
The Centers for Disease Control and Prevention (CDC) further report that a total of over two million middle and high school students in the United States have used e-cigarettes within the past month. This number includes 11.3 percent of high school students and 4.3 percent of middle school students. These numbers may be clues about the rate of regular use of vaping among teenagers, and, in fact, American youth use e-cigarettes at a higher rate than adults do.
Although vaping e-cigarettes is often thought of as a safer alternative to smoking cigarettes and an aid to quit smoking, there is some evidence that it may actually be a gateway to smoking. Data provided by the National Institute on Drug Abuse (NIDA) show that 30.7 percent of teen e-cigarette users start smoking within six months. In contrast, only 8.1 percent of teens who do not use e-cigarettes do likewise.
Importantly, according to NIDA, manufacturers of e-cigarettes do not have to report what ingredients are in them. Consequently, the extent to which nicotine or other potentially harmful or addictive substances are in them cannot be known. Despite this reality, most teens believe that flavoring is all that is in their e-cigarettes.
While all of the contents of all of the available vapors and THC or CBD e-cigarettes cannot be known, Psychiatry Online discusses data showing that 20 percent of adolescents who used marijuana did so by vaping it. That figure corresponds with one in 20 teen vapers reporting that they vaped marijuana. Overall, there is concern that the growing popularity of vaping among teens may undo the benefits of successful reductions in adolescent smoking rates over the past 20 years. In fact, the vaping phenomenon is happening at a time when, encouragingly, other rates of illicit substance use among minors have been in decline.
As noted by Sheila Kaplan of the New York Times, cigarette smoking rates among adults have declined from 42 percent in 1965 to 15 percent in 2015. This decline could likewise be in jeopardy as the popularity of vaping grows. Consistent with the concern about vaping being a possible gateway is the reality that nicotine in vaping products is just as addictive as nicotine in cigarettes. Indeed, there is ongoing debate over how much nicotine should be allowed in cigarettes.
While pointing out that, at this stage, much more research is needed on the effects and safety of vaping, Kaplan does document a report showing that vaping is at least safer than smoking and may help smokers quit. If nothing else, switching to vaping does reduce exposure to the chemicals and carcinogens found in cigarettes. One cautionary note, though, is that the wisdom of starting use of these products other than as a strategy to stop smoking remains questionable. Another is that smokers who continue to smoke while starting to vape do not get the benefits of switching.
A CNN report indicates that, overall, the increase in e-cigarette use among high school students from 2011 to 2015 was 900 percent. It is alleged that this exponential growth is being driven by manufacturers and stores, who are perhaps intentionally marketing these products to teenagers. The retailers deny doing this; nevertheless, enforcement action by the Food and Drug Administration (FDA) could be forthcoming.
At any rate, while it has been discussed that cannabis vaping products appear to at least be better than cigarettes, that is not to say that there is no reason to question their safety. Anecdotal evidence suggests that kids think that they just contain water. However, they actually contain e-liquids that change to aerosols when heated, and preliminary research has found chromium, zinc, nickel and lead in these aerosols. No amount of lead should be considered safe.