Many teenagers are using e-cigarettes for their first experience of tobacco, researchers warned today.
A study found that 20% of teenagers have used the devices.
And for 16%, e-cigarettes provided their first experience of smoking. Another 23% may have turned to the devices because they tried cigarettes and did not like them.
The findings come from a survey of more than 16,000 school-aged teenagers in the north west of England.
The research at Liverpool John Moores University, UK, was published in BMC Public Health.
They found a link between the use of e-cigarettes and other risk behaviour, such as binge drinking and involvement in violence after drinking.
The findings will sharpen the debate on e-cigarettes which are marketed as a safer substitute for smokers. Companies are not allowed to market them to teenagers.
Researcher Mark Bellis said: "Our research suggests that we should be very concerned about teenagers accessing e-cigarettes. While debate on e-cigarettes has focused largely on whether or not they act as a gateway to tobacco cigarette use, e-cigarettes themselves contain a highly addictive drug that may have more serious and longer lasting impacts on children because their brains are still developing.
"Despite being practically unheard of just a decade ago, e-cigarettes are now widely available, heavily promoted yet weakly regulated and our study found that one in five 14-17 year old school children in the North West has accessed them. Such rapid penetration into teenage culture of what is essentially a new drug use option is without precedent.
"Of particular concern is our finding that teenage ex-smokers who accessed e-cigarettes were outnumbered by those who had never smoked but simply decided to experiment with what might be packaged to look like a safe attractive product but actually contains a highly addictive drug."
Associations between e-cigarette access and smoking and drinking behaviours in teenagers BMC Public Health 30 March 2015; doi:10.1186/s12889-015-1618-4 [abstract]
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