E cigarettes have been widely promoted as a way for people to quit smoking conventional cigarettes.
Now, in the first study of its kind, UC San Francisco researchers are reporting that, at the point in time they studied, youth using e cigarettes were more likely to be trying to quit, but also were less likely to have stopped smoking and were smoking more, not less.
We are witnessing the beginning of a new phase of the nicotine epidemic and a new route to nicotine addiction for kids, according to senior author Stanton A. Glantz, PhD, UCSF professor of medicine and director of the Center for Tobacco Control Research and Education at UCSF.
E cigarettes are battery powered devices that look like cigarettes and deliver an aerosol of nicotine and other chemicals. Promoted as safer alternatives to cigarettes and smoking cessation aids, e cigarettes are rapidly gaining popularity among adults and youth in the United States and around the world. The devices are largely unregulated, with no effective controls on marketing them to minors.
In the UCSF study, the researchers assessed e cigarette use among youth in Korea, where the devices are marketed much the way they are in the U.S. The study analyzed smoking among some 75,000 Korean youth.
The study appears online in the current issue of the Journal of Adolescent Health.
Our paper raises serious concern about the effects of the Wild West marketing of e cigarettes on youth, said Glantz.
E Cigarettes Gain Ground in Youth Market
Despite industry claims that it markets only to adults, e cigarettes have achieved substantial penetration into the youth market.
In the U.S., the federal Centers for Disease Control and Prevention recently reported that the majority of adolescents who have ever smoked e cigarettes also have smoked regular cigarettes, and that the percentage of middle and high school students who ever used e cigarettes more than doubled from 2011 to 2012. An estimated 1.78 million U.S. students had used the devices as of 2012, said the CDC.
Stanton A. Glantz, PhD
In the UCSF study, the researchers report that four out of five Korean adolescent e cigarette users are dual smokers who use both tobacco and e cigarettes.
The authors conclude that young e cigarette smokers are more likely to have tried quitting smoking, which suggests that, consistent with cigarette marketing messages, some youth may be using e cigarettes as a smoking cessation aid. … Use of e cigarettes is associated with heavier use of conventional cigarettes, which raises the likelihood that actual use of e cigarettes may increase harm by creating a new pathway for youth to become addicted to nicotine and by reducing the odds that an adolescent will stop smoking conventional cigarettes.
The data for the study came from the Korea Youth Risk Behavior Web based Survey, an annual, nationally representative survey conducted by the Korea Centers for Disease Control in 2011. The sample included 75,643 youth in grades 7 through 12.
Sungkyu Lee, PhD, lead author of the paper and a UCSF postdoctoral fellow at the time that he conducted the study, noted that e cigarette use has skyrocketed in Korea less than 1 percent of youths had tried the product in 2008 when the device was first introduced, compared to more than 9 percent in 2011. Lee is now on the staff of the National Evidence Based Healthcare Collaborating Agency in Seoul, Korea.
Among students who used e cigarettes, 8 percent were concurrently smoking conventional cigarettes. After adjusting for demographics, current cigarette smokers in the study were found to be much more likely to use e cigarettes than non smokers.
The researchers also found that the odds of using e cigarettes were considerably higher among students who had made an attempt to quit smoking than those who had not. Students no longer using cigarettes were rare among current e cigarette users, the researchers said.
Rachel Grana, PhD, a UCSF postdoctoral fellow, was a co author of the study.
The research was funded in part by the National Cancer Institute the University of California Tobacco Related Diseases Research Program and the Hellmann Family Fund.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions, and excellence in patient care. It includes top ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and two top ranked hospitals, UCSF Medical Center and UCSF Benioff Children s Hospital.
Vaping: how e-cigs work (infographic)
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In 1963, Herbert A. Gilbert invented a “smokeless nontobacco cigarette,” but it was never commercialized. “Vaping,” or smoking electronic cigarettes, first became widely popular in China, where 60 percent of men are smokers. Modern e cigarettes were patented in 2003 by Chinese inventor Hon Lik.
E cigarettes feature a replaceable inhaler cartridge containing vegetable glycerin and/or polyethylene glycol, flavoring and nicotine. With every inhalation, a sensor triggers a vaporizer to heat a small amount of liquid flavoring. The liquid turns to vapor and is drawn into the user s mouth.
Vaping is not the same as smoking a water pipe, or hookah. In a hookah, a burned mixture of tobacco and molasses is drawn through water to cool the smoke. Burning creates cancer causing chemicals that are inhaled by the smoker.
The vaping technology of e cigarettes does not burn anything the liquid mixture is simply vaporized. The vapor does not contain the harmful compounds found in smoke from hookahs or cigarettes.
The so called “hookah pen” works like an e cigarette. The pen vaporizes a liquid and does not involve burning.
In theory, since vaping does not burn tobacco, it should be safer than conventional cigarette smoking. A main ingredient in the liquid cartridges, polyethylene glycol, is FDA approved and is used in many consumer products.
A 2013 study in the journal Tobacco Control found that the harmful chemicals in e cigarettes occurred at levels 9 to 450 times lower than in regular cigarette smoke.
A 2009 study by the U.S. Food and Drug Administration found that the e cigarettes studied “contained detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed.”
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