A publication of the Kentucky Center for Public Service Journalism

Researchers say e-cigs safer, but boost chances of youth smoking; more young adults vaping

By Melissa Patrick
Kentucky Health News

A federally commissioned report on electronic cigarettes found “substantial evidence” that e-cigarette use among teens and young adults increases their chance of using tobacco cigarettes in the future. The report was released the same week as a poll that found e-cigarette use among young adults in Kentucky is increasing.

The Kentucky Health Issues Poll, taken Oct. 24-Dec. 2, found that nearly half of young adults ages 18-29 in Kentucky said they had tried e-cigarettes, which is up from 37 percent in last year’s poll.

“E-cigarettes can be a gateway to tobacco usage, especially for young people,” said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsors the poll.”We know they expose users to toxic chemicals, including nicotine, which long has been proven to be addictive and responsible for a wide range of health issues.”

The National Academies of Science, Engineering, and Medicine committee came to this strong conclusion based on 10 high-quality studies, Julia Belluz reports in her breakdown of the report for Vox.

The National Academies’ 680-page study analyzed the findings of over 800 peer-reviewed studies to determine the human health effects of e-cigarettes The researchers said research has been relatively limited because e-cigarettes haven’t been on the market very long. However, they said they were able to conclude that e-cigarettes are less harmful than traditional cigarettes — which is likely to create a shift in the way policymakers view them.

“Evidence suggests that while e-cigarettes are not without health risks, they are likely to be far less harmful than conventional cigarettes,” the report says.

In a statement, U.S. Food and Drug Administration Commissioner Dr. Scott Gottlieb recognized the importance of the comprehensive report to inform future policy, adding that it also helps to identify the areas that need further study.

He said, “We need to put novel products like e-cigarettes through an appropriate series of regulatory gates to fully evaluate their risks and maximize their potential benefits.”

Kentuckians smoke more than other Americans, and their use of e-cigarettes, 28 percent in the poll, is higher than the national average of 22 percent. And like the rest of the nation, older Kentucky adults were less likely to have used e-cigs, with use reported by 29 percent between age 30 and 64 but only 10 percent 65 and older.

The poll also found that current smokers in Kentucky were much more likely to have ever used e-cigarettes, at 62 percent, than former smokers (27 percent) and never-smoking Kentuckians (9 percent). Those numbers were is similar to the previous year’s poll.

The researchers in the federal report were asked to determine whether e-cigarettes help people stop traditional smoking. They said the answer remains unknown, writing that there was “insufficient evidence” in the three available randomized controlled trials to support this claim, and only “moderate evidence” in the observational studies, reports Vox.

The National Academies report says that while e-cigarettes contain fewer numbers and lower levels of toxic substances than conventional cigarettes, their long term effects are not yet clear. It also clearly states that the overall positive or negative impact of e-cigarettes on public health is still not known, and calls for more research.

“It is deeply troubling that there are still so many unanswered questions about the impact of e-cigarettes on public health despite the fact they have been on the market for a decade and are being used by millions of kids and adults,” said Amy Barkley, an advocacy director for the Campaign for Tobacco-Free Kids. “This report and the latest Kentucky Health Issues Poll results underscore the need for full and immediate FDA regulation of e-cigarettes so we can obtain the information necessary to provide the public and smokers with complete answers to these vital questions.”

Last summer, the FDA pushed back the compliance deadline for FDA regulation of e-cigarette products until 2022.

E-cigarettes are battery-powered devices that turn liquid nicotine into an aerosol, which is often called a vapor that is “vaped,” not smoked. At a workshop on covering health in November, Ellen Hahn, a University of Kentucky nursing professor and long-time smoke-free advocate, explainedthe importance of not referring to the aerosol as a vapor, which is language the industry uses. She said a vapor is diffused matter suspended in the air, but an aerosol is a liquid or solid of fine particles in a gaseous medium. She added that there are over 400 types of e-cigarettes on the market.

Much like tobacco produces secondhand smoke, e-cigarettes produce secondhand aerosol. About half of Kentucky adults (51 percent) said they believed the aerosol causes “some or little harm” to children, almost one-third (27 percent) said it caused “a lot of harm,” 10 percent said it caused “no harm” and 11 percent said they “don’t know.” Noticeably, 17 percent of those who had tried e-cigarettes said the vapor caused “no harm” to children, compared to 6 percent of never-users.

The Kentucky Health Issues Poll is funded by the Foundation for a Healthy Kentucky and Interact for Health, a Cincinnati-area foundation. It surveyed a random sample of 1,692 Kentucky adults vial landlines and cell phones. The margin of error for each statewide result is plus or minus 2.4 percentage points.

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