Since 2010, e-cigarette experimentation has increased and smoking declined among French middle school students

A cohort survey conducted between 2010 and 2014 by the French Observatory of Drugs and Addictions (OFDT) [1] in the framework of the Health Behaviour in School-aged Children (HBSC) France shows an overall increase of drug experimentation among middle school students (11-15 year old).

The data collected do not demonstrate that it may constitute a gateway to smoking, since smoking rates have declined in the meantime among teenagers. However, the authors suggest qualitative studies should be conducted to consolidate their work.

Teenagers are tempted by experimentation

Experimentation rates (in %) for Alcohol (Alcool), Tobacco (Tabac), Inebriation (Ivresse) and Cannabis among 11-15 year old teenagers, according to school grade (6e = 1st grade) in 2014.

This study converges with other findings that non-smoking and non-vaping teenagers have a low profile for risky behaviours.

For the most audacious ones, boys rather than girls, the experimentation of alcohol combines with that of waterpipes, of conventional and electronic cigarettes and of inebriation, cannabis being the least popular. Alcohol is probably the most accessible substance, followed by tobacco. Among tobacco products, a raise of the e-cigarette is described.

The study finds that nearly 4 of 10 students (39.4%), between 13 and 15 years old, admit having ever tried an e-cigarette and only 1.9% admit using e-cigarettes every day. For a large majority of the teenagers, it was found that the the contact with the e-cigarette remained at the stage of an experimentation, meaning that they did not carry on with its use.

From international sources, risky behaviours happen generally associated to socializing events like parties, concerts, and not necessarily in the schoolyard. Teenagers’ motivations for using e-cigarettes, in that sense, differ from adults’ for whom vaping is considered a risk-reduction approach.

Tobacco experimentation precedes that of the e-cigarette

Experimentation levels (%) for risky behaviours: Alcohol (Alcool), Tobacco (Tabac), Inebriation (Ivresse) and Cannabis
Experimentation levels (%) for risky behaviours: Alcohol (Alcool), Tobacco (Tabac), Inebriation (Ivresse) and Cannabis
  • Around half (51%) of the students have never touched any cigarette (conventional or electronic).
  • The % of exclusif experimenters of the e-cigarette (9.0%) is roughly equivalent to exclusif experimenters of tobacco (10%).
  • 30.3% of e-cigarettes ever-users are dual experimenters (e-cigarette + tobacco).

The study highlights interesting patterns among “dual experimenters”:

  • Tobacco experimentation precedes that of the e-cigarette by about one year, on average at 12.8 years old and 13.7 years old, respectively.
  • Students having experimented the e-cigarette before tobacco are a minority (7.8%)
    • for more than 1 of 3, both experimentations occurred within the same year and assessing the sequence precisely was not possible.

A Tobacco-vaping rather than a vaping-tobacco gateway effect

The fear of a gateway to smoking is being swept away by an increasing amount of international surveys in different domains, even if the conclusions drawn from authors’ figures do not always reflect scientific integrity, or are skewed in the media. The most interesting finding of the present study is indeed the fact that smoking would rather constitute a gateway to vaping than the opposite, based on the sequential process of experimenting both products.

The questions of risk perception is missing

For the electronic cigarette, “no harmfulness could be demonstrated to date”, reads the report. This study does unfortunately not address the perception of the harmfulness of smoking tobacco compared to vaping, as the MTF survey did among US teenagers. The perception of nicotine ingestion with e-cigarette is also pending to further investigate the share between the seek of a psychoactive effect or of an adult-like behaviour.

The authors of the present study compare to the use of conventional and electronic cigarettes to that of waterpipes that is almost similar in terms of toxicity that is rather associated to more socialization. With its recent introduction on the market (2007-2008), the e-cigarette, whose gestures resemble to smoking, competes with its “nerdy” sibling on visual perception aspects. The teenagers admit however to use the electronic rather than “stinky” cigarettes when interfering with other people and principally with teachers or their parents.

[1] Spilka S., Ehlinger V., Le Nézet O., Pacoricona D., Ngantcha M. and Godeau E., (Dec 2015). Alcool, tabac et cannabis en 2014, durant les « années collège », Tendances 106