Today's guest blogger is Blair Thornley, PharmD, a certified specialist in poison information, at Poison Control Center at the Children's Hospital of Philadelphia.

Electronic cigarettes, or "e-cig" use among teens has increased tremendously in the last 2 years, from approximately 780,000 in 2013 to more than 3 million students in 2015. Similarly, between 2011 and 2013, exposure to e-cigarette TV ads increased by 256 percent among 12 to 17 year olds and by 321 percent among young adults between the ages of 18 and 24. Of those surveyed, 40 percent said that they used e-cigarettes because they tasted good; only 10 percent admitted to using them as a quitting aid for conventional cigarettes.  These results seem to suggest that, not only are adolescents using e-cigarettes primarily for recreational purposes, but that their increase in popularity may be due to the successful marketing techniques of e-cigarette manufacturers. Many of these efforts mimic the tactics that Big Tobacco used in the mid-1900s, and they're working – again.

When you look at old tobacco ads next to newer, e-cigarette ads, the similarities are astounding. Until late this past summer, e-cigarettes were not considered tobacco products by the FDA, so marketers did not have to adhere to the same standards and laws as the tobacco companies. They used celebrity spokespeople such as Jenny McCarthy, or Courtney Love. Their ads portrayed rugged men, and glamorous women, sending the message that using e-cigarettes is masculine, sexy, or rebellious. They knew that sex sells, and therefore portrayed their products as something that will make the user more attractive to the opposite sex. Some e-cigarette companies even sponsored sporting events, and music festivals, because they knew it would help them reach large audiences, including young children and teens. Many e-liquids come in sweet flavors, with names that are appealing to younger audiences, such as "I love donuts" or "Mama's cookies". They also used cartoons, reminiscent of Joe Camel, who successfully marketed cigarettes to kids in the 1990s. It's little wonder why e-cigarette use among youth is on the rise.

Another important factor that might be fueling e-cigarette use in teens is, is the belief among young people that they aren't harmful, at least not compared to  tobacco products. Some teens are unaware that the e-liquids they're using contain nicotine, and nearly 20 percent of young people believe that they cause no harm at all! Many teens are likely using e cigs out of sheer curiosity, because they taste good, and because it's a fun thing to do with their friends. Nicotine can lead to a powerful, life-long addiction, as well as a permanent lowering of impulse control among teens. There is also evidence that the aerosol vapors from the e-cigarette may not be as harmless as first thought.

Flavoring is added with a chemical known as diacetyl, which has been associated with serious lung disease. E-liquids may also contain heavy metals, such as nickel, lead or tin. Another risk that has been making headlines recently is the e-cigarette batteries that have exploded in users' pockets, resulting in serious injuries, and significant harmful effects to young kids who may have accidently been exposed to the e cigarette liquid .

Because this trend is so new, scientists are still working to understand the long-term health effects, but all the preliminary evidence seems to indicate that e-cigarettes may not be a safe as once thought and should not be used recreationally by teenagers. Years ago, smoking cigarettes was considered to be healthy and safe, and the advertisements promoted them as such. It wasn't until several years after wide spread use,  that we began to realize the long-reaching health consequences of conventional cigarettes. E-cigarettes are still a relatively new phenomenon, and because we do not yet have long-term data regarding their health consequences, consumers would be wise not to jump to conclusions that they are completely without harm.

With all of this new information, it's important to establish an open dialogue with your teens and young adults, and make sure they're aware of the risks associated with e-cigarettes. The more you know, the better equipped you will be to protect your children. If you have any questions about e-cigarettes, you can feel free to call the Poison Control Center at 1-800-222-1222, where a pharmacist or nurse is on staff 24 hours a day to answer your call.

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