The substantial reduction in smoking in the United States represents one of the most important public health advances of the last 50 years. Among children and adolescents this progress has been particularly encouraging, with smoking rates declining among 8th-, 10th-, and 12th-grade students from 28.3% in 1997 to 5.4% in 2017.1 These positive trends suggest that the powerful appeal of tobacco and nicotine has been reduced in younger generations. However, emerging products such as JUUL, Suorin Air, Envii FITT, and MYLE, high-tech e-cigarettes capable of delivering nicotine at levels comparable to cigarettes, have the potential to undo years of progress if a new generation of young people becomes addicted to nicotine. An expert committee of the National Academy of Sciences, Engineering, and Medicine presented e-cigarettes as a safer alternative to cigarettes in a 2018 report, concluding, “There is conclusive evidence that completely substituting e-cigarettes for combustible tobacco cigarettes reduces users’ exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes.”2
Koval R, Willett J, Briggs J. Potential Benefits and Risks of High-Nicotine e-Cigarettes. JAMA. 2018;320(14):1429–1430. doi:10.1001/jama.2018.12328
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