Use of e-cigarettes and alternative tobacco products may lead to increased tobacco use


Staff member
Researchers at NYU Langone Medical Center sound the alarm on burgeoning public health crisis

The increasing use of alternative tobacco products, such as water pipes and e-cigarettes, by children under the age of 18 is a burgeoning public health crisis, researchers from NYU Langone Medical Center write in a commentary in the current issue of the Journal of the American Medical Association (JAMA).

"Alternative tobacco products represent a new challenge in the 75-year-old war against tobacco," says commentary co-author Michael Weitzman, MD, a professor of Pediatrics and of Environmental Medicine at NYU Langone. "With the increasing numbers of young adults using alternative tobacco products, we have every reason to be concerned."

In "Alternative Tobacco Products as a Second Front in the War on Tobacco," Dr. Weitzman and Stephen M. Amrock, MD, a former NYU Langone medical student who is now an intern in internal medicine at the University of Oregon, highlight research on the use of alternative tobacco products by young adults published earlier this year in JAMA Pediatrics by Brian A. Primack, MD, PhD, and colleagues at the University of Pittsburgh School of Medicine. That paper reported the results of a longitudinal study of 1596 young adults ranging in age from 15 to 23, including 1048 who had never smoked prior to the study. The study authors showed that use of water pipes, also known as hookahs, and other alternative tobacco products is associated with a 2.5 times increase in later cigarette use.

"The findings in the JAMA Pediatrics paper corroborate what many of us in the public health field are tremendously worried about," says Dr. Weitzman.

Public health specialists consider cigarette smoking to be a pediatric disease since nine out of 10 adult smokers started smoking as children. Although cigarette use overall has decreased by 33 percent in the past decade in the United States, the use of alternative tobacco products such as hookahs has increased an alarming 123 percent, with nearly 20 percent of high school seniors smoking hookahs. Dr. Weitzman says this increase can be attributed, in part, to a general unawareness of the dangers of alternative tobacco products by the public, the medical community, and the media.

There is a misperception that alternative tobacco products are safer than cigarettes, but the evidence says otherwise. "Other researchers have demonstrated that a typical 45 minute hookah session is equivalent to smoking as many as five packs of cigarettes," Dr. Weitzman says. In a study published last year in the journal Tobacco Control, Dr. Weitzman and colleagues discovered potentially hazardous levels of second hand smoke and other air pollutants, as well as evidence of nicotine, in New York City hookah bars. And water pipes in particular, Dr. Weitzman says, "are a terrible mechanism for spreading infectious diseases."

The increasing popularity of alternative tobacco products threatens to undermine the gains seen in the last several years with the decline in cigarette use. The U.S. Food and Drug Administration proposes extending its tobacco authority to additional tobacco products, including e-cigarettes and hookahs, not already under the FDA's authority. Dr. Weitzman argues that the same tactics used to decrease cigarette smoking in the United States--taxation, education, and restrictions on advertising and sales to minors--need to be applied to alternative tobacco products. And, he says, more research needs to be done to determine what is being burned and inhaled with these products.

"Nicotine is the most addictive substance," Dr. Weitzman says. "The use of alternative tobacco products by children can be the beginning of an addiction that can lead to later cigarette use. Tobacco use is the leading preventable cause of death worldwide, causing more deaths than HIV, tuberculosis and malaria combined."

Source: NYU Langone Medical Center / New York University School of Medicine

Journal: JAMA

This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ConductDisorders or its staff.


Crazy Cat Lady
Well, other than the fact that e-cigarettes are NOT tobacco products, contain NO tobacco, only nicotine, and none of the toxic or carcinogenic principles found in tobacco...

And this is the only study I've read that shows vaping to be a gateway to later tobacco use.

Nicotine itself has been shown to have only a slightly more deletorious effect on health than caffeine provided the user doesn't suffer from circulatory impairment and isn't pregnant.

Vaping has been shown to be the ONLY method by which smokers are able to quit inhaling the smoke from burning tobacco and remain quit of tobacco other than the use of snus, which is a tobacco product, though highly purified.

The primary motivation here is not to ban e-cigs, but rather to tax the hell out of them.

The burgeoning popularity of e-cigarettes and the huge numbers of ex-smokers turning from burning tobacco to vaporizing nicotine are costing government entities billions and billions in sin taxes.

My question? When are we going to regulate, restrict, and heavily tax a deadly drug that not only kills hundreds of thousands if not millions each year, doesn't only kill users, but family members and even strangers who cross paths with users, costs governments untold millions in medical and mental health care, and is readily available and most retail food and convenience outlets.

What substance? Why, alcohol, of course! Personally, If I had to make the choice, I'd rather see my kid with an e-cig or a joint of good indica in his or her hand, than a cigarette and a can of Steel Reserve in their hands.

At least I know the e-cig, provided it has a regulated battery, and the joint, isn't going to kill them down the road. The cigarette and booze very well could.

in my opinion, as a vaper who smoked for 40 years.