teen smoking e-cigarette
Addiction & Substance Overuse

New Policy Statements Urge Strong Regulations of E-Cigarettes

Parents and grandparents, take note! While adolescent use of tobacco has declined since the 1970s, e-cigarettes are threatening to addict a new generation to nicotine. In a comprehensive set of policies issued during its National Conference & Exhibition in October 2015 in Washington D.C., the American Academy of Pediatrics (AAP) presented extensive recommendations to protect our nation’s youth from the pernicious effects of tobacco and nicotine.

The AAP now strongly recommends the minimum age to purchase tobacco products, including e-cigarettes, should be increased to age 21 nationwide.

A release from the academy quotes Karen M. Wilson, MD, MPH, FAAP, chair of the AAP Section on Tobacco Control and section head of Pediatric Hospital Medicine at Children’s Hospital Colorado, as saying, “Tobacco use continues to be a major health threat to children, adolescents and adults. 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 dangerous to their long-term health.”

The AAP recommendations are contained in three policy statements announced on Monday, Oct. 26 and published simultaneously in Pediatrics. The statements outline recommendations for public policy changes, clinical guidance for physicians to counsel families on reducing exposure and dependence on tobacco, and recommendations for the regulation of e-cigarettes. A companion technical report provides a review of the scientific evidence that supports the recommendations.

The AAP urges the U.S. Federal Food and Drug Administration (FDA) to regulate e-cigarettes and other electronic nicotine delivery systems the same as other tobacco products. This includes age restrictions, taxes, bans on advertising to youth, and bans on flavored products that are particularly attractive to youth.

Child-resistant packaging is critically needed to protect curious young children from exposure to liquid nicotine, according to the AAP. Liquid nicotine is extremely toxic; as little as half a teaspoon can be fatal if ingested by an average sized toddler. In 2014, there were more than 3,000 calls to U.S. poison control centers for liquid nicotine exposure, and one toddler died.

The AAP recommends smoke-free laws that already govern secondhand smoke be expanded to include e-cigarettes. The aerosol emitted from e-cigarettes is not harmless; it contains a variety of toxic chemicals, including some carcinogens and significant amounts of nicotine. Parents should not use e-cigarettes around their children, according to the AAP.


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