The rapidly growing use of
electronic cigarettes, hookahs and other smoking alternatives by middle school
and high school students concerns US health officials.
While use of these devices
nearly doubled in some cases between 2011 and 2012, no corresponding decline
has been seen in cigarette smoking, the US00 Centres for Disease Control and
Prevention reported Thursday.
"We have seen, between
2011 and 2012, a big increase in the percentage of middle- and high-school
students who are using non-conventional tobacco products, particularly
electronic cigarettes and hookahs," said Brian King, a senior scientific
adviser in CDC's office on smoking and health.
These products are marketed
in innovative ways on TV and through social media, he said. "So, it's not
surprising that we are seeing this increase among youths," he added.
E-cigarettes and hookah
tobacco come in flavours, which appeals to kids. And since hookahs are often
used in groups, they also provide a social experience, which may be adding to
their popularity, King said.
Teens may also believe that
e-cigarettes are safer than tobacco, said Stanton Glantz, director of the Centre
for Tobacco Control Research and Education at the University of California, San
Francisco. However, nicotine is addictive and can hamper the developing brains
"This paper shows that
the return of nicotine advertising to TV and radio, combined with an aggressive
social media presence and use of flavours is promoting rapid uptake of
electronic cigarettes by youth," said Glantz.
The report, based on data
from the 2012 National Youth Tobacco Survey, was published in the issue of the
CDC's Morbidity and Mortality Weekly Report.
King said efforts are
needed to curb use of these tobacco products and prevent other teens from ever
trying them. "We know that 90% of smokers start in their teens, so if we
can stop them from using tobacco at this point, we could potentially prevent
another generation from being addicted to tobacco," King noted.
Smoking is the leading
cause of preventable death and disease in the United States, killing more than
1 200 people every day.
E-cigarettes simulate the
experience of smoking without delivering smoke. They are shaped like cigarettes
but users inhale a vaporised, nicotine-based liquid.
"Nicotine is an
addictive drug that affects brain development, especially in adolescents, whose
brains are still developing," he said.
Not regulated by FDA
According to the report,
from 2011 to 2012 use of e-cigarettes among middle-school students rose from
0.6% to 1.1%. Their use by high school students jumped from 1.5% to 2.8%.
Over the same period,
hookah use among high schoolers jumped from 4.1% to 5.4%, the researchers
cigarettes, hookah tobacco, cigars and certain other new tobacco products are
not regulated by the US Food and Drug Administration.
The FDA has said it intends
to classify these products as tobacco products, putting them under the agency's
The popularity of these new
products hurts ongoing tobacco-prevention efforts, experts say. "This
proliferation of novel tobacco products that are priced and marketed to appeal
to kids are slowing our progress in reducing tobacco use among kids," said
Danny McGoldrick, research director for Campaign for Tobacco-Free Kids.
"You have the marketing
of electronic cigarettes that are using all the themes and tactics that have
been used by cigarette companies for decades to market to kids, like flavours,
the use of celebrities, the use of sports and entertainment, as well as
glamour, sex and rebellion," he said.
This is why the FDA needs
to assert jurisdiction over all tobacco products, McGoldrick said.
Cigar use is also rising
among adolescents. Their use by black high school students rose from about 12%
to nearly 17% from 2011 to 2012, and since 2009 has more than doubled,
according to the report.
Cigars and cigarettes were
smoked by about the same number of boys in 2012 – more than 16%.
Cigars include so-called
"little cigars," which are similar in size, shape and filter to
cigarettes, King said. But since they are taxed at lower rates than cigarettes,
they are more affordable. "You can buy a single, flavoured little cigar
for mere pocket change, which could increase their appeal among youth," he
Fruit and candy flavours,
which are banned from cigarettes, are added to some of these little cigars,
According to the CDC, about
one in three middle- and high-school students who smoke cigars use flavoured
Every day, more than 2000
teens and young adults start smoking. Smoking-related diseases cost $96 billion
a year in direct health care expenses, according to the CDC.
For more information on
stopping smoking, visit the American Cancer Society.