If health care providers would prefer that pediatric patients inhale tar, carbon monoxide, particles of partially burned tobacco and paper, and thousands of chemicals that are created by the process of combustion along with their nicotine, then they need to dupe the kids into believing that e-cigarettes are no less hazardous than the real ones.
So far, there is absolutely no evidence that starting with e-cigarettes leads to tobacco use. Even the statistics that the CDC is providing about youth non-tobacco users taking up use of e-cigarettes is suspect. The CDC did not ask whether youth identified as non-tobacco users had switched to the e-cigarette and, as a result, no longer use tobacco products. The CDC described as "users" any youth who ever--at any time in the past--took so much as one puff. A more accurate descriptor of this group would be "experimenters." Only 2.2% of middle school and high school students were recent experimenters who had taken at least one puff within the 30 days before the survey. The CDC didn't even bother to find out (or, if it did, didn't bother to report) what percent of students are daily users.
If we are going to panic about acquiring addiction, daily users who never used tobacco in the past would be the group to worry about. How many of those are there? We don't know because surveillance isn't capturing this number. But since 90% of youth experimenting with e-cigarettes were current tobacco users, we can bet that the group of daily e-cigarette users who never used tobacco in the past will prove to be very, very small. And then this group would be further reduced by any member who was using a nicotine-free e-cigarette.
It is important to note that, although the CDC didn't provide the statistics until November 15--months after alarming the public about increased e-cigarette experimentation--smoking rates among middle and high school students continue to decline.
SAMHSA also reported a significant decline in smoking initiation rates among ages 12 to 17 years. So if there is a gateway, it appears to swing away from smoking. Let's not reverse that directionality.
Youth (correctly) believe e-cigarettes to be less harmful than conventional cigarettes. As long as youth continue to believe this truism, the direction of switching will continue to be away from real cigarettes toward the low-risk substitute. Kids are much smarter than many adults give them credit for.
But if, in a lame-brained attempt to scare kids away from anything that even looks like smoking, health providers claim that using an e-cigarette is no less harmful than smoking the real thing, the health providers remove a very important reason for sticking with the lower risk product. And sooner or later, the truth will out.
Let's not repeat the mistakes an earlier generation made with "...... Madness". When in the mid- to late-1960s, college age and high school kids figured out that their elders had been tremendously exaggerating the health hazards of ........., there was a veritable stampede to experiment with much more hazardous drugs ranging from ... to ...... and ........ That generation of kids reasoned, "If they lied about ........., they are probably lying about these other drugs."
If health providers are not scrupulously honest about providing accurate information to their patients (of any age), they run the risk of destroying trust and are likely to lose the opportunity to have a positive influence on the health of their patients.
