Electronic cigarettes, or e-cigarettes as they are most commonly referred, are a relatively new alternative to traditional smoking. They have been steadily increasing in popularity the past couple of years. Because e-cigarettes are so new, little is known about the long-term effects of use. Initially, they were being marketed as a healthy alternative to help people quit traditional smoking. New research has experts wondering if instead of helping people quit their addiction to smoking, the novelty of the product is actually creating new smokers by making smoking socially acceptable again. Recent studies have some researchers believing that while they may not be as harmful as conventional cigarettes in terms of cancer-causing chemicals, they are far from safe to ingest. Additionally, they come with their own set of inherent risks. For that reason, doctors are reluctant to promote e-cigarettes as a smoking cessation aid. Pediatricians, in particular, are pushing for strict regulation of these products in an effort to keep them away from children.

E-cigarettes are also known as hookah pens, vape pens, or electronic nicotine delivery systems (ENDS). They typically resemble real cigarettes and are used in the same way. There is generally a tip that lights up when the e-cigarette is puffed and then a smoke-like cloud of vapor is taken in through the lungs and exhaled. The inside of the e-cigarettes is much different than traditional cigarettes. Each contains a battery, a heating element, and a cartridge that contains nicotine and other chemicals such as those that create smoke and add flavor. The American Academy of Pediatrics (AAP) is concerned that e-cigarette companies are specifically targeting a teenage market. The devices are appealing to children and adolescents because they come in a variety of colors and flavors.

According to a recent study from the Centers for Disease Control and Prevention (CDC), the amount of cigarettes smoked by adolescents has decreased in the last few years but the number of e-cigarettes smoked has increased. Though they do not have to, e-cigarettes often contain nicotine in liquid form. E-cigarettes are now the number one way adolescents ingest nicotine. Nicotine is extremely addictive and could become a gateway drug for conventional smoking or even smoking marijuana. The e-cigarette device can also be used to smoke marijuana. The AAP affirms, “e-cigarette use among teens is associated with a higher likelihood of using regular tobacco and lower rates of smoking cessation.”

The 2014 CDC survey also reported that 13.4 percent of high school students surveyed claimed they had vaped at least once in the previous 30 days. Even more surprisingly, 3.9 percent of middle school aged students admitted their use of e-cigarettes within the last month. Those numbers represent a 300 percent increase over what they were in 2013. Karen M. Wilson, chair of the AAP Section on Tobacco Control explains that “the developing brains of children and teens are particularly vulnerable to nicotine, which is why the growing popularity of e-cigarettes among adolescents is so alarming and dangerous to their long-term health.”

While all other tobacco products are subject to strict regulations, there are no current federal guidelines placed on e-cigarettes. The AAP came up with several potential guidelines for e-cigarettes during its national conference held this past October. Among these is the recommendation that the minimum age to purchase any tobacco products, including e-cigarettes, be raised to 21. They also urge the U.S. Federal Food and Drug Administration (FDA) to enforce the same regulations for e-cigarettes that they do for other tobacco products. This would mean that bans would be placed on the advertising of the product. In particular, they want to target ads aimed at children and adolescents. They also want to put a stop to using flavors like cotton candy or peanut butter cup in e-cigarettes to attract children. The AAP also calls for e-cigarettes to be subject to the same higher sales tax rate that other forms of tobacco have been taxed at for years.

The chance of a child using an e-cigarette and becoming addicted to nicotine is great cause for concern. But it is not the only risk associated with these smoking devices. The liquid nicotine inside of e-cigarettes is extremely toxic, and in some instances, deadly. Drinking just a half a teaspoon could be fatal to a toddler sized child. reported that a one-year-old toddler from upstate New York died from ingesting liquid nicotine in the fall of 2014. An even smaller amount can lead to serious illness for children, adults, or pets. For that reason, the AAP is also calling for child resistant packaging to be required on e-cigarettes and accessories that contain the toxic substance. Parents who smoke are advised to keep their devices out of reach of children. Proper disposal of e-cigarette cartridges is also important to avoid accidental ingestion.

Despite the obvious health risks, every year, new people start smoking. Nicotine is extremely addictive and the earlier a person begins the habit, the more likely they are to continue. U.S. News and World Report states the following statistics: “Addiction to nicotine usually starts early in life – about 90 percent of people who smoke cigarettes start before age 19. About three of every four teen smokers continue into adulthood.” This is why the AAP is endeavoring to raise the legal smoking age to 21. Those three extra years in which young adults would be prevented from walking into a store and easily purchasing tobacco products might be all the time they need to avoid the habit altogether. U.S. News and World Report went on to say that, “Adolescence is a crucial time for brain development. Research suggests that when nicotine addiction starts in adolescence (rather than at older ages), it’s harder to kick the habit.”

Using an e-cigarette, or vaping, is often touted as a healthier alternative to traditional cigarettes. E-cigarettes do not contain as many chemicals as regular cigarettes and they can be used with or without nicotine or tobacco. For this reason, a smoker could theoretically use the e-cigarette device to taper themselves off nicotine until they are no longer addicted. At the outset, these e-cigarettes were somewhat embraced by the medical community as a way to help wean people off traditional methods of smoking. However, the AAP states, “There is no scientific evidence that supports the efficacy or safety of e-cigarettes as a tobacco-dependence treatment product.”

The risks of first- and secondhand exposure to traditional tobacco smoke can no longer be denied. Smokers of cigarettes, cigars, and pipes are finding themselves unwelcome in restaurants, bars, even on city streets. E-cigarettes are a high-tech attempt to satisfy smokers’ cravings while reducing the risks involved in smoking or being around smokers. Despite initial claims, these devices are not harmless, especially not in the hands of children whose brains are still developing. Even if used without nicotine, these devices can instill a habit in users that can last a lifetime and lead to other, more dangerous activities. It is important to educate children to the risks involved in using e-cigarettes. Parents who smoke should try their hardest to quit and until they do, they should keep their devices locked up where children and teenagers can’t get to them.