Maybe the best thing you could say about vaping is that some evidence suggests that it may help some adults quit regular cigarettes – emphasis on the word “some.” In fact, over half of adult e-cigarette users also use conventional tobacco products. In young adults, vaping has been linked to “more frequent cigarette smoking and more intensive cigarette use.”

The question is: Does vaping predict this later tobacco use? A new study in Pediatrics says maybe so.

Analyzing data from a large, multi-year study of tobacco use and health in the US, the research team found that over 60% of individuals aged 12 to 24 had used tobacco at some point. By the last “wave” of the selected study period, roughly 30% had tried more than 5 tobacco products. As Wired reported,

Of all the young people in the study, those who experimented with many different products were 15 percentage points more likely to become daily cigarette smokers than those who had only tried one kind of tobacco product. And teenagers who experimented with e-cigarettes before age 18 were more likely to become daily smokers than those who tried vaping later in life.

Most of those daily tobacco users were smoking cigarettes. Among 25- to 28-year-olds, about 20% smoked cigarettes daily; only 3.3% vaped daily.

Of course, it could be that a lot of those people would have begun smoking anyway, regardless of e-cigarette use. We still can’t say that the one necessarily leads to the other.

What we can say, though, is that vaping is not without harm to both oral and whole body health – an issue we’ve explored before. And while its effects on the mouth in particular may be different from smoking, those effects are still quite negative.

For instance, a study from last spring suggests that vaping flavored products in particular could raise the risk of both tooth decay (caries) and gum (periodontal) disease:

Three patients presented to one dental practice with unusual patterns of dental caries, and all three admitted to regular vaping. Vaping components include propylene glycol, glycerin, nicotine, and flavors, which contain sucrose, sucralose, and ethyl maltol. The vapor produced by vaping devices is thick and viscous and much of it is retained on oral tissues. There are over 10 000 different vaping liquids, including some that contain tetrahydrocannabinol (THC) and vitamin E acetate. Vaping clearly has the potential to negatively affect general health, periodontal health, and accelerate the development of caries. There is also evidence that teenagers are being attracted to vaping in astonishing numbers.

A 2019 study suggests some specific mechanisms that may contribute to poor oral health among people who vape: oxidative stress fueling the chronic inflammation that is the hallmark of gum disease.

Although, the e-cigarettes may be less harmful than…traditional or conventional smoking,…the e-cigarettes can still contribute to the pathogenesis of the periodontal diseases by the cell injury, inflammation and impaired repair ability. The chemicals in the e-cigarette vapor are known to cause the DNA damage and also cellular senescence.

A 2020 study in the Australian Dental Journal similarly found that vaping contributed to oxidative stress and inflammation.

“Electronic and conventional cigarette use was each significantly associated with increased periodontal disease rates,” notes a 2019 study in the Journal of Periodontology, which found that although periodontitis was slightly less prevalent among vapers than smokers, both had much worse gum health than non-smokers and non-vapers.

After adjusting for demographic, socioeconomic, and health‐related characteristics, both vaping and smoking each had significant association with periodontal diseases. Therefore, this study suggests that vaping may not be a safe alternative to smoking. Cessation of both types of cigarettes is necessary for maintaining oral health.

Indeed.

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