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Millions of Teens Exposed to E-Cigarette Ads: CDC

Unrestricted marketing could upend decades of progress against youth smoking

By Steven Reinberg
HealthDay Reporter

TUESDAY, Jan. 5, 2016 (HealthDay News) -- E-cigarette use is soaring among U.S. teenagers, largely because of advertising aimed at their age group, federal health officials said Tuesday.

Seven out of 10 middle school and high school students say they've seen e-cigarette ads in stores, online or in other media, according to a new report from the U.S. Centers for Disease Control and Prevention.

"Not coincidentally, e-cigarette use is increasing rapidly in kids," said CDC Director Dr. Tom Frieden.

Frieden said the ads are similar to those "that got a generation of kids hooked on tobacco." They rely on the same themes -- independence, rebellion and sex -- used to sell cigarettes and other tobacco products, he said.

"This is a page right out of the tobacco company playbook," Frieden said.

According to the "Vital Signs" report published online Jan. 5 in the CDC's Morbidity and Mortality Weekly Report, more than 13 percent of high school students were using e-cigarettes in 2014 -- more than the number smoking regular cigarettes, and up from 1.5 percent from three years earlier.

In middle schools, nearly 4 percent of students were using e-cigarettes by 2014. Meanwhile, spending on e-cigarette advertising jumped from $6.4 million in 2011 to about $115 million in 2014, the study authors noted.

"E-cigarettes shouldn't be used by kids," Frieden said. They are nicotine-delivery devices that can become addictive and lead to smoking regular cigarettes, he added.

Moreover, "there is increasing evidence that nicotine may cause long-term damage to the developing brain," Frieden said. "It may change the wiring of the brain in ways that may be permanent."

Noting that tobacco advertising has been shown to prompt some kids to start smoking, the researchers said unrestricted marketing of e-cigarettes could upend the progress made over decades to prevent kids from smoking.

For the report, CDC researcher Dr. Tushar Singh and colleagues used data from the 2014 National Youth Tobacco Survey. The investigators found that about 69 percent of middle and high school students see e-cigarettes ads from one or more media sources. More than half see ads in retail stores, while about 40 percent see them online. About 36 percent see the ads on TV or at the movies, and around 30 percent spot them in newspapers and magazines.

Currently, e-cigarettes are not regulated in the United States, although the U.S. Food and Drug Administration has said it intends to regulate them. "We need a regulatory framework for e-cigarettes -- that's very important," Frieden said. "It's a wild West out there."

The U.S. Office of Management and Budget is reviewing the regulatory process, but no timetable has been set, the CDC authors stated.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, said it's time for government action.

"It shouldn't be a surprise that youth use of e-cigarettes has skyrocketed when kids are being inundated with marketing for these products," Myers said.

Indiscriminate e-cigarette marketing, coupled with a lack of government oversight, "is putting the health of our nation's kids at risk," said Myers. "This report makes clear that we can't afford more delays in government oversight of e-cigarettes."

The final rules, he said, should include strong restrictions on youth-oriented marketing, flavors and Internet sales.

For now, the CDC suggests several ways to keep e-cigarettes out of the hands of teenagers:

  • Limit sales to places that never admit minors.
  • Restrict the number of stores that sell tobacco and e-cigarettes and how close they can be to schools.
  • Ban e-cigarette sales over the Internet.
  • Require age restrictions to enter e-cigarette websites and to buy or accept deliveries of e-cigarettes.

"E-cigarettes and kids should not be mixing," Frieden said. "It's unfortunate that the industry has not been responsible about appealing to kids, and it's unfortunate that more than 2 million of our kids are using e-cigarettes as a result."

More information

For more on e-cigarettes, visit the U.S. National Institute on Drug Abuse.

SOURCES: Tom Frieden, M.D., M.P.H., director, U.S. Centers for Disease Control and Prevention; Matthew Myers, president, Campaign for Tobacco-Free Kids; Jan. 5, 2016, Morbidity and Mortality Weekly Report, "Vital Signs: Exposure to Electronic Cigarette Advertising Among Middle School and High School Students -- United States, 2014"

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