Vaping as a gateway to smoking – evidence briefing

Methodology

This evidence briefing is based on a search and analysis of scholarly research on vaping as a gateway to tobacco smoking carried out between December 2022 and November 2023.

The search was conducted on a number of search engines: KandE (a Scottish Government resource covering several databases), Google Scholar, PubMed and ScienceDirect. It included the following terms: “ENDS”, “e-cigarettes”, “vapes”, “vaping”, “gateway”, “gateway effect”, “tobacco smoking”, “cigarettes”, “young people”, “children”, “adolescents”, “teenagers”, “addiction”.

Thirty-seven papers/reports were selected and reviewed (opinion pieces and editorials were excluded). Of these, eight were systematic reviews and/or meta-analyses, hence have been prioritised and represent the core sources used to write this briefing. No critical appraisal of the evidence they examined was undertaken.

Furthermore, Scottish Government officials have engaged with colleagues from Public Health Scotland, academics and international experts to discuss ongoing research and upcoming publications on the gateway effect to adopt a balanced approach on a highly debated topic.

In this briefing we make reference to “vaping products” to describe both nicotine and non-nicotine devices used to inhale an aerosol. The sources analysed here adopt different terms and definitions. For accuracy and in order to preserve the original meaning, the terminology chosen by the authors of each review has been retained when summarising their findings.