If and when the Food and Drug Administration drops some sort of heavy regulations on e-cigarettes, a study released today is the one it, and politicians who hail the decision, will inevitably turn to: A pair of scientists at Columbia University have slapped the dreaded "gateway drug" term on nicotine, and, with it, e-cigarettes.
The study, published today in the New England Journal of Medicine, has all of the makings of a bombshell report (for prohibitionists, at least). It's coming out in a major journal, one of the two authors has a Nobel Prize, and it's decidedly anti-e-cigarette.
The study's authors, Eric and Denise Kandel, say that they've found the "molecular basis" for nicotine's role as a gateway drug. Adult mice who are given cocaine show more addictive behavior and stronger effects from the cocaine if they've been "primed" with seven days of nicotine use beforehand, according to the study. In other words, cocaine is more addictive to mice if they're already addicted to nicotine.
"Nicotine acts as a gateway drug and exerts a priming effect on cocaine in the sequence of drug use through global acetylation in the striatum, creating an environment primed for the induction of gene expression," they wrote.
On its own, the finding is interesting, and perhaps something to be aware of if you're a nicotine user who is thinking about getting into cocaine. But toward the end of the study, the Kandels make a leap in logic that suggests their study should be used to more strictly regulate e-cigarettes.
"E-cigarettes have the same effects on the brain as those reported here for nicotine … and they pose the same risk of addiction to other drugs and experiences," they write. "Our society needs to be concerned about the effect of e-cigarettes on the brain, especially in young people, and the potential for creating a new generation of persons addicted to nicotine. The effects we found in adult mice are likely to be even stronger in adolescent animals."
There's no reason to doubt any of the Kandels' science. They suggest that perhaps addiction is something of a "learned" behavior, so it makes sense that if you're addicted to one thing, you can more easily become addicted to another thing. You might not believe it, but the conclusion is supported by their work.
"Whether e-cigarettes will prove to be a gateway to the use of combustible cigarettes and illicit drugs is uncertain, but it is clearly a possibility," they write. "Our data suggest that effective [e-cigarette] interventions would not only prevent smoking and its negative health consequences but also decrease the risk of progressing to illicit drug use and addiction."
That passage, on the other hand, is worth fighting over—the idea that someone who uses nicotine is inevitably going to use cocaine or harder drugs. The Kandels note that less than 10 percent of cocaine users have never smoked cigarettes or started smoking at the same time they started doing cocaine.
But that has way, way more to do with social aspects, such as the fact that someone who is willing to do cocaine probably isn't going to fret about smoking a cigarette from time to time rather than it has to do with the nicotine's "gateway" properties.
The answer here isn't to make it inherently more difficult to get e-cigarettes, a technology that health groups and all the evidence points to as being less harmful than combustibles and a technology that many have said is saving their lives. The answer, instead, is to make it clear that doing cocaine and other hard drugs is dangerous, whether you smoke e-cigs or not.