Electronic Cigarette Use Has Doubled Among Middle School Students

Expect new CDC numbers to amplify talk of regulation.

U.S. Students Who Have Tried E-Cigarettes

The CDC just announced that the percentage of U.S. middle and high school students who use e-cigarettes more than doubled from 2011 to 2012.

In case you're not among the six percent of adults who've tried them, e-cigarettes work by heating up and aerosolizing nicotine so that one can inhale it without smoke. They are not regulated by the FDA, and are fast becoming the new thing; this century's chew. Whether that's a scourge or boon is in the eyes of various beholders and stakeholders. The timbre of news today is decidedly scourge.

We expect that electronic cigarettes are safer than cigarettes, and early data supports that, but there is not great long-term research or unanimous agreement. Many medical organizations range from noncommittal to reserved in their approbation. In theory, they should involve risks comparable to using a nicotine patch or gum; still invoking an addictive stimulant, but not involving inhalation of carcinogenic smoke. According to the report this afternoon by the Centers for Disease Control, 1,780,000 U.S. middle and high school students have tried them. The percentage of high school students who've tried e-cigarettes recently doubled from 4.7 to 10.0 percent, and students who said they'd used e-cigarettes within the past month increased from 1.5 to 2.8 percent.

"The increased use of e-cigarettes by teens is deeply troubling," said Dr. Tom Frieden, CDC director.

How deeply? I trust Frieden. I wouldn't want my teenage kid using nicotine, by whatever mechanism of delivery. I would resent e-cigarette companies that seem to be marketing to kids. Ideally, my kid should be in bubble wrap and snazzy overalls until long past the normal age for that. But kids do use nicotine, and the e-cigarette idea remains complex. Consider the points made by Dr. Brad Radu, chair of tobacco-harm-reduction research at the University of Louisville, recently about the myopia of aiming for a tobacco-free society. He believes e-cigarettes to be 98 percent safer than traditional cigarettes.

Director of the FDA Center for Tobacco Products ​Mitch Zeller said today, "These findings reinforce why the FDA intends to expand its authority over all tobacco products and establish a comprehensive and appropriate regulatory framework."

It's widely agreed, even by the e-cigarette companies, that teens should not use nicotine. Demonizing e-cigarettes drastically based on today's report, though, may not be prudent. Like almost every public health issue and regulation debate, the way we regard e-cigarettes socially and institutionally comes with a glut of downstream factors to consider. Do more people try nicotine because e-cigarettes paint a health halo or gateway? Is cultivating a health halo good because it encourages adults to use e-cigarettes instead of smoking, or bad because it implies to kids that they're cool to use them? If your kid was going to use nicotine, and you couldn't stop it with bubble wrap, would you rather it be via e-cigarette?

Dr. Gary Giovino, a professor of health behavior at the University at Buffalo, told the New York Times that the rising use of e-cigarettes risked reversing societal trends in which smoking had fallen out of fashion.

Do they? And, have they?