The U.S. Center for Disease Control recently released a news release that reported 1 in 10 teens tried e-cigs in 2012, doubling the use reported in 2011.  These statistics, like all data, can be used to support either side of this debate, and to make headlines.  For example, the 10% use is based on surveys of whether those teens had ever tried an e-cigarette, even one time.  Also, 76.3% of those that had tried e-cigs were already smokers.  That statistic limits the argument of the gateway effect, but more on that later.  There are some valid questions and concerns about teen or non-smoker use of e-cigarettes and nicotine, and the research is being done now to learn more.

The Houston Chronicle had a story about this survey that looked a little closer at some of the data, and raised some legitimate points about the headline grabbing statistic.  Here’s a small clip, but you can read the full story here:

“Not to dismiss these troubling findings, but we think that focusing on “tried once” is a little scare mongering. When e-cigarette smokers pull out the device at parties or bars, often non-smokers want to give it a puff to see what it’s like. The novelty gets them interested. It is possible a large portion of these kids who have tried them felt the same pull.

Since most were already smokers, they may also be reducing their cigarette consumption or trying to quit altogether by using these e-cigarettes as an alternate source of nicotine. While stories of exploding e-cigarettes will generally get more airtime in the national and international media, studies that show the potential benefits to smokers looking to quit by using e-cigarettes can get lost in the mix.”

On a FoxNews video clip about this study, CDC Director Dr. Tom Frieden  states,

“If kids get hooked on nicotine because of e-cigarettes that may make them life- long smokers, not just of e-cigarettes but of traditional cigarettes, and we know that cigarettes remain the number one cause of death in this country. So anything that gets more kids hooked on nicotine is a really bad thing.”

Dr. Frieden is being a bit misleading by making an assumptive claim that nicotine use leads to smoking, since that is not a proven cause and effect fact.  But it is well known that nicotine is quite addictive, and is quite toxic in high doses.  The clip goes on to discuss the positive aspects of e-cigs including their potential to help smokers reduce or quit smoking, so it is balanced and worth watching.

When talking about a gateway effect, the issue being raised is whether one product (i.e. e-cigarettes) leads to another product or behavior (smoking cigarettes).  In other words, is there a cause and effect relationship between the two?  And in this case is it a direct relationship (growth in use of e-cigs will lead to increased use of cigarettes)?

There are three potential outcomes that would result from the needed research:

1)      e-cigarettes increase the likelihood that a teen (or non-smoker) will become a smoker

2)      e-cigarettes decrease the likelihood that a teen (or non-smoker) will become a smoker

3)      e-cigarettes do not affect the likelihood that a teen (or non-smoker) will become a smoker

There is no clear empirical evidence to state any of these outcomes as fact.  We simply do not have enough research available, and research on cause and effect is difficult.  But what everyone agrees is that e-cigs appear to be much safer and healthier for a user than smoking cigarettes.  So for many doctors the distinction is made between smoking cessation and nicotine cessation, with smoking being the most important to control and reduce.

In fact, here’s a quote from Dr. Steven Schroeder from UC San Francisco and Director of the Smoking Cessation Leadership Center there.

“If it is a choice between smoking tobacco product or a nicotine replacement — of course, keep taking the nicotine. It is a heck of a lot healthier than tobacco smoking.”

Our Conclusion: The choice is clear – don’t keep taking nicotine – Try Novus Twigs and eTwigs which contain NO TOBACCO AND NO NICOTINE but still provide satisfaction to smokers.

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UPDATE TO THIS STORY [SEP 27, 2013]

Dr. Michael Siegel, on his Tobacco Analyst blog , uncovered some additional information hidden beneath the headline grabbing claim that teen trial and use of e-cigarettes is rapidly increasing.  Over the course of 3 waves of surveys (4,766 responses), there were only 12 who indicated they had even tried an e-cigarette the 30 days before.  This is a reflection of just a single use, not regular use, and that is only 0.25%.  In the most recent survey of 1,345 teens, only 5 non-smokers had tried an e-cig, which is still a very small 0.4%, and again not an indication they were using but rather had tried it once.