Surgeon general calls youth e-cigarette use a public health threat

image Campaign for Tobacco-Free Kids

The Office of the U.S. Surgeon General issued its first report on electronic cigarettes Dec. 8, calling them a "major public health concern" for youth. Surgeon General Vivek Murthy also announced an interactive website with information and resources for parents and youth.

 "E-cigarettes went from being rare in 2010 to now being the most common tobacco product used by our nation's youth," Murthy said during a news conference, HealthDay News reports. "This represents a staggering development in a relatively short period of time. It also threatens 50 years of hard-fought progress we have made curbing tobacco use, and it places a whole new generation at risk for addiction to nicotine."

E-cigarette use more than tripled since 2011 among middle and high school students, with more than 3 million of them current users (past 30-day use) in 2015, says the report. And after a period of relative stability from 2011 to 2013, vaping more than doubled from 2013 to 2014 among young adults between 18 and 24 years old.

In Kentucky, 41.7 percent of high school students  have ever used an electronic vapor product and 23.4 percent reported being current users ( past 30-day use) in 2015, the first year this data was collected in Kentucky on the Youth Risk Behavior Survey. As for cigarettes, 44.1 percent had ever tried cigarette smoking and 16.9 percent were current smokers.

The 2016 Monitoring the Future survey released after this report on Dec. 13 found for the first time since they started measuring e-cigarette usage, the rate "declined significantly" from 2015 to 2016, dropping from 16.3 percent to 12.5 percent among 12th graders.

"This is a promising turnaround after several surveys found a rapid rise in youth use of e-cigarettes in recent years. However, youth e-cigarette use remains disturbingly high and exceeds use of conventional cigarettes. As the Surgeon General’s report released last week concluded, e-cigarettes pose a serious threat to the health of young people," Matthew L. Myers, president of Campaign for Tobacco-Free Kids, said in a statement.

The surgeon general's report notes the dangers of nicotine on teen and young adult brains, saying it can cause addiction, reduced impulse control, deficits in attention and learning and mood disorders.

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

Murthy dismissed industry claims the e-cigarettes prevent youth from becoming smokers, noting the strong association between the use of tobacco products and e-cigarettes. The report says that in 2015, 58.8 percent of high school students used both combustible tobacco products and e-cigarettes.

"There is actually no evidence to support this claim when you look closely at the data," Murthy told HealthDay News.

The report raised concerns about the potential health risks from chemicals found in e-cigarette liquids, which are heated in the device to create a vapor that users inhale. It also notes that e-cigarette aerosol is not harmless 'water vapor," though it also recognizes that it has fewer toxicants than a traditional tobacco product, and that the liquids in them "can cause acute toxicity and possibly death" if consumed.

The report says that students in the 8th, 10th and 12th grades are choosing e-cigarettes over tobacco cigarettes. "In 2015, almost 7 percent of 8th graders exclusively used e-cigarettes during the previous month, alongside 10.4 percent of 10th and 12th graders. Meanwhile, conventional cigarette use occurred in 1.4 percent, just over 2 percent and slightly more than 5 percent of 8th, 10th and 12th graders, respectively," HealthDay reports.

image from the Surgeon General report

Murthy said: "The e-cigarette industry is enticing teens to try their products by flavoring the vapor to taste like candy and fruit, and by using advertising strategies that focus on celebrity endorsements, sponsorship of sports and music events, along with themes of rebellion and sex."

The report concludes with a call to action, including incorporating e-cigarettes in to all smoke-free policies; educating parents, teachers and teens about their danger; to implement and enforce regulations to decrease youth smoking; and to strengthen regulations around advertisements that appeal to youth. It also calls for more research.

In a different statement, Myers calls for the current regulations on e-cigarettes to be strengthened by prohibiting flavors and marketing that appeal to youth, while noting there is a pending proposal in Congress that would weaken the current regulation, adding: "Research has found that more than 85 percent of current youth e-cigarette users use flavored e-cigarettes, and flavors are the leading reason for youth use."

The FDA issued some long-awaited regulations on e-cigarettes earlier this year that ban e-cigarette sales to minors and require makers of the devices to submit their ingredients, among other things. But the regulation did not address the use of flavorings or advertising.

"Federal, state and local policymakers must heed this call from the Surgeon General to protect our children from becoming the next generation hooked on tobacco," American Lung Association National President and CEO Harold Wimmer said in a statement.