By Mark Gold, MD
Electronic cigarettes (e-cigarettes) are the most commonly used nicotine-delivery product among US youth and their popularity is rising - 1 in 5 high school students currently use them. Until recently, there were few regulations on how companies that sell e-cigarettes can market and sell them - although companies claim that the product was made for and is marketed to adults, there has been a major uptick in use. Aggressive marketing campaigns that position e-cigarettes as a safe alternative to smoking have worked, convincing adults and youth that e-cigarettes are harmless. Because they are new to market, E-cigarette companies can also employ types of marketing strategies that are forbidden to traditional cigarette companies due to their efficacy among adolescents, such as sponsoring film and music festivals. E-cigarettes, also called vapes, vape-pens, and e-hookahs, can be filled with tobacco products that are far more addictive than cigarettes due to their much higher nicotine concentration. Instead of being packed with tobacco, e-cigarettes use cartridges that are filled with liquid that can deliver a much higher dosage of nicotine. These cartridges can also be filled with cannabis.
The rising number of students using e-cigarettes and the high co-occurring use of cannabis and tobacco products, has prompted concern, and regulatory agencies such as the FDA are working to create new regulations that will help inform adolescents on the dangers of vaping and protect them from e-cigarette advertisements in the same way they are protected from traditional tobacco products advertisements. Trivers and colleagues from the Centers for Disease Control (CDC) have analyzed the 2016 National Youth Tobacco Survey (NYTS) to reveal the trends of e-cigarette and cannabis use in school-aged teenagers.
8.9% of all students had ever used cannabis in an e-cigarette in 2016 - that’s almost 1 in 11 students.
*1 in 3 high school students, and nearly 1 in 4 middle school students, that had ever used e-cigarettes had also used cannabis in an e-cigarette.
People who already used e-cigarettes to consume other nicotine and non-nicotine substances were more likely to use cannabis in an e-cigarette.
What Effect Does Smoking Cannabis in E-cigarettes Have on Health?
E-cigarettes, contrary to popular belief, can be harmful to a person’s health, according to the US Surgeon General’s Advisory on E-cigarette Use Among Youth. Cigarette aerosol can contain carcinogenic compounds and even formaldehyde - very harmful chemicals that can put the user at a higher risk of organ failure or developing cancer.
Cannabis use in youth can have harmful effects on the memory and learning, even impairing later achievement in education - when consumed via e-cigarette, the health risks of both e-cigarettes and cannabis compound each other. Using nicotine and cannabis products in adolescence also makes a person more likely to develop a substance use disorder in life.
Looking to the Future
E-cigarettes are harder to detect than many other forms of cannabis consumption, and easier to purchase - anyone can get one online with a credit card. A lack of knowledge among the adults in these students’ lives may make the use of e-cigarettes and the consumption of nicotine and cannabis more accessible to teenagers. When parents and educators are unaware of the dangers e-cigarettes pose to health, they are unable to adequately educate their teens, and they are also unable to recognize use as it happens.
We need to increase awareness among students, their educators, providers, and parents in order to help foster an understanding of the potential health risks and repercussions the use of e-cigarettes to consume cannabis can cause.
To determine what trends exist among students, data from the NYTS school survey were analyzed. A total of 20,675 students participated in this survey to create a representative cluster of students attending public and private secondary schools.
Trivers, K.F., Phillips, E., Gentzke, A.S., Tynan, M.A., Neff, L.J. (2018). Prevalence of Cannabis Use in Electronic Cigarettes Among US Youth. Atlanta, GA; JAMA Pediatrics
Dr. Mark S. Gold is a teacher of the year, translational researcher, author, mentor and inventor best known for his work on the brain systems underlying the effects of opiate drugs, cocaine and food. Read more by Dr. Gold here.