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E-cigarettes: an evidence update <br /> <br />37 <br />Figure 8: Prevalence of regular smoking among 11–15 year olds in England 1980–20142 <br /> <br /> <br />Please note: decimal places were not used in the published data. <br /> <br />Gateway <br />The gateway theory or hypothesis is commonly invoked in addiction discourse, broadly <br />to suggest that the use of one drug (sometimes a legal one such as tobacco or alcohol) <br />leads to the use of another drug (sometimes an illegal one) but its definition is <br />contested. No clear provenance exists and its origin appears to derive from lay, <br />academic and political models [22]. It is apparent that discussions about the natural <br />progression of drug use observed in longitudinal studies of young people appear to <br />have morphed into implicit conclusions on causality without any evidential backing. <br />Some have argued that the effect could be causal if the use of one drug, biochemically <br />or pharmacologically, sensitises the brains of users to the rewarding effects of other <br />drugs [23] making the dependent use of these other drugs more likely. However, there <br />are many plausible competing hypotheses for such a progression [24] including i) <br />shared networks and opportunities to purchase the drugs; and ii) individual <br />characteristics such as genetic predispositions or shared problematic environment. <br />Academic experts have stated that the gateway concept “has been one of the most <br />controversial hypotheses…in part because proponents and opponents of the hypothesis <br />have not always been clear about what the hypothesis means and what poli cies it <br />entails” [24]. Indeed, a recent analysis of gateway concluded “Although the concept of <br /> <br /> <br />2 Smoking drinking and drug use among young people in England surveys. Health and Social Care Information Centre, 2014. <br /> <br />0 <br />2 <br />4 <br />6 <br />8 <br />10 <br />12 <br />14 <br />19 <br />8 <br />2 <br />19 <br />8 <br />4 <br />19 <br />8 <br />6 <br />19 <br />8 <br />8 <br />19 <br />9 <br />0 <br />19 <br />9 <br />2 <br />19 <br />9 <br />3 <br />19 <br />9 <br />4 <br />19 <br />9 <br />6 <br />19 <br />9 <br />8 <br />19 <br />9 <br />9 <br />20 <br />0 <br />0 <br />20 <br />0 <br />1 <br />20 <br />0 <br />2 <br />20 <br />0 <br />3 <br />20 <br />0 <br />4 <br />20 <br />0 <br />5 <br />20 <br />0 <br />6 <br />20 <br />0 <br />7 <br />20 <br />0 <br />8 <br />20 <br />0 <br />9 <br />20 <br />1 <br />0 <br />20 <br />1 <br />1 <br />20 <br />1 <br />2 <br />20 <br />1 <br />3 <br />20 <br />1 <br />4 <br />Sm <br />o <br />k <br />i <br />n <br />g <br /> <br />P <br />r <br />e <br />v <br />a <br />l <br />a <br />n <br />c <br />e <br /> <br />( <br />% <br />) <br />