E-cigarettes' growing popularity underscores the need for regulation

In April, new federal data was released showing e-cigarette use has tripled among students in middle and high school. We asked MD Anderson’s head of Cancer Prevention and Population Sciences, Ernest Hawk, M.D., to share his thoughts:

Parents, cancer researchers, physicians and public health practitioners should all be encouraged by substantial declines in the use of traditional cigarettes among teenagers. From 2011-2014, the percentage of high school students that smoke cigarettes fell from 16% to 9%, according to Centers for Disease Control and Prevention’s annual youth tobacco survey.

The same report, however, showed an increase of nearly 9% — from 4.5% to 13.4% — between 2013 and 2014 in the use of e-cigarettes among high-schoolers. That’s a jump from 660,000 to 2 million in the span of just one year.

This dramatic rise in the use of e-cigarettes, which may be related to the decline in the use of combustible tobacco, is troubling.

There’s been no shortage of theorizing about whether e-cigarettes are less dangerous than smoking. But at this time, there is no sufficient evidence-based research to support e-cigarettes as a healthy alternative to tobacco products for current smokers.

Paul Cinciripini, Ph.D., MD Anderson’s chair ad interim of Behavioral Science shared these concerns last year:

“The absence of smoke, which is replaced by the odorless vapor, gives smokers a false sense of security that there’s less risk involved with using e-cigarettes, known as vaping," said Cinciripini. "Because e-cigarettes aren’t regulated by the Food and Drug Administration (FDA), we have no evidence to prove they’re safe.”

More than a year ago, the FDA proposed regulations for the e-cigarette industry, which operates with little oversight and uses marketing tactics such as candy flavoring that likely contribute to the swell of younger users. The proposals would ban the sale of e-cigarettes to those below the age of 18, halt the distribution of free samples, place health warnings about nicotine on packages and disclose their ingredients. To date, no government action has been taken.

As tobacco use is ultimately a result of nicotine addition, the uptake of e-cigarettes among non-smokers is of particular concern. Regardless of what science tells us about the potential long-term health effects of e-cigarettes, we must not forget these are products intended to deliver nicotine, an addictive substance that can be detrimental to developing adolescent brains and can potentially lead to future tobacco use.

At this time, 42 states prohibit the sale of e-cigarettes to minors. That number may soon increase.

Texas lawmakers are considering extended restrictions on tobacco products to e-cigarettes. We’re pleased that Texas and other states are taking seriously the health impacts of e-cigarettes on future generations. We’re hopeful the FDA will quickly follow suit.