Many health professionals, parents, and school officials probably felt some progress was made when the U.S. Food and Drug Administration announced last week sharp restrictions on where most flavored e-cigarette products can be sold.
What prompted the FDA to take action? Among high school students, current e-cigarette use increased from 1.5 percent (220,000 students) in 2011 to 20.8 percent (3.05 million students) in 2018.
One in five high school students and one in 20 middle school students currently uses e-cigarettes, according to new data from the U.S. Centers for Disease Control and Prevention. Approximately 74 percent of youth e-cigarette users report obtaining their nicotine products, sold legally only to adults 18 years or older, from a physical retail location.
Although e-cigarettes were created with the intention of helping adult cigarette smokers stop smoking cigarettes by acting as a nicotine replacement, adolescents have adopted e-cigarettes as their own. More high school students use e-cigarette than adults.They've created verbiage such as "juuling" and it dominates meme culture. A quick search on Google about e-cigarettes will reflect the growing problem at high schools of students vaping in the bathroom or even in the classroom.
These numbers are alarming given the long lasting health consequences of using e-cigarettes. Did you know a car exhaust pipe and e-cigarette both emit benzene—a volatile organic compound? E-cigarettes contain harmful substances such as heavy metals including nickel, tin or lead, which have ultrafine particles that can be inhaled into the lungs. They also have flavorants such as diacetyl, which can cause a serious lung disease called "popcorn lung". Not all e-cigarette liquids contain all of these harmful substances, and some may even be a healthier alternative for adult cigarette smokers, but the ingredients remain unmonitored by the FDA.
Nicotine falls under the same category as heroin, methamphetamine, and cocaine on the list of the most addictive substances in the world. What does this mean for nicotine's teen users? The human brain is not fully developed until approximately age 25. This means that adolescents' brains are gathering new information and skills based on their actions and surroundings. Adolescents' brains learn new information quicker than adults and this puts them at greater risk of developing an addiction. On top of this, nicotine effects the way that the brain grows, causing a reduction in attention and learning.
A study also found that the use of e-cigarettes is closely linked to the eventual use of other tobacco products, such as regular cigarettes, cigars, hookah, and smokeless tobacco. Some e-cigarette systems can be used to deliver illicit substances, like marijuana, in unidentifiable flavored smoke.
"The data make unmistakably clear that, if we're to break the cycle of addiction to nicotine, preventing youth initiation on nicotine is a paramount imperative," said FDA Commissioner Scott Gottlieb, M.D., in a statement.
The latest move from the FDA to put a limit on flavored e-cigarette liquids is a step in the right direction and will hopefully be enough to reverse this trend. Parents and caregivers, please take the time to talk to your child about the dangers of e-cigarettes if you haven't yet.
Haley Mesaros, PharmD Candidate at Wilkes University Nesbitt School of Pharmacy, wrote this in conjunction with the Poison Control Center at Children's Hospital of Philadelphia.