Every year on May 31, people and organizations mark World No Tobacco Day by highlighting the health and other risks associated with tobacco use and advocating for effective policies to reduce tobacco consumption.
This year the Forum of International Respiratory Societies (FIRS) has released a new position paper on electronic cigarettes and youth. More than 450,000 American middle school students used e-cigarettes in 2016, four times the number of reported users the previous year.
E-cigarette in youth is associated with higher smoking prevalence, at younger age, and heavier tobacco use. It appears that youth directed advertising and flavoring are important factors leading to experimentation with electronic cigarettes by youth. A study of 600 British children, aged 11 to 16 years, showed that electronic cigarette advertising increased the appeal of electronic cigarettes and interest in trying them.
Contrary to industry claims, electronic cigarette aerosols are not simply “harmless water vapor” as some have claimed. Just as decades passed before the health consequences of cigarettes were known, many years may be needed to determine the magnitude of the health burden of e-cigarettes.
Based on this information, the Forum of International Respiratory Societies recommends:
- To protect youth, electronic nicotine delivery systems should be considered tobacco products and regulated as such. The addictive power of nicotine and its adverse effects in youth should not be underestimated. All forms of promotion must be regulated.
- The sale of electronic cigarettes to youth must be banned in all nations, and those bans must be enforced.
- Electronic cigarettes have been claimed to be safer than combustible cigarettes, but comparison to the most lethal product in the history of the world is faulty. The appropriate comparison would be to non-use of tobacco products. All health and safety claims regarding electronic cigarettes relative to combustible tobacco in advertising and media should cease.
- Because flavorings increase rates of youth initiation, they should be banned in electronic nicotine delivery products.
- As electronic cigarette vapor exposes non-users to nicotine and other harmful chemicals, use should be prohibited in indoor locations, public parks, and places where children and youth are present.
- While their health risks are increasingly recognized, the physiological and deleterious effects of electronic cigarettes have still not been adequately studied, especially their impact on the developing lung and brain. Greater research is needed.
- Routine surveillance and surveys concerning combustible and electronic cigarette use should be carried out in many settings to better understand the scope and health threat of tobacco products to youth in different countries and regions.