Over the past 40 years, public health campaigns and legislative policies have helped get the message out that cigarettes are a bad idea for everyone, especially kids. The last few years, however, have seen a skyrocketing trend that threatens to undo the progress we have made in curtailing children’s interest in — and access to – cigarettes. I’m referring, of course, to electronic nicotine devices (ENDs), also called electronic cigarettes, e-cigs or vapes.
A summary put out by the American Academy of Pediatrics in September 2015 lays out some alarming statistics. For example, the Centers for Disease Control and Prevention (CDC) reports that from 2011 to 2013, the number of kids who had never smoked conventional cigarettes but had tried electronic cigarettes tripled. That’s 250,000 young new users of nicotine products. They also report that in 2014, more teens used e-cigarettes than all other tobacco products. 
State legislatures are scrambling to keep up with the trend. Most states, including Texas, now prohibit sales of e-cigarettes to anyone under 18. In 2015, the Texas legislature put forth about a dozen proposals concerning e-cigarettes, including classifying them as hazardous substances and fining vendors who sell them to youth. There still are no restrictions, however, on advertising e-cigarettes, portraying them in movies, or flavoring them to appeal to children, measures that have been so important to anti-smoking efforts. 
What’s the big deal? Aren’t they safe – or at least safer than tobacco cigarettes? The short answer is no, they are not safe, and we really want to keep kids from all nicotine products. Nicotine itself is not only harmful but also highly addictive. It is particularly damaging to the developing brains of children and adolescents. The nicotine solutions for e-cigarettes also contain known toxins and carcinogens – not just “water vapor” as marketers would have us believe. Even worse, the vials of nicotine pose a hazard to unsuspecting small children. A single cartridge of e-cigarette solution, usually about ½ teaspoon of liquid, can be lethal to a child who drinks it. 
All of us—pediatricians, parents, teachers—have a responsibility to educate our kids about this sneaky new danger and to keep it from gaining an even stronger foothold in our communities. It’s unsafe, it’s addictive, and it’s marketed right at the young people we are trying to protect.
Dr. Suzanne Condron is a board-certified pediatrician at Kelsey-Seybold Clinic – Fort Bend Medical and Diagnostic Center whose clinical interests include obesity, nutrition, allergies, asthma, childhood development, literacy, infectious diseases and preventive medicine.
 State Advocacy Focus: E-Cigarettes. American Academy of Pediatrics. https://www.aap.org/en-us/advocacy-and-policy/state-advocacy/Documents/E-Cigarettes.pdf
 Legislative Report—Tobacco: Electronic cigarettes. http://www.cqstatetrack.com/texis/statetrack/insession/viewrpt/main.html?event=4d89ebee1d36
 AAP Section on Tobacco Control. Electronic Nicotine Delivery Systems. Pediatrics 2015; 138; 1018.