But devices deliver as much, if not more, nicotine than cigarettes, smoking experts say
By Steven Reinberg
TUESDAY, Oct. 25, 2016 (HealthDay News) -- Close to three-quarters of American teenagers believe e-cigarettes are less harmful or addictive than real cigarettes, a new study finds.
The same can't be said for their notions about the safety of cigars and smokeless tobacco. And the perception of the safety of these products is directly related to how popular they are, the researchers added.
"E-cigarettes are now the most commonly used tobacco product among U.S. youth, and the increases in e-cigarettes' perceived safety mirrors rapid increases observed in their use," said lead researcher Dr. Stephen Amrock, from the department of medicine at Oregon Health and Science University in Portland.
"Our research thus provides a missing descriptive link into the underpinnings between these products' rising popularity," he said.
E-cigarettes, powered by battery, heat up a liquid containing nicotine, flavorings and other chemicals. The vapor is then inhaled.
Children who use e-cigarettes are more likely than those who do not to go on to use traditional cigarettes, Amrock added.
"This is not a no-risk situation. The FDA has just recently begun to consider e-cigarettes as tobacco and regulate them accordingly. That is an important part of the process in getting these products out of the hands of children," he said.
Using data from the 2012 and 2014 National Youth Tobacco Survey, Amrock and his colleagues found that 73 percent of teens believed e-cigarettes were less harmful than cigarettes. This compares with 20 percent who thought smokeless tobacco was less harmful and 26 percent who thought cigars were less harmful.
In addition, 47 percent believed that e-cigarettes were less addictive than cigarettes, but only 14 percent thought smokeless tobacco was less addictive. And, 31.5 percent believed cigars were less addictive, Amrock's team found.
Teens who thought e-cigarettes were less harmful or addictive tended to be male, white or live with someone who used these products, Amrock said.
Between 2012 and 2014, increasing numbers of teens decided that e-cigarettes were less harmful than cigarettes, he added.
The findings were published online Oct. 25 in the journal Pediatrics.
"Concern exists that e-cigarettes are re-normalizing smoking," Amrock said. "Children and parents need to understand that these products contain nicotine and are potentially harmful, both now and because they have been linked to later cigarette use."
Stanton Glantz is a professor at the University of California, San Francisco's Center for Tobacco Control, Research and Education. He said the study adds to the evidence that e-cigarettes are expanding the tobacco epidemic.
The finding that teens think e-cigarettes are less addictive than conventional cigarettes is especially concerning "because e-cigarettes are designed to deliver nicotine, the same addictive drug as [in] cigarettes," he said.
"Indeed, the ideal e-cigarette will deliver as much or even more nicotine than a conventional cigarette," Glantz added.
Compounding the problem, according to Glantz: the Obama administration directed the FDA to drop the regulation of flavors from the recent rule taking over jurisdiction of e-cigarettes.
"The effect of this deletion will delay regulation of flavors in e-cigarettes, which appeal to kids, by years, leading more kids to get addicted to nicotine," he said.
Erika Sward, assistant vice president for national advocacy at the American Lung Association, said, "We know that kids are very attracted by the flavors of e-cigarettes, and we also know that there is likely to be much more use of these products."
A recent study found that "several flavorings impacted the toxicity of e-cigarettes, and strawberry was the most toxic of the ones they found," she said.
Some in Congress are trying to weaken the FDA's authority over e-cigarettes, Sward said, "to essentially grandfather in all of these products that are on the market, so FDA can't easily remove the ones that are most dangerous.
"It's critical that Congress push back against the attempts by some to give this sweetheart deal to the e-cigarette industry. It's quite appalling," she added.
"We are seeing a threat to all of the work we have done as a nation to reduce the deadly burden of tobacco use," Sward said.
For more information on e-cigarettes, visit the U.S. Food and Drug Administration.
SOURCES: Stephen Amrock, M.D., department of medicine, Oregon Health and Science University, Portland; Erika Sward, assistant vice president, national advocacy, American Lung Association; Stanton Glantz, Ph.D., professor, medicine, Center for Tobacco Control, Research and Education, University of California, San Francisco; Oct. 25, 2016, Pediatrics, online
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