Alcohol, Marijuana or E-cigarettes: which of these is a gateway drug?

The “gateway theory” of substance abuse has again taken center stage as dozens of states debate the legalization of marijuana, and, quite suddenly, a new substance has entered the conversation: e-cigarettes. In the first national analysis of the increasingly popular e-cigarette, researchers found that e-cigarettes “may actually be a new route to conventional smoking and nicotine addiction,” according to the study, out of the University of California, San Francisco.  The study involved nearly 40,000 youth nationwide.

Noted lead author Lauren Dutra, a postdoctoral fellow at UCSF’s Center for Tobacco Control Research & Education: ““Despite claims that e-cigarettes are helping people quit smoking, we found that e-cigarettes were associated with more, not less, cigarette smoking among adolescents.”

Both the UCSF study, and another that involved 75,000 Korean adolescents, found that teens who use e-cigarettes (battery-powered devices that deliver an aerosol of nicotine and other chemicals) were less likely, not more likely, to stop conventional smoking.  Explained senior author Stanton Glantz, UCSF professor of medicine and director of the Center for Tobacco Control Research and Education: ““It looks to me like the wild west marketing of e-cigarettes is not only encouraging youth to smoke them, but also is promoting regular cigarette smoking among youth.” The UCSF study cited statistics from the Centers for Disease Control and Prevention which estimates that 1.78 million U.S. students used e-cigarettes as of 2012.

Said the report: “In spite of the growing consumption of e-cigarettes and the fact that there has been limited research on their health effects, e-cigarettes are currently unregulated by the FDA.  Unlike traditional tobacco products, e-cigarettes are not subject to federal age verification laws and can be legally sold to children unless state or local laws bar their sale to minors.  Presently, 28 states prohibit the sale of e-cigarettes to minors.”

Marijuana legalization

Is marijuana a gate drug? The body of research continues to grow, and the dial, increasingly, points to no. Maintains the Marijuana Policy Project: “[Marijuana is] simply the first (or more likely, third, after alcohol and cigarettes) in a normal progression to more dangerous substances among those predisposed to use such drugs.”

A 2012 study out of Yale, in fact, found alcohol’s gateway effect to be much larger than marijuana’s.  The study set out to examine the “gateway effect” as it relates to the abuse of prescription opiate drugs.  In other words, the researchers wanted to know if a person’s early use of substances (alcohol, cigarettes, marijuana) correlated with abuse patterns later in life.  The short conclusion: yes, “people who used alcohol or tobacco in their youth are almost twice as likely to abuse prescription opiate drugs than those who only used marijuana,” according to an article authored by Stephen Webster for www.rawstory.com.  Webster noted that, according to the CDC, prescription opiate overdoses kills more Americans each year than cocaine and heroin overdoses combined.

Webster cited two additional studies which pointed the finger at alcohol.  The first, published in the Journal of School Health, “pinpointed alcohol, instead of marijuana, as the most commonly abused substance for first-time drug users.” The second, published in 2010 in the medical journal Lancet, “ranked alcohol as the most harmful drug known to man, with more than double the potential harms of heroin use.” 

The fact that fewer Americans now consider marijuana a gateway drug may account for the rising tide for legalization. A Huffington Post article listed 14 states which appear next in line to legalize the product – following positive experiences in Washington (the state) and Colorado. The 14 states, according to Huffington Post, are as follows (in each state, surveys found that a majority of residents are in favor of legalization): Alaska, Arizona, California, Delaware, Hawaii, Maine, Maryland, Massachusetts, Montana, Nevada, New York, Oregon, Rhode Island and Vermont.

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