Electronic cigarettes, otherwise known as e-cigarettes, are battery-operated electronic smoking devices that differ from traditional cigarettes because they emit an aerosol vapor instead of smoke, and typically consists of various flavorings of fruits and candy, nicotine, propylene glycol, and other chemicals. They are manufactured to resemble either traditional cigarettes, cigars or pipes, pens, or even USB memory drives. Since its initial introduction in the United States in 2007, the trend of adolescents who use e-cigarettes has grown rapidly. Between 2013 and 2014 alone, e-cigarette use has tripled among middle school students (1.1%-3.9%) and high school students (4.5%-13.4%) making e-cigarettes the most commonly used nicotine product among adolescents. This is a public health concern because research suggests that adolescents who use e-cigarettes are likely to experiment with other tobacco products in the future, such as conventional cigarettes, putting them at risk of several associated diseases.
Several factors contribute to the alarming rates of e-cigarette use among teens, which includes concentrated amounts of tobacco retail stores in their environments, as well as advertisements displayed on TV, billboards, print media, the internet, and through point of sales (POS) displays of tobacco products. Adolescents who have never smoked but recall tobacco POS are more likely to become smokers after 30 months of follow-up. The opposite effect is true when tobacco POS is banned, as seen in other parts of the world, as well as when increased taxes on cigarettes are imposed. Consequently, increased availability and advertising of e-cigarettes is associated with its higher consumption among youth.
Although research is limited to the exact health effects associated with e-cigarette use, it can likely cause secondhand exposure, despite the fact that emittance of nicotine and probable carcinogens are released at lower rates than traditional cigarettes. Also, accidental overdose and poisoning of nicotine liquids are likely among youth, due to the fact that the solution is sold in bottles and cartridges. There is contradicting evidence to support the claims made by e-cigarette manufacturers that e-cigarettes are a healthier alternative to traditional cigarette products and are useful as a smoking cessation tool, especially due to the fact that it contains nicotine and other harmful substances as well. Studies have proven that exposure to nicotine during adolescence has several harmful effects on brain development such as attention and cognition deficits, mood dysfunctions, and increased propensity for negative risk taking. Nonetheless, very little is known about the product in general and thus, it is difficult to determine its health risks and if it differentiates at all from regular cigarettes.
Adolescents are increasingly exposed to e-cigarette advertisements primarily because there are no regulations on them. Since April 2014, the FDA only proposes to regulate e-cigarettes that are marketed for its therapeutic use, for instance, to aid in the cessation of smoking. However, there is currently no e-cigarette that is approved by the FDA according to this standard. Lack of regulation has allowed the e-cigarette industry to launch marketing campaigns that appeal particularly to adolescents, which contributes to their increased use and inception of use among those who have never smoked. Advertisements for e-cigarettes have been broadcasted on many popular television programs such as during the 2013 Super Bowl commercials by the e-cigarette company NJOY and are frequently advertised on popular social media websites like Facebook and YouTube. Even popular cartoon characters like “Hello Kitty” have been used in advertisements of e-cigarettes. Overall, due to the propensity of e-cigarette companies to market their products that are appealing towards youth, their subsequent surge of use, as well as the potential health risks that are associated with it, there is a need for regulation of e-cigarette products that involve banning or restricting its promotion, advertisement, and sponsorship.
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