April 17, 2015 Kim Krisberg 17Comment

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.

For a full copy of the new youth e-cigarette data, visit CDC. For more coverage of the data, including interviews with youth e-cigarette users, check out this New York Times article.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.

17 thoughts on “CDC: American youth now use e-cigarettes more than any other tobacco product

  1. In my hometown, empty e-cig boxes have replaced the cigarette butts that I used to see on the side of the road. The jump in the number of young users is very troubling

  2. As a fair warning I am commenting as part of an assignment for the University of Pretoria, but this topic is particularly interesting to me as I am a user of the e-cigarette. What a lot of data does not clearly state, but what I can confidently state from personal experience and observation of many other “smokers” around me, is that many of the e-cigarette users still smoke regular brand cigarettes. This brings to mind the thought that perhaps the increase in the use of e-cigarettes may actually be more detrimental to young people who smoke, than helpful. It could become a “gateway” to smoking regular cigarettes, or it could double the amount of damage being done to regular smokers, who are now smoking both kinds of cigarette. Just an interesting thought which does not seem to be of much concern at this stage but perhaps should be? 15385010

  3. As I see it, the idea that e-cigarettes are less harmful than regular ones is plausible, but there’s no solid evidence either way. We do know, however, that nicotine itself has risks, including birth defects, so e-cigs are not harmless.

    Common sense says they should be restricted the same way that regular cigarettes are. No sales to children, all marketing must be targeted to adult users.

    Unfortunately, their marketers are very clever indeed and have convinced their regular users that any attempts at regulation are part of a nefarious plot to ban the product and force them back to regular tobacco products.

  4. The nicotine in e-cigarettes is addictive. When a user stops using it, he/she can experience withdrawal symptoms including depression, restlessness and anxiety.it can also harm a person’s arteries over time.This is dangerous, especially for growing teens. The alarming rate of increase in e-cigarette usage among teens could indicate a future health problems. However tests prove that the levels of dangerous chemicals given off by e-cigarettes are a fraction of what is given off by a real cigarette. Smoking, in general has many side effects, including lung cancer and its user statistics should be decreasing instead of increasing. Teenagers have their entire lives ahead of them, hence the smoking statistics among teens should decrease.
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  5. As Damon Xavier Laurent said, most e-cigarette smokers smoke regular cigarettes too- this i can say from personal experience. Yet the problem with e-cigarettes is that smokers think that this is a healthy alternative for their unhealthy smoking habits, because when smoking an e-cigarette it does not feel like it has the same effects on your lungs as a cigarette has.
    Something that could perhaps bring down the amount of e-cigarette smokers is if e-cigarette producers print the dangers that e-cigarettes can have on the packaging, just like cigarette producers do.

  6. Caffeine is also addictive as hell, as any serious coffee drinker will attest. Migraine-like headaches, inability to concentrate, irritable mood, cravings, etc. etc. So if it’s addiction we’re concerned about, then consistency also requires raising the age of access to caffeine, and taking it out of beverages that are flavored to attract kids (e.g. soft drinks, sweetened coffees, etc.).

    The solution to all of this is really simple: age 18 for access to caffeine, nicotine, alcohol, cannabis, or any product containing any of the same except upon a valid prescription by a board-licensed medical doctor (e.g. cannabis for chemo patients). Note that we have seen a huge rise in collegiate binge drinking as a direct correlate (probably causal) of the change of the drinking age to 21.

    Another exception that’s worthwhile is for parentally-supervised usage down to age 16. That would enable socialization of the use of these substances in a controlled setting, which would further decrease the degree of abuse in later life.

    There’s no need to generate a bunch of moralistic emotionalism about the “evils” of smoking (or “steaming”, as e-cig usage ought to be known): it comes across as more Reefer Madness and imperils the credibility of health arguements generally. And let’s not forget that forbidden fruits taste even sweeter. Frankly in light of the addictiveness of caffeine, and the addictiveness and enormous dangers of alcohol, it also comes across as hypocritical: “My drugs are OK but yours are evil.” Bah humbug to that.

  7. do e cigarettes also contain nicotine?and if they do how is it built and why is the government allowing a new form of drug which seems that teenagers are likely to get addicted too?

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  8. E-cigarettes should not be a substitute for tobacco cigarettes, they contain toxic chemicals including nicotine which is also addictive and may damage the proteins in the lungs.15147208

  9. I think the idea of e cigarettes is quite appropriate but given the high increase in students smoking it, rises quite a shock to see this, especially that a huge debate about it’s long term and short term symptoms/ health issues still continuing, maybe a different approach can be made or even further study this before fully implementing it worldwide. 15238122

  10. From personal experience E-cigs have really changed my daily life. I enjoy smoking and the benefits that come with it but was becoming so expensive along with the negative health affects. E cigs have relieved alot of the health related issues to do with smoking despite the high nicotine concentration. I just moderate it accordingly but really has provided a “healthi- er” option for those who chose to intake nicotine and who would prefer a better smell taste and less deadly option

  11. It is about time research is done to show weather e-cigarettes are as detrimental to ones health as normal cigarettes. With that said, I do not approve of them as they are tobacco products and seem better in that they smell and taste better, this attracts more people to them and this is evident as more teenagers are smoking them now so even though they may be less deadly, the affect more people so are they worth it?
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  12. I am not a smoker myself and I grew up in a household were smoking was not part of the everyday routine, however I have seen first-hand how deadly the effects of tobacco and nicotine products can be, especially after prolonged use of these products. I don’t think the e-cigarette are in anyway a better option for smokers than regular cigarettes, it is just a more attractive option (better smell and taste). More research must be conducted in order for us to see how damaging the e-cigarettes really are.

  13. From what I have read It appears that e-cigarettes are less harmful than actual cigarettes. From what I understand they contain little if no harmful toxins such as tar and carbon monoxide which both cause lung cancer. I do, however, wonder if the increased rates of youths smoking e-cigarettes may not cause teens to begin smoking actual cigarettes. I also wonder if there isn’t more research into the true effects of smoking e-cigarettes.

  14. This whole “somebody do something for the children!” mentality has gotten so out of control in this country. We should celebrate that children are smoking less and using something less dangerous.

    Yes, it hasn’t been scientifically established that vaping is less dangerous than smoking. However, anyone with half a brain can come to the conclusion that the hundreds of cancer causing ingredients in cigarettes are more dangerous to someone’s health in comparison to the, by far, most often used three chemical formulation of e-juice (nicotine, propylene glycol- the same chemical used in asthma inhalers, and vegetable glycerin) And anyone with personal experience using both can tell you that it is less dangerous based on the state of their health alone. This a good thing and has been a miracle for many. It will extend many people’s lives and even the lives of our children.

    This is a nation full of paranoid parents who think they have carte blanche to restrict the freedom of grown adults to do as they please simply because some new trend seems bad. The majority of these people have no first hand experience with cigarettes or e-juice, having never tried either, who have so much self-righteousness and superiority complex to think they know better than the people it most directly affects to the point of forcing them to comply with the will of others to tell them what they can or cannot put into their bodies.

    I love vaping. It has been a miracle for myself and many others. I do not smoke the occasional cigarette. I never smoke anymore. I do not plan to stop vaping because I like nicotine just as you like caffeine and alcohol. But I don’t try to restrict your freedom to it. Nicotine on its face its not as harmful a drug as it is claimed to be. It is the smoking of nicotine or possibly the inhalation through vaping of it into the lungs which is most damaging. If you were to consume it in low doses through drinking or food it would be much more akin to the damages of caffeine (increases heart rate, blood flow
    problems, etc). They are both stimulants.

    Vapera see exactly where this is going. And we don’t all think its some sort of conspiracy. But it is obvious that ill informed fascists are having knee jerk reactions are demanding to restrict our freedom.

    Why shouldn’t I be able to buy an e-juice flavor that tastes good? I’m 31 years old and I like to eat cotton candy and like the flavor of sweets. They are trying to do the same thing that they did with cigarettes. They want to make it taste terrible and tax the heck out of it to gain revenue. Even know this has never even been shown to be an effective method for reduction of use in the past with cigarettes.

    Cigarettes and e-cigs are completely different things. They should be treated differently. I’m not advocating for zero regulation but it shouldn’t be regulated exactly like or to the same extent as cigarettes. What most paranoid alarmists are doing is essentially wanting to transform e-juice and e-cigarettes into a more similar product. If some of this discussed regulation happens; many adult vapors and children will turn back to regular cigarettes to get their nictotine because there will no longer be that many obvious differences or benefits.

    And what you will be essentially doing is advocating the genocide of that group of people who do not have the willpower to live without nictotine when there is a readily available and potentially non cancer causing or less cancer causing alternative. You could even consider vaping a medicine to the addiction of cigarettes. But you want to rush to demonize it. Shame on you all.

  15. Replacing E-cigs for regular smokes is like replacing heroin with methadone. It a treatment, sort of…

  16. “… offset those gains, resulting in no real change in overall tobacco use among high school and middle school students.”

    Could you please in the future replace statements such as “overall tobacco use” with “overall nicotine use” – because e-cigarettes are not a tobacco product in anything other than a legislative sense. The only commonality between e-cigarettes and analog/lit cigarettes is the nicotine. It is rather like saying that nicotine patches/inhalers/lozenges/gum are tobacco products – or we could go further with categorizing every foodstuff in the nightshade family as tobacco products.

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