E-cigarettes appear to be a gateway product to cigarette smoking among youths, according to researchers who studied the "vaping" and smoking patterns of nearly 40,000 teens nationwide.
The controversial nicotine-containing products used in smoking cessation programs to help cigarette smokers break their habit are having the opposite effect on some youths, according to a study in this month's Pediatrics, a journal of the American Medical Association.
Once hooked on the nicotine in e-cigs, some kids graduate to the more powerful nicotine punch delivered by cigarettes, according to Stanton Glantz, lead investigator of the research, which analyzed data from the National Youth Tobacco Survey.
He found that middle school and high school students who are current e-cigarette users have more than a seven times greater likelihood of turning to and using conventional cigarettes.
E-cigarettes, which are an unregulated product, have become a target of fiery debate. Critics say guidelines are desperately needed because the products are also sold in flavors -- such as strawberry, licorice and chocolate -- that are especially enticing to kids.
School districts in Nassau and Suffolk are cracking down on electronic cigarettes and have added bans on the devices, whether they contain nicotine or are nicotine-free, to their anti-tobacco policies. State law prohibits smoking on school grounds.
The LIRR banned vaping on its trains as part of its overall smoking policies. In December, New York City banned vaping in public spaces.
Dr. Stephen Dewey, a brain researcher at the Feinstein Institute for Medical Research in Manhasset and a community-outreach speaker who gives weekly talks at local schools on addiction, said he's well aware of kids trying out e-cigs then moving to conventional products.
"Some kids are saying it's cooler to smoke a real cigarette," Dewey said.
Regardless of the product, it is nicotine's impact on the dopamine receptors of the brain that causes addiction, Dewey said.
"Dopamine is a neurotransmitter and it plays an important role in pleasure. Playing a good game of Xbox can cause the release of dopamine," Dewey said of the popular video game console.
But nicotine-containing products cause a more potent release of the pleasure-causing biochemical, Dewey said. E-cigarettes require more study because the long-term health effects are still unknown, Dewey said.
Instead of tobacco, e-cigarettes contain an atomizer that releases a vapor of propylene glycol. The liquid is generally considered safe.
Glantz found that in 2011, 3.1 percent of adolescents in the study had tried e-cigarettes at least once. By 2012, 6.5 percent had tried them.
His research comes on the heels of a September federal study, which also found increasing use of e-cigarettes among teens.
Dr. Gilbert Ross, executive director of consumer education at the American Council on Health and Science in Manhattan, took issue with Glantz's study and attempts to regulate e-cigarettes.
"The campaigners against e-cigarettes, and I am including the federal government and the nonprofits, like the American Cancer Society and the American Heart Association, are motivated to some extent by greed," Ross said.
"The federal government is being funded by cigarette taxes. And big pharma is heavily invested in selling nicotine-replacement drugs," Ross said.
But Glantz countered that youths are being lured into e-cig use by provocative advertising that largely mimics the way cigarettes were marketed in the 1950s and '60s. Glantz heads the Center for Tobacco Research and Education at the University of California, San Francisco.