While major cities like New York, Chicago and Los Angeles have taken steps to ban the use of e-cigarettes in most public places, national authorities have done little to keep them out of the hands of children.
"E-cigarettes are easy to find, easy to use and easy to hide for far too many children in this country," said Amy Lukowski, PsyD, MPH, a psychologist at National Jewish Health in Denver, "and what's worse is that they are being marketed directly to adolescents."
Unlike the restrictions that have been placed on the marketing and advertising of tobacco products for decades, there are virtually no rules when it comes to e-cigarettes.
"We haven't seen a television commercial for a tobacco product since 1971, but suddenly e-cigarettes are everywhere," said Lukowski.
Not only are they on billboards and in magazines, but they're also being marketed on television and "directly to teenagers on social media," she said. "We are taking steps backwards by re-normalizing smoking," said Lukowski, "and if nicotine gets into the hands of adolescents, we have a real problem."
Critics often counter that not all e-cigarettes contain nicotine, and those that do contain it might actually be helpful to those who are trying to quit using tobacco.
"The problem is, there's no regulation as to the dose of nicotine that's in these products," said David Tinkleman, MD, medical director of the smoking cessation programs at National Jewish Health.
"Some electronic cigarettes deliver a very high content of nicotine - far, far higher than smoking several cigarettes," he said. In the hands of children that can be dangerous.
"There's a part of the brain that's called the limbic system that is very susceptible to the effects of nicotine, and it relates to behavior control as well as emotional development," said Tinkleman.
"Children who may become addicted early in life and use these products in a relatively high dose, and over a prolonged period of time during their adolescence, may in fact have life-long changes in their brain development," he said.
Because of that concern, Tinkleman is urging the Food and Drug Administration to take steps to keep e-cigarettes away from children.
"If the FDA is going to allow these products, I would like to see them regulate the dosage of nicotine that goes into them," he said. "I would also like to see an age limit of 21 for using them until we know more about them. Finally, regulations are needed around the advertising and marketing of these products, particularly as they relate to children," said Tinkleman.
"What I've seen is that the popularity of e-cigarettes is really out-pacing our knowledge," she said. "We don't know much about them still, but what we do know is that in just one year (2011-2012) the number of middle and high school students who tried e-cigarettes more than doubled to nearly two million" she said.
That's a frightening thought for Tinkleman.
"It doesn't take long from using these products and ingesting the nicotine to become addicted to them," he said. "Once that happens, you've got someone who becomes a user for a longer period of time, maybe even for life. So, we've got to do something to keep these out of the hands of children, and time is of the essence," he said.
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