A person smokes an electronic cigarette on March 05, 2013 in Paris.(Photo: KENZO TRIBOUILLARD, AFP/Getty Images)
Two new studies have found that far more kids are using electronic cigarettes than previously reported, raising fears that the products could hook another generation on nicotine even as cigarette use is falling.
About 25% of high school students in Connecticut and 29% of teens in Hawaii have used e-cigarettes, according to separate studies. About 18% of the Hawaii teens and 12% of the Connecticut high school students had used e-cigarettes in the past month. Both studies were done in 2013.
Those rates are much higher than the latest data from the Centers for Disease Control and Prevention, which found 4.5% of high schoolers and 1.1% of middle schoolers had used e-cigarettes in the past 30 days in 2013.
Authors of the Hawaii study, published online Monday in
Pediatrics, note that e-cigarette use has grown exponentially among kids, doubling every year since 2009. Sales of e-cigarettes in the USA were $11.7 billion in 2013, according to a January report in the
New England Journal of Medicine. The Connecticut study was published Tuesday in
Nicotine and Tobacco Research.
The Food and Drug Administration has proposed regulating e-cigarettes and other tobacco products, but it has not issued a final rule. The proposed rule would ban sale of e-cigarettes to people under age 18. Manufacturers of e-cigarettes would have to register any new products with the FDA.
Although 40 states prohibit e-cigarette sales to minors, 16 million kids under age 18 live in states where they can buy e-cigarettes legally, according to a report released Thursday by the CDC.
E-cigarettes resemble cigarettes but contain no tobacco. They heat a liquid into a vapor that's inhaled. The liquid contains nicotine as well as chemicals and flavorings such as chocolate, bubble gum and mango.
The Smoke-Free Alternatives Trade Association, an e-cigarette industry group, says it opposes marketing to minors and supports a ban on sales of e-cigarettes to people under 18. The association began a program this year that urges retailers to require proof of age before selling to anyone and to display signs saying they don't sell to minors.
Manufacturers say e-cigarettes are a substitute for tobacco and can help adult smokers quit.
But authors of the Hawaii study note that e-cigarettes are marketed in places that are popular with teens, such as shopping malls and movie theaters. Many teens who use e-cigarettes have never tried conventional cigarettes, the new studies show.
"There's no question that e-cigarettes are a gateway to smoking," says long-time tobacco researcher Stanton Glantz, a professor at the University of California-San Diego not involved in the new research.
Peter Hamm, a spokesman for the Campaign for Tobacco-Free Kids, says the FDA should quickly put its proposed regulations in place. "We can't afford more delays that buy the tobacco industry time to continue targeting kids with a new generation of products," Hamm says.
Two-thirds of the teens in the Hawaii survey saw e-cigarettes as healthier than traditional cigarettes, which may explain why more of them had experimented with e-cigarettes than other drugs. About 47% of the Hawaii teens had tried alcohol, 18% had tried marijuana and 15% had tried conventional cigarettes, according to the study.
Studies show fewer kids today are using conventional tobacco.
Conventional cigarette use among teens has been cut in half since 2000, falling from 28% of high-school students in 2000 to 12.7% of high schoolers in 2013, according to the Campaign for Tobacco-Free Kids.
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