Teens now more likely to use e-cigs than tobacco; health officials call for regulations and better education about the products

By Melissa Patrick
Kentucky Health News

The number of adolescents using electronic cigarettes has risen so much that more of them use e-cigs than tobacco products, says the federal Centers for Disease Control and Prevention.

The findings come from the National Youth Tobacco Survey, which collected data from about 20,000 middle- and high-school students across the country from 2011 to 2015.

Only 1.5 percent of high schoolers used e-cigarettes in 2011, but that zoomed to 16 percent in 2015, with most of the increase seen between 2013 and 2014. The number of middle-school students using e-cigarettes increased from less than 1 percent in 2011 to 5.3 percent in 2015.

Tobacco smoking with hookahs, or water pipes, showed a lesser but significant increase, rising to 7.2 percent from 4.1 percent among high-school students and to 2 percent from 1 percent among middle-school students.

During this same time frame, children’s use of cigarettes, cigars and other tobacco products decreased. The share of high-school and middle-school students who reported smoking a cigarette in the last month dropped, respectively, to 9.3 percent from 15.8 percent; and to 2.3 percent from 4.3 percent.

The rise in e-cigarette and hookah use offset the decrease in traditional tobacco use, meaning there was no overall change in use of nicotine or tobacco products among middle and high school students between 2011 and 2015.

An estimated 25.3 percent of high school students and 7.4 percent of middle school students say they have used a tobacco or nicotine product in the past 30 days. That amounts to 3.82 million high school students and 880,000 middle school students.

The study did not give state-by-state figures, but Kentucky has long ranked high in youth tobacco use.

One of the reasons for the rise in popularity of e-cigarettes is that there are no restrictions on buying them on the internet, Carina Storrs reports for CNN after interviewing Brian A. King, deputy director of research translation in the CDC Office on Smoking and Health, who led the current research.

“The fact that we have a flavored product that is easier to access and possibly cheaper has created a perfect storm to lead to increased use,” King said.

Also, King said, e-cigarette companies appeal to youth by advertising heavily on social media, selling trendy accessories and employing celebrities to market the products. King said older peers and family members could also be providing e-cigs, just as they have provided conventional cigarettes to.

Pediatricians have called for raising the smoking age to 21 and for the regulation of e-cigarettes.

As of April, 2016, 141 cities in 10 states and the state of Hawaii have raised the legal age to buy tobacco or vaping products to 21, according to the tobacco21.org website.

In Kentucky, Democratic Rep. David Watkins, a retired physician from Henderson, filed a bill this year to raise the legal age for buying tobacco or vaping products to 21, which made it out the the House Health and Welfare Committee, but was not called up for a vote on the House floor. Kentucky banned the sale of e-cigarettes to minors in 2014.

The Food and Drug Administration introduced a proposal in 2014 to oversee and regulate electronic cigarettes, but it has still not been finalized.

Dr. M. Brad Drummond, associate professor of pulmonary and critical care medicine at Johns Hopkins University School of Medicine, told Storrs that tighter restrictions are needed around purchasing, taxation, flavoring and advertising of e-cigarettes, noting that this would have an effect on “denormalizing their use.” He also said teens need to be better educated about the harms associated with e-cigs.

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