Surgeon general to healthcare professionals: Ask kids about e-cigarette use

Surgeon General Jerome Adams, M.D., issued an advisory warning about the health risks to kids of e-cigarettes. (Getty Images)

With e-cigarette use doubling among high school seniors in the last year alone, the U.S. surgeon general issued a rare advisory warning (PDF) on Tuesday about the health risk to kids. 

Surgeon General Jerome M. Adams, M.D., said e-cigarette use among youth has become an epidemic in the U.S. He called on parents, teachers and healthcare professionals to take aggressive steps to keep kids from using the increasingly popular vaping products that could get them addicted to nicotine.

As the nation’s doctor, Adams said he was using his bully pulpit to advise healthcare professionals to ask about tobacco use when seeing young patients, including the use of e-cigarettes.

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Jerome Adams, M.D. (PHSCC)

He also urged doctors and other healthcare providers to educate themselves about e-cigarette products and their use.

“Do you even know what to ask them about?” he asked.

Healthcare professionals can also help by talking to patients’ parents and asking if they are talking to their kids about the health dangers of e-cigarettes, Adams said.

To help healthcare providers talk to kids about the risks, the government has created a “conversation card” (PDF) and provided other resources at

“We’ve seen this play before,” Adams said, about the challenge of communicating the risk of e-cigarette use to kids. For generations, the tobacco industry made smoking appear cool and safe, he said, recalling an old cigarette ad that said 9 out of 10 doctors recommended a particular brand. While kids now recognize the health risks of smoking traditional cigarettes, “they think e-cigarettes are both cool and safe,” he said.

In a survey earlier this year, U.S. physicians said they worry the products may get a new generation addicted to nicotine as their popularity grows with teens. While e-cigarettes may help adults quit smoking, 3% of adults are using the devices and 20% of high school students, Adams said.

He was joined at the press conference by Sarah Ryan, a high school student from Holbrook, Massachusetts, who has been a leader in anti-vaping efforts. “The use of e-cigarettes has exploded in my town,” Ryan said.

Vaping is ingrained in the high school culture, she said, with kids using e-cigarettes in school bathrooms and even during class. Kids don’t realize many e-cigarettes contain nicotine, she said. Among younger students, candy-flavored e-cigarettes are the most popular, while fruit-flavored products are popular with older students, she said.

Department of Health and Human Services (HHS) Secretary Alex Azar, who kicked off the press conference, said the country has never seen such an increase in the use of a substance by young people as it has with the historic increase in e-cigarette use. He said action must be taken to prevent vaping brands from addicting a new generation of teens.

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According to data from the Centers for Disease Control and Prevention and the Food and Drug Administration’s National Youth Tobacco Survey, the percentage of high school-age children reporting past 30-day use of e-cigarettes rose by more than 75% between 2017 and 2018. Use among middle school-age children also increased by nearly 50%.

Data from National Institutes of Health’s Monitoring the Future survey also show that America’s teens reported a dramatic increase in their use of e-cigarettes in just a single year, with 37.3% of 12th graders reporting use in the past 12 months, compared to 27.8% in 2017.

Food and Drug Administration Commissioner Scott Gottlieb, M.D., also said at the press conference, his agency would continue to take enforcement measures to stop convenience stores from selling electronic cigarettes to kids. He said his agency will not stand for another year of unprecedented, historic growth in e-cigarette use among young people.

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