Teens and e-cigarettes

Why not regulate e-cigarettes like other forms of tobacco?

The use of electronic cigarettes has gained considerable popularity among middle and high school students in recent years, their use tripling since 2013 to an estimated 4.6 million teens nationwide. If that weren't already a cause for concern, the latest findings from a National Institutes of Health-backed study underscore why it's alarming — teens who use e-cigarettes are more likely to start smoking tobacco.

In other words, the whole mythology over "vaping" — that it's a smoking cessation product or substantially safer than smoking regular cigarettes — is wholly misleading when it comes to the most vulnerable potential customers. Instead, e-cigarettes may actually increase the risk of addiction and may provide a gateway to smoking and its attendant adverse health conditions from cancer to respiratory diseases.

The study published this week in the Journal of the American Medical Association followed a group of Los Angeles ninth graders at 10 public high schools who had either used e-cigarettes already but not smoked tobacco or had never consumed tobacco in any form. Six months after the initial survey, nearly one-third of the e-cig users reported having smoked tobacco compared to 8.1 percent of those who had never used an e-cigarette. The study stops short of blaming e-cigarettes for causing youngsters to take up smoking but strongly raises that possibility.

While there may be a legitimate difference of opinion over the relative health risks of e-cigarettes versus smoking, e-cigarettes (which heat a liquid containing nicotine to create an aerosol that is inhaled and don't contain tar or some of the other dangerous chemicals in cigarette smoke) can't claim any benefit for teens if they end up steering so many to smoking. That smoking rates among teens have been in decline in recent years doesn't excuse the risk but begs a question: How much further would they fall if e-cigarettes were not available?

In Maryland, the debate over the use of e-cigarettes has sparked strong differences of opinion. Montgomery and Howard counties, for instance, have taken steps to regulate them like other forms of tobacco — making it potentially just as illegal to use an e-cigarette in a no-smoking venue as it is to light up a cigarette in those same places. Baltimore also adopted restrictions in the past year but exempted bars, restaurants and casinos from them.

In the General Assembly, however, efforts to similarly restrict e-cigs haven't gotten much traction. Instead, lawmakers have tightened rules to make it illegal to sell them to minors, expanding that restriction to components of e-cigarettes (and not just the devices themselves) just this year. That move was overdue and drew little opposition.

Still, it's fair to wonder if allowing adults to use e-cigarettes in bars, restaurants or other public places doesn't send a message to teens, unintentionally or not, that the controversial devices are not only safe but socially acceptable. That, in turn, may cause youngsters to try e-cigarettes themselves and perhaps to eventually experiment with smoking cigars, cigarettes, hookahs or use other forms of tobacco.

And even if e-cigarettes prove to be safer than regular cigarettes or helpful in smoking cessation (a matter still under review by the U.S. Food and Drug Administration), restricting their use to the same venues where people are allowed to smoke would not prevent smokers from switching to vaping. Rather, it would be a sensible response to what researchers know conclusively — that nicotine is an addictive and potentially dangerous drug, whether transmitted through smoke or aerosol, that youngsters should be discouraged from using.

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