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E-Cigarette Use Tied to More Smoking in Teens

Devices may serve as gateway to tobacco use, study author says
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"They come in flavors like bubblegum and advertisements that include images of bikinis," Dutra said. "In terms of basic numbers, e-cigarette use among adolescents is disconcerting. Most of these devices do have tobacco in them and we should be concerned and try to limit access to these products."

Michael Burke, the treatment program coordinator at the Mayo Clinic Nicotine Dependence Center, said the study shows that e-cigarettes seem to be making inroads with young people. He said it is concerning because most people who become addicted to nicotine start smoking when they're young.

"Ninety percent of people who catch this addictive disease, it happens before they're 18," Burke said. "Some e-cigarettes are being marketed without nicotine, so the immediate concern is with the ones with nicotine. They can start someone on a path of nicotine addiction and they'll eventually move to a better nicotine-delivery device and none is better or more damaging than cigarettes."

Burke said a lot of progress was made thanks to public health efforts and education between 1996 and 2004 in reducing youth smoking. "This has a chance of undermining the education and prevention activities that we're working on to reduce tobacco use," he said.

Study author Dutra said regulations need to be placed on the advertising and manufacturing of electronic cigarettes.

In an accompanying editorial in the March 6 issue of the journal JAMA Pediatrics, Frank Chaloupka, a professor of economics with the Institute for Health Research and Policy at the University of Illinois at Chicago, also said policies surrounding e-cigarettes need to be examined. More needs to be uncovered about the public health benefits or consequences of e-cigarette use, he said.

"Their exponential growth in recent years, including their rapid uptake among youths, makes it clear that policymakers need to act quickly," Chaloupka wrote.

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