E-Cigarettes Finding New Users in Teens

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Touted as a way to quit smoking, the latest data raise concerns that electronic cigarettes, or e-cigarettes, may actually be a gateway for teens into tobacco use.

According to the latest data from the National Youth Tobacco Survey,  the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012. There was a similar doubling of current e-cigarette smokers, defined as having smoked an e-cigarette in the last 30 days, from 1.1% to 2.1%.

Overall, that translated to 1.78 million middle school and high school e-cigarette smokers. Even more concerning, said CDC director Dr. Thomas Frieden in a statement, is that 76.3% of these smokers also said they smoked conventional cigarettes. “The increased use of e-cigarettes by teens is deeply troubling,” he said. “Nicotine is a highly addictive drug.  Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.”

(MORE: Doctors Asked to Counsel Teens About the Dangers of Smoking)

Most addictions to nicotine start at a young age, and the findings, published in the CDC’s Morbidity and Mortality Weekly Report, suggest that a vast majority of students who use e-cigarettes also turn to conventional tobacco products as well.

As TIME’s Josh Sanburn reported early this year, the e-cigarette business is rapidly growing, with UBS estimating that sales–which have doubled every year since 2008–will reach $1 billion in 2013. “Consumption of e-cigs may overtake traditional cigarettes in the next decade,” Wells Fargo analyst Bonnie Herzog told Sanburn. “And they’ll only evolve and improve as time goes forward — at far less risk. The technology portion of it is sort of like Apple. This is just Version 1.”

E-cigarettes are battery-operated products — designed to look like regular cigarettes, cigars, or pipes — that can contain varying amounts of nicotine, or none at all. They turn the nicotine or other chemicals into a vapor that users inhale, sparing them exposure to the smoke created by burning tobacco, which can release carcinogens into the lungs. Whether e-cigarettes are actually safer than regular cigarettes isn’t clear; a recent study found that e-cigarettes can cause increased resistance in the airways, making it harder to breathe, within minutes of inhalation of the vapors, while other studies have suggested the products can help smokers to quit.

The Food and Drug Administration is currently studying the data on electronic cigarettes and plans to issue a regulatory rule on the products soon. For now, only e-cigarettes that are prescribed for treating smoking are regulated by the FDA; other uses are not. But, based on the results, the agency reiterated its plans to extend its tobacco control jurisdiction to cover these products as well as the cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco that it already regulates.

(MORE: Can Electronic Cigarettes Challenge Big Tobacco?)

The agency’s rule will certainly take into consideration the question of how teens are using e-cigarettes, and will consider studies that investigate whether the products serve as a gateway to other tobacco use. “About 90 percent of all smokers begin smoking as teenagers. We must keep our youth from experimenting or using any tobacco product,” Dr. Tim McAfee, the director of the CDC Office on Smoking and Health said in a statement.

If, as the results suggest, e-cigarette use is tied to tobacco use among teens, then electronic cigarettes could be just as enabling as conventional cigarettes for nicotine addictions. “These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical,” said McAfee.