While the number of U.S. college students smoking cigarettes has been increasing since 1993 to the current 33 percent, the use of e-cigarettes has been climbing since 2011.
A recent study led by Adam Goldstein, director of UNC Tobacco Intervention Programs, published results showing that adolescents with prior experience only with electronic cigarettes are more susceptible to future cigarette usage. It also shows there is a large population of adolescents from the study who have been identified as susceptible to e-cigarette usage but not traditional cigarette usage.
This finding is unsurprising, considering the public perception that e-cigarettes are acceptable tobacco substitutes, despite the 2016 Surgeon General’s report stating e-cigarette use among adolescents as a major public health concern.
Leah Ranney, associate director of the UNC's Tobacco Prevention and Evaluation Program, credited adolescent appeal to e-cigarettes to three main factors. The association of tobacco products by friends and family was the primary reason, but flavors are a close second, particularly concerning middle and high school students, as 73 percent of young adults use flavored tobacco products. The third reason, Ranney said, is the idea that e-cigarettes are less harmful, though that data concerning their health effects is not yet available.
Evidence for nicotine damage, however, is in. Nicotine causes harm to developing brains, which continue to grow until an individual’s early- to mid-20s. Furthermore, Ranney noted that e-cigarettes contain chemicals that are harmful to lungs.
“There should be more regulation around e-cigarettes,” Ranney said. “Youth who don’t have any experience with cigarettes may start with e-cigarettes and later may uptake other tobacco products, and the tobacco industry promotes tobacco products to its youngest legal audience.”
Ranney’s program classifies e-cigarettes under “other tobacco products,” where items like hookah would be placed, as well as other similar products containing nicotine. The harmful effect of the addictive nicotine found in these alternate products is often overlooked by adolescents and young adults.
According to Goldstein’s study, “adolescents susceptible to using e-cigarettes perceived e-cigarettes and secondhand e-cigarette vapor to be less harmful than adolescents not susceptible to using e-cigarettes.”
The results also explained that older adolescents are more likely to be using e-cigarettes. Furthermore, the exposure of vapor in public places increases the susceptibility of an adolescent to use alternative tobacco products.
Despite UNC’s non-smoking policy, which limits smoking to 100 feet from most buildings, Juuls, e-cigarettes and other vaporized products do not fall into this category because they do not emit smoke. Individuals addicted to nicotine on UNC’s campus may turn from cigarettes towards these vaporized products, thus exposing more adolescents to variables that could increase their future use of e-cigarettes.
First-year Drew Crum uses his Juul on campus and prefers it over cigarettes for a number of reasons.
Crum is a member of Sigma Nu fraternity. A study published by the National Center for Biotechnology Information found a link between those belonging to Greek organizations and higher rates of smoking.
“I Juul because it's more discrete, seems healthier than cigarettes and smells better,” Crum said.
Ranney believes there needs to be more regulation around e-cigarettes, like Juuls, given its causal relationship to future tobacco usage. Her explanations for the climb in alternative tobacco products since 2011 include changing product modifications and tobacco marketing becoming more inclusive.
Goldstein’s study has labelled e-cigarettes as a gateway device into future tobacco usage and hopes to “aid future public health interventions to reduce e-cigarette use among adolescents and young adults.”
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