Teen e-cigarette use tripled in the past year

Liz Szabo | USA TODAY

The percentage of teens using e-cigarettes tripled from 2013 to 2014, according to a new report from the Centers for Disease Control and Prevention.

Two million teens, 13.4% of high school students, used e-cigarettes in 2014, up from 4.5% in 2013 and 1.5% in 2011. Among middle schoolers, e-cigarette use rose from 1.1% in 2013 to 3.9% in 2014, representing about 450,000 students, the report says.

About one in four teens use tobacco in some form, from pipes to cigars to smokeless tobacco. Among high school students, 9.4% use a hookah, a tobacco pipe with a long tube that draws smoke through water.

High schoolers use e-cigarettes and hookahs more than conventional tobacco cigarettes, the CDC says. Among high school students, 9.2% smoked cigarettes in 2014.

Though e-cigarettes don't contain tobacco or create smoke, they usually contain addictive nicotine.

Nicotine can harm brain development in young people and get them addicted, according to the CDC. About 90% of smokers first tried cigarettes as teens.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the report's finding "stunning." He said it is a welcome sign of progress against tobacco, which kills 480,000 Americans a year, although he's concerned about teens using nicotine in any form.

"It represents a historic drop in cigarette use — the first time in history that we've seen cigarette use in high school youth below 10%," says Myers, who was not involved in the report. "At the same time, the explosive rise in e-cigarette use is a wake-up call."

Phil Daman, president of the e-cigarette industry group the Smoke-Free Alternatives Trade Association, agreed that the growing number of teens using e-cigarettes is "very concerning."

"We want to make sure that youth don't have access to these products," said Daman, whose group includes nearly 500 e-cigarette companies. "We've spent a lot of time and money lobbying in almost every state to ban sales to minors."

At least 42 states ban the sale of e-cigarettes to minors, according to the National Conference of State Legislatures. However, studies show teens can easily buy e-cigarettes online.

The Food and Drug Administration released proposed regulations for e-cigarettes one year ago. Some e-cigarette makers oppose regulating the products like tobacco. Many health advocates say the FDA proposal would not go far enough to protect children.

The FDA's proposed rules would ban e-cigarette sales to buyers under 18. They would not ban flavors such as bubble gum and cotton candy that make the products attractive to kids, said Chris Hansen, president of the American Cancer Society Cancer Action Network.

The FDA has not finalized its proposed regulations.

"Every day that passes without FDA acting creates a greater public health crisis," Myers said, noting that the FDA first announced its intention to regulate e-cigarettes in 2010. "Five years of bureaucratic delay is inexcusable."

The FDA is concerned about the "staggering increases in such a short time" in teen e-cigarette use, agency spokesman Michael Felberbaum says.

"Rulemaking is a complex process, and this particular proposed rule resulted in more than 135,000 public comments for the agency to review and consider," Felberbaum says. "FDA is committed to moving forward expeditiously to finalize the rule that will extend its authority to additional tobacco products such as e-cigarettes, cigars, pipe tobacco and other currently unregulated tobacco products."

Some former smokers say e-cigarettes helped them give up tobacco. Research does not clearly show whether using e-cigarettes helps smokers quit or merely prolongs their habit.

A study released this week by the University of California-San Diego found that smokers who have used e-cigarettes are 59% less likely to quit using cigarettes than smokers who have never used them. The study followed 1,000 Californians for one year.

Daman said e-cigarettes give people a safer alternative to tobacco.

"Maybe the reason the cigarette smoking rates (among teens) are so low is because there is an alternative for people," he said. "Anything that helps people avoid starting the very fatal habit of smoking, we're in favor of it."