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Several large cities throughout the United States have decided to ban the use of electronic cigarettes in public areas, such as restaurants. Even though studies have not determined if these products are safe to use, some of the state officials have expressed concerns over effects of smoking e-cigarettes, called "vaping" on young children. Now, in a new study, researchers reported that middle and high school children who vape are also more likely to start smoking real cigarettes and less likely to quit.

In this study, the researchers examined data provided by a government survey of over 17,000 middle school and high school students in 2011 and over 22,000 students in 2012. The researchers noted that the survey did not follow the same students in 2012, but rather, they interviewed a new group of kids. Based from these findings, the study's lead author, Stanton Glantz, a professor of medicine at the University of California, San Francisco concluded that e-cigarettes use could predict which kids will become established smokers.

"The use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents," the authors concluded reported by the New York Times.

Glantz added, "One of the arguments that people make for e-cigarettes is that they are a way to cut down on the smoking of cigarettes, but the actual use pattern is just the opposite."

Several critics reported that the data from this study could be interpreted in many ways and therefore, the authors' conclusion that e-cigarettes lead to smoking is not reliable. One of the critics, David Abrams stated that the study did not identify whether or not the children were already smokers before trying e-cigarettes. Abrams, who is the executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the Legacy Foundation, which is an anti-smoking research group, stated that oftentimes, heavy established smokers are highly likely to experiment with new products, such as e-cigarettes.

"I am quite certain that a survey would find that people who have used nicotine gum are much more likely to be smokers and to have trouble quitting, but that does not mean that gum is a gateway to smoking or makes it harder to quit," Abrams said.

The study was published in JAMA Pediatrics.