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E-cigarette use soaring among teens

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According to a new study, e-cigarette use is soaring among middle school and high school students. Furthermore, the investigators found evidence that use of e-cigarettes (vaping) may increase the likelihood of smoking tobacco. The findings were published in the July edition of JAMA Pediatrics by researchers at the Center for Tobacco Control Research and Education, University of California, San Francisco.

The study authors note that e-cigarette use is increasing rapidly among adolescents, and e-cigarettes are currently unregulated. Therefore, they conducted a study to assess e-cigarette use and conventional cigarette smoking among teens. They reviewed survey data from a representative sample of US middle and high school students in 2011 (17,353 students) and 2012 (22,529 students) who completed the 2011 and 2012 National Youth Tobacco Survey. They assessed experimentation with, ever, and current smoking, and smoking abstinence.

The investigators found that, among cigarette experimenters (one or more puffs), ever e-cigarette use was associated with higher risk of ever smoking regular cigarettes (100 or more cigarettes; 6.31-fold increased risk) and current tobacco cigarette smoking. Current e-cigarette use was related to an increased likelihood of ever smoking cigarettes (7.42-fold increased risk) and current cigarette smoking (7.88-fold increased risk). In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to try to quit smoking within the next year (1.53-fold increased attempt). Among experimenters with regular cigarettes, ever use of e-cigarettes was associated with lower 30-day, 6-month, and 1-year abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day, 6-month, and 1-year abstinence.

Among ever smokers of regular cigarettes (100 or more cigarettes), ever e-cigarette use was negatively associated with 30-day, 6-month, and 1-year abstinence from conventional cigarettes, meaning these teens were less likely to quit. Current e-cigarette use was also negatively associated with 30-day, 6-month, and 1-year abstinence.

The authors concluded that use of e-cigarettes was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. They noted that the use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US teens.

Take home message:

This study notes that the use of e-cigarettes is rapidly increasing among teens and that their use may lead to taking up the habit of smoking tobacco. Although e-cigarettes do not contain the carcinogens found in tobacco, nicotine is highly addictive. E-cigarettes contain three main ingredients: nicotine, a flavoring agent, and propylene glycol, which is a syrupy synthetic liquid that is added to food, cosmetics, and certain medicines to absorb water and preserve moisture. A proven negative of e-cigarettes is the nicotine, which is a highly addictive stimulant. Nicotine causes constriction of the arteries, which can increase the risk of cardiovascular disease. It also has resulted in amputation of limbs in susceptible individuals. Some studies have suggested that nicotine may impact the immune system. The FDA has designated the substances as “generally recognized as safe,” (GRAS); however this designation has been applied to ingestion rather than inhaling its vapor.

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