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However, they noted some limitations including the cross-sectional study design, the potential for recall bias among participants, and not including key health and behavioral factors such as diet, exercise, sleep or socioeconomic status, which may have affected results

Smith KR, Shuhua G, Kun H, et al

The study continues: These findings suggest that e-cigarettes are not merely a marker for individuals who would have gone on to smoke combustible cigarettes, regardless of the availability of e-cigarettes, but that e-cigarette use is likely introducing new youth to tobacco products and is increasing the likelihood of future smoking among the low-risk group who expressed confidence that they would not do so. The health department has launched a public education campaign in order to help parents, teachers and other influential adults learn how to talk with youth about vaping, spearheaded by the campaigns website, TobaccoFreeCo.org