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Are E-Cigarettes Safe for Our Teens?

Many smokers believe that electronic cigarettes are safer than regular cigarettes - but as a pediatrician, I'm concerned about the health effects these devices could have on teens, a population that's increasingly using them.

A recent survey from the U.S. Centers of Disease Control and Prevention (CDC) found that the percentage of high school students who had smoked electronic cigarettes more than doubled from 4.7 percent in 2011 to 10 percent in 2012. For middle-schoolers, this rose from 1.4 percent to 2.7 percent. More than three-quarters of students who used these devices in the last 30 days reported smoking regular cigarettes at the same time. 

Electronic cigarettes ("e-cigarettes" or "e-cigs"), formally called "electronic nicotine delivery systems," have the same shape, size and general appearance as real cigarettes. E-cigs use a battery to vaporize a nicotine-containing solution, creating mist that's inhaled. The tips of e-cigs often have a light that looks like the burning ash of a regular cigarette. Using e-cigs is called "vaping." 

Like regular cigarettes, e-cigs contain nicotine. They don't contain the thousands of other toxic chemicals – many of them cancer-causing – found in regular cigarettes. It's the nicotine in cigarettes and e-cigs that's highly addictive. 

Nicotine addiction usually starts early in life – about 90 percent of people who smoke started before age 19. Research suggests that when nicotine addiction starts in adolescence (rather than older ages), it's harder to kick the habit. Unless a smoker can stop, this addiction creates a lifetime of tobacco dependence. Smokers face higher risks of developing lung cancer and other cancers, heart disease and other miserable diseases. In the U.S., 440,000 people die from smoking each year – about 1,200 deaths per day – an astounding number. 

So it's really worrisome when I hear that teens are using e-cigs because this could be another road to nicotine addiction and using regular cigarettes. Some studies show that there are cancer-causing and other chemicals in the vapor, and there may be adverse effects on lung functioning. E-cig use in public may expose others involuntarily to harmful substances in the vapor – including nicotine!

Experts are concerned that e-cigs are heavily promoted to teens, who may find the products especially appealing because they are available in vanilla, menthol and fruit flavors. Companies employ young attractive celebrities to market e-cigs, making them appear glamorous and cool. They are touted as being better smelling, cheaper and a guilt-free way to smoke.    

Unlike regular cigarettes (and nicotine replacement products used to help smokers stop), e-cigs are not regulated by the FDA. However, the FDA has expressed "great concern" over the dramatic rise in e-cig use among youth and is discussing regulating these products.  Some states, including New York and New Jersey, have prohibited the sale of e-cigs to minors.

As a pediatrician, I routinely discuss tobacco use with teens and parents.  Fortunately, most teens aren't using tobacco – that's great! It's so important for teens never to start smoking cigarettes or using other tobacco products. If teens smoke, we discuss how to stop. Based on the CDC report, I'm going to ask my teen patients about e-cigarettes and will strongly advise teens not to use them – their lifelong health may depend on it.    

Sophie J. Balk, MD, is an Attending Pediatrician at The Children's Hospital at Montefiore and Professor of Clinical Pediatrics at the Albert Einstein College of Medicine.

Posted by blogmoderator on 10/11/2013 at 8:48 AM Add Comment