SALT LAKE CITY — Teens may think they’re playing it safe by using e-cigarettes, hookahs and smokeless tobacco, but they’re twice as likely to have smoked cigarettes a year later if they use alternative tobacco products, a new report says.

Consequently, the gains made in public health as cigarette smoking has declined in recent years may be at risk if the use of novel tobacco products continues to rise, according to the authors of the study, published Tuesday in the journal JAMA Pediatrics.

Researchers at the University of California, San Francisco, examined the records of 13,651 adolescents enrolled in the Population Assessment of Tobacco and Health, a nationwide study begun in 2013 by the National Institutes of Health and the Food and Drug Administration.

At the beginning of the study period, the teens, ages 12-17, had not smoked a cigarette, and a year later, a majority of them were still not tobacco users.

However, youths who reported using e-cigarettes or other non-cigarette forms of tobacco the first year of the study were twice as likely to have smoked at least one cigarette or smoked in the past 30 days one year later.

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