusive e-cigarette users. For students already experimenting with other tobacco products, e-cigarettes did not appear to further increase their likelihood of starting to smoke cigarettes.

How was the study conducted to determine the link between e-cigarette use and cigarette initiation among college students?

The study involved tracking 2,558 cigarette-naïve students aged 18-25 from 24 Texas colleges over 1.5 years. Data was collected in four waves, spaced six months apart, allowing researchers to observe when and how students initiated cigarette use. Sophisticated statistical models were employed to predict cigarette initiation and account for potential alternative explanations.

What does it mean when people say e-cigarettes can be a "gateway" to cigarette smoking?

This study supports the idea that e-cigarettes can act as a 'gateway' to cigarette smoking, especially for young adults who are not already using other tobacco products. This suggests that initial e-cigarette use might normalize the act of smoking or expose individuals to nicotine, leading them to experiment with and ultimately adopt traditional cigarettes. This is concerning because it introduces a new pathway to nicotine addiction and the well-documented health risks associated with cigarette smoking.

What are the implications of these findings, and what steps can be taken to address the potential risks associated with e-cigarette use among young adults?

The findings highlight the need for targeted prevention and public health initiatives. These programs could focus on educating young adults about the potential risks of e-cigarette use, particularly the risk of transitioning to traditional cigarettes. Policies could also regulate the marketing and availability of e-cigarettes to reduce their appeal to non-smokers. Further research could examine the specific factors that contribute to the gateway effect, such as the flavors used in e-cigarettes or the social contexts in which they are used.