US Pharm. 2015;40(5):HS-32-HS-33.

Teens have branched out to using alternative tobacco products such as e-cigarettes, hookahs, and little cigars. In fact, e-cigarette use is rising rapidly among both cigarette smokers and nonsmokers, according to a study presented at the Pediatric Academic Societies (PAS) annual meeting in San Diego.

“Electronic cigarettes are of great concern. They are highly addictive nicotine delivery devices, and the vapor can and does cause harm to lungs,” said principal investigator Jonathan D. Klein, MD, MPH, FAAP, director of the AAP Julius B. Richmond Center of Excellence and associate executive director of the American Academy of Pediatrics.

Data for the national study were collected from 142 pediatric practices participating in a randomized, controlled trial to improve the quality of services to help teens stop smoking. Youths ages 14 and older who went to one of the practices for a checkup or a nonurgent sick visit in 2012-2014 were recruited to fill out a survey about their tobacco use. The questionnaire asked whether they had ever used cigarettes, e-cigarettes, hookahs, chewing tobacco, or small cigars/cigarillos. Data from 10,405 teens were analyzed to identify trends in use.

Results showed traditional cigarettes were the most common tobacco product used by adolescents (22% of teens), followed by hookahs (13%) and e-cigarettes (10%).

E-cigarette use increased from 8% of teens in 2012 to 11% in 2014. Use of e-cigarettes was especially high among those who also smoked traditional cigarettes (56% in 2014).

“Adolescent use of alternative tobacco products is problematic among current smokers, as it may prolong or worsen nicotine addiction,” Dr. Klein said. “It is also problematic among nonsmokers, as it may serve as a gateway to further tobacco use and nicotine addiction.”