Surgeon General Warns Against E-cigarette Use Among Kids

The U.S. Surgeon General  Food and Drug Administration urged all parents to "take a stand against e-cigarette use by our nation's young people" at a press conference on Thursday, Dec. 8.

Dr. Vivek H. Murthy said e-cigarettes are the most commonly used form of tobacco among young people in the United States, surpassing conventional tobacco products, including cigarettes, cigars, chewing tobacco and hookahs.

From 2011 to 2015, e-cigarette use among high school students increased 900 percent.

"Compared with older adults, the brain of youth and young adults is more vulnerable to the negative consequences of nicotine exposure," Dr.. Murthy said. 

During the press conference, Dr. Murthy took the opportunity to introduce a new interactive website to provide the facts on e-cigarette use among young and young adults. 

The site states that 6 of 10 American teens believe that e-cigarettes cause little or only some harm as long as they are used sometimes, but not every day. However, the site says that e-cigarettes pose a "significant -- and avoidable -- health risk to young people in the United States. Besides increasing hte possibility of addiction and long-term harm to brain development and respiratory health, e-cigarettes use is associated with the use of tobacco products that can do even more damage to the body. Even breathing e-cigarette aerosol that someone else has exhaled poses potential health risks.

To learn more about e-cigarettes, we talked to Don Wilson, M.D., an endocrinologist and an Endowed Chair of Cardiovascular Health and Risk Prevention at Cook Children’s.

What do e-cigarettes do?

E-cigarettes are designed to simulate the act of smoking and deliver nicotine without the toxic chemicals produced by burning tobacco. The use of nicotine, however, is highly addictive. Recent research suggested nicotine exposure may also cause the brain to become addicted to other substances. Vapor from some e-cigarettes has also been shown to contain known cancer producing and toxic chemicals, such as diethylene glycol and nitrosamines, as well as small particles of toxic metals. Although not well studied, there is the potential for second hand exposure by others in the environment.

How do e-cigarettes work?

E-cigarettes are smokeless, battery operated devices designed to deliver nicotine mixed with a variety of flavorings (fruit, mint, chocolate, etc.) and other chemicals via an inhaled aerosol. They typically resemble regular tobacco cigarettes, cigars, pipes or everyday items like pins or USB memory sticks.

Most e-cigarettes generally contain three components: a cartridge that contains a liquid solution containing various amounts of nicotine, flavoring and other chemicals, a heating device or vaporizer, and a rechargeable battery. Puffing on the e-cigarette activates the battery powered heating device causing the liquid to vaporize. The vapor is inhaled by the user. E-cigarette vapor may include metals, rubber and ceramics which may be aerosolized and have adverse health effects.

Are e-cigarettes safe?

Although a limited number of studies have been conducted, the safety of e-cigarettes has not thoroughly been evaluated in scientific studies.

Here are a few points to consider:

• Nicotine is highly addictive and has negative effects on brain development from infancy to teens.
• Potential consequences of using e-cigarettes among youth include nicotine addiction, withdrawal and the potential for overdose.
• The use of a variety of flavoring in the liquid solution of e-cigarettes has created concern for accidental ingestion by smaller children.
• With the rapid increase in use of electronic nicotine delivery systems (ENDS), users and nonusers are exposed to the aerosol product. While e-cigarette aerosol may contain fewer toxins than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive.

Bottom line: e-cigarettes are often promoted as safer alternatives to cigarette smoking. Although very little is known about their safety, they are increasingly being used by youth and young adults.

What about second hand exposure?

The potential exists for secondhand nicotine and other tobacco-related toxin exposures to others. Studies have shown that e-cigarettes are a source of secondhand exposure to nicotine but not to combustion toxins. Thus, while use of e-cigarettes in indoor environments may involuntarily expose nonsmokers to nicotine, it does not seem to expose them to toxic, tobacco-specific combustion products.

What does the American Academy of Pediatrics recommend?

To protect the health of youth, the American Academy of Pediatrics has made the following recommendations:

• Sales of e-cigarettes to minors (under 18 years of age) should be prohibited.
• Candy and fruit flavored e-cigarettes, which encouraged youth smoking initiation, should be banded.
• To avoid exposing others to potential harm, laws should mandate smoke-free environments which include e-cigarette vapor.
• To prevent poisoning, all e-liquids should be required to be sold in child-proof packaging.