JAMA Study Raises Concerns Youth E-Cigarette Use Could Lead to Smoking Other Tobacco Products, Shows Urgent Need for FDA Regulation

WASHINGTON, DC – A study published today in the Journal of the American Medical Association (JAMA) provides troubling new evidence that use of electronic cigarettes by youth who had not previously smoked could lead to use of cigarettes and other smoked tobacco products.

Along with a recent CDC report that youth use of e-cigarettes tripled from 2013 to 2014, including many youth who were not cigarette smokers, the JAMA study underscores why the FDA and the White House must act now to protect our kids and finalize a long-overdue rule to regulate all tobacco products, including e-cigarettes. Administration officials told Congress the final rule would be issued this summer, but as summer winds down, we’re still waiting. This rule must be issued without further delay, and it must extend to e-cigarettes the same restrictions on youth-oriented marketing and flavors that currently apply to regular cigarettes.

The new JAMA study examined whether teens who reported ever using e-cigarettes were more likely to initiate use of combustible (smoked) tobacco products, such as cigarettes, cigars and hookah. The study involved 2,530 students from ten public high schools in Los Angeles who reported never using combustible tobacco at the start of the study (when the students were in the 9th grade) and were re-assessed six months and 12 months later. The researchers found that students who had ever used e-cigarettes (222 students at the start of the study) were more likely to report initiation of combustible tobacco use over the next year. These students were also more likely to initiate use of each individual combustible product, including cigarettes, cigars and hookah.

This study indicates that e-cigarettes are introducing many kids to use of and possible addiction to nicotine. It also adds to concerns that e-cigarettes could serve as a gateway to use of other tobacco products, including regular cigarettes.

While it is still an open scientific question whether e-cigarettes might be able to help adult smokers give up cigarettes, kids should not be using any tobacco product, including e-cigarettes. As the CDC and other experts have stated, youth use of tobacco in any form is unsafe as nicotine exposure harms adolescent brain development, causes addiction and could lead to sustained use of tobacco products.

In April, the CDC reported that current (past-month) e-cigarette use among high school students jumped from 4.5 percent in 2013 to 13.4 percent in 2014 (it was just 1.5 percent in 2011). Current e-cigarette use now exceeds current use of regular cigarettes (9.2 percent of high school students smoked cigarettes in 2014).

This increase in youth e-cigarette use comes as e-cigarette makers have marketed their products with the same tactics long used to market regular cigarettes to kids, including celebrity endorsements, slick TV and magazine ads that portray e-cigarettes as fun and glamorous, and sponsorships of race cars and concerts. In addition, many e-cigarettes come in sweet, colorful flavors such as gummy bear and cotton candy that obviously appeal to youth.

We cannot allow the tobacco industry to keep addicting kids and create another epidemic with a new generation of tobacco products. The FDA and the White House must act promptly to end this unregulated experiment that threatens our kids’ health.