Possible link between e-cigs and tobacco use.

• Position: Student Smoking

Students who have used electronic cigarettes by the time they start ninth grade are more likely than others to start smoking traditional cigarettes and other combustible tobacco products within the next year, according to a study funded by the National Institutes of Health, Bethesda, Md. E-cigarettes deliver nicotine to the lungs by heating a liquid solution that contains nicotine and other chemicals to produce an aerosol that the user inhales, a process often called "vaping."

The study compared tobacco use initiation among students who had used e-cigarettes, but not combustible tobacco products, and those who neither had used e-cigarettes nor combustible tobacco products when initially surveyed at the start of ninth grade. During the first six months after being surveyed, 30.7% of those who had used e-cigarettes started using combustible tobacco products, such as cigarettes, cigars, and hookahs, compared to 8.1% of those who never had used e-cigarettes. Over the following six months, leading into the start of 10th grade, 25.2% of e-cigarette users had tried combustible tobacco products, compared to 9.3% of nonusers.

"While teen tobacco use has fallen in recent years, this study confirms that we should continue to...