For the proposition of “e-cigarettes induce teenagers”, public medicine, government, schools and other parties often use a logic: e-cigarettes contain addictive nicotine, and teenagers will start to smoke cigarettes containing the same nicotine when they are addicted to nicotine.
Some early studies have linked e-cigarettes to traditional tobacco.
For example, in April 2018, a research paper Electronic cigarette use and progression from experimentation to established smoking from the University of California linked “adolescent smoking” with “electronic cigarette use”. In this one-year study, 1295 young people aged 12-17 who had tried cigarettes but smoked no more than 100 cigarettes in total were not considered “traditional smokers”.
The experimental results show that compared with the subjects who have never used electronic cigarettes, the probability of smoking cigarettes among the users of electronic cigarettes is much higher. In the paper, the authors also clearly put forward that this can only show that the “electronic cigarette” and “cigarette” use of teenagers have a “correlation”, but not a “causal relationship”.
According to the study, “shared risk factors” of tobacco use can be attributed to young people smoking electronic cigarettes or between cigarette smoking. For example, in the occasion of drinking, or around friends smoking, will jointly lead to smoking and vaping.
Researchers led by Arielle Selya investigated 12000 students in grade 8-10, and designed complex statistical methods to explain the differences among young people, namely the so-called “common risk variables”, such as basic information such as race and gender; more disciplined or adventurous daily behaviors of young people; alcohol use and drug use history; whether received health risk education on tobacco products; whether feel uncomfortable when people around you smoke.
Before controlling these characteristic variables, using electronic cigarette can increase the probability of smoking traditional tobacco by nearly 36 times.
But when the researchers took 14 “common risk variables” into account, the impact disappeared.
E-cigarettes do increase the risk of young people “trying” to smoke, but they don’t end up being regular smokers.
That is to say, vaping and smoking are two parallel states. There is no relationship between them. Whether affected by the environment or for personal reasons, the use groups of e-cigarettes and cigarettes themselves are highly overlapped. Even if there is no electronic cigarette, they still smoke cigarettes.
Arielle Selya’s research questions the previous research. “E-cigarette is the threshold of cigarette entry” is just a fallacy of landslide (using a series of causal inference, but exaggerating the causal strength of each link, and getting unreasonable conclusions).
Many praised the logic and methodology of the study, while others thought it was just another piece of evidence in the growing and conflicting field of e-cigarettes.
Some insiders said that Selya’s research is a very important one using innovative methods.
Dr. Sharon Levy, director of the substance use and addiction program for adolescents at Boston Children’s Hospital, said, “This study uses complex data analysis strategies, but unfortunately, I don’t have much confidence in these findings. Because it doesn’t take into account the basic nature of addiction and epidemics, that is, once people are addicted to a substance, they will try every way to get it and use it. ”
Chadi, a professor at the University of Montreal, also noted that the study used data from 2015-2016. This period has not yet reached the peak of the rapid growth in the use of electronic cigarettes by teenagers. Newer, higher nicotine products such as Juul were only beginning to be widely available then, so today’s same study may show different results.
Selya said it was a “major limitation” of her research, and admitted in her paper that the study did not focus on adolescents over time, but relied on them to recall current and previous tobacco use. With the passage of time, it is necessary to carry out more long-term research on adolescents.
This also proves that, in most cases, there are errors and biases in the data statistics and experiments of electronic cigarettes. Selya believes that there is now a “subconscious” phenomenon of regulate e-cigarettes as combustible cigarettes. These efforts are good, but they still have shortcomings.
“The public health community generally believes that e-cigarettes are the starting point of nicotine use and can easily attract new users. But the latest data do not support this hypothesis.
Before we have a more solid understanding of the impact of e-cigarettes, it is very important to delay the formulation of e-cigarettes policy. In fact, excessive restrictions on e-cigarettes may encourage teenagers to smoke cigarettes. ”
In every country that strictly limits or even suppresses e-cigarettes, “protecting teenagers” is the primary consideration of multi game.
The adult world is calling for industry standards, corporate responsibility and policy regulation. However, the voice of minors and the methodology that meets the needs of this group are rarely expressed by the media.
First of all, teenagers have the ability of scientific judgment and risk-taking in some degree.
Eliza Shapiro, a senior high school student in New York, spoke on CNN in September, representing some teenagers’ views on the issue of e-cigarettes.
She said, “The vast majority of teenagers use e-cigarettes to enjoy the feeling of high concentrations of nicotine. They feel peer pressure and want to look cool. I think most students who use e-cigarettes have heard that e-cigarettes are not good for them, but in fact, young people always take risks to do something unsafe, not only e-cigarettes but also other things.”
Young people are always rebellious. The more adults refuse them to do something, the more curious they will be to try.
So how to deal with young people vaping?
Discuss risks with scientific basis and implementation.
It can be compared to sex education: at present, most schools have stopped talking about abstinence to students, instead, they will teach them how to ensure safety and improve risk awareness.
Teenagers respond to real data and science. If you really want young people to take e-cigarettes seriously, officials should listen to science. ”
Teenagers should be protected in society, and they are also being protected from many aspects.
There is less and less room for every generation of teenagers to make mistakes, and the risk cost is higher and higher on their way to adulthood. But the development of science and media has also made these children learn to measure right and wrong and pros and cons earlier.
In addition, behind the use of electronic cigarettes by teenagers, there is a hidden particularity of this group.
Why do teenagers like nicotine?
The classic theory of addiction is based on direct neurobiology, which is often understood as the physiological response brought by brain “reward mechanism“, and it is inevitable.
However, psychologist Bruce Alexander from Vancouver did a classic mouse Park experiment. The mouse is placed in a cage without anything. Give it a cup of pure water and a cup of water with morphine. The mouse will choose to live in a drunken dream.
In another “mouse Eden” cage, there are plenty of cheese and other food, balls for playing, rollers, slides, and many other mouse companions. In the face of the same two glasses of water, the mice in the park will not drink the liquid that makes them addicted to anesthesia, nor will they have excessive symptoms.
Alexander was surprised to find that it was not water but cage that decided the mouse not to become addicted.
The same is true for humans.
As a group animal, it is human’s instinct to establish connection, so we are all happy to maintain social relations with others in our daily life. But the trauma, pressure, helplessness and isolation of real life make people rely on other things that can be comforted. It can be tobacco, wine or virtual network.
We need to know that teenagers have had several cases of Internet addiction and game addiction in various countries.
The opposite of addiction is not lucidity, but connection.
This is also another way of thinking about teenagers’ physical and mental health. Those who have become addicted to electronic cigarettes should not only say “no, no” to them, but also think about their real needs in life?
Maybe this is the biggest common risk variable.