E-cigarettes and children: what we know

Here at Bundoo, my job is to present information that pertains to children and their families in a manner consistent with best practices in medicine and science. After reviewing the current literature on the subject, I feel electronic cigarette (e-cigarette) exposure for children (including secondhand vaping) cannot be safely endorsed.

There are certain undisputable facts. E-cigarette use is increasing rapidly among adolescents and adults, and e-cigarettes are currently unregulated. Because of this, no standards exist regarding product manufacturing or safety. The amount of nicotine is variable as a result of this lack in regulatory oversight. Until rigorous research by unbiased parties is done on e-cigarettes, their true safety profile will remain elusive. E-cigarettes have not been approved by the FDA as aids in smoking cessation even though many powerful anecdotal stories have been reported. Secondhand risks are still a mystery. One would assume the number of carcinogens and toxins in electronic vapors is less than in conventional cigarettes, but to say e-cigarettes are “safe” based on this notion is dangerous.

Popular e-cigarette devices mimic traditional cigarettes and help to normalize smoking behaviors. Because they are offered in many child-friendly flavors (such as cherry, peppermint, and cookies and cream), there is also a concern that e-cigarettes pose a poison risk to children. Additionally, not all states have laws regulating the age at which e-cigarettes can be purchased, meaning minors may have easier access than with conventional cigarettes.

In a cross-sectional study published in the March 6, 2014, edition of JAMA Pediatrics, researchers from the Center for Tobacco Research and Education at the University of California, San Francisco found that e-cigarette use was associated with higher odds of ever or current cigarette smoking, higher odds of established smoking, higher odds of planning to quit smoking among current smokers, and, among experimenters, lower odds of abstinence from conventional cigarettes. Use of e-cigarettes does not discourage, and may encourage youth to try tobacco products.

In summary, whether or not e-cigarettes are safer than typical tobacco cigarettes is beyond the intent of my review. I look forward to more research regarding the possible utility of e-cigarettes as smoking cessation aids in adults. However, as with traditional tobacco cigarettes, exposure to e-cigarettes should be avoided in children.

Reviewed by Dr. Sara Connolly, August 2019

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About Dr. Justin Morgan, Bundoo Pediatrician

Justin Morgan, MD, FAAP, is a board-certified pediatrician who practices general pediatrics in Louisville, Kentucky. He cares for children of all ages.


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