The Grapevine

Vaping A Gateway To Cigarettes For Youth, Experts Say, Want Flavors Banned

The Forum of International Respiratory Societies published a statement detailing the dangers of electronic cigarettes when used by children and adolescents. The group of respiratory doctors and scientists from six continents called for a ban on flavors and marketing e-cigarettes as a lower-risk alternative.

The report "Electronic cigarette use in youths: a position statement of the Forum of International Respiratory Societies" was published in the European Respiratory Journal on May 30.

E-cigarettes are generally safer to use than tobacco cigarettes, with users of the former having comparatively lower carcinogen and toxin levels. But the health effects of their long-term use remain unclear, as one report mentions, the presence of chemicals like formaldehyde and acrolein can potentially cause cancer and DNA damage.

Furthermore, when e-cigarettes are picked up by people who have never smoked, they can actually have a reverse effect i.e. act as a "one-way bridge" to cigarette smoking in adolescents, the authors of the new statement wrote.

"Some people truly believe e-cigarettes could be used as a smoking cessation technique, but these products also are an entry to nicotine addiction and tobacco use in young people," said co-author Dr. Thomas Ferkol, professor of pediatrics and cell biology and physiology at Washington University.

Previously, a report from the Surgeon General estimated the use of e-cigarettes among American youth skyrocketed by 900 percent from 2011 to 2015. The authors also highlighted how more than 450,000 American middle school students used e-cigarettes in 2016. This was four times the number of reported users the previous year.

Expert recommendations were included in the paper for the protection of the vulnerable age group. Regulations for e-cigarettes should be the same as those for tobacco products and included in smoke-free policies, the authors said. They also supported enforcing a ban on sales to young people across nations.

Advertising was a major point of criticism with recommendations to stop marketing e-cigarettes as lower-risk alternatives aimed at young people. Ferkol expressed concern over factors like marketing, design, flavors, etc., which have increased the appeal of the product to young people.

Currently, there are more than 7,500 different flavored e-cigarettes and refills available. A ban on flavored products was recommended as evidence showed they increased rates of youth initiation.

In a previous study, scientists at the Harvard T.H. Chan School of Public Health examined 51 flavored e-cigarettes including fruit, candy, and cocktail-flavored ones. Diacetyl, a chemical associated with the “popcorn lung” disease, was found in 39 of the flavors.

The adolescent brain is ultimately at greater risk of addiction due to an increased vulnerability to the rewarding effects of nicotine, said co-author Dr. Aneesa Vanker, a senior specialist in pediatric pulmonology from South Africa.

"Inhaling something other than air is never good for a child's lungs," she said, urging decision-makers around the world to recognize the growing public health threat that e-cigarettes pose to children and adolescents.