EXCLUSIVE: Vivek H. Murthy — e-cigarettes aren’t safe for our kids

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Having recently become a father, I have a new appreciation for the anxieties that parents feel about the health of their children. So I can imagine how the rapid rise of e-cigarette use among youth and young adults in recent years is a source of concern.

Last year, I met a teacher in Washington state who shared that her students were routinely using e-cigarettes in class. Her school had prohibited cigarette smoking, alcohol consumption and chewing gum in class, but it wasn’t sure how to deal with e-cigarettes, so there was no school policy. As I meet parents, teachers, elected leaders and healthcare professionals across America, I find that confusion about e-cigarettes is widespread.   

{mosads}E-cigarettes went from being rare in 2010 to now being the most common tobacco product used by our nation’s youth — surpassing traditional cigarettes, cigars and hookahs. This represents a staggering development in a relatively short time. It threatens 50 years of hard-fought progress we have made curbing youth tobacco use and places a new generation of Americans at risk.

In response, I issued the first surgeon general’s report on “E-cigarette Use Among and Youth and Young Adults”, on Dec. 8. The report is meant to help families and communities understand what science tells us about the health impact of e-cigarettes on young people. An important conclusion of the report is that youth use of nicotine-containing products in any form — including e-cigarettes — is unsafe.

So, what are e-cigarettes? 

E-cigarettes come in many forms and are known by different names, including e-cigs, e-hookahs, vapes and vape pens. They are battery-operated devices designed to deliver nicotine, flavorings and other chemicals in the form of an aerosol, which is a suspension of particles in a gas that can then be inhaled.

Here’s why the growing use of e-cigarettes by our nation’s young people is so concerning: nicotine comes from tobacco, and it is highly addictive. It can also have adverse effects on the developing adolescent brain, leading to addiction, attention deficits, reduced impulse control, mood disorders and compromised learning. Furthermore, e-cigarette use by young people is strongly associated with the use of other tobacco products, and research has shown that kids who use e-cigarettes are twice as likely to be open to using traditional cigarettes.  

Contrary to the belief of many, the aerosol produced by e-cigarettes is not harmless water vapor — it often contains nicotine and other chemical compounds that can have harmful effects on the user as well as those who inhale it secondhand. We know that nicotine can cross the placenta and have toxic effects on the developing fetus.

Additionally, some say that use of e-cigarettes might protect young people from becoming cigarette smokers. But there is no evidence to support this claim.  Instead, there is evidence that millions more children are being exposed to nicotine through e-cigarettes.

The dramatic growth in the use of e-cigarettes by young people has been driven by easy access and widespread advertising. Indeed, many e-cigarette companies are using advertising tactics employed by the cigarette industry to persuade young people to smoke, including the use of flavors, celebrity endorsements, themes such as rebellion and sex, and sponsored sports and music events. In 2014, seven in 10 middle and high school students reported seeing e-cigarette advertising in retail stores, online sites, newspapers, magazines, TV shows and movies.

To be certain, there is more to learn about e-cigarettes, including the full health impact of e-cigarette ingredients and the factors that lead to youth use. Additionally, the important question of whether or not e-cigarettes can help adults quit smoking has yet to be answered with high quality scientific data.

But we now know enough about the potential health risks of e-cigarettes to young people to take action.

Protecting our children will take all parts of our society working together. Parents, teachers and healthcare professionals can advise young people about the dangers of nicotine and discourage the use of tobacco in any form, including e-cigarettes. State and local leaders can implement strategies to protect youth and young adults from harm by passing clean indoor air policies that include e-cigarettes and protect people from secondhand exposure.

Public health coalitions can work with lawmakers to restrict e-cigarette advertising to youth and sponsor high-impact media campaigns to inform youth and young adults about the health consequences of e-cigarette use. Given that nearly all adult tobacco users initiate tobacco use during adolescence or young adulthood, it is crucial that we address the alarming rates of use of these products by young people.

Since Surgeon General Luther Terry’s first report on tobacco in 1964, we have made extraordinary progress as a nation in decreasing the number of adults who smoke cigarettes, to 15 percent from 42 percent.

But things didn’t get better simply because of a surgeon general’s warning.

Things got better because we, as a country, were presented with clear information, and we chose to act on it. We now are presented with another such opportunity. If we act now, we can take an essential step forward to creating a healthy, strong, tobacco-free generation.

As surgeon general and as a new father, I urge all Americans to take a stand against e-cigarette use by our nation’s young people. 

Dr. Vivek H. Murthy is the surgeon general of the United States.


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