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UK teenagers who at present vape are as prone to take up smoking as their friends within the Seventies, regardless of a considerable fall within the prevalence of teenage smoking over the previous 50 years, suggests a long-term intergenerational research revealed on-line within the journal Tobacco Management.
The chance of beginning to smoke amongst teenagers who do not vape was round 1.5%, however 33% amongst those that do, the findings point out.
It isn’t totally clear if the rise in recognition of e-cigarettes (vapes) amongst teenagers threatens the regular decline within the prevalence of cigarette smoking on this age group, say the researchers, because the revealed analysis is considerably equivocal.
And if historic declines are slowing, it is not clear how the chance of cigarette smoking amongst as we speak’s younger folks—particularly those that vape—compares to that of earlier generations who got here of age earlier than notable tobacco management laws and the appearance of e-cigarettes, they add.
To try to discover out, they drew on intergenerational knowledge from three nationally consultant delivery cohorts of UK teenagers born in 1958 (Nationwide Baby Growth Research; NCDS), 1970 (The British Cohort Research; BCS), and 2001 (Millennium Cohort Research; MCS).
In addition to baseline surveys at both delivery or 9 months, MCS members supplied knowledge at ages 3, 5, 7, 11, 14, 17 and 23; BCS members at ages 5, 10, 16, 26, 30, 34, 38, 42, 46 and 51; and NCDS members at ages 7, 11, 16, 23, 33, 42, 46, 50, 55 and 62.
The prevalence of youngster smoking was assessed in 1974 amongst 11,969 NCDS members, in 1986 amongst 6,222 BCS members, and in 2018 amongst 9,733 MCS members. The percentages of smoking amongst 16- and 17-year-olds had been estimated, based mostly on a typical set of childhood danger and protecting elements; teen vaping was included as a predictor within the MCS.
Danger/protecting elements included whether or not they had ever drunk alcohol by age 16 or 17; how engaged they had been with training in school; the extent of externalizing behaviors reported by the mom or primary caregiver at ages 10 or 11; and parental occupation, training, and smoking habits— together with throughout being pregnant.
Evaluation of the intergenerational knowledge revealed a steep decline within the prevalence of cigarette smoking amongst teenagers, falling from 33% in 1974, to 25% in 1986, and to 12% in 2018. Round half of the MCS members hadn’t vaped by the point they had been 17; 41% mentioned they’d beforehand vaped; and 11% reported present vaping.
The decline within the prevalence of youngster smoking may be attributed to a mixture of tobacco management laws, higher public understanding of the well being penalties of smoking, and a shift away from the notion of smoking as socially acceptable, recommend the researchers.
Danger/protecting elements additionally modified over time. For instance, the proportion of teenagers who had began ingesting by the age of 16 or 17 fell from 94% within the NCDS to 83% within the MCS.
The common age at which moms left training additionally rose from 15.5 within the NCDS to 17 within the MCS. Equally, the prevalence of parental smoking fell from over 70% within the NCDS to 27% within the MCS; and fewer moms continued smoking whereas pregnant within the MCS than within the NCDS and the BCS.
Many danger elements for teen smoking had been related throughout the cohorts—ingesting earlier than the age of 17 and better externalizing behaviors, for instance—as had been some child-level protecting elements—better engagement with training, for instance.
As an example the chance of cigarette smoking for an “average” teen (16–17) over time, the researchers labored out predicted chances of cigarette smoking with all danger elements included from the intergenerational knowledge.
This likelihood was 30% within the NCDS and 22% within the BCS. Amongst those that had by no means vaped within the MCS, this was round 1.5%, however 33% for the kids who reported present vaping.
“This probability is especially concerning given the recent increases in e-cigarette use prevalence among UK youth, despite some initial assurances that e-cigarettes would have little appeal to [them],” say the researchers.
The researchers acknowledge that they had been unable to account for some sociodemographic traits, together with race and ethnicity, as a result of inadequate pattern sizes within the earlier cohorts. They usually emphasize that estimates of the associations between vaping and smoking within the MCS aren’t causal and should not be interpreted as such, particularly because the temporal sequencing of smoking and vaping is not express.
However, they conclude, “Whereas our analysis reveals that the historic decline within the chance of youth cigarette smoking has continued on this latest cohort of UK youth, general, we discover that this isn’t the case amongst e-cigarette customers.
“Youth who had by no means used e-cigarettes had an estimated lower than one in 50 likelihood of reporting weekly cigarette use at age 17, whereas those that had beforehand used e-cigarettes had over a one in 10 likelihood. Youth who reported present e-cigarette use had an virtually one in three likelihood of additionally reporting present cigarette use.
“As such, the decline within the chance of cigarette smoking is waning for youth who’ve used e-cigarettes—about half of our pattern—and has reversed for these at present utilizing e-cigarettes.
“Among contemporary youth, efforts to reduce cigarette smoking should focus both on those who are currently using e-cigarettes and on the prevention of e-cigarette use among youth, to maintain the promising declines in youth nicotine use in years to come.”
Extra info:
Danger of adolescent cigarette use in three UK delivery cohorts earlier than and after e-cigarettes, Tobacco Management (2025). DOI: 10.1136/tc-2024-059212
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British Medical Journal
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UK teenagers who at present vape as prone to begin smoking as their friends within the Seventies, research suggests (2025, July 29)
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