Adolescent e-cigarette use triples: Is 'vaping' renormalizing nicotine?

Teen use of traditional cigarettes fell 25 percent between 2013 and 2014, but experts worry that the surge in electronic cigarettes could be just as harmful.

Mike Segar/Reuters/Files
Various e-cigarette products for sale are seen at the Henley Vaporium in New York City, December 18, 2013.

The use of electronic cigarettes, or “vaping,” tripled among high-school students between 2013-2014, according to a national survey by the Centers for Disease Control and Prevention (CDC).  In fact, more high-school students are smoking e-cigarettes than traditional cigarettes, the survey showed.

According to the study, which was released on Thursday, 13.4 percent of high-school students confirmed they had used an e-cigarette over the past 30 days. The number of students who reported smoking traditional cigarettes declined by 25 percent between 2013 and 2014, the fastest decrease seen in years.

But while supporters of e-cigarettes say the decrease of traditional cigarette use demonstrated in the survey is good news, other experts are concerned that the surge in e-cigarette use is renormalizing the consumption of nicotine products before the long-term health effects of vaping have been determined.

“Adolescence is a critical time for brain development. Nicotine exposure at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use,” CDC Director Tom Frieden said in a statement.

Electronic cigarettes are battery-powered devices that heat liquid nicotine into inhalable vapor. Vaping advocates say that e-cigarettes exclude the tar and many of the chemicals found in traditional cigarettes and many users believe them to be safer than traditional cigarettes.

A January report by the California Department of Public Health determined that e-cigarettes are addictive and release cancer-causing chemicals. Although many scientists agree that e-cigarettes are likely to be less harmful than regular cigarettes, many point out that insufficient information has been collected about the potential health risks.

Currently, the e-cigarette market remains mostly unregulated, but the Food and Drug Administration is attempting to introduce legislation this year. In April, the FDA proposed preliminary rules that would prohibit sales to minors. A final rule is expected in June.

Some experts have expressed concern that young people are forming an e-cigarette habit before the rules have solidified. Teenagers told The New York Times that over the past few years, e-cigarettes have become almost as common in schools as laptops.

Selling e-cigarettes to minors is already illegal in many states, but the FDA rules would make it illegal at the federal level. Currently, adolescents who live in states with age restrictions are able to circumvent regulations by purchasing vaping packs online.

Generally a customer will be asked to confirm that they are 18 years old before purchasing the e-cigarette kit, which include cylindrical batteries, reservoirs filled with liquid-nicotine cartridges, and battery chargers. But many adolescents confirm that they can easily purchase the packages by simply clicking a button, The New York Times reported.

Critics now say the ubiquity of e-cigarettes is hampering anti-smoking efforts, which have been found to have saved 8 million lives.

“In today’s rapidly evolving tobacco marketplace, the surge in youth use of novel products like e-cigarettes forces us to confront the reality that the progress we have made in reducing youth cigarette smoking rates is being threatened,” Mitch Zeller, director of the FDA’s Center for Tobacco Products, said in a statement. “These staggering increases in such a short time underscore why FDA intends to regulate these additional products to protect public health.”

But supporters of e-cigarettes point to the declining number of young people smoking traditional cigarettes. They claim that teenagers are using e-cigarettes to kick their already existing habits of smoking regular cigarettes or marijuana. The shift from regular cigarettes to e-cigarettes disproves the hypothesis that e-cigarettes are a gateway to traditional cigarette use, they say. However, it remains unclear whether young people start out smoking or vaping. Critics say it is premature to say that e-cigarettes are a path to quitting nicotine, pointing out that correlation and causation are not the same thing.

Some observers have also pointed out that the pattern resembles a similar phenomenon seen in Norway and Sweden, where the use of a smokeless tobacco product was followed by a sudden decline in the use of traditional cigarettes.

“What you’re seeing is the largest decline in teen smoking in the history of the study,” says Gregory Conley, president of industry group the American Vaping Association, told U.S. News and World Report. “It occurred at the same time as this dramatic increase of experimentation of vaping.”

Smoking kills around 480,000 Americans each year and is the single-biggest cause of preventable death in the country, according to the CDC.

Last year, e-cigarette sales across the country topped $2.5 billion, according to Forbes.

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