In September, 2018, FDA Commissioner, Scott Gottlieb, MD addressed the growing use of e-cigarettes among teenagers as an epidemic. “Unfortunately, I now have good reason to believe that it’s reached nothing short of an epidemic proportion of growth. I use the word epidemic with great care. E-cigs have become an almost ubiquitous ‒ and dangerous ‒ trend among teens. The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end.”
“Unfortunately, I now have good reason to believe that it’s reached nothing short of an epidemic proportion of growth.”
— Scott Gottlieb, MD, FDA Commissioner
E-cigarette use among 18-24 year olds has become a matter of urgency for public health to address. Kelly McIntee, Specialist, Health Promotion at the American Lung Association of Minnesota presented at Champ Software’s April 2019 Expert Webinar on the trends, impact, and dangers of youth vaping as well as how public health professionals can advocate for healthier lungs. Below are some of the trends, impacts, statistics, and resources she shared.
Vaping has risen dramatically in popularity among youth smokers, with many 18-24 year old first-time smokers choosing e-cigarettes as their smoking method of choice. Nationwide, 95% of current smokers start before the age of 21 and 88% start before the age of 18.
In Minnesota alone:
- The percentage of 18-24-year olds who had used e-cigarettes in the past 30 days rose from 12.8% of smokers in 2014 to 21.9% of smokers in 2018.
- Youth tobacco use has increased for the first time in 17 years.
- 2014 saw a 50% increase of e-cigarette use among high school students.
- 1 in 5 high schoolers use e-cigarettes according to a 2017 survey.
Why are e-cigarettes so popular among youth?
- Youth-friendly flavors of e-cigarette cartridges (e.g. candy flavors, blue raspberry slushy, etc.)
- Easy access to e-cigarette products (e.g. retail outlets, vape shops, etc.) and to an 18 year old who can purchase the products for underage youth
- The ease of smoking e-cigarettes undetected and hiding e-cigarettes or vaping pens in plain sight.
- Heavy marketing on social media and aggressive marketing targeting youth
Youth are viewed as “replacement smokers” by tobacco companies who purposefully target them with their advertising and products. According to one tobacco executive, “Today’s teenager is tomorrow’s potential regular customer, and the overwhelming majority of smokers first begin to smoke while still in their teens… The smoking patterns of teenagers are especially important to Philip Morris.” – Philip Morris
“Today’s teenager is tomorrow’s potential regular customer, and the overwhelming majority of smokers first begin to smoke while still in their teens… The smoking patterns of teenagers are especially important to Philip Morris.” – Philip Morris
McIntee shared some sobering statistics, such as 95% of current smokers started smoking before the age of 21 and 87% began smoking before the age of 18. Nicotine use by youth can harm the developing brain. Youth who use e-cigarettes are more likely to go on to use traditional cigarettes.
Are e-cigarettes are less harmful than traditional cigarettes?
- The public health standard is breathing clean air
- E-cigarettes almost always contain harmful ingredients including nicotine
- According to one of the most popular e-cigarette brands, one e-cigarette pod may contain as much nicotine as an entire pack of cigarettes
What are the health risks of using e-cigarettes?
- E-cigarettes contain chemicals that cause irreversible lung damage and alter teen brains, including nicotine, tobacco-specific nitrosamines, formaldehyde, carcinogens, benzene, acetaldehyde
- Short term-aerosol can irritate your lungs, throat, and eyes and make it more likely that you’ll catch colds or get the flu
- Contrary to popular myth, no e-cigarette has been found to be safe and effective to help people quit smoking; they are not an FDA approved smoking cessation device
- Tobacco is the only legal consumer product on the market that, if used as it is intended to be used, will kill half of its long-term users
- The vapor emitted by e-cigarettes is not harmless; secondhand emissions contain harmful chemicals, heavy metals, and volatile organic compounds
Tobacco is the only legal consumer product on the market that, if used as it is intended to be used, will kill half of its long-term users. – US Food & Drug Administration
What are the risks specific to youth who use e-cigarettes?
- Nicotine exposure during adolescence can harm the developing brain, negatively impacting learning, memory, and attention span
- Nearly all contain nicotine which primes the adolescent brain for addiction
- Youth who have tried e-cigarettes are twice as likely to begin smoking
- Symptoms of nicotine addiction can appear among youth within only a few days or weeks after smoking initiation
- An emerging concern: 1/3 of high school e-cigarette users report having used their vaping device for recreational marijuana
What can we do?
McIntee shared a variety of information and resources that public health professionals can use to educate themselves and youth on this topic. Counseling paired with nicotine replacement therapy is one of the most successful ways for people to quit using tobacco products. Nicotine is addictive and the marketing and use of nicotine is a vicious cycle. New smoking device technologies deliver a high dose of nicotine and these products are marketed directly to youth; because of this, youth e-cigarette use is rising. The younger you start, the harder it is to quit.
We can help stop the start:
- We can become more educated about the products- what are the health risks and how to identify the products (see McIntee’s full presentation for product examples and information on how to identify e-cigarettes)
- We can work to reduce access to these products in our communities
Examples of what some Minnesota communities are doing:
- The Minnesota Clean Indoor Air Act (MCIAA) restricts e-cigarette use indoors
- 34 communities have raised the minimum age to buy tobacco to age 21
- Some communities are limiting sales of flavored tobacco products, including e-cigarettes, to adult-only tobacco shops
- There is a move to increase funding for comprehensive tobacco prevention and control aimed at reducing or preventing youth tobacco use
To view the information and resources, download a digital copy of the Youth Vaping info-graphic, or watch the video of Kelly McIntee’s presentation, visit the resources page.