The American Academy of Pediatrics called Monday for a major new effort to discourage children and teenagers from using e-cigarettes. According to AAP data, last year 20 percent of high school students, and five percent of middle school students, used e-cigarettes; that is a 75 percent jump overall since 2017.
"The increasing use of e-cigarettes among youth threatens five decades of public health gains," the AAP said.
On Monday the health organization called for new federal regulations, including:
- Setting a minimum age of 21 to buy the products;
- Banning online sales and youth-targeted marketing; and
- Stopping production of certain flavored e-cigarette products.
On "CBS This Morning," Dr. Tara Narula called the use ofas "an epidemic" that is affecting 3.6 million youth. "And we know it's not just the harms of the e-cigarettes, but the fact that it is a gateway to traditional cigarette use."
When asked to describe the dangers of e-cigarettes, which have been sold as "safer" than traditional cigarettes, Dr. Narula said, "Let's start with just nicotine itself. We know that nicotine is extremely addictive. Whether you use it once, twice, a couple of weeks, you can become addicted. The amount of nicotine that kids are getting from e-cigarettes may be much more than they would get from traditional cigarettes. In fact, one of these pods has as much nicotine as a whole pack of cigarettes.
"Nicotine has cardiovascular side effects, and it affects the adolescent brain. The brain develops until the age of 25, and nicotine has the potential to change learning, memory, [and] impulse control. It also can affect mood disorders, increasing the risk of mood disorders, and prime the brain for risk of addiction to other substances. …
"What's so unfortunate is that the marketing to kids has been so aggressive, [including] marketing on television, which is not allowed for traditional cigarettes; marketing through social media; at sporting events. Some even offer scholarships to kids."
In addition to nicotine, vaping produces ultrafine particles that can be irritants or affect the lungs.
"The flavorings which we think are generally recognized as safe for ingestion, may not be safe for inhalation," said Dr. Narula. "There are toxins, carcinogens, risk of accidental ingestion of the liquid that's led to poison control calls, as well as burns and fires."
When asked about the effects on bystanders, such as with second-hand smoke, Dr. Narula said there have not been enough studies to judge those effects, or even the long-term effects of vaping.
When asked what parents can do, Dr. Narula said parents should be screening their children for possible e-cigarette use, and seeking help for them: "Not, importantly, punishing them, but recognizing that this is a health problem, it is an addiction. And unfortunately, we don't have a lot of treatments for kids who are hooked to vaping. We don't have the same kind of treatments like we might offer adults in terms of nicotine replacement therapy, patches, etc., or medications. They haven't been approved for kids."
In 2017 the Food and Drug Administration, which had been tasked by the Obama administration to expand its review of tobacco products to include e-cigarettes, delayed its review of e-cigarettes until 2022. Last March the AAP and other organizations, including the American Cancer Society,, saying they are not doing enough in terms of regulating e-cigarettes.