Teens who use nicotine in e-cigs vape more and smoke more cigarettes

Nov. 16, 2017—Electronic cigarettes (e-cigs) with higher nicotine levels may pose a serious health risk to teenagers. A new, small study suggests that teens who use them may be more likely to vape more and smoke more traditional cigarettes.

Teens, nicotine and smoking

According to the researchers, 11 percent of 10th graders in the U.S. in 2016 reported using e-cigs in the last 30 days. To learn more about this use, the researchers looked at survey results from 181 teens who vape in the Los Angeles area. The students reported their habits in 10th grade and then six months later in 11th grade.

Not all e-cigs contain nicotine. But at the start of the study, about 60 percent of participants said they had used e-cigs with the highly addictive substance within the last 30 days. Many of the students in the study also smoked regular cigarettes.

Teens who vaped higher concentrations of nicotine were more likely to vape and smoke more regularly—and to smoke more cigarettes per day—than their peers who didn't use nicotine in their e-cigs. This was true at both the beginning and the end of the study.

The amount of nicotine was the key factor. After six months, with each increase in the nicotine level, the odds that the teens would be vaping more than two days a month—as opposed to having quit vaping—were 1.73 times greater.

Intense cigarette use at younger ages is tied to increased nicotine dependence later in life, according to the study authors. Exposure to higher levels of the substance in early adolescence also increases the risk of dependence.

And using nicotine may also affect teens' brains, the authors said, citing previous research. Teens who vape may be prone to poor decision making and risk taking behaviors, like choosing to vape and smoke more.

The U.S. Food and Drug Administration does regulate e-cigs as tobacco products. And the researchers feel the study provides evidence in favor of developing policies about nicotine concentration in e-cigs.

While more studies are needed to find out if vaping causes smoking, the researchers believe such policies could affect the use of tobacco products among youth.

A main limitation of the study was the small sample size.

The study was published in JAMA Pediatrics.

What parents should know

E-cigs don't look like traditional cigarettes. But that doesn't mean they're safe. According to a patient information page published with the study, here's what you need to know:

  • The liquid in e-cigs and the vapor that's inhaled contain harmful chemicals, including a component of antifreeze that can be poisonous. Carcinogens are in there too.
  • The nicotine in e-cigs is addictive. It also harms brain development.
  • Secondhand vapor from e-cigs can harm growing lungs.
  • E-cigs aren't currently recommended as a way to quit smoking.
  • E-cigs have occasionally exploded, causing burning and fires.
  • Since e-cigs are fairly new, the long-term health effects aren't known.

The page suggests discussing with teens how nicotine companies target them with sweet flavors and hip advertising. Point out that not using these products can be a way to "rebel."

Talk to your teen about nicotine and vaping. Start a conversation by taking our e-cig quiz together.