Sunday, January 24, 2016

As ads for electronic cigarettes increase, more teenagers are using the devices; Kentucky health officials notice trend

By Melissa Patrick
Kentucky Health News

Teenagers' use of electronic cigarettes tripled between 2013 and 2014, surpassing the use of all tobacco products, and federal officials are blaming unrestricted advertisement of the products.

Seven out of 10 middle-school and high-school students (69 percent) say they've seen e-cigarette ads in stores, online or in other media, with most of the ads using the same themes that have been used to sell traditional cigarettes for years: sex, independence and rebellion, according to a recent report from the U.S. Centers for Disease Control and Prevention.

"The same advertising tactics the tobacco industry used years ago to get kids addicted to nicotine are now being used to entice a new generation of young people to use e-cigarettes," Tom Frieden, director of the CDC, said in an online statement.

The "Vital Signs" report, published Jan. 5 in the CDC's Morbidity and Mortality Weekly Report, attributes the increase in e-cigarette use in youth with the increase in e-cigarette advertising.

"Spending on e-cigarette advertising rose from $6.4 million in 2011 to an estimated $115 million in 2014," says the report. "During 2011 to 2014, current e-cigarette use among high school students soared from 1.5 percent to 13.4 percent, and among middle school students from 0.6 percent to 3.9 percent."

Kentucky health official also links the two

A health educator at the Barren River District Health Department, Carol Douglas, told Wes Swietek of the Bowling Green Daily News that the regional agency has also seen an increase in e-cigarette use.

“We’re seeing more and more adolescents who have never smoked smoking e-cigarettes,” she said. “This is the new fad."

Several studies have found that e-cigarettes are often a gateway to smoking traditional cigarettes, including one from the CDC that found "never-smokers who had ever used e-cigarettes were nearly twice as likely to have an intention to smoke conventional cigarettes than never smokers who had not used e-cigarettes." Another study from the University of California came to the same conclusion.

“We’re hearing more and more about that,” Douglas told Swietek. “We’re doing more presentations at schools” as young people are “getting bombarded with ads for e-cigarettes."

E-cigarettes come with risks

“They are not just water vapor,” Douglas told Swietek. “There’s a [false] perception that it’s safe."

The Kentucky Center for Smoke-free Policy said e-cigarette cartridges and vapors often contain harmful and even cancer-causing chemicals such as formaldehyde, glycol, acetone and nicotine, Swietek reports.

In addition, some of the flavorings include diacetyl, a butter-flavored chemical, or a chemically similar substitute, acetyl propionyl, which are known to cause lung disease.

"The largely unregulated mixtures used to produce the vapors can leave particles in user’s lungs that can cause disease and respiratory problems," Swietek writes.

The center, at at the University of Kentucky, lists several other problems with e-cigarettes, including: e-cigarettes are not a proven cessation aid and could derail true cessation attempts; some e-cigarettes are marketed as “green” and “healthy,” which may encourage youth to experiment and become addicted; lack of regulation hinders research about safety and efficacy because the product keeps changing; and five minutes of e-cigarette use has lung effects similar to tobacco smoking.

"E-cigarettes typically deliver nicotine, which at a young age may cause lasting harm to brain development, promote addiction, and lead to sustained tobacco use," Brian King, deputy director for research translation at CDC's Office on Smoking and Health, said in an online statement.

Call to action

The CDC wants the U.S. Food and Drug Administration to regulate the manufacturing, distribution, and marketing of e-cigarettes. The FDA proposed regulations on e-cigarettes April 2014, but they have not been finalized.

The CDC report says, "This unrestricted marketing of e-cigarettes, coupled with rising use of these products among youth, has the potential to compromise decades of progress in preventing tobacco use and promoting a tobacco-free lifestyle among youths."

For a larger version of this map, click on it
For now, the CDC offers these strategies to decrease youth access to e-cigarettes: Limit product sales to places that never admit minors; restrict the number of stores that sell tobacco and e-cigarettes and how close they can be to schools; require face-to-face transactions; ban e-cigarette sales over the Internet; and require age-verification to enter vendor websites, to make purchases or to accept deliveries of e-cigarettes.

Kentucky school districts typically prohibit e-cigarettes when they go tobacco-free. Kentucky also restricts selling e-cigarettes to minors.

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