Rise of E-Cigarettes, Hookahs Among Teens Offsets Drop in Other Tobacco Products

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Soaring e-cigarette use will likely increase momentum for FDA's proposed regulation of the product, which critics say is being heavily marketed at teenagers.

Fewer teenagers are smoking cigarettes and cigars, but that good news is offset by the numbers flocking to e-cigarettes and hookahs, or water pipes, according to data released Thursday by the CDC.

In 2014, a total of 24.6% high school students reported current use of a tobacco product, with e-cigarettes eclipsing all others, including cigarettes, for the first time. More than half of the high school students using any tobacco product were using e-cigarettes (13.4%); the next most common was the hookah (9.4%). Cigarettes (9.2%), cigars (8.2%), and smokeless tobacco (5.5%) trailed.

Among whites, Hispanics, and races other than blacks, e-cigarettes were most popular, while cigars were most popular among black teens. The findings are based on a nationwide survey of 20,000 middle- and high school students.

The rate of e-cigarette use has tripled from 2011 to 2014, according to CDC; that rapid rise will likely increase pressure to regulate how these products are marketed to teenagers. The FDA gained regulatory powers over tobacco in 2009 and just this month moved to regulate e-cigarettes. Its proposed rule would include all products made or derived from tobacco subject to its jurisdiction, which would cover everything from the manufacturing and distribution of e-cigarette products to prevention strategies.


“These staggering increases in such a short time underscore why the FDA intends to regulate those additional products to protect public health,” Mitch Zeller, head of the agency’s Center for Tobacco Products, said in a statement Thursday.

While cigarettes were shown to cause lung cancer in 1964 and have since been linked to scores of other cancers and diseases, little is known about the long-term health effects of e-cigarettes. Powered by batteries, e-cigarettes heat up liquid that contains nicotine and flavors—which critics say are especially designed to target youth. Thus, the device is not really a cigarette at all, but a nicotine delivery device without the harms of burning tobacco.

But as CDC has reported, nicotine is not without its own problems. In a recent letter to North Carolina health officials, CDC noted that nicotine is addictive, can have adverse effects on brain development, can be harmful to pregnant women, and may even have “secondhand” effects on non-users. The effect of cigarettes on those who chose not to smoke ultimately proved key to the effort to get cigarettes out of workplaces and public spaces.

Promoters of e-cigarettes say they offer a way for long-term cigarette smokers to quit. But critics say even if that is true, it doesn’t explain the industry’s aggressive marketing to youth, who may be attracted not only by the flavors but the perceived less harmful health effects and the product’s lower overall cost. “Nicotine is dangerous for kids at any age,” CDC Director Tom Frieden said in a statement.

Around the Web

Mortality and Morbidity Weekly Report

CDC Press release on tobacco use among high school students

CDC letter on effects of nicotine