Public health advocates hope that a new study showing a significant spike in the use of e-cigarettes by teenagers will push the federal government to tighten its proposed regulations of the electronic products. The analysis, conducted by the Centers for Disease Control and Prevention (CDC), found that as e-cigarette use among youth has tripled from 2011 to 2013, young people who try the slickly packaged products, and are also more likely to experiment with traditional combustible cigarettes.
“We hope that studies like this will show the FDA [Food and Drug Administration] that they need to act very quickly,” Vince Willmore, a spokesperson for the Campaign for Tobacco-Free Kids, said. “The FDA has been behind the curve in regulating e-cigarettes and we certainly hope that studies like this show why it’s so urgent that they finish regulations.”
In April, the Food and Drug Administration released proposed rules banning sale of e-cigarettes to minors under the age of 18 and requiring warning labels on packaging. But the office did not restrict the industry’s use of flavors or its advertising practices. Campaign for Tobacco-Free Kids, along with other public health advocacy groups, is calling on the federal agency to “close the gaps in its proposed rule specifically with regard to marketing and flavor that appeal to kids,” Willmore said.
“The ads for e-cigarettes comes right out of the playbook that has always been used to market regular cigarettes to kids,” he added, noting that several companies are running commercials deeply reminiscent of traditional tobacco ads, relying on actors and celebrities to sell their products.
The campaign seems to be working. CDC researchers analyzed data from the National Youth Tobacco Surveys of students in grades 6 through 12 for 2011, 2012, and 2013. The results showed that more than 263,000 kids who had not used combustable cigarettes used an e-cigarettes in 2013, up from 79,000 in 2011. 43.9 percent of these first-time electronic cigarette users said they planned to try combustible cigarettes.
A study in the Journal of the American Medical Association (JAMA) Pediatrics published in March also found that “[u]se of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents.” The analysis concluded that young e-cigarette users were more likely to have ever smoked regular cigarettes or be current smokers, and also had higher odds of being regular, established smokers.
E-cigarette manufacturers, which also happen to be some of the nation’s largest tobacco companies, claim that the overwhelming majority of customers are existing users and deny allegations that they use flavors like Cherry Crush, Chocolate Treat and Peachy Keen to attract youth smokers. But in a report released in April, senators on the Health, Education, Labor and Pensions Committee (HELP) pointed out that the industry is promoting its products through sponsorship of youth-oriented events, television ads that are run during programs with high youth viewership and in social media campaigns that target younger audiences.
While major American cities — New York City, Chicago, and Los Angeles — have banned smoking of e-cigarettes indoors and in public parks, the product remains largely unregulated on the federal level. On Tuesday, the World Health Organization ruled that e-cigarette use “poses serious threats to adolescents and fetuses” and called on countries to ban their indoor use and prohibit flavors that appeal to children.
A spokesperson for Reynolds American Inc, the second-largest tobacco company in the United States, says that the company would “support legislation and regulation that prohibits the sale and possession of tobacco to youth.” But she disputed claims that e-cigarettes act as a gateway to traditional smokes, pointing to research from a Boston University professor and a public health physician who claim that “virtually all experimentation with c-cigarettes is happening among people who are already smokers” and that the CDC “fails to discriminate between one-time experimentation and continuing use which leaves results open to multiple interpretations.”
This post has been updated with comments from the tobacco industry.