Surgeon general: E-cigarettes a public health threat

E-cigarettes pose a public health threat to young people who are using them at “alarming” rates according to a new report from the U.S. surgeon general.

Nicotine in e-cigarettes “can lead to not only addiction but also to deficits in attention and learning, reduced impulse control and mood disorders,” said U.S. Surgeon General Vivek H. Murthy, M.D., M.B.A. “Furthermore e-cigarette use among young people is strongly associated with the use of other tobacco products.”

The comprehensive report details patterns of e-cigarette use, health effects, e-cigarette marketing, policy recommendations and action steps and was reviewed by more than 150 experts including the Academy.

The findings come as e-cigarettes have surpassed traditional cigarettes as the most common tobacco product used by adolescents. In 2015, about one in six high school students said they had used e-cigarettes in the past month, and many cite the attraction of thousands of flavors, glamorous advertising, celebrity endorsements and sponsorships.

New Mexico teen Tyra Nicolay, a tobacco control advocate, once was among those young users.

“My friends and I believed e-cigarettes only released water vapor and we loved trying flavors that reminded us of ice cream and smoothies,” she said. “We didn’t know e-cigarettes contain nicotine or that they could be addictive or harmful.”

In recent years, e-cigarettes have “raised alarm among pediatricians tremendously,” said AAP President Benard P. Dreyer, M.D., FAAP.

“Nicotine … regardless of the source, is highly addictive and has clear neurotoxic effects, especially on the developing brains of adolescents and even into young adulthood," Dr. Dreyer said.

E-cigarette users and those who breathe in secondhand smoke also are exposed to heavy metals and carcinogens. In addition, young children are at risk of being poisoned if they ingest the e-cigarette refill cartridges.

The report cites the Academy’s 2015 policy statement Electronic Nicotine Delivery Systems, that calls for screening adolescents for use and educating families about the dangers of e-cigarettes.

“Doctors, especially those of us who treat children and adolescents, must be vigilant and proactive in explaining the harms of tobacco products of any kind to our patients,” Dr. Dreyer said.

The surgeon general’s report also calls for

• educating parents and teachers,
• raising the minimum age to buy any tobacco products,
• including e-cigarettes in local indoor smoke-free policies,
• curbing e-cigarette marketing and
• expanding research on e-cigarettes.

“What’s at stake is protecting a generation of young people from addiction to nicotine and tobacco-related diseases,” Dr. Murthy said. “If we act now, we can take an essential step forward to creating a healthy, strong, tobacco-free generation.”