Albert tried his first electronic cigarette last year, when he was 14. He liked it so much — mint is his favorite flavor — that he “vapes” with his friends whenever a group of them has enough of these unregulated, vapor-only cigs to pass around.
“It’s the coolest thing out,” says the Killian High 10th grader.
Most adults think otherwise. Albert, who asked that his real name not be used because his parents don’t know his vaping habits, are part of what public health officials consider a growing trend that saw e-cigarette use among minors double in a single year. At Wednesday’s meeting of the Miami-Dade School Board, member Raquel Regalado will propose adding an e-cigarette ban to the Student Code of Conduct.
“They need to be treated as regular cigarettes,” she said. “Right now we don’t have a standardized policy. Some teachers confiscate them and others don’t. We shouldn’t leave something like that to a judgment call.”
Even as traditional cigarette use is decreasing, a report released last month by the Centers for Disease Control and Prevention showed a sharp spike in e-cig experimentation among U.S. middle and high school students between 2011 and 2012. That has raised concern among both educators and public health officials, who fear that e-cigs may be an entry point to the use of conventional tobacco products.
“We know that if kids start with e-cigarettes, there’s the potential for them to move on to cigarettes,” said Tim McAfee, director of the CDC Office on Smoking and Health. “About 90 percent of all smokers begin smoking as teenagers, so it’s very important that we keep our young people from using or experimenting with any tobacco product.”
An estimated 1.78 million children and teens in the U.S. used e-cigs last year, according to the CDC report, many of them prompted by their easy accessibility and their coolness factor. E-cigarettes look like traditional cigarettes but are battery-powered devices that provide doses of nicotine and other additives in an aerosol. They’re also cheaper and come in a variety of designs and flavors. They are often used as a tool to help smokers quit conventional cigarettes, and are seen by some as a less harmful alternative. But McAfee and others are skeptical of these claims.
As the Food and Drug Administration studies how to deal with e-cigs, state and local officials are working on their own bans. As in Miami-Dade, Broward educators are working on a policy that will be presented for public comment in mid-December, said Amalio Nieves, director of prevention for Broward schools. He hopes a ban will be in effect for the 2014-2015 school year.
“We’re not hearing that it’s a problem yet, but we want to be proactive about this,” Nieves said. “We’re concerned for our youth, that this may be an entryway” for regular cigarettes.
In Tallahassee a Senate bill sponsored by Lizbeth Benacquisto, a Fort Myers Republican, unanimously passed the regulated industries committee in November and moved on to the criminal justice committee. Senate Bill 224 prohibits the sale of electronic cigarettes and other alternative tobacco products to minors.
“Nicotine,” McAfee said, “is highly addictive. Just because it’s safer than a cigarette doesn’t mean it’s safe. We already know that nicotine can interfere with adolescent brain development.”
Though the e-cig market is fragmented, growth has been explosive. A Wells Fargo Securities study predicted retail and online sales would jump by 240 percent or more this year. “They’re crazy popular,” Regalado said, “and not just as a [smoking] cessation device. Kids are buying them without a problem.”
Many blame the increased use of e-cigs by teens on the lack of federal regulation. Selling regular cigarettes to minors is illegal, but there is no such law for e-cigarettes. “You can just go out and buy them,” said Arlett Gonzalez, president of the Students Working Against Tobacco prevention club at Westland Hialeah High School. “There’s no age limit and no one asks you any questions.”
Arlett has noticed more of her peers vaping every year, even as her club members diligently hand out information about e-cigs and help with special educational programs, such as the Great American Smokeout in November. “I see them in the movies, in the mall, anywhere teenagers hang out,” she added. “They’re not hard to find.”
The FDA has announced its intent to issue a rule regulating e-cigs and other tobacco products under the Family Smoking Prevention and Tobacco Control Act, but this may take months and the FDA does not comment on proposed regulations. In a prepared statement, a spokesperson said in an email: “Further research is needed to assess the potential public health benefits and risks of electronic cigarettes and other novel tobacco products.”
No one doubts that the FDA will get around to regulating e-cigs. In the meantime, the debate over the risks — and the potential benefits — of the product has grown more heated. The e-cigarette industry association backs a ban on sales to minors.
“We consider this a tobacco product,” said Tom Kiklas, CFO of the Tobacco Vapor Electronic Cigarette Association. “We agree this should not be sold or marketed to minors.”
Some local retailers agree. Eric Stein, store manage at Navarro Pharmacy in Memorial Hospital in Broward, stocks one brand of e-cigs and uses them himself, but he refuses to sell them to teens. “My policy is I don’t do it. I don’t promote. I don’t think children should be smoking anything.”
VMR, the parent company of V2, the Miami-based, third-largest e-cig vendor in the country, does not sell or market to minors. They voluntarily label their products “Underage Sale Prohibited” and support youth bans. A VMR spokesman said in an email that the company helped found the Smoke Free Alternatives Trade Association to engage “state and federal agencies to craft and implement needed, responsible regulations, for issues like youth access.”
Anti-tobacco advocates, however, maintain that, regardless of the industry association’s position, e-cig manufacturers and retailers are taking a page from Big Tobacco’s playbook to market the product to minors. Valencia Morris, the Tobacco Prevention Specialist in Miami-Dade for the Florida Department of Health, cites celebrity endorsers, including TV personality Jenny McCarthy and rock musician Courtney Love, as an example of the effort to attract teens.
“They make it sound like the product is cool and trendy and sexy,” Morris said of ads featuring such stars. “The kids see that and they want to try it.”
Teens who use e-cigs believe they’re safer than traditional cigarettes. Albert, the 10th grader who vapes socially, said he’s confident he won’t get addicted.. “I don’t have an affinity for it,” he said. “If it’s present, I’ll try. I don’t go looking for it.”
That sentiment is not uncommon. The American Journal of Public Health reported last year that 53 percent of young adults who had heard of e-cigs thought they were less harmful that traditional cigarettes, and the FDA maintains there hasn’t been enough research to pass final judgment.. However, a 2009 FDA analysis of 19 varieties of e-cigs found that half contained nitrosamines, the same carcinogen found in real cigarettes, and many contained diethylene glycol, the poisonous ingredient in antifreeze.
The CDC’s McAfee calls e-cigs a “starter product” with the potential to hook kids on more serious tobacco products. Industry spokesman Kiklas calls such statements “irresponsible. If you’re going to say they are a gateway product to cigarettes, then show me the study.”
For school board member Regalado, the potential for harm goes beyond the vaporized chemicals. She’s alarmed at the e-cig’s growing popularity — and adults’ lack of knowledge about them.
“I’ve talked to a lot of parents,” she added, “and they’re completely clues about them.”