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E-cigarette use as a predictor of cigarette smoking: results from a 1-year follow-up of a national sample of 12th grade students
  1. Richard Miech,
  2. Megan E Patrick,
  3. Patrick M O'Malley,
  4. Lloyd D Johnston
  1. Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Richard Miech, Institute for Social Research, University of Michigan, 426 Thompson, Ann Arbor, MI, 48104 USA; ramiech{at}


Objective To prospectively examine vaping as a predictor of future cigarette smoking among youth with and without previous cigarette smoking experience. A secondary aim is to investigate whether vaping may desensitise youth to the dangers of smoking.

Methods Analysis of prospective longitudinal panel data from the nationally representative Monitoring the Future study. The analysis is based on 347 12th grade students who were part of a randomly selected subsample that completed in-school surveys in 2014 and were resurveyed 1-year later.

Results Among youth who had never smoked a cigarette by 12th grade, baseline, recent vapers were more than 4 times (relative risk (RR)=4.78) more likely to report past-year cigarette smoking at follow-up, even among youth who reported the highest possible level of perceived risk for cigarette smoking at baseline. Among 12th grade students who had smoked in the past but had not recently smoked at baseline, recent vapers were twice (RR=2.15) as likely to report smoking in the past 12 months at the follow-up. Vaping did not predict cessation of smoking among recent smokers at baseline. Among never-smokers at baseline, recent vapers were more than 4 times (RR=4.73) more likely to move away from the perception of cigarettes as posing a ‘great risk’ of harm, a finding consistent with a desensitisation process.

Conclusions These results contribute to the growing body of evidence supporting vaping as a one-way bridge to cigarette smoking among youth. Vaping as a risk factor for future smoking is a strong, scientifically-based rationale for restricting youth access to e-cigarettes.

  • Electronic nicotine delivery devices
  • Harm Reduction
  • Priority/special populations

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  • Contributors LDJ is the principal investigator of the Monitoring the Future Study, and the other authors are all co-investigators. RM developed the paper plan, performed the data analysis, and drafted the manuscript, assisted by MEP. All authors contributed to drafts of the manuscript.

  • Funding This study was supported by the National Institute on Drug Abuse, part of the National Institutes of Health, by grants numbers R01DA001411 and R01DA016575.

  • Competing interests None declared.

  • Ethics approval University of Michigan Institutional Review Board, approval number HUM00063656.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data are drawn from a wider survey that examines trends in the use of a variety of substances among adolescents, as well as trends in many substance use related variables. Each year a de-identified version of the previous year's data is made publicly available and can be downloaded for no charge at: Researchers wishing to use sensitive data that cannot be publicly released should send a request to to start the application process.