In just a year, electronic cigarette use has tripled among American teens. And considering that no one really knows what the related health impacts are and any regulatory framework is lagging far behind the growing popularity of e-cigarettes, public health advocates say it’s time for action.
Earlier this week, the Centers for Disease Control and Prevention released new data from the 2014 National Youth Tobacco Survey finding that current e-cigarette use among high school students, which is defined as using at least once in the prior 30 days, nearly tripled — from 4.5 percent in 2013 to 13.4 percent in 2014. In sheer numbers that means e-cigarette use grew from about 660,000 high school students to 2 million. Among middle school students, e-cigarette use more than tripled, from 1.1 percent in 2013 to 3.9 percent in 2014. CDC reports that for the first time since the youth survey began collecting information on the new trend, current e-cigarette use has officially surpassed the use of every other tobacco product. E-cigarettes are battery-powered devices that heat up liquid mixtures usually containing nicotine and other flavorings and produce a vapor that users inhale.
While the CDC data did find declines in cigarette smoking among high school students — the 2014 rate was 9.2 percent, a new low — increases in e-cigarette and hookah use offset those gains, resulting in no real change in overall tobacco use among high school and middle school students. Overall, about 4.6 million middle and high school students currently use some type of tobacco product. The new data were published in this week’s issue of CDC’s Morbidity and Mortality Weekly Report.
In reacting to the new data, Matthew Myers, president of the Campaign for Tobacco-Free Kids, said:
The dramatic decline in youth cigarette smoking is terrific news for our nation’s health and shows that the fight against tobacco is winnable if we do what we know works. However, the skyrocketing use of e-cigarettes is frightening and threatens this progress. It should spur strong and prompt action to prevent kids from using any tobacco product, not just cigarettes. We cannot allow the tobacco industry to keep addicting kids and create another epidemic with a new generation of tobacco products.
These survey results show why the Food and Drug Administration must act with urgency to protect our kids and issue a final rule to regulate all tobacco products, including e-cigarettes, cigars and hookah. We again call on the FDA and the Obama Administration to issue a final rule by April 25 — one year after the FDA issued a proposed rule — and to close gaps in the rule by cracking down on marketing and flavors that appeal to kids. The FDA first announced in early 2011 that it planned to regulate e-cigarettes, cigars and other unregulated tobacco products, so these important public health protections are long overdue. We cannot afford more delays that allow the tobacco industry to continue targeting our kids with unregulated tobacco products.
And in a similar reaction from the American Lung Association, CEO and President Harold Wimmer said:
Previous studies should have served as warning bells to the federal government that FDA oversight of all tobacco products was urgently needed. Today’s study highlights the consequences of allowing these products to remain without oversight.
April 25 will mark the one-year anniversary from when FDA’s proposed rule was released, and over four years after FDA first announced its plan to oversee cigars, e-cigarettes and hookah. It is time for the Obama Administration to act with urgency.
The new CDC data found that in 2014, the most commonly used tobacco products among high school students were e-cigarettes, followed by hookahs (9.4 percent), cigarettes (9.2 percent), cigars (8.2 percent), smokeless tobacco (5.5 percent), snus (1.9 percent) and pipes (1.5 percent). Hookah use about doubled among middle school students, from 1.1 percent in 2013 to 2.5 percent in 2014, and among high school students, from 5.2 percent in 2013 to 9.4 percent in 2014. Overall, there were about 1.6 million young hookah users in 2014.
Research on the short- and long-term effects of e-cigarettes, which often contain a mixture of chemicals and flavorings, is still very much emerging, but most researchers agree that whether or not the novelty products are less harmful than cigarettes is yet to be known. One research article published just this week in the journal Tobacco Control found that “some flavour chemicals in e-cigarette fluids are sufficiently high for inhalation exposure by vaping to be of toxicological concern.” (And this recent in-depth investigation into worker exposure to diacetyl, a chemical that can permanently damage the lungs, also explored the chemical’s use in e-cigarettes.) However, one issue advocates are quick to point out is that the e-cigarette industry is using many of the same tactics to appeal to young people as Big Tobacco did. For instance, many e-cigarette flavors seem eerily kid-friendly, with flavors such as cotton candy, banana split and cherry crush.
Today, FDA only regulates e-cigarettes that are marketed for therapeutic purposes; however, the agency will be collecting public comments on its third and final public workshop on e-cigarettes and public health through July 2. For more on the June 1-2 FDA workshop and info on submitting comments, click here.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.