The CDC released their latest Morbidity and Mortality Weekly Report (April 17, 2016) and findings were mixed. The smoking of tobacco cigarettes, cigars and smokeless tobacco among Middle and High School students continues to drop. This is good news, because tobacco use and addiction most generally begin during teen and young adulthood and research is clear that youth use of tobacco in any form, whether it be combustible, noncombustible, or electronic, is unsafe.
On the other hand, the report shows alarming increases in the number of HS students who said they used an eCig at least once in the last month — increasing to 16 percent in 2015 from 1.5 percent in 2011. There was a statistically significant and massive increase in the number of MS students using eCigs as well — leaping from 0.6 percent in 2011 to 5.3 percent in 2015. Additionally, the use of hookahs nearly doubled among HS students to 7.2 percent from 4.1 percent. Hookah use doubled among MS students between 2011 (1%) and 2015 (2%).
CDC researchers point out that regardless the mode of delivery, nicotine exposure during adolescence, a critical time for brain development, might have lasting adverse consequences for brain development, causes addiction, and might lead to sustained use of tobacco products. Rapid changes in use of traditional and emerging tobacco products among youths underscore the importance of enhanced surveillance of all tobacco use.
The illustration below shows how tobacco cigarettes, cigars, smokeless tobacco use have decreased in high school students since 2011. Yet the explosion in eCig and Hookah experimentation led overall tobacco use in high school teens to jump significantly.
National Youth Tobacco Survey, United States, 2011–2014
A young athlete I train recently asked me whether eCigs are safe. He told me a number of athletes at his high school have begun using “vape” products, as they believe nicotine is beneficial for them and they consider eCigs not to be harmful since they’re not burning and smoking the tobacco leaf. This is an excellent question. How does one answer a curious teen?
I told him the truth — yes, no and I don’t know. Confusing? Exactly! YES, it’s great his friends are shunning smoking tobacco. We all agree this is positive. NO, many people who experiment with vaping soon start smoking traditional cigarettes due to the intense power of nicotine addiction. Finally, I DON’T KNOW, as the research about the safety of eCigs remains undetermined today. There are many chemicals in a common “vaping” solution and some have led to PopCorn Lung.
Diacetyl, a flavoring chemical linked to cases of severe respiratory disease, was found in more than 75% of flavored electronic cigarettes and refill liquids tested by researchers at Harvard T.H. Chan School of Public Health. Two other potentially harmful related compounds were also found in many of the tested flavors, which included varieties with potential appeal to young people such as Cotton Candy, Fruit Squirts, and Cupcake. 
According to the Harvard study, the condition otherwise known as bronchiolitis obliterans was colloquially termed “Popcorn Lung” because it first appeared in workers who inhaled artificial butter flavor in microwave popcorn processing facilities. Popcorn Lung is a debilitating and irreversible respiratory disease which causes “scarring in tiny air sacs in the lungs that lead to excessive coughing and shortness of breath” similar to that seen in people with chronic obstructive pulmonary disease.
Lungs are a terrible thing to waste! Let’s educate our youth and teens to this growing social concern. Let’s demand better regulation of eCigs and limit access until society has a better understanding of these complex chemicals. Don’t be afraid to tell your children the truth … even if it is Yes, No and I Don’t Know. Your kids will appreciate your honest. My young athlete-in-training sure did.