Teen E-Cigarette Use Rises Rapidly

September 9, 2013

News Review From Harvard Medical School -- Teen E-Cigarette Use Rises Rapidly

Use of e-cigarettes by U.S. teens doubled in just a year, a new report says. The Centers for Disease Control and Prevention (CDC) released the report. It was based on the National Youth Tobacco Survey from 2011 and 2012. The surveys included students in grades 6 through 12. The percentage of high school students who had ever used e-cigarettes rose from 4.7% to 10%. About 2.8% had used them in the last month, compared with 1.5% in the first year of the survey. Numbers for middle school students were smaller, but they also doubled. Electronic cigarettes don't burn tobacco. They release a vapor that often contains nicotine. The tobacco industry says they can be used to help adults quit smoking. But that's not how the teenagers were using them. About 76% of e-cigarette users also smoked cigarettes. Among middle schoolers, 20% of users had never smoked tobacco. Interviewed by HealthDay News, a CDC official described the trends as alarming. He said they suggest that e-cigarettes may lead teens to try cigarettes. Unlike tobacco, e-cigarettes are sold without restrictions, so teens can buy them. The Morbidity and Mortality Weekly Report published the study. HealthDay wrote about it September 5.   

By Claire McCarthy, M.D.
Harvard Medical School

What Is the Doctor's Reaction? 

There's no such thing as a safe cigarette. 

That's the message from the U.S. Centers for Disease Control and Prevention (CDC). A  recent report from the CDC showed that the use of electronic cigarettes among high school and middle school students doubled between 2011 and 2012. Among high school students, the use went from 5% to 10%. That's scary.

Electronic cigarettes, commonly known as e-cigarettes, are battery-operated devices that are shaped like cigarettes.  They give off a vapor. Sometimes that vapor contains nicotine. Either way, they give the illusion and feel of smoking a cigarette without burning tobacco.

That's what advocates and manufacturers of e-cigarettes point to: There's no burning tobacco involved, so they are healthier. Not so fast, the CDC and many experts say. First of all, we don't actually know that the vapor is safe; it's being studied. Second, if nicotine is used, it can be addictive.

Using e-cigarettes as part of a quitting strategy may be a good idea, but that's not how most youth are using them.

The majority (76%) of the youth in the study who use e-cigarettes also use regular cigarettes. The habits may reinforce one another. But 20% of middle school students who use e-cigarettes have never smoked.

It's possible that they started because of the way that e-cigarettes glamorize smoking. It doesn't help that they come in flavors like chocolate and bubble gum.

The marketing of e-cigarettes is part of the problem as well. It's been largely unregulated, meaning that manufacturers can target youth. The Food and Drug Administration (FDA) Center for Tobacco products says it's going to start regulating e-cigarettes, which is good news. But in the meantime, it's up to parents and others who live with and work with youth.

What Changes Can I Make Now?

Please, if there are teens in your life, talk to them about e-cigarettes. Help them see that there is simply nothing good about them. Make sure they understand that we don't know if they are safe. Walk them through how using e-cigarettes can end up becoming a regular cigarette habit. Understanding all the possible consequences of actions is not usually a strong point for teens.

It's also important that all of us speak up against the marketing of these products. Jenny McCarthy has an ad for them that makes them seem wonderfully glamorous. Much of the marketing also portrays them as safe. They are neither glamorous nor safe.

Talk to your elected officials, and talk to retailers in your area. Encourage them not to sell e-cigarettes. Or, at the very least, ask them not to place e-cigarettes in a prominent place and not to display advertising that might appeal to youth.

What Can I Expect Looking to the Future? 

If we don't do something to limit the sale of e-cigarettes, what we can likely expect is more youth smokers. That would be very sad, as we have finally begun to make some progress there.

I hope that the FDA will get regulations out soon to limit the marketing and sale of e-cigarettes to youth. And I hope that we will have more research soon to strengthen those limitations -- and to better inform the public of the risks of e-cigarettes.

In the meantime, please keep repeating to every teen you encounter: There's no such thing as a safe cigarette.