KIDS
August 12, 2016

E-Cigarettes, The Coolness Factor

Kids like e-cigarettes mostly because they seem cool. But are e-cigs safer than smoking tobacco?

One of the motivations behind the new FDA regulations regarding e-cigarettes has to do with the idea that they serve as a gateway to smoking for children and adolescents. This is not an idle concern, as a study of Canadian ninth graders found. Doctors, parents and others hoping to prevent youngsters from trying e-cigarettes will have to work hard to convince them that e-cigarettes are not fun or cool.

In the study, over 70 percent of the students said they started because e-cigarettes were cool, were fun and were new.

In Canada, e-cigarette use is now more common among teenagers than smoking.

Between 15 and 20 percent of adolescents and young adults use e-cigarettes, according to other Canadian studies. This study was interested in finding out how they got started.

Ninth graders in the Niagara region of Canada were sent a questionnaire that included questions on health, stress and smoking. Over 2,300 students answered at least one question in the smoking section. Of this group, 238 (10.4%) said they had used e-cigarettes.

E-cigarette use was greater among boys than among girls. Having family members or friends who smoked also raised the odds of a student using e-cigarettes, as did having smoked cigarettes, cigarillos or a water pipe within the last 30 days.

Another question asked why students started using e-cigarettes and offered five different choices. Nearly 72 percent chose the answer, “It's cool/fun/something new,” though over ten percent of the respondents did not answer the question.

There was little indication that students were using e-cigarettes instead of tobacco cigarettes. Only about six percent said they had tried e-cigarettes either to help them quit smoking or to smoke less.

The study authors think that the reason they found a lower rate of e-cigarette compared to other Canadian studies is simply because they were looking at a younger population (age 14-15) than earlier studies did. Still, in Canada, e-cigarette use is now more common among teenagers than smoking.

E-cigarette use was highest among the most vulnerable youth — those reporting poorer health, more stress or lower estimated family income. As an editorial accompanying the study puts it, “Nothing good can come of providing vulnerable individuals with a more appealing way to become addicted to nicotine.”

E-cigarettes should have the same advertising restrictions as exist for other tobacco products, according to the editorial, which also called for prohibition of flavorings, which may make e-cigarettes more attractive, citing them as the main reason they appeal to youth.

The good news, such as it is, is that the appeal of e-cigarettes seems to be strongest for ninth graders who already smoke. Odds of e-cigarette use were 12 times higher in those who already smoked. So while they may be serving as a gateway to smoking, they're being used more by teens who already smoke cigarettes, at least in this study.

Both the study and the editorial appear in the Canadian Medical Association Journal (CMAJ).

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