Media scaremongering about tobacco harm reduction options, often involving credulous amplifications or distortions of studies that are themselves incomplete or flawed, is a long-established pattern. Press coverage of this kind isn’t confined to tabloids—the New York Times has been one repeat offender—and a recent story in a British national “broadsheet” is being held up as a subtler example.
The news story was published in the Guardian at the end of July, bearing the headline, “Third of UK teenagers who vape will go on to start smoking, research shows.”
The article concerns a study published in the Tobacco Control journal, which compared smoking prevalence among UK teens (aged 16-17) in three years representing different generations—1974, 1986 and 2018—using data from national surveys.
The study indicated that smoking prevalence fell from 33 percent in 1974 to 25 percent in 1986 and 12 percent in 2018—a year in which 11 percent were meanwhile found to be vaping.
Analyzing risk factors associated with smoking, the University of Michigan researchers used logistic regression models to estimate the likelihood that teens who were vaping in 2018 would go on to smoke.
They wrote that “the average predicted probability of smoking ranged from 1% among e-cigarette naïve youth to 33% among youth currently using e-cigarettes.”
“The findings suggest that e-cigarettes are increasingly acting as a ‘gateway’ to nicotine cigarettes for children,” the Guardian claimed, “undermining falling rates of teen smoking over the past 50 years.”
Based on this, the Guardian article stated that, “A third of UK teenagers who vape will go on to start smoking tobacco, research shows, meaning they are as likely to smoke as their peers were in the 1970s.”
“The findings suggest that e-cigarettes are increasingly acting as a ‘gateway’ to nicotine cigarettes for children,” the Guardian claimed, “undermining falling rates of teen smoking over the past 50 years.”
Dr. Arielle Selya, a behavioral scientist with a background in adolescent substance use and addiction, took to her blog to critique both the study and the Guardian coverage. She wrote that the wording used by the Guardian, including the headline, “sounds like smoking is an objectively documented outcome, but it’s speculative, uncertain, and probably overestimated.”
“The results don’t support this claim,” Selya told Filter, noting that the study “could have looked at actual smoking behavior in 2018 in relation to e-cigarette use, but didn’t.”
“When they say ‘will go on to smoke,’ this does not refer to actual measured behavior,” she elaborated, “it refers to a hypothetical and indirect estimation of smoking (based on risk factors).”
Selya explained that the study showed that personal and situational risk factors correlated with cigarette smoking since 1974—such as alcohol use, parental smoking and sociodemographics—were more common among youth who vaped in 2018 than among the youth who didn’t.
She suggested that a “neutral” headline would center on how youth who vaped in 2018 were similar to youth who smoked in 1974, in terms of those risk factors.
“This is simply a more accurate description of what the results actually show, without any unjustified inference,” she said.
Instead, the Guardian’s assertion, in both the subtitle of the article and the main text, that the results suggest a “gateway” from youth vaping to smoking is unsupported by the study, Selya said.
“This is confirmation bias at work. I think the authors interpreted ambiguous results in a way that confirms their pre-existing views.”
But that’s a trap the study authors seem to have fallen into as well.
“The academics wrote that although the research did not establish a causal link, their findings were ‘especially concerning,” stated the Guardian, which quoted the authors as claiming: “The success of previous tobacco control efforts and broad shifts in intergenerational risk factors in reducing risk of cigarette smoking may be mitigated when adolescents use e-cigarettes.”
“This is confirmation bias at work,” Selya commented. “I think the authors interpreted ambiguous results in a way that confirms their pre-existing views.”
“They caution against drawing casual conclusions,” she continued, “but then strongly imply them anyway, without even acknowledging alternative explanations, or designing the study in a way that can test their hypothesis against others.”
In her blog, Selya noted further issues including questionable accuracy of the models used to produce estimates of how many vapers would go on to smoke. And she wondered why the researchers would use a “circuitous process” to produce estimates rather than looking at readily available real-world data. “Is this because the rates of estimated smoking are higher than actual smoking?” she asked.
Moreover, using exactly the same results, Selya said, she could make a case for common liability—the idea that certain youth are, for various reasons, predisposed to nicotine use of whatever kind, which would explain correlations between vaping and smoking.
As such, the study’s findings around vaping are a “Rorschach test that can be interpreted in opposite ways,” she wrote.
But the study authors, she said, “infer one specific explanation (that vaping could lead to smoking)” and “don’t mention competing explanations or thoroughly convey how ambiguous the results really are.”
“I think alarmist media articles are responsible for these misconceptions,” Selya told Filter.
Meanwhile, new data from the charity Action on Smoking and Health (ASH UK) show that UK adult vaping has very slightly dipped to a rate of 10.4 percent, while smoking has stayed at 13 percent. (Fifty-five percent of adults who vape formerly smoked, while 40 percent are dual users.)
Among youth, 20 percent of those aged 11-17 have ever vaped, and 7 percent currently vape (only 40 percent of whom vape daily)—rates that have stayed the same. But 21 percent have ever smoked—troublingly up from 14 percent in 2023.
Youth who had tried both cigarettes and vapes were more likely to have tried cigarettes first, ASH found.
A deeply concerning finding was that 56 percent of adults who smoke now wrongly believe vaping is as harmful as smoking or worse—up from 43 percent in 2023. Youth aged 11-17 are even more misinformed, with 63 percent—up from 54 percent in 2023—now believing vapes are at least as bad for you as cigarettes.
“I think alarmist media articles are responsible for these misconceptions,” Selya told Filter. She cited another recent study that found many young adult vapers in the United States have switched to smoking—with 44 percent of them believing smoking to be “healthier.”
Photograph (cropped) by Jonathan Billinger via Geograph/Creative Commons 2.0
Dr. Selya is an employee of Pinney Associates, Inc. which consults to Juul Labs on tobacco harm minimization. She also individually provides consulting services on behavioral science to the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR) through ECLAT Srl, which received funding from the Foundation for a Smoke-Free World (now Global Action to End Smoking), and serves as a scientific advisor to the Global Forum on Nicotine (GFN) in exchange for travel support to the annual GFN conference and a small honorarium. Her commentary in this article is her own and these funders had no involvement. The Influence Foundation, the nonprofit that operates Filter, has received unrestricted grants from Juul Labs, Inc (previously) and donations and travel support from the GFN organizers. Joe Gitchell, the CEO of Pinney Associates, has made personal donations to The Influence Foundation. Filter’s Editorial Independence Policy applies.
