Yale Study: 'Vaping' On The Rise In Connecticut Schools

Are your kids “vaping”? New study finds that 1 in 4 high school kids have tried e-cigarettes

One in four Connecticut high school students has used an electronic cigarette, according to a study by researchers from the Yale School of Medicine, and even more students reported that they are likely to try an e-cigarette at some point in the future.

The study provides one of the first glimpses into the rapid rise of the e-cigarette phenomenon among Connecticut high school and middle school students and also offers insights into the product's increasing popularity with youths, according to Suchitra Krishnan-Sarin, an associate professor of psychiatry at Yale and the lead author of the study.

"We were surprised so many kids were using these products," Krishnan-Sarin said. "The other thing that both surprised and worried me is that adolescents who have never smoked cigarettes are initiating use of e-cigarettes. We know very little about the content and safety of these products."

E-cigarettes are battery-powered devices that can sometimes look like conventional tobacco cigarettes but they rely upon electric coils known as an atomizer to heat and vaporize a liquid that is then inhaled by the user. Many different types of devices are available as are different flavors of liquid containing varying levels of nicotine that can be purchased online, at tobacco stores or gas stations.

Students at four high schools and two middle schools in southeastern Connecticut were surveyed in November 2013 as part of the study, which asked if students at the schools had ever heard of, tried or were likely to try an e-cigarette. The schools were not identified by name. The survey studied the responses of 1,166 middle school students and 3,614 high school students. The study was published in December in the journal Nicotine and Tobacco Research.

Of middle schoolers surveyed, 84.3 percent had heard of e-cigarettes, but only 3.5 percent said they had ever tried one, although 26.4 percent said they were likely to in the future. Only 1.5 percent of the middle school students surveyed said they had tried an e-cigarette in the past 30 days.

On the high school level, 92 percent of students were aware of e-cigarettes and 25.2 percent had tried them in the past. In addition, 31.7 percent of high school students surveyed said they were likely to try an e-cigarette in the future, but only 12 percent had used one in the past 30 days.

Krishnan-Sarin said she found the results troubling because many youths surveyed said they did not know that e-cigarettes contained nicotine. She said that e-cigarettes could lead to a "pathway to nicotine dependence" for a new generation.

"It was particularly concerning that 20.4 percent of adolescents who had tried e-cigarettes reported not knowing whether the first e-cigarette they had used contained nicotine," the study stated.

The study also details how e-cigarettes are marketed to youths and how they were obtained.

Almost 50 percent of the high school students reported being given e-cigarettes by a friend, while almost 40 percent of middle school students said the same thing. Only about 15 percent of high schoolers said they purchased e-cigarettes from a tobacco shop and the number was closer to 10 percent for gas stations.

Like conventional cigarettes, customers must be 18 years old to purchase e-cigarettes in Connecticut. The study noted that e-cigarettes do not currently face the same advertising restriction as cigarettes, such as being banned from television, which the study said could be fueling the e-cigarette rise among youths.

"Emerging evidence suggests that many point-of-sale locations like gas stations display e-cigarette advertisements on both the interior and exterior of the establishment, which heavily focus on the availability of flavors and are displayed at easy viewing levels for children," the study stated. "Our results indicate that these marketing strategies may be troublingly effective, as many adolescents reported obtaining e-cigarettes from point-of-sale locations like gas stations and tobacco shops, as well from social media outlets."

Phil Brewer, a medical doctor and the director for student health services at Quinnipiac University, said he is seeing more use of e-cigarettes among students on campus precisely because e-cigarette companies are targeting a younger demographic.

"They have come up with these flavors that are very clearly designed to attract children," Brewer said. "Can you see some 45-year-old carpenter sucking on a Cherry Berry e-cigarette?"

The Yale study found that almost 71 percent of students surveyed who had tried an e-cigarette reported using a flavored one.

Even the Oxford dictionary acknowledged the popularity of the e-cigarette trend by naming "vape" its word of the year for 2014.

"As e-cigarettes [or e-cigs] have become much more common, so vape has grown significantly in popularity. You are thirty times more likely to come across the word vape than you were two years ago, and usage has more than doubled in the past year," Oxford wrote explaining its decision.

Max Young, one of the owners of the White Buffalo e-cigarette lounge in New Haven, acknowledged that "vaping" is a "big trend" right now, but said that his shop does not sell to minors and has a rule in place that you must be at last 18 years old to enter.

Young, who opened his shop in March, said his customers include people of all ages and that many older customers tell him they are using e-cigarettes to wean themselves off of conventional cigarettes.

"This is a healthier alternative that's way cheaper" than regular cigarettes, Young said.

Still, Brewer said that e-cigarettes are not without health risks.

"They are a nicotine delivery device," Brewer said. "And nicotine is a very, very, very addictive chemical."

Brewer said that high or prolonged doses of nicotine can lead to poisoning, increased heart rate and blood pressure and make long-term users more susceptible to heart attacks and strokes.

But it is not only the presence of nicotine in e-cigarettes that is a problem, Brewer said, adding that since the products are relatively new, there is little long-term or extensive research on their effects on users' health.

"Having people start using them as adolescents is bad news for long-term health," Brewer said. "It's not just the nicotine. There are other chemicals in there, and we don't know yet what the long-term effects of exposure to those chemicals could be."

Krishnan-Sarin said that Yale expanded its study to include 10 high schools and six middle schools in June of this year, but that those results have not been compiled yet. She said the school would continue to study the effects of e-cigarettes on users' health.

"Our evidence points to the critical need for appropriate and extensive public health education programs that address parental and peer permissiveness around use of e-cigarettes," the study states.

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