Home / Medical News / Big Tobacco Successfully Increasing E-Cigarette Use In Youths

Big Tobacco Successfully Increasing E-Cigarette Use In Youths

e-cigsBy Brad Broker

Don’t fool yourself: smoking electronic cigarettes is still smoking.  The tobacco industry has positioned e-cigs as a less dangerous form of smoking than traditional, combustable cigarettes.  However, “less dangerous” still contains the word “dangerous.”

The Family Smoking Prevention and Tobacco Control Act of 2009 allowed the FDA to restrict the sales and marketing of tobacco products to youths including proof of identification to purchase, limiting color and design in packaging, etc.  However, that was prior to the popularity of e-cigs.  So in April of 2014, the FDA sought to close that loophole and include in the Act similar products like electronic cigarettes, cigars, pipe tobacco, hookah, and more.

Studies have shown that use of e-cigs by youths leads to an increasing likelihood of smoking traditional cigarettes.  And it may not be very helpful to those trying to kick the habit altogether.

“Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among US adolescents,” according to Lauren M. Dutra, ScD; Stanton A. Glantz, PhD, authors of a study in JAMA Pediatrics.

The causal relationship between traditional and electronic cigarettes is not entirely understood.  Which comes first?  Does one lead to, encourage, or compliment the other?  Researchers are unsure.

But it is known that electronic cigarettes are, like the old fashioned combustable kind, still a form of delivering nicotine.  Hence the phrase “less dangerous” instead of something like “safe.” In fact, as the industry matures, more information shows that e-cigs may not be much less dangerous.

“More powerful e-cigarettes, commonly known as tank systems, heat nicotine liquid hot enough to produce cancer-causing carcinogens, such as formaldehyde and acetaldehyde, in their vapor,” said Lawrence O. Gostin, JD and Aliza Y. Glasner, JD of the O’Neill Institute for National and Global Health Law at Georgetown University. “In addition, the virulence of drug-resistant bacteria can be increased by e-cigarette vapors and affect the ability of cells to destroy bacteria,” they wrote in a JAMA editorial.

But industry, particularly the tobacco lobby, often prevails in the U.S.  The comment period for the inclusion of e-cigs to the 2009 Tobacco Act ended in July and the FDA will most likely side with the industry by saying there is not yet conclusive evidence of danger and therefore these products should not be included.

“By contrast, in February 2014, the European Union issued a Tobacco Products Directive to safeguard youth, including bans on advertising, promoting taste, and nicotine flavorings for e-cigarettes,” said Gostin and Glasner. “Other countries, including Brazil, Lebanon, and Singapore, have banned e-cigarettes entirely.”

The use of electronic cigarettes between 2011 and 2012 doubled to more than 10 percent of youths. And that didn’t even include the use of other popular products like e-hookahs, hookah pens, and vape pipes.

According to Gostin and Glasner, there is “a major risk that e-cigarettes will revive the popular smoking culture that has taken decades to dismantle.”

This Physicians News story can be republished for free. (See details)

(Photo by Michael Dorausch via Flickr)


  1. The growing mountain of scientific and empirical evidence consistently indicates that electronic cigarettes (e-cigs):
    – are 99% (+/-1%) less hazardous than cigarettes,
    – are consumed almost exclusively (i.e. >99%) by smokers and exsmokers who quit by switching to e-cigs,
    – have helped several million smokers quit and/or sharply reduce cigarette consumption,
    – have replaced about 1 Billion packs of cigarettes in the US in the past five years,
    – are more effective than FDA approved nicotine gums, lozenges, patches and inhalers for smoking cessation and reducing cigarette consumption,
    – pose fewer risks than FDA approved Verenicline (Chantix),
    – pose no risks to nonusers,
    – have further denormalized cigarette smoking,
    – have never been found to create nicotine dependence in any nonsmoker, and
    – have never been found to precede cigarette smoking in any daily smoker.

    In April 2009, Obama’s FDA revealed its unscientific, unethical and inhumane policy to deceive Americans about e-cigs and defend the FDA’s e-cig ban and nearly 1,000 product seizures by US Customs agents: “We don’t want the public to perceive them as a safer alternative to cigarettes.”

    In July 2009, Obama appointee (and former Waxman staffer) FDA Deputy Commissioner Josh Sharfstein held a press conference (defending the agency’s unlawful and unwarranted e-cig ban from lawsuits by two companies whose products were seized) where FDA’s e-cig lab findings were misrepresented to scare the public to believe e-cigs are carcinogenic and toxic, where e-cig companies were falsely accused of target marketing to youth, and where it was alleged (without any evidence) that e-cigs are addicting children, can be gateways to cigarettes, can renormalize smoking, and don’t help smokers quit.

    Thankfully for the rule of law, public health, civil liberties, market competition and common sense, all 12 federal appeals court judges upheld Judge Richard Leon’s Janaury 15, 2010 ruling striking down FDA’s e-cig ban as unlawful.

    But instead of correcting or clarifying (or apologizing for) their many false and misleading fear mongering claims about e-cigs (in a failed attempt to win a lawsuit), FDA officials (and other DHHS officials) have further misrepresented the scientific and empirical evidence on e-cigs to lobby for their recently proposed Deeming Regulation, which will protect cigarette markets by banning >99.9% of all e-cigs, and will give the e-cig industry to the Big Tobacco companies.

    Instead of protecting cigarettes (under the deceitful guise of protecting children), public health officials have an ethical duty to truthfully inform smokers and vapers that e-cigs are far less hazardous alternatives to cigarettes, and to keep them legal and affordable.

    Just as FDA commits public health malpractice, Physicians News Digest has done so as well.

    All real public health advocates support smokers switching to e-cigs, and keeping e-cigs legal.

    Bill Godshall
    Executive Director
    Smokefree Pennsylvania
    1926 Monongahela Avenue
    Pittsburgh, PA 15218

  2. I switched from smoking to e-cigarettes a while ago. What a difference in how I feel. Can’t say enough good things about e-cigarettes. I think e-cigarettes should be restricted to people over 18 but that’s all. I feel if that the people against e-cigarettes don’t understand how much of a difference switching really makes.

  3. To be quite honest, I don’t know ANYONE that has tried an e-cig that hasn’t smoked a cigarette before.

  4. “The business of cancer”??? That must be one of the most ignorant comments on the web. Obviously said by someone lucky enough to have never been affected by cancer. Do you feel the same way about regular cigarettes? Do you believe that they really do not cause cancer and it’s just one big conspiracy by physicians and/or CAT scan manufacturers?

    Any study can spin results to make their point. E-cigarettes are a nicotine delivery system. Less than traditional cigarettes, which is why smokers believe it helps them quit. The electronic cigarettes allow smokers to wean themselves down from a lot of nicotine to less nicotine. However, kids are seeing how much “better” e-cigs are than regular cigs and believe it must be ok. It’s not. That’s what the JAMA articles are about.

  5. Really wish people would stop citing to Dutra and Glantz about the gateway effects of e-cigarettes. That article, which improperly drew causal connections from a cross-sectional study, inspired several later publications regarding scientific integrity and ethics. Looking directly at the NYTS 2012 data on which the article was based (available at http://www.cdc.gov/tobacco/data_statistics/surveys/NYTS/) shows that of the 24,658 surveyed students, only 466 (1.89%) had used e-cigarettes in the past 30 days. Of those 466, only 40 students (0.16%) were never-smokers.

    • The burden of proof isn’t on the skeptic here
      and never has been.

      It’s on the proponent, and more properly the vendor,
      to show that highly addictive nicotine delivery devices
      somehow do not generate later use of other nicotine products,
      including cigarettes engineered for nicotine delivery,
      aggressively promoted, and in many cases by the same
      vendor who sold the devices.

      This burden has not been met. You want a longitudinal
      study on how much youth e-cig use flows into cig use?
      Fine! DO ONE. Proponents and vendors have no leg
      to stand on in criticizing the lack of one; DO ONE.
      And they’re silly in pretending the lack of one
      means we should all assume the flow is zero.

      What Dutra and Glantz add is a basis for a preliminary
      estimate of the size of the flow.

      • What DNAgent pointed out is basic to science. Correlation is NOT causation. This is not science but conjecture. The burden of proof ALWAYS lies with the proponent.

        “While the cross-sectional nature of our study does not allow us to identify whether most youths are initiating smoking with conventional cigarettes and then moving on to (usually dual use of) e-cigareetes or vice versa, our results suggest that e-cigarettes are not discouraging use of conventional cigarettes.” Dutra LM, Glantz SA. Electronic cigarettes and conventional cigarette use amoung US adolescents: a cross-sectional study. JAMA Pediatrics (E7). Published online March 6, 2014.

  6. The EU TPD does NOT restrict flavors for electronic cigarettes – so apart from all the other biased, misleading errors in this article, there’s your readers’ proof that you’re trying to knowingly cloud the truth around the issue here. Facts, not biased opinion please. Read the two most recent reviews of the safety and efficacy of electronic cigarettes and there’s your truth. Read the report written by ASH UK and there’s your truth regarding this so called ”gateway effect”. Physicians want tighter regulation for e-cigs because it takes away a massive cash-cow for them – the business of cancer. E-cigs are prolonging and improving the lives of millions of smokers worldwide. Let’s keep our eye on that prize here for a second, NOT on the bottom line of big pharmacaeutical companies that make quit products that have an efficacy rate of less than 7%.

  7. This is perhaps the most biased, mislead edging an article on e cigarettes I have ever read.

    But don’t take my word for it. Look up the literature review on e cigarettes published in Addiction journal this month.

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