While traditional cigarette smoking declines among U.S. high school students, and stays the same among middle schoolers, the increasing use of electronic cigarettes and water pipes called hookahs means that tobacco use among teens remains steady.
The use of electronic cigarettes by teens is soaring, causing concern among health experts who question the safety of the battery-powered devices and complain that they are creating a new generation of nicotine addicts.
E-cigarettes create an inhalable vapor by heating liquid nicotine – in flavors such as candy or fruit – in a disposable cartridge or refillable tank. The vapor lacks the tar of traditional cigarette smoke but still contains cancer-causing chemicals, said Leslie Kohman, MD, a lung surgeon and medical director of the Upstate Cancer Center. While the U.S. Food and Drug Administration has declared the main component of e-cigarettes, propylene glycol, safe for eating, she said, “Inhaling it is very different because the lungs absorb things in a very different way than the intestinal tract.”
Kohman is concerned about the lack of regulation, too. “E-cigarettes are manufactured in various locations around the world with no manufacturing controls, no safety controls whatsoever,” she said. The FDA has proposed regulations, and a group of health organizations in New York state is trying to add e-cigarettes to the state’s Clean Indoor Air Act so the devices would be prohibited anywhere cigarettes are prohibited.
Also, since an 18-month-old boy from the Albany area died after swallowing a small amount of liquid nicotine, New York state now requires childproof packaging of liquid nicotine.
The sale of tobacco products, including e-cigarettes and liquid nicotine, to those younger than 18 years of age is illegal in New York state. Some local jurisdictions have set the age higher: In Onondaga County, where Upstate Medical University is located, the minimum age is 19. In New York City, it’s 21.
Data from the U.S. Centers for Disease Control and Prevention tracks smoking rates among high school and middle school students, revealing underage tobacco use. Experts fear that three of every four teen smokers will continue into adulthood because almost 90 percent of adult smokers say they first tried cigarettes as teens.
This article appears in the summer 2015 issue of Cancer Care magazine.
Hear Kohman’s radio interview about the dangers of e-cigarettes.
