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PCPs should educate adolescents on dangers of e-cigarettes, aid in quitting

PCPs should counsel their adolescent patients about the risks of using any product that contains nicotine, including e-cigarettes, the use of which has escalated rapidly among teens, according to data published in Preventing Chronic Disease.

 The researchers added that clinicians should also provide adolescent e-cigarette users with information about cessation resources.

“… Unlike adults’ reasons for using e-cigarettes, adolescents’ top reason is not a desire to reduce cigarette smoking; for adolescents, curiosity, appealing flavors and peer influences rank as higher reasons,” Li-Ling Huang, PhD, MPH, of the Center for Regulatory Research on Tobacco Communication, at the University of North Carolina Lineberger Comprehensive Cancer Center, in Chapel Hill, and colleagues wrote. “Public health concerns about adolescent e-cigarette use have been raised because the adolescent’s developing brain is particularly vulnerable to the negative effects of nicotine neurotoxin and nicotine dependence.”

To determine and analyze the trends of e-cigarette use, and concurrent cigarette use, and the relationships between e-cigarette use and intentions to quit smoking among high school students, the researchers collected data from teens who completed the North Carolina Youth Tobacco Survey in 2011 and 2013. The voluntary, anonymous, school-based survey of middle and high school students has been administered biannually since 1999.

The researchers focused their sample on public high school students in grades 9 through 12 only. They assessed changes in the prevalence of e-cigarette and cigarette use from 2011 through 2013. In addition, they analyzed cessation-related factors associated with students’ current and past use of e-cigarettes in 2013. The sample included 4,791 high school students who completed the survey in 2011, and 4,092 who completed it in 2013.

According to the researchers, the prevalence of e-cigarette use within the past 30 days significantly increased from 1.7% in 2011 (95% CI, 1.3-2.2) to 7.7% in 2013 (95% CI, 5.9-10). Among users of both e-cigarettes and cigarettes, current e-cigarette use was negatively associated with an intention to quit cigarettes for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29-0.87), and also with attempts to quit smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49-0.97). In addition, current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21-0.82) or 1 year (RRR = 0.21; 95% CI, 0.09-0.51). They were also more likely to have used any kind of smoking cessation aid (RRR = 0.46; 95% CI, 0.29-0.74).

“Our research supports FDA’s recent announcement to extend its authority to regulate e-cigarettes as tobacco products, which includes prohibiting unsubstantiated cessation aid claims and restricting the sale of e-cigarettes to adolescents under the age of 18,” Huang and colleagues wrote. “… Messages about negative effects of e-cigarette use, including the severity and rapid development of nicotine neurotoxin and addiction, on adolescents’ health should be part of this counseling and youth tobacco control media campaigns as well.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.