Understanding the Gateway Hypothesis: Discusses the Concept of the Gateway Hypothesis and its Relevance to High School Students in Northern Cyprus

Abstract

This quantitative survey was conducted by the Anti-Drug Commission under the Prime Ministry of the Northern Cyprus. The objective of this study was to investigate the frequency of alcohol, cigarettes, and addictive substances among high school students in the Northern Cyprus. The data was collected from a sample of 763 students through the utilization of the European School Survey Project Alcohol and Other Drugs (ESPAD Survey). The findings of study stated that, positive relationship between the decrease in the legal age for smoking and the increase in the use of e-cigarettes. Additionally, it was established that there exists a positive relationship among smoking and e-cigarette usage between high school students in the Northern Cyprus. Other additionally, the study demonstrated that as the age of initiation for cigarette or e-cigarette usage decreases, the age at which students engage in daily substance use also decreases. Furthermore, it was observed that early exposure to these substances is linked to becoming a daily user. In terms of the results of regression analysis of the study, the use of legally defined tobacco products (cigarettes, e-cigarettes, hookah) in Northern Cyprus is not effective in predicting the use of illicit substances such as bonzai. However, frequency of cannabis use predicts bonzai use among high school students.

Keywords: Cannabis use, bonzai use, substance use, smoke use, Northern Cyprus

Introduction

Use of tobacco and smoke products, e-cigarettes among high school students have reached a level of concern due to changing social norms and technological developments now a days. Despite substantial efforts to prevent the negative effects of smoking and the development of innovative nicotine delivery methods, the temptation of these substances remains strong and permeates the very fabric of our educational institutions (Christophi et al., 2008; Singh et al., 2016). Youth use of tobacco-related products is on the rise, and this is a worrying development in the high school setting (Emekdar et al., 2017). Through clever digital adaptation of ever-changing cigarette marketing strategies, these products are now able to reach new target audiences, especially young minds (Dunlop et al., 2016). Therefore, of considerable importance to identify the underlying causes of this problem, in order to risks it poses to the health and well-being of minors.

The influence of peer groups is strong. Young individuals are often influenced by their classmates and make efforts to fit in and be accepted in society (Noland et al., 2016). Some students tend to start smoking or vaping because they think it is fashionable or popular in their social groups (Phua, 2011). While smoking or vaping can function as a coping mechanism for individuals to cope with various pressures, including academic, social or personal stressors (Long, 2003), it can also be seen as a form of curiosity, lack of taste or smell awareness, or a form of defiance against social norms (Kaleta et al., 2017; Nodora et al., 2014).

Tobacco and e-cigarette manufacturers promote their products through sophisticated marketing strategies. These products are made to attractive due to appealing brands, colourful packaging, various flavour options, and advertising that appeals to young people (Carpenter, 2005; Escobedo et al., 2018). Disinformation or misleading marketing advertisements may cause young people to perceive and be attracted to these products as less dangerous than they are. Moreover, easy accessibility and lack of control mechanisms over restrictive factors have a great influence on first trials or increased use (Prokhorov et al., 2006).

The family and environment exert significant influences on young individuals, serving as role models. This is especially evident when adolescents face limited alternative activities, as they may be more inclined to engage in smoking or vaping due to a dearth of other options for leisure or recreational pursuits (McGee et al., 2015).

Findings of recent studies, use of cigarettes, e-cigarettes and tobacco products has a significant effect on the consumption of cannabis and bonzai, a synthetic cannabinoid. The act of smoking cigarettes or other tobacco products may heighten the likelihood of an individual experimenting with other substances, such as marijuana, thereby inducing what is commonly known as the gateway effect (Nkyi, 2015). Additionally, it is quite prevalent for individuals to engage in simultaneous usage, whereby both cigarettes and marijuana are smoked concurrently, either through the blending of the two substances or by alternating between them (Mete et al., 2020). In addition to cigarettes, a substantial number of individuals amalgamate tobacco and cannabis in order to create "spliffs" or "blunts". E-cigarettes, also recognized as vapes, particularly among the younger population, may serve as an entry point to the consumption of other drugs, including cannabis and bonzai (Etter, 2018). Smoking, e-cigarettes, and tobacco use in general can act as a gateway to cannabis and bonzai use.

Literature Review

In this section, the gateway hypothesis is explained, and substance use in Northern Cyprus is discussed.

Methodology

Discussion

The results of the study show that, there is a moderate relationship between hookah use and cigarette and e-cigarette use. Hookah smoking entails inhaling tobacco smoke that has passed through water before being breathed. The relationship among hookah usage and other substance usage, such as cigarettes, e-cigarettes, bonzai (synthetic cannabinoids), and cannabis, varies and is influenced by several factors. Hookah and cigarette use are highly correlated, particularly among young adults. Many people who smoke hookah also smoke cigarettes. Some people use both types of smoking interchangeably, while others combine the two. Hookah and cigarette use together can increase overall exposure to hazardous chemicals contained in tobacco smoke (Doran et al., 2015). Many of hookah users might utilize e-cigarettes. The combination these, may be caused by the increasing popularity of flavored e-liquids and the belief that vaping is less harmful than smoking (Barnett et al., 2015)

In terms of findings about the smoking age decreases, so does the age at which people switch to e-cigarettes. Similarly, findings, as the age of first cigarette and e-cigarette smoking falls, so does the age of daily usage of cigarettes and e-cigarettes. Students who are introduced to smoking at an early age are more likely to grow up engaged to other tobacco-related products in their later years. Early years smoking is related with an increased likelihood of nicotine addiction, dependency, and lifetime tobacco use (Kandel et al., 2007).

Also, the age when e-cigarette use begins is also a significant factor. The stage of life when the use of e-cigarettes starts is also a significant factor. Early e-cigarettes use exposes people to the hazards of breathing harmful chemicals and nicotine, that can lead to an addiction to nicotine. Furthermore, early vaping may lead to later tobacco cigarette smoking (Chapman et al., 2019).

This study found that starting to be exposed to cigarettes and e-cigarettes, in addition to making smoking a daily habit at a young age, lowers the age of cannabis use, albeit at a low level. The literature (Agrawal et al., 2004; Kokkevi et al., 2006) underlines that early cannabis intake is associated with a range of harmful effects. Therefore, cannabis use, increases of risks that may impair brain development and cognitive functioning, also increase memory problems, and would increase adolescents harm their mental health. Additionally, there is a relationship among early cannabis usage and a greater risk of cannabis use mental disorder and dependency. It is crucial to remember that using cannabis can be harmful to varying degrees depending on several of factors, including product potency, individual sensitivity, and frequency of use.

The study’s findings state that, consistent with previous research and show the complicated and connected nature of the relationship among the age at which people begin smoking, using e-cigarettes, and using cannabis (Butler et al., 2022; Weinberger et al., 2021). The gateway hypothesis states that experimenting with one substance earlier in life may increase the probability of trying additional substances (Kandel & Kandel, 2015). People who start using nicotine or e-cigarettes at an early age may also be more likely to try with cannabis (Ren & Lotfipour, 2019). Additionally, the age at which these substances are initially taken is determined both social and legal factors. The age at which people are exposed to cigarettes, e-cigarettes, and cannabis varies depending on the legal age in each jurisdiction (Dave et al., 2019; Pesko et al., 2016). In conclusion, there may be ramifications for someone's overall health, wellness, addiction, and well-being from the complicated relationship among the age at when a person begins smoking, using e-cigarettes, and using cannabis. Postponing substance use, especially in adolescence, is associated with better results and fewer risks.

When the study's regression findings are examined, it becomes clear that bonzai use wasn't predicted by students' lifetime smoking frequency, age at when they began smoking, frequency of e-cigarette use, age at which they initially tried a hookah, or usage of heated non-combustible tobacco products. On the other hand, a higher frequency of cannabis usage among students is a strong indicator of bonzai consumption. In terms of Çoban (2014)'s report, the high number of deaths related to bonzai use suggests that more research needs to be done on the use of this substance and that it should be prioritized as the primary reason for worry on the public's agenda. Karaaziz and Keskindağ (2016) also emphasize that bonzai, a substance particularly abused by young individuals and capable of generating addiction at a rapid pace, carries a significant degree of risk due to the presence of various chemicals. The notion that bonzaies yields effects akin to those of cannabis is widely prevalent among the general population. The regression findings have rendered valuable insights into the factors predicting the consumption of bonzai among students. The heightened likelihood of bonzai intake associated with increased utilization of cannabis underscores the urgent need for a comprehensive approach towards preventing and intervening in drug use. Subsequent investigations may examine deeper the specific mechanisms and underlying factors that account for the association between cannabis and bonzai intake, potentially yielding more efficacious strategies for managing substance use among adolescents.

Conclusion

The findings of the research emphasize the importance of addressing alcohol, cigarettes, and addictive substances among high school students in the Northern Cyprus.

The findings of study stated that, positive relationship between the decrease in the legal age for smoking and the increase in the use of e-cigarettes. The study's conclusions showed a positive correlation between the rise in e-cigarette use and the decline in the smoking age. Furthermore, it was found that among Northern Cyprus' high school pupils, using e-cigarettes and smoking are positively correlated.

Moreover, the study demonstrated that as the age of initiation for cigarette or e-cigarette usage decreases, the age at which students engage in daily substance use also decreases. It has also been noted that early exposure to these substances is associated with the development of a daily user behaviour. According to the study's regression analysis results, using legally classified tobacco products (hookahs, e-cigarettes, and cigarettes) in Northern Cyprus does not accurately predict using illegal substances like bonzai. Nonetheless, among high school students, the frequency of cannabis use predicts the use of bonzai.

Challenges and Limitations of the Study

Additionally, tobacco and e-cigarette companies employ sophisticated marketing strategies that incorporate health-related claims, branding, colorful packaging, and flavors. These marketing tactics are continuously evolving, making it difficult to evaluate them accurately and consistently over time. The messages on marketing materials that may lead individuals to believe that tobacco and e-cigarette products contain fewer harmful compounds than they actually do, as well as the additional risk associated with developmental exposure, further complicate the assessment of what constitutes an actual puff and obscure the actual risks associated with tobacco and e-cigarettes.

On the other hand, accessibility emerges as the most significant challenge. Tobacco and e-cigarette products are easily obtainable, with fewer controls in place to ensure that minors do not have easy access to them, making it difficult to regulate their usage and experimentation. Additionally, this study identifies a range of individual behavioural and psychological factors, such as coping, curiosity, and rebellion against social norms, that are believed to enhance youth vulnerability to smoking and vaping. However, these factors are interconnected and complex, making it exceptionally difficult to isolate and study them individually, particularly with regard to their contribution to smoking and vaping behavior. This study also aims to identify the underlying causes of youth tobacco and e-cigarette use in order to address the risks to health and well-being. However, understanding and addressing these underlying causes is challenging due to the multifaceted nature of the influences involved. The findings of the study may be limited in their generalizability due to variations in social norms, technological developments, and marketing strategies across different regions and populations. This limitation affects the broader applicability of the study’s conclusions. By tackling these challenges and limitations, the study aims to provide a comprehensive understanding of the factors influencing youth tobacco and e-cigarette use and to inform effective prevention and intervention strategies.

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