February 6th, 2015

In a guest post last November, Dr. Sunil Khushalani stressed the need for research data to try to resolve the controversy regarding the benefits versus dangers of e-cigarettes. We are fortunate that in its report on substance use in 2014, the highly regarded Monitoring the Future survey did, in fact, address the issue of e-cigarettes and teenagers for the first time. It documents clearly that teenagers’ use of e-cigarettes has now surpassed their use of tobacco cigarettes.

At every grade level, e-cigarette use in the past 30 days exceeded tobacco cigarette use, the difference is more striking in the earlier grades. The specific percentages were:

Grade E-Cigarettes (%) Tobacco Cigarettes (%)
8th 9 6
10th 16 7
12th 17 14

One area of concern has been to what extent e-cigarettes would be a “point of entry into the use of nicotine” rather than moving current users to a less dangerous form. In this study, the percentages of e-cigarette users who had never smoked tobacco cigarettes in their lives ranged from 4 percent to 7 percent in the 8th through 12th grades.

Here are some highlights from the summary of the finding on e-cigarettes and teenagers:

  • For these youth, e-cigarettes are a primary source of nicotine and not a supplement to tobacco cigarette use.
  • Whether youth who use e-cigarettes exclusively later go on to become tobacco cigarette smokers is yet to be determined by this study and is of substantial concern to the public health community.
  • E-cigarette use among youth offsets a long-term decline in the use of tobacco cigarettes, which is at a historic low in the life of the study.
  • One important cause of the decline in smoking is that many fewer young people today have ever started to smoke tobacco cigarettes. In 2014, only 23 percent of students had ever tried tobacco cigarettes, as compared to 56 percent in 1998. Of particular concern is the possibility that e-cigarettes may lead to tobacco cigarette smoking, and reverse this hard-won, long-term decline.
  • Part of the reason for the popularity of e-cigarettes is the perception among teens that they do not harm health. Only 15 percent of 8th-graders think there is a great risk of people harming themselves with regular use of e-cigarettes. This compares to 62 percent of 8th-graders who think there is a great risk of people harming themselves by smoking one or more packs of tobacco cigarettes a day.

The regulatory aspect of this story is still developing. The Centers for Disease Control’s (CDC) Office on Smoking and Health recently reported that 10 states and our own District of Columbia still allow sales of these devices to minors.

This post concludes my summary of the 2014 Monitoring the Future survey. For those interested in an excellent summary of the findings regarding electronic cigarettes, as well as the rest of the study, I would recommend a NIDA site.

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