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What the FDA forgets in the battle against e-cigarettes

Charlene Gaw
Health Policy
December 20, 2018
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How can we forget John Bender from The Breakfast Club? How can we forget his tousled wave of chestnut hair, cutoff lumberjack shirt, emanating cool with a cigarette perpetually in hand? In light of the 78 percent rise in e-cigarette use by high school students this past year, what we cannot forget is how deftly he convinced his peers to smoke with him. While the dramatic announcement by FDA to regulate e-cigarette sales to teenagers is expansive in its reach and extremely important, we must not forget the power of peer and social media influence to educate our teens. For what significant change has ever been made without an accompanying social and cultural shift?

Let’s start this cultural wave against the rapidly growing e-cigarette usage ourselves. We can start with the basics — just what are e-cigarettes? While seven in ten teens are being marketed e-cigarettes, an alarming majority of teens are unaware of what they contain — 66 percent of teens believe that “just flavoring” is in their e-cigarette, and 13.7 percent of teens report they do not know what is in e-cigarettes. This is a massive information gap to be addressed.

Specifically, teens are more likely to use e-cigarettes than traditional cigarettes. After starting e-cigarette usage, teens are nearly four times as likely to start smoking as compared their non-user peers. E-cigarettes contain nicotine — a highly addictive substance that harms the adolescent brain at its most sensitive time, as it is undergoing maturation. The long-term adverse effects of e-cigarettes have yet to be determined. However, e-cigarettes contain harmful chemicals often found in traditional cigarettes, for which there is plenty of data on detrimental effects on one’s health. Not only are e-cigarettes addictive in the moment, but the damage inflicted has lasting effects on a teen’s life before she has even reached adulthood.

A promising venue to address teen use of e-cigarettes exists in social media. As a past teacher of the teenage population, I personally witnessed teens communicating endlessly and sharing lifestyle tips through Instagram and Snapchat, among other social media platforms. This is supported by research, with young adults self-reporting their greatest preference for information delivery via social media that communicates “concisely, with sources, [and] without authoritative tones.” To properly educate teens, let’s meet them where they are – 95 percent report they have access to a smartphone, and 45 percent say they are online “almost constantly.”

We can combine the power of social media with another significant predictor of future smoking behavior — peer influence and social acceptability. To be most effective, the social media targeting must offer a different social perception of smoking e-cigarettes from being “cool.” One suggestion is to recruit diverse groups of teens to share personal stories of why they choose not to smoke e-cigarettes. This recruitment and engagement process may begin in high school, an access point to most American teens.

What the FDA announcement is forgetting to do is call upon our citizens to use our voices to effect change. Never underestimate the power of your individual voice, my voice, and how our voices reverberate in our own circles. It is individual actions that cause collective change. Who is more convincing, an FDA add describing how “dangerous” e-cigarettes are or a word from a childhood friend of over 10 years? For our children, our future generation, let’s provide information for teens to make thoughtful decisions for themselves. Teenagers — please talk about e-cigarettes with your friends or share this on your Instagram and Twitter platforms. Parents, and other concerned citizens — start real conversations with high schoolers and remember that authoritative tones may only put them into detention with another John Bender.

Charlene Gaw is a medical student.

Image credit: Shutterstock.com

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What the FDA forgets in the battle against e-cigarettes
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