E-cigarette examinations elicit unclear evidence

There is a worrisome new trend of teenagers smoking e-cigarettes, and the evidence of e-cigarettes’ safety is not reassuring. In a recent study by JAMA (Journal of the American Medical Association) Pediatrics, 11 teenagers aged 14 to 17 were asked to order e-cigarettes from 98 online e-cigarette vendors. The results were shocking: 77% of the teens received their orders, with no attempts being made to verify the buyer’s age. 95% of the delivered orders were simply left at the door, with no chance to check for age. According to the study’s authors, “of the total orders, 18 failed for reasons unrelated to age verification. Only 5 of the remaining 80 youth purchase attempts were rejected owing to age verification, resulting in a youth buy rate of 93.7%.” This study was conducted in response to a North Carolina law requiring e-cigarette vendors to verify a customer’s age through a government database, and the JAMA Pediatrics study clearly shows that this law is ineffective.

However, my main concern is not North Carolina’s failure to properly enforce its law. My primary concern is the broader issue of young people smoking e-cigarettes and similar devices. Few reliable studies have been done on the topic, and the results have been mixed. One study found that there are changes in pulmonary (lung) functions after e-cigarette use, although the changes were not as severe as those caused by traditional cigarettes. E-cigarettes are also known to cause minor negative effects, such as “throat and mouth irritation, cough, nausea, and vomiting,” according to a scientific review by the American Heart Association; however, the AHA also said that “long-term biological effects are unknown at this time because e-cigarettes have not been in widespread use long enough for assessment.” A study published by The Lancet medical journal said e-cigarettes were “modestly effective” at helping people quit smoking. Deputy Shorter also commented on the issue, saying “when you look at any kind of study, it’s usually 10 years in advance,” and opining that e-cigarettes haven’t been out long enough to know their long-term effects.

With this limited and tentative evidence, using e-cigarettes is still fraught with risk. There is some evidence that e-cigarettes are marginally less harmful than traditional smoking, and there is some evidence that e-cigarettes are good for people trying to quit smoking, but the risks involved means that e-cigarettes are simply not suitable for young people who have never smoked. Considering that 10% of American high schoolers have tried e-cigarettes, this issue is especially relevant. The fact that teenagers have such easy access to e-cigarettes is disgraceful, and the e-cigarette industry must take the initiative to control their own products until we can know for certain the effects of e-cigarette usage.

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