Why I don’t recommend e-cigarettes for teens

E-cigarette use in teens has doubled in a year. The CDC reports that 1 in 10 high school students admitted to ever using an e-cigarette in 2012. The rate of use doubled for middle school students as well. Although I’m not surprised, I remember just weeks ago tweeting about my dismay with Jenny McCarthy’s new job — advertising e-cigarettes. I took flak. Some advocates for e-cigs felt I was shortsighted and not valuing the potential benefits of these electronic nicotine-laden vapor tubes. All I could think of was her image, the lure she may create for teens, and the likelihood that teens would peek in on e-cigs with greater fervor.

Just a month ago we learned that smokeless tobacco use is steady with teens (5%) and many teens are now turning to novel sources of nicotine (dissolvable tobacco, snuff, snus) in addition to tobacco cigarettes. I consider myself fairly up to date, and until the AAP report came out in August I’d never once heard of snus. You?

Some people are wed to the concept that e-cigs may reduce the burden of illness and smoking-related morbidity from tobacco cigarettes. Even if you believe in harm-reduction for adults (switching from tobacco cigarettes to e-cigs to reduce use or quit) this is an entirely different issue for our middle and high-school students. A nice summary of the data for e-cigs from pediatrician, Aaron E. Carroll, with numerous associated comments helps frame the issue.

I wish I could remain agnostic about these devices, but I can’t. This is pretty easy to say: I don’t recommend e-cigarettes for a teen.

Compare two stats: One in five adults who smoke has used an e-cig with one in ten of all high school students have tried an e-cig. Teens aren’t wired to conceptualize the power of nicotine addiction.

The e-cig really does feel like the gateway to the gateway drug.

There is still a lot of unknowns about e-cigarettes. More research will come out and the FDA is likely to regulate e-cig use shortly.

In the meantime, check in with your teens, look around, and I urge your to support regulation of e-cigs and advertising of e-cigs to teens. This just can’t be good.

Wendy Sue Swanson is a pediatrician who blogs at Seattle Mama Doc.

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