Use of e-cigarettes on the rise among young people

It's an unfortunate trend that experts say ultimately can lead to serious health factors down the road.

According to a recent Centers for Disease Control and Prevention study, the use of electronic nicotine delivery systems, or e-cigarettes among young people continues to rise rapidly in the United States, including here in Northern Michigan.

Electronic cigarettes are battery-operated devices designed to deliver nicotine with flavorings and other chemicals to users in vapor rather than smoke. They can be manufactured to resemble traditional tobacco cigarettes, cigars or pipes or even everyday items like pens or USB memory sticks.

Newer devices, such as those with fillable tanks even look different, and currently there are more than 250 different e-cigarette brands on the market.

According to the CDC, from 2011 to 2015, past 30-day use of e-cigarettes increased more than 10 times for high school students (1.5 percent to 16 percent) and nearly nine times for middle school students (.6 percent to 5.3 percent).

Nearly 3 million U.S. middle and high school students were past 30-day e-cigarette users in 2015, including about one in seven high school students, the CDC report states.

When e-cigarettes first came onto the market, they were often promoted as safer alternatives to traditional cigarettes, which deliver nicotine by burning tobacco, but little was actually known about the health risks of using the devices.

Now, more and more information about the health risks of using e-cigarettes is being made public. That and the FDA's new tobacco rule is shining more light on e-cigarettes.

"I really believe that young people do not believe that they're hostile," said Susan Pulaski, community health coordinator at the Health Department of Northwest Michigan and SAFE (Substance Abuse Free Environment) in Northern Michigan coordinator. "For a long time there were a lot of misconceptions and kids believed they were water vapor and didn't have nicotine in them.

"For years these makers didn't have to put any labels on them," Pulaski added. "They weren't required until recent FDA regulations."

Earlier this month, the University of Michigan's Tobacco Consultation Service conducted a presentation describing the FDA's new tobacco rule.

In May, the FDA finalized a rule that "deems" all products meeting the statutory definition of tobacco product, including components or parts (but excluding accessories), to be subject to FDA's tobacco product authorities, including all electronic nicotine devices (e-cigarettes, e-cigars, vape pens, etc), nicotine gels, waterpipes and future tobacco products.

The defining automatic provisions and applicable regulations would require e-cigarette manufactures to report ingredients and harmful and potentially harmful constituents, require premarket review and market authorization or new tobacco products and not sell tobacco products that make modified risk tobacco claims (including light, low or mild) unless authorized by the FDA.

Also, additional restrictions would not allow products to be sold to persons under the age of 18 both in person and online, would require age verification by photo ID for anyone under 27 and not allow for sale in vending machines.

"For years they were advertised as a safe alternative and that's the problem," Pulaski said. "For years kids thought they were helpful. I hope with these new FDA regulations a lot of that will change, but a lot of damage has already been done. You could sell them to young people without labels and no listed ingredients."

By May of 2018, health warnings are required to be displayed on cigarette tobacco, roll-your-own tobacco and all newly deemed covered tobacco products. Text warnings on product packages must cover 30 percent of principal display panels.

Currently, the FDA conducts on average more than 10,000 compliance checks per month nationwide to determine if retailers are complying with regulations that prohibit sales to minors. In September, the FDA issued its first set of warning letters to retailers that illegally sold e-cigarettes and cigars to kids.

"The important thing is they (e-cigarettes) are highly, highly addictive and not safe," Pulaski said. "Kids really need to realize they're not a safe alternative by any means. They will become addicted to them just like they would become addicted to chewing tobacco, cigars or cigarettes. It's all the same addictive drug and that's nicotine."

The CDC also mentioned e-cigarettes are not an FDA-approved quit aid. E-cigarette aerosol is not harmless water vapor and is not as safe as clean air.

E-cigarettes generally emit lower levels of dangerous toxins than combusted cigarettes. However, in addition to nicotine, e-cigarette aerosols can contain heavy metals, ultrafine particulate and cancer-causing agents like acrolein.

E-cigarettes also contain propylene glycol or glycerin and flavorings. The popularity among teens and younger users may also be a result of an aggressive marketing campaign by designers using similar tactics as those proven to lead to youth cigarette smoking, including candy-flavored products and youth-resonant themes such as rebellion, glamour, sex, celebrity endorsements, sports and music.

Spending on advertising of e-cigarettes tripled each year from 2011 to 2013, the CDC reports, while sales also increased dramatically over that time period.

To help educate local middle and high school-aged kids of the dangers of e-cigarettes and other tobacco-related products, Pulaski coordinates various SAFE in Northern Michigan curriculum in schools throughout Charlevoix, Emmet and Antrim counties.

Other events SAFE in Northern Michigan has conducted include "Brown Out" nights at high school sporting events in recent years, during which student cheering sections received a T-shirt with an anti-tobacco message. The group also produces youth videos, lanyards, safe-spirit nights and a prom initiative.

"Kids don't see the risk as high with them because there's been a lot of miscommunication about them and whether or not they're hostile," Pulaski said. "They (e-cigarettes) for years were advertised as a safe alternative and that's the problem. The amount of nicotine in them is often higher than cigarettes, it's not exactly helping them quit."

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