UF study: More Florida teens using e-cigarettes

Electronic cigarette use is rising among adolescents, say University of Florida researchers, who found that 12 percent of Florida high school students reported trying e-cigarettes, up from 8 percent the previous year.

The research team also found that teens who used e-cigarettes were more likely to use other tobacco products, including traditional cigarettes and hookah. The findings are troubling because they indicate that e-cigarettes may be serving as an introduction to smoking for a group who may have never started, said lead investigator Tracey Barnett, Ph.D., an assistant professor of behavioral science and community health in the UF College of Public Health and Health Professions, part of UF Health.

“We had been making good strides in preventing tobacco use in adolescents,” she said. “The concern is we don’t want a whole new generation of users.”

The study findings were recently published online ahead of print in the American Journal of Preventive Medicine.

While other studies have shown a connection between e-cigarette and cigarette use in young people, the UF study, which was conducted in collaboration with the Florida Department of Health, is the first to show that e-cigarette smoking is strongly associated with hookah use.

“This is important because both e-cigarettes and hookah are appealing to adolescents and have fewer policy restrictions in place regarding flavors and public smoking, which could lead to re-normalizing smoking for youth,” Barnett said.

Some experts see the potential for e-cigarettes, which produce a nicotine vapor that users inhale, as a smoking cessation device for long-term smokers. But it is unlikely that teens would be using them for that purpose, Barnett said.

“Even if scientific findings eventually show that e-cigarettes help the majority of adults who use them to quit smoking, which still has not been found, this wouldn’t be the reason for the uptick in use of e-cigarettes by youth,” she said.

The UF study findings are based on data from the 2013 Florida Youth Tobacco Survey, an anonymous, annual survey administered by the Florida Department of Health to a random sample of public middle and high schools. The 2013 survey was completed by 12,600 students.

In addition to e-cigarettes, the survey asked about use of other tobacco products. More than one-fourth of high school students (grades 9 through 12) said they had tried traditional cigarettes and 35 percent of those respondents also reported e-cigarette use. Among high school respondents, 17 percent said they had tried hookah. Of hookah users, 43 percent had also used e-cigarettes.

A 2014 Florida state law bans the sale of nicotine dispensing devices, including e-cigarettes, to minors. UF researchers will continue to monitor rates of adolescent e-cigarette smoking to assess the law’s effect on e-cigarette use.

Hookah and e-cigarettes are available in a variety of flavors, some of which may be particularly attractive to adolescents, such as watermelon, bubble gum and gummy bear, Barnett said. The Food and Drug Administration does not yet regulate flavorings for tobacco products other than traditional cigarettes. The UF scientists say future research and regulation should consider the role flavorings play in youth tobacco use.

“The rates of e-cigarette use in Florida youth are going up fast,” Barnett said. “E-cigarettes are becoming popular even faster than hookah did.”