US Surgeon General releases advisory on e-cigarette use among youth

Jerome M. Adams

The U.S. Surgeon General issued an advisory today on the dangers of youth e-cigarette use.

“The purpose of this advisory is to talk about the epidemic rise in youth use,” U.S. Surgeon General Vice Adm. Jerome M. Adams, MD, MPH, said at a press conference.

In a statement, the Surgeon General reported that e-cigarette use among youth “has skyrocketed in the past year at a rate of epidemic proportions.”

The percentage of high school-aged children who reported e-cigarette use in the past 30 days rose by more than 75% between 2017 and 2018, according to data from the CDC and the FDA’s National Youth Tobacco Survey. Use among middle school-aged children also increased nearly 50%.

Data from the NIH’s Monitoring the Future survey also revealed a sharp increase in e-cigarette use among U.S. teens between 2017 and 2018. For example, 37.3% of 12th graders reported use in the past 12 months compared with 27.8% in 2017.

“Combustible tobacco [use] has been going down for the past 2 decades,” Adams said. “We are at the lowest level of youth tobacco use on all products that are combustible that we were ever at before we saw this spike in e-cigarette use, which is reversing those trends.”

The 2016 Surgeon General’s report on e-cigarette use among youth and young adults found e-cigarette use posed a significant health risk. Besides the possibility of addiction and long-term harm to brain development and respiratory health, the Surgeon General warned that e-cigarette use may led to the use of regular cigarettes.

“The best way to stop folks from being addicted is to prevent them from using the products in the first place,” Adams said. “That’s what today is all about. It’s turning off the spigot.”

Adams added that, “treating an addicted child is not the same as treating an addicted adult.

The Surgeon General’s advisory also noted that the surge in youth e-cigarette use has been fueled by newer cartridge-based devices, which can look like a USB flash drive and are easy to conceal. A commonly sold version of e-cigarettes is JUUL, which has a more than 70% share in the cartridge-based e-cigarette market in the U.S. A typical JUUL cartridge contains about as much nicotine as a pack of 20 regular cigarettes, according to a press release.

FDA Commissioner Scott Gottlieb, MD, announced plans earlier this year to form a Youth Tobacco Prevention Plan, which has a specific focus on electronic nicotine delivery systems like JUUL.

“The percentage of adults using these products is 3%, [and] the percentage of high-schoolers using these products is 20%,” Adams said. “So, we need to find some balance in terms of marketing and availability of flavors and restore some sense of normalcy [and] common sense to the way we are making these things available. We want to preserve the harm reduction potential for adults, but it can’t be at the expense of our young people.” – by Bruce Thiel

Disclosure: Adams reports no relevant financial disclosures.