A recent study published in the New England Journal of Medicine has found that nicotine, regardless of its delivery source, is a gateway drugs that leads to more cocaine abuse.

Dr. Denise B. Kandel and her husband, Eric, reviewed Kandel’s research on nicotine collected over the last three decades. Both work at the Columbia University Medical Center.

They performed this study as an attempt to differentiate between why nicotine would act as a gateway drug. They thought it could be because of how easily attainable the drug was, or it could be because of changes in neural pathways in the brain that caused more addiction to develop in individuals.

Through testing with rats they found that brain circuitry was changed to incorporate more activity the regions of the brain that deals with rewards. When given cocaine after the exposure to nicotine, this effect seem to be enhanced. The same did not appear to be true when exposure to these same drugs was switched and cocaine was introduced first. Thus, they concluded that e-cigarettes were equally as dangerous as regular cigarettes in that they acted as a gateway to hard drugs.

Not all experts agree that this is a plausible conclusion to draw. Some point out that, while a rat’s biology is similar to human biology, it is by no means the same and such strong conclusions can not be reached by rat experimentation alone.

Director of the Vitality Institute of New York, Derek Yach, said that statistical evidence does not align with the claims of Kandel. According to Yach, if these claims were true then there would be an increase in cocaine abuse evident that coincides with the increased popularity of e-cigarettes, yet statistics indicate a decline in use.

Dr. Gopal Bhatnagar, a cardiac surgeon in Toronto, refers to the whole topic as “the gateway myth” and considers the study’s choice to group e-cigarettes, smokeless tobacco and traditional cigarettes into the same category to be an inherent flaw in the study. He brings up past research that found that only one in 1,300 surveyed college students began smoking e-cigarettes before switching to traditional ones.

He says, “The primary reason smokers use e-cigarette is to cut down or quit cigarettes. Vilifying a safer alternative to cigarettes is counter-productive to good health.”