E-cigarettes are battery operated devices that emit doses of vaporized nicotine that are inhaled. The benefits and the health risks of e-cigarettes are uncertain and the long-term health effects are unknown.
E-cigarettes - thought by some to be responsible for a decline in
youth cigarette smoking - are actually attracting a new population of
adolescents who might not otherwise have smoked tobacco products, suggested a new UC San Francisco study.
‘E-cigarettes are attracting a new population of adolescents who might not otherwise have smoked tobacco products.’
In the first national analysis of the impact of e-cigarettes on
trends in youth smoking in the United States, UCSF researchers did not
find evidence that e-cigarettes have caused youth smoking to decline. In
fact, combined e-cigarette and cigarette use among adolescents in 2014
was higher than total cigarette use in 2009, according to the study.
The authors concluded that the low-risk youth in the study, who went
on to smoke regular cigarettes, may not have used nicotine at all if
e-cigarettes did not exist.
The study will be published online in Pediatrics
as well as the February print issue of the journal.
"We didn't find any evidence that e-cigarettes are causing youth
smoking to decline," said lead author Lauren Dutra, a former
postdoctoral fellow at the UCSF Center for Tobacco Control Research and
Education and current social scientist at RTI International, a
not-for-profit research organization based in North Carolina.
"While some of the kids using e-cigarettes were also smoking
cigarettes, we found that kids who were at low risk of starting nicotine
with cigarettes were using e-cigarettes," Dutra said. "Recent declines
in youth smoking are likely due to tobacco control efforts, not to
The national analysis builds on several previous studies that have
reported that adolescents who start with e-cigarettes are more likely to
subsequently smoke traditional cigarettes.
In August 2016, the U.S. Food and Drug Administration restricted
e-cigarette purchases to adults ages 18 and older (California set the
age to 21). The FDA also will require a warning label on e-cigarettes,
starting August 2018, regarding the addictive nature of nicotine.
However, the FDA's ruling does not regulate advertising or flavors, and
e-cigarettes continue to be sold in flavors that appeal to youth.
In the new UCSF study, the researchers examined survey data from
more than 140,000 middle and high school students who completed the
CDC's National Youth Tobacco Survey between 2004 and 2014.
The authors found that cigarette smoking among U.S. adolescents
declined during that decade, but did not decline faster after the advent
of e-cigarettes in the U.S. between 2007 and 2009.
The authors also performed an in-depth analysis of the psychosocial
characteristics of e-cigarette users. Research has established that
smokers tend to display certain characteristics that non-smokers are
less likely to show, such as a tendency to live with a smoker or to wear
clothing that displays a tobacco product logo. The smokers in the
national youth survey displayed these characteristics, but the
adolescents who were only using e-cigarettes displayed few of these
"E-cigarettes are encouraging - not discouraging - youth to smoke
and to consume nicotine, and are expanding the tobacco market," said
senior author Stanton A. Glantz, UCSF professor of medicine and
director of the UCSF Center for Tobacco Control Research and Education.
The new results are consistent with a similar study of youth in
California conducted last year by researchers at the University of
Southern California and also published in Pediatrics
researchers also found that adolescents who used e-cigarettes - but not
cigarettes - displayed few of the risk factors commonly found among
In combination, the two studies suggest that "e-cigarettes are attracting low-risk youth," the UCSF scientists said.