What's the latest with e-cigarettes?

With more teens trying e-cigarettes, health professionals are concerned that a new generation is getting hooked to a harmful product and that it could lead to smoking traditional cigarettes.

PolicyLab at Children's Hospital of Philadelphia recently held a webinar addressing recent trends, the marketing of e-cigarettes, and how health providers can play a role in preventing the spread of e-cigarette usage. We asked Brian Jenssen, MD, MSHP, a practicing pediatrician and faculty member at PolicyLab, to tell us more about the latest research and how parents can talk to their children about the health risks of e-cigarettes.

What do the latest numbers tell us about kids and teens with e-cigarettes?

E-cigarettes are the most commonly used tobacco product among teenagers. In fact, their use by youth has risen rapidly since they first appeared in the U.S. in 2007, surpassing conventional cigarettes in 2014.

Nearly one in three students in 12th grade reports using a vaping device in the last year, according to an ongoing national survey of adolescent drug use last month. Further, 16.6 percent of 12th graders and 6.6 percent of eighth graders say they vaped in the last month, which is a stronger indicator of regular use. E-cigarettes and other vaping devices typically deliver nicotine, flavorings, and other additives through an inhaled aerosol, but research suggests many teens do not actually know what is in the device they are using.

What is the risk profile of e-cigarettes?

The biggest risk we face with youth using e-cigarettes is that they will move on to smoking traditional cigarettes. Several studies show adolescents who use e-cigarettes compared with  those who do not are at higher risk of transitioning to traditional cigarettes. These studies also found that adolescents previously at low risk for using cigarettes can be drawn to traditional tobacco products through their e-cigarette use.

These findings raise significant concern that e-cigarettes have the potential to addict a new generation to nicotine and smoking – the leading preventable cause of disease and death in the U.S. Other research found that e-cigarette use can hurt developing lungs and adolescent brain development. Finally, the emissions from e-cigarettes are not "harmless water vapor," a claim often made by advertisers. This secondhand aerosol has been found to contain chemicals and toxins that are known to hurt human health and cause cancer.

How can we talk to kids about the marketing of e-cigarettes?

E-cigarette companies market their products using a wide variety of media channels and approaches that the tobacco industry previously relied on to market conventional tobacco products to kids and teenagers. One of those tactics is to promote unique flavors for e-cigarette solution, the majority of which are candy-like and appealing to children that are now banned for traditional cigarettes. Enticing flavorings have been shown to encourage youth experimentation, regular use, and addiction to both traditional and e-cigarettes.

We should counteract the industry's deceptive marketing practices using effective approaches found in successful education campaigns, such as "Truth." Rather than talking only about health harms, we should remind teens that tobacco and e-cigarette companies are intentionally trying to get them addicted to a product so they can keep making money. Being e-cigarette- and tobacco-free is a way to push back against being manipulated.

If a parent uses e-cigarettes, how can teens be urged to not use them?

The vast majority of smokers want to quit. Although many adults use e-cigarettes in the hope that they may help them quit cigarettes, it's not clear from the latest research studies whether e-cigarettes actually help smokers quit smoking.

Instead, studies in real-world clinical settings of smokers interested in quitting found that e-cigarette users have lower rates of successful quitting compared with never e-cigarette users. But, there are several effective smoking cessation medications and additional treatment options available to smokers.

Parents should talk with their children about the risk of using e-cigarettes and becoming addicted to traditional cigarettes. If you're a parent trying to quit tobacco, share the reasons why you want to be tobacco-free with your children and family. Emphasize how, if you could make the choice again, you never would have started smoking.

Many e-cigarette smokers say they're not as bad as regular cigarettes, citing that the ingredients are not as harmful. How can we talk to teens about this?

We really don't know whether e-cigarettes are not as bad as traditional cigarettes. We do know that tobacco companies lied about the dangers of smoking cigarettes for years, including denying the links between smoking and disease even though they internally recognized it and concealing evidence that nicotine is addictive, and rejecting the clear health harms of secondhand smoke.

E-cigarette businesses, many of which are owned by major tobacco companies, have already been caught making false claims about the solutions and emissions from their products. Although scientists are still learning more about how e-cigarettes directly affect health, there is strong evidence that e-cigarette use by teens can lead to cigarette use – a product that is addictive and kills half of its long-term users. When talking to teens, advise them that the best way to avoid tobacco company manipulation and be tobacco-free is to avoid using any tobacco product, including e-cigarettes.