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Non-smoking teenagers are using e-cigarettes

Fifth of teenagers admit to using e-cigarettes

Adrian O'Dowd

Tuesday, 31 March 2015

A small proportion of teenagers who are not smokers have admitted to using e-cigarettes, according to research published in the open access journal BMC Public Health.

UK researchers found that a fifth of teenagers in a large survey had accessed e-cigarettes, and of these, 16% had never otherwise smoked, although the highest numbers were regular smokers, of whom over two thirds had accessed them.

E-cigarettes have been marketed as an alternative nicotine delivery system that is healthier than tobacco, but there has been debate around the safety and efficacy of these devices, and whether they reduce the harm caused by smoking, or if they detract from healthy anti-smoking messages.

A particular concern with clinicians, policymakers and parents has been whether these devices act as a potential gateway to smoking.

Researchers from Liverpool John Moores University surveyed 16,193 secondary school students in the north west of England aged from 14 to 17 years.

The participants were asked about their alcohol and tobacco-related behaviours as part of a biennial survey conducted in partnership with Trading Standards whose remit includes enforcing regulations on the sale of age-restricted products in the UK.

The teenagers were asked if had ever bought or tried electronic cigarettes and if the students were smokers and drinkers they were also asked about their behaviour during this type of activity.

One in five teenagers who responded to the survey said they had accessed e-cigarettes and this figure was higher in males, increasing with age and if living in a deprived area.

Of the teenagers that had accessed e-cigarettes, 15.8% had never smoked, 23.3% had tried smoking but did not like it, 35.8% were regular smokers, 11.6% only smoked when drinking, and 13.6% were ex-smokers.

The researchers also found that there was also a link between alcohol and e-cigarette access.

Students who drank alcohol were significantly more likely to have accessed e-cigarettes than non-drinkers.

Among those teenagers who had never smoked, it was found that those who regularly binge drank were four times more likely to access e-cigarettes than those who did not drink.

The researchers noted that because these data were self-reported, there could be under or over-reporting of the figures due to various factors such as poor recall or lack of knowledge.

They concluded: “There is an urgent need for controls on the promotion and sale of e-cigarettes to children. Findings suggest that e-cigarettes are being accessed by teenagers more for experimentation than smoking cessation.”

One of the study authors, Mark Bellis said: “Our research suggests that we should be very concerned about teenagers accessing e-cigarettes.

“While debate on e-cigarettes has focused largely on whether or not they act as a gateway to tobacco cigarette use, e-cigarettes themselves contain a highly addictive drug that may have more serious and longer lasting impacts on children because their brains are still developing.”

Dr Penny Woods, chief executive of the British Lung Foundation, said: "It is concerning that so many people under the age of 18 are using e-cigarettes. Although they almost certainly represent a mere fraction of the harm that cigarettes present, there is currently a lack of certainty over their long-term health impact.

“That said, it is not possible to conclude from this data whether e-cigarettes are acting as a gateway to smoking or drinking. This research suggests e-cigarette use is higher among those who also try alcohol and cigarettes, but we don’t know whether these children would have tried these substances anyway.

"The fact that smoking rates are generally declining among children and young people even as e-cigarette use rises, suggests a lack of a gateway effect."

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