E-cigarettes are setting anti-smoking efforts back by as much as a decade.
That’s what researchers found after analyzing this year’s Illinois Youth Survey.
Over the past decade, the survey has shown a decrease in cigarette smoking among teenagers. But new data on e-cigarettes challenges the narrative. The survey, which is funded by the Illinois Department of Human Services, has only collected data on e-cigarettes for two years, but during that period their use has increased by 65 percent among high school sophomores and 45 percent among seniors.
Senior researcher Scott Hays, who works for the University of Illinois Center for Prevention Research and Development, which conducts the study, says the trend could result in teens becoming addicted to nicotine.
“E-cigarettes have a heavier concentration of nicotine, which makes them even more dangerous than tobacco use,” he said. “A single, 14-milligram cartridge can include the same amount of nicotine content as an entire pack of cigarettes.”
Just one high-nicotine e-cigarette a day, he continued, effectively means that the user is a pack-a-day smoker.
Hays noted that e-cigarettes’ popularity is accompanied by the perception that they are safer than traditional cigarettes. Teens who are not aware of the ingredients may not realize they’re ingesting large of quantities of nicotine, along with other harmful substances.
“Ninety-nine percent of the e-cigarettes sold in the U.S. contain nicotine,” said Dr. Brian King, deputy director of research translation at CDC’s Office on Smoking and Health. He cited CDC research that analyzed retail sales data to determine nicotine content in e-cigarettes.
“Nicotine can harm developing adolescent brain,” King said. “Particularly the areas responsible for learning, and memory and cognition and attention.”
He also said that the CDC has seen an increase in nicotine poisoning incidents since 2010. Half of those calls were for children under 5, but anyone can be at risk if they ingest a high-enough concentration of nicotine.
“Nicotine is one of the most potent substances in terms of addiction that there is out there,” Hays said. “Being as addictive as heroin.”
Public health officials aren’t the only ones concerned. The FDA has announced a series of proposed rules that would ban the sale of most e-cigarette flavors in retail stores and require age verification for online sales.
The city of Chicago is also suing eight companies that sold e-cigarettes to people under the age of 21.
King noted that Juul products, which made up 70 percent of the U.S. market share for e-cigarettes and are especially popular among teens due to their appearance, contain very high levels of nicotine.
Nicotine isn’t the only health risk either.
The aerosol from e-cigarettes is more than just water vapor. It includes other substances, including ultra-fine particulates, heavy metals, cancer-causing chemicals and flavorings.
Ultra-fine particulates can be trapped in the lungs, causing long-term effects and respiratory illness.
Exposure to heavy metals can lead to a number of health conditions, including neurological and cardiovascular disease.
Another issue is one of the very things that makes e-cigarettes so appealing to young people - the variety of flavors available.
“A lot of these flavorings are approved for ingestion,” King said. “But they aren’t approved by the FDA for inhalation.”
Ingredients in flavorings include diacetyl, which gives movie-theater popcorn its fake butter flavor. It’s also linked to a disease known as popcorn lung, which is so named because it affected workers who inhaled vapor working in a popcorn factory. While no cases of popcorn lung have been attributed to e-cigarettes so far, there is a lack of long-term research into their use.
“The gut can handle a lot more than the lungs,” Dr. King said. “So just because something may be safe to eat doesn’t mean it’s safe to inhale deep into your lungs.”