The use of electronic cigarettes among middle and high
school students has been rising rapidly, a trend that public health officials
worry could undermine decades of efforts to reduce youth smoking and put a
growing number of teenagers on a path toward conventional cigarettes.
According to data released Thursday by the Centers for
Disease Control and Prevention, the percentage of middle and high school
students in the United States who have used e-cigarettes more than doubled from
2011 to 2012.
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“The increased use of e-cigarettes by teens is deeply
troubling,” CDC Director Tom Frieden said in announcing findings from the
National Youth Tobacco Survey. “Nicotine is a highly addictive drug. Many teens
who start with e-cigarettes may be condemned to struggling with a lifelong
addiction to nicotine and conventional cigarettes.”
E-cigarettes are battery-powered devices that look like
cigarettes but do not burn tobacco. Rather, they deliver nicotine, flavor and
other chemicals in the form of a vapor. A starter kit, which typically includes
two e-cigarettes, extra batteries and various nicotine cartridges, can cost $20
to $200. Because of the limited research into e-cigarette use, their risks and
benefits remain uncertain and subject to widespread debate.
What’s more certain is their steady growth in popularity
among adults and, according to the CDC survey, young people.
The survey found that the percentage of high school students
who said they had used an e-cigarette jumped from 4.7 percent in 2011 to
10 percent in 2012. Nearly 3 percent of those students said they had
used an e-cigarette in the past 30 days, up from 1.5 percent a year
earlier. Use also doubled among middle school students, the CDC reported.
All told, more than 1.78 million middle and high school
students nationwide had tried e-cigarettes in 2012, the agency said.
Perhaps most troubling for public health advocates, the
survey found that more than three-quarters of middle and high school students
who had used e-cigarettes within the past month also had smoked conventional
cigarettes during the same period. About 1 in 5 middle school students who
reported using e-cigarettes said they had never tried conventional cigarettes.
The CDC’s findings are in line with a more recent survey
conducted in Florida that found that more than 4 percent of
middle-schoolers and 12 percent of high-schoolers had tried e-cigarettes —
figures that have risen dramatically over the past two years.
Big U.S. tobacco companies have begun scooping up
e-cigarette manufacturers with an eye toward a not-so-distant future, when,
some analysts say, sales of e-cigarettes could eclipse those of conventional
cigarettes. This year alone, tobacco giants such as Lorillard, Altria and
Reynolds have begun wading into the e-cigarette market. E-cigarette use also
has boomed in Europe in recent years.
Anti-smoking activists say that the rise in the popularity
has happened in part because the devices are largely unregulated and cultivate
an image as a cooler, less harmful alternative to regular cigarettes.
Although the Food and Drug Administration has long said it
intends to expand its regulatory authority over tobacco products to include
e-cigarettes, the agency has not done so.
“FDA needs to act and act quickly to get a handle both on
the product and its marketing,” said Matthew Myers, president of the Campaign
for Tobacco Free Kids.
Without that kind of oversight, he said, e-cigarette
companies have remained free to sell their products online and spend huge sums
mimicking the advertising practices that big tobacco companies once used.
“We have seen e-cigarettes marketed using exactly the same
images in exactly the same places that the cigarette industry used decades
ago,” he said. “Open a magazine, and you’ll see beautiful women and young
celebrities marketing e-cigarettes. Go to NASCAR, and you’ll see cars sponsored
by e-cigarettes.”
Those efforts to “re-glamorize” smoking, Myers said,
threaten to undo years of efforts and millions of dollars spent on campaigns to
cut down on youth smoking in the United States and could create a new
generation of smokers.
Proponents of e-cigarettes reject comparisons to traditional
cigarettes, arguing that they contain nowhere near the amount of harmful
substances that smokers inhale. They also have argued that rather than creating
a slippery slope that could lead nonsmokers toward other tobacco products,
e-cigarettes have the potential to help people wean themselves off conventional
cigarettes.
Thomas Kiklas, president of the Tobacco Vapor Electronic
Cigarette Association, said he doesn’t buy the argument that e-cigarettes are a
“gateway” to traditional cigarettes for young people.
“Kids have been smoking for hundreds of years,” he said. “So
I don’t think any singular technology is going to push kids into cigarette
use.”
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