How should the epidemic of e-cigarettes among teens be addressed? Health experts weigh in

On December 18th, the Surgeon General announced an advisory on e-cigarette use. In it, he called the rise in popularity of products like Juul an epidemic. Juul and its competitors in the e-cigarette industry have come under fire for potential health risks their products impose on users (largely teens). E-cigarettes contain addictive levels of nicotine, yet they appeal to youth with kid-friendly flavors in ways regular cigarettes often do not, presenting a unique challenge for public health experts.

In an interview with the chief medical officer of the Association of State and Territorial Health Officials, U.S. News covered various efforts to reduce the use of e-cigarettes. Experts have drawn many ideas from successful policies with traditional tobacco products, like taxation. Experiences with conventional cigarettes have taught us that price is important: where cigarettes cost more, people smoke less. When it comes to youth, who generally have a lower incomes than adults, a tax-induced price hike could be even more effective. Other time-tested interventions include smoke-free indoor air policies and reducing flavors with “blatant appeal to children.”

The medical officer also noted how regular cigarettes were once marketed as sexy, like Juul and its new technology are attractive to kids today. Yet social acceptance of cigarettes has reversed as cigarette health threats were exposed—the same change in norms could be possible with e-cigarette consumption.  

Other health experts caution against conflating traditional cigarettes with e-cigarettes. After all, there are notable differences between the two: the amount of nicotine in e-cigarettes varies widely; current laws allow e-cigarettes in many areas where traditional cigarettes are prohibited; and, unlike traditional cigarettes, users can stop and restart “smoking” e-cigarettes (e-cigarettes “burn” using a battery rather than flame, meaning users take take single puffs at a time rather than committing to an entire cigarette).  Mirroring e-cigarette policy with traditional cigarette policy in ways that fails to account for these differences could render the new interventions ineffective.

Ultimately, more research is needed on the health risks e-cigarettes impose on teens before effective interventions will be made possible on a nationwide level.