The American Academy of Pediatrics (AAP) has issued a set of new policy statements that urge raising the legal age for purchasing tobacco products from 18 to 21 nationwide. Published online Oct. 26 in the journal Pediatrics and presented at the AAP’s national conference in Washington, DC, the statements on age restriction also call for strong regulation of e-cigarettes.
“Tobacco use continues to be a major health threat to children, adolescents and adults,” co-author Karen Wilson, MD, MPH, chair of the AAP Section on Tobacco Control and section head of Pediatric Hospital Medicine at Children’s Hospital Colorado, said in an AAP news release. “The developing brains of children and teens are particularly vulnerable to nicotine, which is why the growing popularity of e-cigarettes among adolescents is so alarming and so dangerous to their long-term health.”
The effect of nicotine on developing brains is one of the main reasons the AAP is recommending raising the legal age to purchase tobacco. Both cigarettes and e-cigarettes have neurotoxic effects and earlier exposure makes younger users more vulnerable to addiction. According to the Centers for Disease Control and Prevention (CDC), 90 percent of current smokers took up tobacco products before they were 18.
Health experts are particularly concerned that e-cigarettes are threatening to addict a new generation of smokers. The CDC reports that in 2014, more young adults reported using e-cigarettes than any other tobacco product. And while e-cigarettes are marketed as a tool to help smokers quit, some research suggests the devices may actually be a gateway to conventional cigarettes, especially among teens.
“There’s a lot we don’t know about e-cigarettes,” Claire McCarthy, MD, a primary care pediatrician at Boston Children’s Hospital and an assistant professor of pediatrics at Harvard Medical School, told CBS News. “We need more research before we can say for sure that e-cigarettes can be useful for people trying to kick the smoking habit. And we don’t have a lot of good information about the effect of e-cigarettes on youth, because they haven’t been around very long,” added McCarthy, who was not involved in the study.
The AAP called for e-cigarettes and all other electronic delivery systems such as e-hookahs to be regulated the same as other tobacco products, with measures that include age restrictions, taxes, bans on advertising to youth, and bans on flavored products that are particularly attractive to young people. In addition, the group emphasized the importance of child-resistant packaging of electronic tobacco products to protect very young children from liquid nicotine poisoning. According to the study authors, as little as half a teaspoon can be fatal if swallowed by an average sized toddler.
Other AAP recommendations include smoke-free laws that already exist be expanded to include e-cigarettes and bans on advertising to kids and teens. The new policies also advocate promoting smoke-free homes and vehicles.
Addressing its constituency, the AAP recommended that pediatricians counsel parents and caregivers who smoke about quitting. They also urge physicians to talk to their young patients about the dangers of tobacco use before they begin to experiment with smoking.
“Tobacco is unique among consumer products in that it severely injures and kills when used exactly as intended,” the AAP policy states. “Protecting children from tobacco products is one of the most important things that a society can do to protect children’s health.”