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E-Cigarettes Are Expanding Tobacco Market By Attracting Low Risk Youth

Between 2004 and 2014, rates of U.S. adolescent cigarette smoking decreased, even as teen e-cigarette use increased rapidly between 2011 and 2014. As a result, some have suggested that e-cigarettes have contributed to declining cigarette smoking among youth. However, authors of the study “E-cigarettes and National Adolescent Cigarette Use: 2004-2014,” to be published in the February 2017 issue of Pediatrics (published online Jan. 23), used the CDC’s National Youth Tobacco Survey to analyze trends in cigarette and e-cigarette use among youth between 2004 and 2014. They found that the advent of e-cigarettes had no effect on already declining cigarette smoking among youth. In fact, combined current use of e-cigarette and cigarette use (accounting for dual use) in 2014 was higher than cigarette smoking alone in 2009. In addition, the authors analyzed the psychosocial characteristics of e-cigarette users and cigarette smokers and found that e-cigarette users would be unlikely to have initiated tobacco product use with cigarettes. This finding calls into question whether these youth would have ever initiated nicotine use at all had e-cigarettes not been available. The authors suggest that including e-cigarettes in smoke-free laws, state tobacco control programs, and national media campaigns, as well as taxing e-cigarettes and eliminating youth-friendly flavors, would combat rapidly rising e-cigarette use among adolescents without causing cigarette smoking to increate among youth.


The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds.

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