Electronic cigarettes are now the most commonly used tobacco product among middle and high school students, according to a study published today by the U.S. Centers for Disease Control and Prevention (CDC).
That finding is due to both the increasing popularity of e-cigarettes and the decreasing popularity of traditional cigarettes.
Between 2013 and 2014, e-cigarette use among young people tripled, rising from 1.1 percent to 3.9 percent among middle school students and from 4.5 percent to 13.4 percent among high school students.
During that same period, traditional cigarette use remained about the same among middle school students, but fell from 12.7 percent to 9.2 percent among high school students — the largest yearly decline in more than a decade, according to the CDC.
In addition, hookah use almost doubled between 2013 and 2014, rising from 5.2 percent to 9.4 percent among high school students and from 1.1 percent to 2.5 percent among middle school students.
CDC officials now estimate that 4.6 million middle and high school students are current tobacco users. Of those, 2.4 million use e-cigarettes and 1.6 million use hookahs.
Overall, the use of tobacco products among young people has shown no decline since 2011, according to the CDC data.
“We want parents to know that nicotine is dangerous for kids at any age, whether it’s an e-cigarette, hookah, cigarette or cigar,” CDC Director Dr. Tom Frieden said in a released statement. “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.”
A debate over safety
The FDA is considering regulating e-cigarettes, including their sales to minors. The agency is expected to make a final decision about that regulation later this year.
Health experts have been debating whether e-cigarettes — which deliver nicotine through a vaporized liquid rather than smoke — are a safer alternative than traditional cigarettes for people who are already habitual smokers and whether the devices can play a role in helping people eventually give up their nicotine addiction. E-cigarettes are so new that little research has been conducted on them.
“Regulations are needed,” write the authors of that study. “These should include compulsory ingredient listing, limiting the levels of certain flavourings, and limiting total permissible levels of flavourings, particularly as there is some concern that flavoured products might make e-cigarettes more attractive to young people.”
Similar numbers in Minnesota
The CDC’s findings regarding the increasing use of e-cigarettes among young people is “discouraging, but not surprising,” said Robert Moffitt, director of communications for the American Lung Association in Minnesota, in an interview with MinnPost.
“It’s very similar to the data we saw from the Minnesota Youth Tobacco Study last year, which showed about 13 percent of students using e-cigarettes,” he said. “That’s about the same rate we’re seeing nationally.”
The discouraging part of the CDC’s report, he added, is that it shows how effective the e-cigarette industry has been at targeting youth, particularly by adding candy-flavored chemicals to their products.
He and his organization want the FDA to more strictly regulate e-cigarettes — and hookahs.
“If you take a puff on a cigarette or cigar, you get a harsh taste and start coughing, and many kids don’t try another one again,” he explained. “However, with hookah the smoke is very cool and very pleasant-tasting — just like with e-cigarettes.”
“There is a misconception among many hookah users that it is somehow safer than smoking cigarettes. It is not,” he added.
Moffett also stressed that e-cigarettes should not be touted as a way of helping people quit their smoking habit — not unless the devices’ manufacturers are willing to submit their products to the same rigorous research that other approved smoking-cessation devices have had to undertake.
“All those devices, like the patch and the gum, have been through FDA approval and have been thoroughly vetted,” he said. “E-cigarettes have not. In fact, they have resisted that.”
Moffitt — and the CDC health officials — worry that the growing popularity of e-cigarettes might reverse recent healthful trends in tobacco use in the United States. Just last year, the CDC reported that the cigarette-smoking rate among U.S. adults had reached an all-time low of 17.8 percent.
“The good news,” Moffitt said, “is that, generally speaking, smoking rates are down. But we don’t want the rise of e-cigarettes and hookahs to try to make smoking cool again.”
The CDC’s report was published in the April 17 issue of the agency’s Morbidity and Mortality Weekly Report (MMWR). The numbers for the study are based on data collected from the 2014 National Youth Tobacco Survey, which involved more than 22,000 students at 207 schools across the country. A student was classified as currently using a tobacco product if he or she reported having smoked or chewed such a product one or more times during the previous 30 days.