New Studies Show E-Cigarette Use is Higher Among Teens Than Originally Thought, but What’s the Real Reason Why?

This week, two new studies were published calling into question the true nature of the use of e-cigarettes among teens. And again, these new studies seem to be painting a negative portrait of e-cigarettes, but what do these studies really tell us?

One of the two new studies was published Monday in Pediatrics, and is claiming that e-cigarettes are being used far more by teen and adolescents than previous studies have indicated. They surveyed just under 2000 high school students from Hawaii to obtain information about their smoking behaviors and their risk for picking up a smoking habit. They found that 29% of teens in Hawaii have used e-cigarettes at some point in the last month. Another study had some similar findings. Published in Nicotine and Tobacco Research, another study also claimed that about 25% of students in Connecticut had used e-cigarettes in the past month.

These numbers are a lot different from the one that the Center for Disease Control released earlier this year which stated that about 4.5% of teen and adolescents had tried some sort of vaping device in the last 30 days.

Part of the issue, some critics believe, is the availability of e-cigarettes for minors. Youth in 8 different states are still allowed to purchase e-cigarettes legally. In Massachusetts, Maine, Montana, New Mexico, North Dakota, Oregon, Pennsylvania, and Texas the sale of e-cigarettes to minor is not currently outlawed, raising concern for youth e-cigarette use though many business owners can reserve the right to refuse sale to minors and do. However, neither Hawaii or Connecticut is included in this list, so it’s unlikely that it is a reason for the increased use.

Many e-cigarette advocacy groups agree that e-cigarettes should not be sold, or marketed to minors. The Smoke-Free Alternatives Trade Association, an e-cigarette industry group, opposes marketing to minors and supports a ban on sales of vaping product to youth and adolescents. The association even runs a program that urges retailers to require proof of age before selling e-cigarettes to anyone as well as suggesting hang up signs indicating they won't sell to minors.

The authors of the Hawaii study note that even with sales bans, e-cigarettes are still sold, and therefore marketed, in places that are popular with teens, such as convenience stores, shopping malls and movie theaters. This study is different because for the first time is suggests that the teens who are using the e-cigarettes may have never even tried e-cigarettes.

Tobacco researcher and professor at the University of California-San Diego, Stanton Glantz, truly believes that e-cigarettes can lead to tobacco use. “There's no question that e-cigarettes are a gateway to smoking.” However, if they are a gateway to smoking, what was the gateway to smoking before e-cigarettes existed?

vaping vs traditional tobaccoIf they truly are a gateway, wouldn’t we see regular tobacco use on the rise as more and more youth use e-cigarettes? The truth is that regular cigarette use is down and has been going down for the last few years. Conventional cigarette use among teens has been cut in half since 2000, falling from 28% of high-school students in 2000 to 12.7% of high schoolers in 2013, according to the Campaign for Tobacco-Free Kids. If e-cigarettes are a gateway, wouldn’t regular tobacco use rise right along with the numbers of youth vaping?

That doesn’t stop the critics from coming out against e-cigarettes, though. Peter Hamm, a spokesman for the Campaign for Tobacco-Free Kids, is adamant about having no more delays in the process to approve the FDA’s proposed regulations. “We can't afford more delays that buy the tobacco industry time to continue targeting kids with a new generation of products.” However, with increased use being reported in states that already have some among of e-cigarette regulation, will the FDA’s rules really change anything.

Over 60% of the teens in the Hawaii survey chose to use e-cigarettes because they viewed them as healthier than traditional cigarettes, which may explain why more of them had experimented with e-cigarettes rather than other drugs. The survey also showed that about 47% of the Hawaiian teens had tried alcohol, 18% had tried marijuana and 15% had tried conventional cigarettes.

Authors of the Hawaii study note that e-cigarette use has grown at a rapid rate among youth, doubling every year since 2009. Just looking at the sales alone, you would find the same trend among adult users. Sales of e-cigarettes in the USA were over 11 and a half billion dollars, a huge growth since e-cigarettes were first introduced into the marketplace in 2007.

The problem with these studies is they never really ask the right questions. The question that needs to be asked in the Hawaiian study is how many of those 29% percent who tried e-cigarettes would have tried traditional cigarettes instead if vaping was not an option? And if e-cigarettes are a gateway, why doesn’t their use at least match that of regular tobacco use? What it really seems like is happening, is that youth who would have smoked anyway are just making the healthier decision to use e-cigarettes instead of combustible smokes. Of course no one wants any youth or adolescent to use either e-cigarettes or regular cigarettes, though what these studies are showing really does just reflect what is going on in our larger social landscape. Adult e-cigarette use mirrors the same trend, with e-cigarette use up, and traditional cigarette smoking down. Continuing to spotlight these studies only confuses the issue and misrepresents it, putting the future of e-cigarettes at risk.

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