Last year, the Centers for Disease Control and Prevention revealed that the use of e-cigarettes among American middle and high school students more than doubled between 2011 and 2012. Now, a new study published in the journal Pediatrics finds that e-cigarette use among teenagers in the US continues to grow, sparking concerns about the potential long-term effects.
For the study, researchers led by Dr. Thomas Wills of the University of Hawaii Cancer Center surveyed 1,941 high school students in Hawaii who were aged 14 or 15 years.
The survey, conducted in 2013, questioned the students about their use of conventional cigarettes, e-cigarettes (electronic cigarettes), alcohol and marijuana. It also assessed students’ psychosocial risk and protective factors, such as parental support, peer smoking, sensation seeking and smoking expectancies.
The researchers found that 30 percent of students reported using e-cigarettes. Dr. Wills and colleagues note that this rate is more than three times higher than that revealed by last year’s report from the Centers for Disease Control and Prevention (CDC), which found that 4.7 percent of teenagers used e-cigarettes in 2011 and 10 percent used them in 2012.
Use of both conventional cigarettes and e-cigarettes – deemed “dual use” – was reported among 12 percent of students, and 3 percent used cigarettes only. While 68 percent of students had never used conventional cigarettes or e-cigarettes, 96 percent reported that they were aware of e-cigarettes and 67 percent thought e-cigarettes were healthier than conventional cigarettes.
Interestingly, the results showed that e-cigarette use among teens was more common in Hawaii than in any other state in the country.
E-cigarettes may be ‘recruiting medium-risk adolescents to tobacco use’
The team also found that 17 percent of students reported using e-cigarettes only. Other than dual users, such students had the highest risk status and lowest protective status, compared with non-users.
Past research has uncovered some unsettling findings about e-cigarette use among young people. In September, a study in the New England Journal of Medicine found that e-cigarettes may be a gateway to conventional smoking. And in March, a study published in JAMA Pediatrics revealed that e-cigarette use could encourage tobacco use in adolescents.
Dr. Wills and colleagues say their research supports such findings:
“The fact that e-cigarette only users were intermediate in risk status between non-users and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use.”
Although the researchers are unable to explain exactly why the rate of e-cigarette use is so high among teenagers in Hawaii, they say it could be down to their widespread availability at the time of survey; restrictions on the sale of the devices to under-18s were only launched in Hawaii in July last year.
Dr. Wills adds that the marketing of e-cigarettes is “very aggressive” in Hawaii, particularly in places accessible to teenagers, such as movie theaters. He also notes that the array of flavored liquids available for e-cigarettes makes them attractive to adolescents.
Overall, Dr. Wills says teenagers and their parents should be aware of the potential risks of e-cigarette use. “You have to think carefully about the risks and benefits of using either tobacco or nicotine, which is known to be an addictive substance,” he says. “A lot of teens think it is easy to quit smoking but it isn’t true. It’s hard for anybody to quit.”