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    Should 16 be the age for e-cigarette purchases?


    Electronic cigarette (e-cigarette) use among adolescents—and liquid nicotine poisoning among children—is increasing, but a new report suggests that lowering the age to purchase e-cigarettes from 18 to 16 may help prevent traditional cigarette smoking.

    “Since e-cigarettes entered the US market in 2007, policy makers have been trying to figure out how to regulate them, given their potential health effects,” says lead author Abigail Friedman, assistant professor of health policy at the Yale School of Public Health in New Haven, Connecticut. “Current evidence indicates that e-cigarettes are not harmless, but that they are far less harmful than conventional cigarettes.”

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    Friedman’s research found that, in states with bans on e-cigarette sales to minors, downward trends in cigarette smoking have actually reversed.

    “State bans on e-cigarette sales to minors increase recent use of conventional cigarettes among 12- to 17-year-olds by 0.9%, relative to the states without these bans. The impact is not evident among older adolescents, and only present once the bans go into effect,” she says.

    Overall smoking rates, however, continue to fall in both types of states, Freidman reports.

    “Among adolescents, conventional smoking has been falling rather steadily for more than a decade. This downward trend is the product of many factors, not just e-cigarettes, and such drivers shift over time,” she says.

    The 0.9% increase is significant, because in the 8 years before the ban went into effect in the states studies, adolescent smoking rates were dropping by 1.3% every 2 years.

    “So a relative increase of 0.9% would counteract 70% of the expected decline in a 2-year period. Given the youth-population in states that implemented these bans during the study period, this finding suggests that tens of thousands of teenagers took up conventional cigarettes who would not have done so if their states had not instituted these bans,” Freidman says.

    The answer to how to improve this trend is not an easy one, Freidman says. Reversing existing bans could lead people in those 40 states that have already implemented bans to believe that e-cigarettes are safe, she explains. One suggestion may include changing the age restriction to 16 years rather than 18 years.
    Nicotine use is bad for adolescents, but conventional cigarettes appear far worse than e-cigarettes,” Friedman explains. “So we would like a policy that leads teenagers who are likely to smoke conventional cigarettes to choose e-cigarettes instead, without inducing nicotine use among teenagers who would not otherwise smoke. The fact that conventional smoking rates first spike at age 16 years suggests that one way to target e-cigarettes towards those at higher risk of cigarette use is to allow teenagers aged 16 years and up to purchase e-cigarettes, but retain the restriction for younger adolescents.”

    NEXT: The debate over e-cigarette regulation

    Rachael Zimlich, RN
    Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare ...


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