By M. Gideon Hoyle
E-cigarettes are nicotine delivery products designed to do such things as lower smokers’ exposure to harmful substances in tobacco and reduce non-smokers’ exposure to secondhand smoke. There is currently a significant amount of disagreement among researchers about the potential harms associated with the use of these products.
In a study published in August 2014 in the journal Nicotine & Tobacco Research, researchers from three U.S. institutions used data gathered from a project called the National Youth Tobacco Survey to determine if e-cigarette use strengthens teenagers’ intentions to use conventional cigarettes at some point in the future.
E-cigarettes are known more formally as electronic cigarettes or electronic nicotine delivery systems. These products — which commonly come in a cylindrical form that approximates the shape of a conventional cigarette — contain a liquefied form of nicotine, the addictive, psychoactive main ingredient found in all forms of tobacco.
How E-Cigarettes Work
In addition, they typically contain additional substances such as flavorings and a chemical called propylene glycol. When a heating element at one end of an e-cigarette is ignited, the liquid housed in the main chamber partially vaporizes and produces an aerosol mist that looks similar to conventional cigarette smoke. When this vapor enters the body through the lungs, it delivers nicotine to the bloodstream and ultimately to the brain.
Conflicting E-Cigarette Research
Some current research indicates that e-cigarette use can trigger direct harm through toxic chemical exposure, as well as indirectly producing harm by increasing the likelihood that a user will eventually start smoking tobacco cigarettes. Conflicting research indicates that e-cigarette use substantially reduces the toxin load associated with the intake of burned tobacco, in addition to decreasing the likelihood that non-smokers will eventually start using tobacco cigarettes. In 2014, the U.S. Food and Drug Administration (FDA) announced plans to more tightly control the distribution and use of e-cigarettes in America. Specific reasons for the FDA’s decision include lack of sufficient information on the short- and long-term harms of using these products, as well as lack of information on the full range of substances found in the average e-cigarette.
The National Youth Tobacco Survey
The National Youth Tobacco Survey is a collaboration between the FDA and the Centers for Disease Control and Prevention (CDC). Its goals include an annual accounting of how many middle school students and high school students use cigarettes and other tobacco products, assessment of the attitudes that middle school students and high school students maintain toward tobacco use, an accounting of how often teenagers are exposed to pro-smoking messages and an accounting of how often teens are exposed to anti-smoking messages. In addition, the survey now also includes e-cigarettes within the scope of its inquiry.
E-Cigarette’s Impact On Intended Tobacco Use
In the study published in Nicotine & Tobacco Research, researchers from Georgia State University, the CDC and the Food and Drug Administration used data from three years of the National Youth Tobacco Survey (2011-2013) to assess the potential connection between teen e-cigarette use and the future desire to smoke tobacco cigarettes. In 2011, figures from the survey indicated that 79,000 U.S. middle schoolers and high schoolers had used an e-cigarette but had never smoked a conventional cigarette. By 2013, the number of teenagers in this category had risen to more than 263,000.
The researchers concluded that 43.9 percent of the middle school and high school e-cigarette users who had never smoked a tobacco cigarette expressed a desire to do so at some point in the future. In contrast, only 21.5 percent of middle schoolers and high schoolers who had never used e-cigarettes or tobacco cigarettes expressed a desire to smoke tobacco at some point in the future. When all potential intervening factors are considered, an e-cigarette-using teenager has about a 70 percent higher chance of stating an interest in conventional cigarette use. Examples of known intervening factors include intake of other smokable substances, intake of non-smokable substances and exposure to significant amounts of the pro-smoking messages contained in various forms of advertising.
Based on their findings, the study’s authors concluded that e-cigarette use among American teenagers is demonstrably linked to increased odds of expressing a desire to smoke tobacco cigarettes. For this reason, they believe that public health campaigns that target the use of tobacco products in middle school- and high school-age children should also target the consumption of e-cigarettes.