New Surgeon General report exposes health risks youth face from e-cigarettes

The truth is out. “Vaping” is not safe.

Last week, Surgeon General Vivek Murthy raised the alarm on e-cigarettes and the particular threat they pose to young people. The report, E-cigarette Use Among Youth and Young Adults, finds that e-cigarettes pack “all the addictive potential of traditional tobacco products,” as well as other dangerous ingredients like heavy metals, ultrafine particles, and chemicals linked to deadly lung diseases. 

The tobacco industry playbook on e-cigarettes is all too familiar: denying that its products are killing off customers and sowing doubt about solid science, in an attempt to stall regulations from sweeping the country and saving millions of lives. 

E-cigarettes pose the greatest risk to youth and young adults. According to Murthy, “no matter how it's delivered, nicotine is harmful for youth and young adults,” since nicotine can damage developing brains and set young people up for lifelong addictions. Vaping isn’t a safe alternative to cigarettes, it’s a gateway to smoking and other health risks, as proven by a recent American Journal of Public Health study that found smokers who have used e-cigarettes are less likely to cut back on cigarettes in the future than smokers who haven’t used them.

California, along with eight other states, has connected the dots, and now classifies e-cigarettes as tobacco products, making them subject to all existing smoke-free laws, age restrictions, and other rules governing tobacco products. This came on the heels of a report issued last year by the California Department of Public Health shedding light on the public health risks of e-cigarettes. The risks include:

• At least 10 toxic chemicals – including benzene, formaldehyde, and lead – are present in e-cigarette vapor known to cause cancer or birth defects.
• E-cigarettes contain nicotine, a neurotoxin that affects the cardiovascular and central nervous systems, causing blood vessels to constrict and raising blood pressure. Nicotine also adversely affects maternal and fetal health during pregnancy, contributing to low birth weight, preterm delivery, and stillbirth.
• In California, e-cigarette poisonings of young children tripled in 2014 alone. From 2012 to 2013, the number of calls to poison control centers involving e-cigarette exposures rose from seven to 154 in children five and under.
• Using an e-cigarette for just five minutes causes similar lung irritation and inflammation, and has a similar effect on blood vessels, as smoking a traditional cigarette.

As researchers continue to expose the health hazards of e-cigarettes, advertising for these products jumped by 1,200 percent between 2011 and 2013. Tobacco industry tactics to hook youth on e-cigarettes have been especially successful – from selling e-cigarette cartridges in candy flavors (favored by more than 85% of youth e-cigarette users) to marketing e-cigarettes (spending $125 million on marketing in 2014 alone, up from $6.4 million in 2011) using celebrities, targeted ad placements, and branding designed to appeal to kids. 

A study in the journal Pediatrics found 12- to 17-year-olds were exposed to 256% more TV ads for e-cigarettes in 2013 than they were in 2011. The use of e-cigarettes is higher among high school students than among adults, with more than three million middle school and high school youth reporting ‘vaping’ regularly in 2015. Not surprising, then, that the use of e-cigarettes more than doubled among middle- and high-school students in 2013 alone, surpassing use of traditional cigarettes in 2014. That’s why the FDA now prohibits retailers from selling e-cigarettes to people under age 18 and the Surgeon General is focusing on this important issue, though e-cigarettes are still too easy for many school-aged youth to access. Policies like California’s new law raising the tobacco purchasing age from 18 to 21 are effective at keeping e-cigarettes and other nicotine products out of high school students’ hands.

And we are seeing progress in countering the tobacco industry’s tactics and misinformation. E-cigarette use dropped among high-school seniors from 16% in 2015 to 12% in 2016, reversing the upward trend that prompted the Surgeon General to recommend increased regulation and taxation.

As policymakers and the public health community develop policies to protect youth from the dangers of e-cigarettes, the Surgeon General’s warning makes a powerful case for strengthening existing e-cigarette regulations to ban flavor cartridges and marketing tactics that draw kids, and to extend smoke-free policies to cover the use of e-cigarettes. Without such strict limits, we will see more children getting hooked on nicotine, more poison control emergencies, and a mounting burden of preventable illness and injury.