Teenagers who try e-cigarettes double their risk for smoking tobacco cigarettes, according to a new study.

The study — from the University of Waterloo and the Wake Forest School of Medicine — found that students in grades seven to 12 who had tried an e-cigarette are 2.16 times more likely to be susceptible to cigarette smoking.

“Since e-cigarettes came on the market there has been a debate about whether their use may lead to cigarette smoking,” said Bruce Baskerville, co-author on the study and a researcher at the Propel Centre for Population Health Impact at the University of Waterloo. “The answer among adolescents is yes.”

Using data from the Canadian Student Tobacco, Alcohol and Drugs Survey, the study found almost 10 per cent of students in grades seven to 12 reported ever having used e-cigarettes.

E-cigarettes can contain nicotine but not many of the harmful substances produced by smoking tobacco, such as tar or carbon monoxide. These products work through an inhalation-activated system that heats a solution to create an inhalable aerosol, often known as vapor.

“While preliminary evidence suggests that e-cigarettes contain fewer toxic chemicals than traditional cigarettes, our findings suggest that a potential increase in harmful cigarette use may follow as e-cigarette use continues to rise among adolescent populations,” said Baskerville.

Provincial regulations for e-cigarettes vary across the country. In Ontario, the Electronic Cigarettes Act came into place on January 1, 2016 and prohibits the sale of e-cigarettes to anyone under 19 years of age.

“This study supports the restricting of e-cigarette access to minors, which have been shown to have heightened risk to initiate smoking,” said Baskerville. “More research is needed in Canada on additional contributing risk factors as well as longitudinal data to evaluate the complex relationship between e-cigarette use and tobacco cigarette use in adolescence.”

Tobacco remains the leading cause of preventable death in Canada.

The study was published in the journal Preventive Medicine.