Manufacturers of the flavored vaping products target
children with marketing and sweet flavors, potentially creating a new
generation of nicotine-addicted youth
ITASCA, IL. - The dramatic rise of teens who use
electronic cigarettes threatens to unravel five decades of public health gains
regarding tobacco use, as evidence shows these teens are significantly more likely
to move on to traditional cigarettes, according to the American Academy of
The AAP renews its call for immediate federal intervention
to restrict the marketing and sales of e-cigarettes to youth in its policy
statement, “E-Cigarettes and Similar Devices,” published in the February 2019 Pediatrics
(published Jan. 28 online).
E-cigarettes appeal to youth because of enticing candy or
fruit flavorings and sleek designs, and often are perceived as less harmful
than traditional tobacco products, research shows. Yet the aerosol “vapor”
produced from e-cigarettes typically comes from a solution that contains
nicotine and other toxins, including known carcinogens.
“Nicotine is highly addictive, and we know that the earlier
that someone uses nicotine products in childhood, the more difficult it is to
quit later,” said Brian P. Jenssen, MD, FAAP, lead author of the statement
generated by the AAP Section on Tobacco Control, primary care pediatrician at
Children's Hospital of Philadelphia and researcher at PolicyLab. “Most adult
smokers started using tobacco before age 18.”
Nicotine also can have lasting damaging effects on
adolescent brain development and is linked to other adverse health outcomes,
especially for a developing fetus.
Nearly 21 percent of high school students and 5 percent of
middle school students reported having used an e-cigarette in the past 30 days
in 2018, according to the National Youth Tobacco Survey; these rates represent
a 78 percent increase from 2017. More than 28 percent of middle and high school
students – or about 20.5 million youth – were exposed to e-cigarette
advertisements from at least one source in 2016, research shows.
“E-cigarettes need stronger federal regulations to prevent
youth access and use,” said Susan C. Walley, MD, FAAP, co-author of the
statement and Chair of the AAP Section on Tobacco Control. “The research is
clear that teens are at higher risk of transitioning to traditional cigarettes
even with experimental use of e-cigarettes.”
Scientific evidence does not support health claims that
e-cigarettes are effective as smoking cessation aids.
The AAP recommends that:
The FDA should act
immediately to regulate e-cigarettes and ban the sale of the products to
people under 21 years old.
Internet sales of
e-cigarettes and e-cigarette solution should be banned.
Efforts should be made
to reduce youth demand, by banning characterizing flavors, including
menthol in e-cigarettes
promotion of e-cigarettes that are accessibly to youth should be banned.
E-cigarettes should be
incorporated into current tobacco-free laws and ordinances where children
and adolescents live, learn, play, work and visit.
screen for e-cigarette use, counsel about health effects and should not
recommend e-cigarettes as a treatment option for tobacco cessation.
“It took decades to raise awareness of the deadly effects of
smoking and traditional tobacco use,” Dr. Jenssen said. “Today, we know that
e-cigarettes are dangerous for children and teens. We have a chance to protect
this generation, but we need to act now.”
The American Academy of Pediatrics is an organization of 67,000 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 www.aap.org and follow us on Twitter @AmerAcadPeds