ACP, U.S Surgeon General Work to Curb E-Cigarette Use Among Youths

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New advisory describes use as an epidemic

Jan. 11, 2019 (ACP) – Supporting the U.S. surgeon general's recent pledge to curb e-cigarette use among youths, the American College of Physicians is calling on its members to help educate their patients about the risks of these products.

In an advisory issued in mid-December, the surgeon general, Dr. Jerome Adams, called the recent surge in e-cigarette use among American youths “a cause for great concern” and “an epidemic” and said that “aggressive steps must be taken to protect children from these highly potent products.”

In 2018, more than 3.6 million U.S. youths – including 1 in 5 high school students and 1 in 20 middle school students – used e-cigarettes, according to the surgeon general's report. It noted that e-cigarettes go by a host of different names, including e-hookahs, mods and vape pens, and come in many flavors, shapes and sizes, including a recent iteration that looks like a USB flash drive.

Though some may argue that these electronic nicotine delivery systems (ENDS) are “safer” than traditional cigarettes, most contain nicotine, and nicotine exposure during adolescence can harm the developing brain, warned Dr. Ana Maria López, ACP's president. “E-cigarettes may be a stepping stone toward other tobacco-related products,” she said.

However, it's not time to be pointing fingers, López said, but rather time to step up efforts to educate patients about the risks and long-term health care consequences of e-cigarettes.

“We are very enthusiastic about the most recent statement from the U.S surgeon general,” she said.

The surgeon general's advisory supports ACP's long-standing position on e-cigarettes. The College went on record about the dangers of ENDS and called for a ban of flavored cigarettes in a position paper published in 2015 in Annals of Internal Medicine. The U.S. Food and Drug Administration announced in November 2018 that it would start to restrict the sale of flavored e-cigarettes in certain retail outlets – those that allow people of all ages to enter – and would ban menthol cigarettes and cigars.

López said that e-cigarette use should be part of physicians' conversations with patients, along with discussions about the use of seatbelts and other health and safety measures. To be most effective, she said, internists should learn as much as they can about e-cigarettes, including the many shapes and sizes that they come in as well as the vernacular.

And internists should ask patients about usage, she said.

“We did so much effective work at curbing smoking,” López said, “and now it's time to use what we know to educate our patients about the risks of e-cigarettes.”

As the surgeon general's advisory said: “Know the risks. Take action. Protect our kids.”

More Information

The Surgeon General's Advisory on E-cigarette Use Among Youth is available online.

ACP's statement issued in response to the advisory is on the College's website.

ACP's position paper on electronic nicotine delivery systems can be viewed on the Annals of Internal Medicine website.

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