Many young adults are enthusiastically "vaping" e-cigarettes, drawn by the nifty technology, tasty flavors and their own physical sense that the devices are doing them no harm, according to new research.
The authors of the small study, which focused on young adults in New York City, say this segment of the vaping population needs more education on the possible health effects of e-cigarettes, including the potential for becoming addicted to nicotine.
A ban on flavors and on marketing tactics that are already prohibited for tobacco could help slow the uptake of e-cigarettes as well, the researchers conclude in the journal Tobacco Control.
"I think my main concern is not so much that this product is going to end up being more toxic than cigarettes - because cigarettes are so toxic you almost can't come up with a product that is worse - but young adults are still in a stage where they are initiating nicotine use," Dr. Pamela Ling, one of the study's two authors, told Reuters Health.
E-cigarettes have grown into a $5 billion (S$6.8 billion) global business in recent years, but research into their safety and how and why people use the devices has lagged. Most researchers agree that the nicotine-laced vapour delivered by e-cigarettes contains far fewer toxic chemicals and none of the tar in traditional cigarettes.
It's still unclear whether e-cigarettes help smokers to cut down or quit traditional cigarettes, but a growing number are using them to try.
Some research suggests that using nicotine in any form could open a gateway to addiction that leads young people to take up tobacco. California's chief public health officer issued a report Wednesday calling e-cigarettes a threat to public health and the state's anti-tobacco efforts (see Reuters article of January 28, 2015: reut.rs/1z7KPaR).
Many e-cigarette studies have focused on smokers, generally older, some with a declared intent to quit using tobacco. Ling and her coauthor wanted to look at how younger people, who may or may not be smokers, are using e-cigarettes and why.
The researchers point out in their report that e-cigarette use in the US is highest among young people, with about 14 per cent of 18-24 year olds having tried "vaping" in 2013.
In 2012 and 2013, Ling and her colleague recruited 87 men and women between the ages of 18 and 27 years old for a series of focus groups followed by in-depth interviews with a smaller group. About a third of participants had used an e-cigarette in the past 30 days. Just over half of those were daily smokers of tobacco and 41 per cent smoked less than daily.
Of the current e-cigarette users, 50 per cent said they had no intention to quit smoking in the next six months, 48 per cent said they had made a quit attempt in the past 12 months and 31 per cent said they were currently trying to quit smoking.
Young adults said they first tried e-cigarettes after friends offered them "puffs" and usually bought the devices in bodegas and smoke shops. They wanted to try the product after seeing commercials and said they considered the devices a fun type of technology. Participants also said they thought the e-cigarette vapour was not as strong or harmful as regular cigarette smoke.
They also assumed the products were safe because they did not feel sick after smoking them and enjoyed the flavors.
Ling, a professor of medicine at the University of California, San Francisco, said more research was needed on the different types of e-cigarettes devices because some might be more dangerous than others. "The amount of exposure is really variable and there haven't been studies of long-term use of the products because they haven't been around that long."
Ling noted that among the troubling themes that emerged in the study was that young adults were too often relying on advertisements that offered "unsupported, untrue claims" about safety, or going by their own body sensations.
Thomas Kiklas, co-founder of the non-profit TVECA (Tobacco Vapor Electronic Cigarette Association), said in an email that his organisation set marketing standards "as to not making any mitigating claims of being safer than, healthier than or other claims in comparison to the predicate tobacco cigarette product."
Kiklas said TVECA lobbied US legislators and the European Union to "establish responsible regulations and standards for the e-Vapor market," and that he was disappointed in the study.
"My reaction was that it was very narrow in its demographic sampling, dated and not at all a serious attempt to understand the issues the consumer has with understanding the e-Vapor industry, now in its eighth year," Kiklas said.
Dr. Joanna Cohen, director of the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health, said the study offered helpful information on young adult smoking habits as public health officials consider how to regulate the products and educate the public about them.