The use of e-cigarettes and hookahs by middle- and high-school students surged between 2011 and 2014, according to the Centers for Disease Control and Prevention.
In 2014, an estimated 4.6 million middle- and high-school students used a tobacco product. Of those, 2.4 million reported using e-cigarettes and 1.6 million reported using hookahs. The largest increase in these products took place between 2013 and 2014, when use of e-cigarettes tripled and use of hookahs almost doubled.
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This is “a very alarming finding,” Dr. Tom Frieden, CDC director, said during a press conference. He noted that the increased use of these products has led to an “uptick in the total number of our children who are using tobacco products” for the “first time in a generation.”
The study, based on data from the 2011-2014 National Youth Tobacco Surveys, found that in the 3-year period between 2011 and 2014, e-cigarette use increased from 1.5% to 13%, and hookah use increased from 4% to 9%. By contrast, there were significant decreases between 2011 and 2014 in use of cigarettes (16% to 9%), cigars (12% to 8%), tobacco pipes (4% to 1.5%), bidis (2.0% to 0.9%), and snus (3% to 2%) (MMWR 2015;64:381-5).
Dr. Frieden emphasized that there is no causal relationship between decreased use of conventional cigarettes and increased use of e-cigarettes and hookahs. Drawing on trends in the adult population, he noted that despite initial hopes that use of e-cigarettes might contribute to reduction in use of combustible cigarettes, this has not been the case and many smokers continue to use both e-cigarettes and combustible cigarettes.
“We reject the notion that we protect kids from cigarettes by allowing them to use e-cigarettes,” said Brian King, Ph.D., deputy director in the CDC Office on Smoking and Health. Any tobacco product is unsafe, “irrespective of whether it’s combustible or noncombustible or electronic.”
“It is important for parents and kids to understand that nicotine is dangerous to kids at any age, whether it’s an e-cigarette, hookah, cigar, or cigarette,” Dr. Frieden emphasized. He urged the establishment of “comprehensive programs,” similar to those used to educate the public about the dangers of conventional cigarettes.