Wednesday, July 1, 2015

Why e-cigarettes should be banned from minors

Are e-cigarettes dangerous? Good data on long-term consequences is not available yet, but no one is talking about addiction and that is the undeniable problem for our children.

Why e-cigarettes should be banned from minors


Are e-cigarettes dangerous? Good data on long-term consequences is not available yet, but no one is talking about addiction and that is the undeniable problem for our children. This is why we need to support a proposal passed by a Philadelphia City Council committee last week that would add e-cigarettes to city's smoke-free law and ban sales to minors, joining dozens of states and localities that are trying to slow the fast-growing sales of a largely unregulated product.

In addition, I would equally tax e-cigarettes like cigarettes since we know that children are more price sensitive than adults. One of the best facets of the heavy taxation of cigarettes is that it discourages the start of smoking and therefore brings down the percent of children and teens using tobacco products (cigars, snuff and snus are not taxed as heavily), which have become gateways to nicotine addiction.

Nicotine is addictive. I have seen newborn babies born to mothers who smoke (or just have a nicotine patch) get very irritable, shaky and breathe rapidly seeming like babies withdrawing from heroin.  You rarely have to treat these babies, but it often takes a day or two before they look or act like normal, healthy babies.  About 18 percent of pregnant women in Pennsylvania smoke and their babies are born with carbon monoxide levels so high and oxygen levels so low that a doctor who did not know about the smoking exposure would think that they were in a house fire and hospitalize them.

If you have any doubts about the addictive quality of nicotine, all you have to do is recall any front of a large office building during the past arctic winter with three or four shivering people puffing their cigarettes while trying to pat themselves warm. They were not smoking for any aesthetic pleasure; they were smoking to not go through withdrawal.

E-cigarettes do not look like anything dangerous. They are much harder to detect than cigarettes because they do not produce smoke, although they do produce vapors. If you stand near someone smoking an e-cigarette, you not only will get a measureable nicotine level (doctors actually measure a metabolite of nicotine called cotinine in human blood), but also get formaldehyde and heavy metals ingestion – both of which are carcinogens. A recent European study in the International Journal of Hygiene and Environmental Health is among a growing number of studies that shows that the gases produced by e-cigarettes are not innocuous.

E-cigarettes are being marketed as a device to help people stop smoking, but what about starting smoking? About 90 percent of smokers start before age 16 and some as early as age 11. Most are addicted to nicotine by age 14. Whatever reason teens have for starting (being “cool”, joining their friends, losing weight and so on), the e-cigarettes appear safer and therefore are more attractive to them. 

We have gotten smoking down nationally from 40 percent of adults to just under 20 percent. Although, the Pennsylvania numbers are a little bit higher than this. Currently, 25 states have banned e-cigarette sales to minors and several states have imposed the same restrictions on cigarettes that they have on smoking. It’s time for Pennsylvania to get on board and curb the usage of e-cigarettes by our children and teens.


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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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