CDC seeks answers on e-cigarette use among kids

ABOUT HALF of the 45 million Americans who smoke cigarettes try to quit each year, according to the Centers for Disease Control and Prevention (CDC). One of the ways to attempt quitting is to use a substitute such as nicotine gum or the electronic cigarette, which is rising in popularity.

Electronic cigarettes, or e-cigarettes, are battery-powered devices that look very much like a typical cigarette and provide doses of nicotine in an aerosol. Cartridges typically contain nicotine, a component to produce the aerosol and flavorings, such as mint.

CDC is concerned because young adults and children are beginning to use e-cigarettes, and the products’ safety is uncertain. Issues include the potential negative impact of nicotine on adolescent brain development, as well as the risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products.

NO REGULATION

The Food and Drug Administration does not regulate the products, and few states have restrictions on selling e-cigarettes to minors.

According to the CDC’s National Youth Tobacco Survey, the percentage of high school students who reported using an e-cigarette even one time rose from 4.7% in 2011 to 10.0% in 2012. Students using e-cigarettes within the past 30 days also rose from 1.5% to 2.8%.

For younger middle school students, use also doubled. During 2011 and 2012, among all students in grades 6 to 12, the prevalence of trying e-cigarettes even once increased from 3.3% to 6.8%-more than double. Altogether, in 2012 more than 1.78 million middle and high school students nationwide reported that they had tried e-cigarettes.

CDC Director Tom Frieden, MD, MPH, said in a statement that “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.”

According to Tim McAfee, MD, MPH, director of the CDC Office on Smoking and Health, 90% of smokers begin the habit as teenagers. 

Some students in the survey reported current use of both e-cigarettes and conventional cigarettes, an increase of 0.8% to 1.6%.

Experts believe the market for e-cigarettes will grow as they become a replacement for, or complement to, traditional cigarettes. The products have been on the market in the United States for about four years.

In March, former U.S. Surgeon General Richard Carmona, MD, who was an advocate for banning all tobacco products, joined the board of directors for the country’s largest e-cigarette marketer.

CDC recommends developing strategies to prevent marketing, sales and use of e-cigarettes among minors.

For health plans, the concern is not only offering cessation to those who smoke, but also the fact that young adult nicotine use could create higher premiums as well.