E-cigarette use skyrockets among U.S. middle and high school students

The percentage of high school students who reported ever using an e-cigarette jumped from 4.7% in 2011 to 10.0% in 2012.

Use of electronic cigarettes (e-cigarettes) more than doubled from 2011 to 2012 among U.S. middle and high school students, according to data published by CDC in the September 6 Morbidity and Mortality Weekly Report.

Findings from the National Youth Tobacco Survey indicated that the percentage of high school students who reported ever using an e-cigarette jumped from 4.7% in 2011 to 10.0% in 2012. More high school students also reported using e-cigarettes within the previous 30 days in 2012 (2.8%) compared with 2011 (1.5%).

E-cigarette use also doubled among middle school students, and CDC estimated that 1.78 million middle and high school students nationwide had tried e-cigarettes as of 2012.

"The increased use of e-cigarettes by teens is deeply troubling," said CDC Director Tom Frieden, MD, MPH, in a news release. "Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes."

Conventional cigarette use also was common among e-cigarette users, as 76.3% of middle and high school students who used e-cigarettes within the previous 30 days also smoked conventional cigarettes during that period. Only one-fifth of middle school students who reported ever using e-cigarettes reported never trying conventional cigarettes. "This raises concern that there may be young people for whom e-cigarettes could be an entry point to use of conventional tobacco products, including cigarettes," said CDC.

Tim McAfee, MD, MPH., Director of the CDC Office on Smoking and Health reported that approximately 90% of smokers start smoking in their teens. “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical,” said McAfee.

E-cigarettes are battery-powered devices that deliver nicotine and other additives to the user via an aerosol. E-cigarette cartridges typically contain nicotine, a component to produce the aerosol (e.g., propylene glycol, glycerol), and flavorings (e.g., mint, fruit, chocolate). CDC also noted that some e-cigarettes have been documented to contain potentially harmful constituents, including irritants, genotoxins, and animal carcinogens.

E-cigarettes not marketed for therapeutic purposes are currently unregulated by FDA. The FDA Center for Tobacco Products reported its intention to expand its jurisdiction over tobacco products to include e-cigarettes, but the center has not issued regulatory rules. "Because e-cigarettes are largely unregulated, the agency does not have good information about them, such as the amounts and types of components and potentially harmful constituents," CDC said.

Some e-cigarettes have been marketed as aids in quitting smoking, but no conclusive evidence exists showing that e-cigarettes promote successful long-term quitting.

Cigarette smoking results in an estimated 443,000 deaths each year and remains the leading preventable cause of death, disease, and disability in the United States. In addition to every one death, 20 Americans are living with a smoking-related disease. Free smoking cessation assistance is available at 800-QUIT NOW or www.cdc.gov/tips.