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Fewer U.S. teens are smoking cigarettes, but more are getting a nicotine fix from hookahs and electronic cigarettes, the Centers for Disease Control and Prevention reports today.
Overall tobacco use among middle- and high school students last year — 6.7% and 23.3%, respectively — was about one percentage point lower than in 2011, mostly due to a decline in teens smoking cigarettes, according to CDC's analysis of the 2012 National Youth Tobacco Survey.
Yet the survey, which queried 24,000 sixth- through 12th-graders, found a notable increase in those who've used hookahs, also known as waterpipes, and e-cigarettes — both of which aren't federally regulated and taxed as are cigarettes. Last year, about 5.4% of high school students said they used hookahs at least once a month, up from 4.1% in 2011, and 2.8% tried e-cigarettes, up from 1.5%.
The CDC attributed the increase to lower prices for these products as well as their increased marketing and availability, and the perception that they are safer alternatives to cigarettes. It also found a slight uptick in high school students who smoked pipes and cigars, including the little ones that look like cigarettes but cost a lot less and come in candy flavors.
"This report raises a red flag about newer tobacco products," said CDC Director Tom Frieden in announcing the findings. "Cigars and hookah tobacco are smoked tobacco – addictive and deadly. We need effective action to protect our kids from addiction to nicotine."
Unlike cigarettes, these products are not regulated by the Food and Drug Administration, which has said it plans to expand its authority to include e-cigarettes and other tobacco products. E-cigarettes don't burn tobacco, but users inhale a liquid that contains nicotine, which is derived from the tobacco leaf.
"These findings show why it is urgent that the FDA move forward with plans to regulate all tobacco products, including cigars and e-cigarettes," said Susan Liss, executive director of the National Campaign for Tobacco-Free Kids.
Many large e-cigarette manufacturers, including NJoy, say they don't object to some FDA regulations such as limiting sales to minors, but they argue that their products don't pose the same health risks as cigarettes and should have different rules. Health groups says more study is needed to assess risks.
The CDC report, published in this week's Morbidity and Mortality Weekly Report, reported that 14% of high school students smoked cigarettes last year, down from 15.8% in 2011 and 28% in 2000. It notes that smoking remains the leading cause of preventable death and disease in the United States, and nearly 90% of adult smokers began smoking by age 18.