Potential Consequences of E-Cigarette Use: Is Youth Health Going Up in Smoke?

Since their U.S. introduction around the beginning of 2007, electronic cigarettes (ecigarettes) have dramatically increased in popularity, particularly among American adolescents.1 This phenomenon has prompted a new but rapidly expanding literature on the causes and consequences of e-cigarette use; furthermore, policy-makers are struggling to understand how to develop well-designed regulations for these products. The Department of Defense (DOD), given its heavy reliance on the adolescent population for future manpower needs, should be especially concerned about how e-cigarette use will affect this group. This study draws on existing literature and publicly available data from the National Youth Tobacco Survey (NYTS) to address three fundamental research questions:

1.  Are e-cigarettes harmful to one’s health, and, if so, how do those negative effects compare with the damage done by traditional cigarettes?
2. What is the relationship between e-cigarette and traditional cigarette use? Specifically, do e-cigarettes serve as a substitute or a complement to regular cigarettes?
3. What is the level of e-cigarette consumption among those who would traditionally be nonsmokers, and are e-cigarettes a “gateway  drug” for using traditional tobacco products?

In addition, we make recommendations aimed at improving DOD policies in this regard, and laying a foundation for future research efforts.

The NYTS is administered by the Centers for Disease Control and Prevention (CDC). It
began in 1999 as a nationally representative survey of American adolescents in the 6th through 12th grades. It continues to the present day, though the latest year of data available on the CDC website2 is 2014. The survey questionnaire explores exposure to various tobacco products, either indirectly (i.e., through secondhand smoke or advertising) or directly. Questions on e-cigarette use first appeared in the survey in 2011, and have reappeared in every annual wave since then.