Last week, the American Academy of Pediatrics publicly joined the group of advocates for federal regulations on e-cigarettes. The AAP urged the government to ban the sale of e-cigarettes to everyone under age 21 and prohibit advertising to minors, and advocated for high taxes on e-cigarette products similar to those on other tobacco products. In its announcement, the AAP cited developing brains’ vulnerability to nicotine and the potential harms to long-term health as reasons for its recommendations to keep e-cigarettes away from youths. It also recommended that smoke-free laws governing secondhand smoke explicitly include e-cigarettes, saying, “[t]he aerosol emitted from e-cigarettes is not harmless; it contains a variety of toxic chemicals, including some carcinogens and significant amounts of nicotine.”
A recently released poll found that a majority of Americans (57%) believe e-cigarettes should be regulated like tobacco products, while less than 25% of respondents felt they should not be. The Food and Drug Administration proposed e-cigarette regulations in 2014, and recently sent the regulations to the Office of Management and Budget for review. While the final form of the regulations is still unknown, the proposal banned the sale of e-cigarettes to minors and required e-cigarette labels include a list of ingredients and a disclosure that they contain nicotine.
There is growing concern about the potential health risks posed by e-cigarettes. Advocates for restrictions on e-cigarettes have long warned that unregulated e-cigarettes frequently expose users to the harmful effects of nicotine, as well as toxic chemicals such as formaldehyde, benzene, and other carcinogens. There have also been warnings about the risk that e-cigarette use may lead to greater social acceptance of smoking and higher rates of tobacco use. (Despite frequent claims that e-cigarettes may help with smoking cessation, longitudinal studies consistently find no evidence that e-cigarette use increases quitting rates.) Anecdotal evidence has linked e-cigarette use to pneumonia and other lung problems. Forty percent of e-cigarette users reported having health concerns about their use.
Many are particularly concerned about e-cigarette use among young people. The Centers for Disease Control and Prevention reported that from 2013-2014, e-cigarette use tripled among middle and high school students. Approximately 2 million high school students (13.4 percent) and 450,000 middle school students (3.9 percent) reported that they had used e-cigarettes within the last 30 days. The CDC’s survey also found that for the first time, e-cigarettes were the most used tobacco product by minors.
These growing numbers are of great concern given a study published in JAMA Pediatrics that found that youths who used e-cigarettes were significantly more likely to progress to traditional cigarette smoking. As the authors themselves stated, “These findings support regulations to limit sales and decrease the appeal of e-cigarettes to adolescents and young adults.” Advocates hope the FDA will listen to their pleas and implement final regulations that restrict the use of e-cigarettes.