Electronic cigarette use

Although cigarette smoking is the most common form of tobacco use worldwide, considering only this may lead to an underestimation of current nicotine consumption because of the growing use of alternative products and new nicotine delivery technologies.

The new ESPAD data revealed a high prevalence of e-cigarette smoking among adolescents: 40% for lifetime use and 14% for last-month use. In particular, those who have never smoked cigarettes (‘never smokers’) reported higher rates of this behaviour than ‘occasional smokers’ and ‘regular smokers’. Moreover, 11 % and
1.7 % of the students reported first use and daily use at age 13 or younger, respectively.

Although there is currently no scientific agreement on whether or not electronic nicotine delivery systems can be a gateway to tobacco smoking, the ESPAD results suggest that a substantial proportion of the adolescent population that uses e-cigarettes does so without previous experience of traditional cigarette smoking.

E-cigarette use among adolescents is a concern because the extent of any possible adverse health effects is not well understood; there is an ongoing debate about both the relative benefits and risks and the possible long-term health implications of using these products.

Although the study did not investigate the contents of e-cigarettes, it is likely that a high proportion of these devices include nicotine and that overall adolescent nicotine use could be rising again. This issue calls for further investigation given the potential for public health consequences.