For a few years now the e-cigarette industry and nonsmoking advocates have been locked in a battle about the effects of vaping.

The state of California itself weighed in with a series of public service TV spots, beginning earlier this year, arguing that electronic vaping products are marketed “for the next generation to be hooked by big tobacco.” 

“E-liquids are available in flavors such as bubble gum, cherry and chocolate, which makes them appealing to children and youth,” the California Department of Public Health says.

The electronic cig business says smoking-style bans on vaping, like one instituted by the city of Los Angeles in 2014, have been premature because the science on the devices is still lacking.

But researchers at Keck Medicine of USC and other universities this week unveiled a study that says teen vapers are more likely to move on to “smokeable tobacco products.” The findings were published this week in The Journal of the American Medical Association.

The academics examined 2,530 14-year-olds at 10 public high schools in Los Angeles and found a good slice of them who had used e-cigarettes moved on to smoked tobacco after six months. According to a summary:

30.7 percent of the e-cigarette users had started smoking one or more combustible tobacco products including cigarettes, cigars and hookahs, as compared with 8.1 percent who had never used e-cigarettes. At the 12-month mark, as the students were heading into 10th grade, differences in rates of tobacco smoking persisted between students who had used e-cigarettes versus those who had not.

USC warns that the study doesn't prove cause (vaping) and effect (smoking) and that more research on the topic is needed. Nonetheless, Adam Leventhal, director of the USC Health, Emotion, & Addiction Laboratory, says:

E-cigarettes may be drawing a new generation of teens into recreational nicotine use because they are high-tech, can be purchased somewhat easily, come in enticing flavors and have a perception that they’re not harmful. Some e-cigarette devices appear to be very efficient at delivering nicotine to the lungs and brain. If you enjoy the experience of inhaling nicotine in e-cigarettes, it makes sense that you would be open to trying other nicotine products, like cigarettes, hookah, and cigars.

The Smoke-Free Alternatives Trade Association, the e-cigarette trade group, maintains that the devices are much healthier than tobacco products and that they can help wean people off cigarettes.

“Any substance containing nicotine is not 100 percent safe,” the organization says in a statement, “but electronic cigarettes do not contain tobacco, a carcinogenic ingredient, and they do not produce smoke. Numerous studies support that an overwhelming majority of tobacco-related deaths are a result of the smoke produced and inhaled by users, not nicotine.”

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