Electronic cigarettes present a conundrum for public health officials. On the one hand, they contain fewer — or perhaps even none — of the cancer-causing substances found in tobacco products “which presents an opportunity for harm reduction if smokers use them as substitutes for cigarettes,” according to the American Heart Association in a new recommendation issued last Monday. The group recommended that doctors should counsel patients to use e-cigarettes when other smoking cessation approaches fail. On the other hand, teens who would never dream of smoking regular cigarettes have been puffing away on vaporized nicotine from e-cigarette cartridges — and some may eventually turn to regular cigarette use as a result.


The latter concern has tipped the balance against e-cigarette use for many of the nation’s health leaders who view them more as a toy for teens than as a legitimate smoking cessation tool on par with nicotine patches, gum, and lozenges, which are regulated by the US Food and Drug Administration as medical products.

In fact, more than a quarter of a million teens who had never smoked a cigarette used electronic cigarettes in 2013, according to national survey data that was published last week by Centers for Disease Control and Prevention researchers. This compares to 79,000 non-smoking teens who reported using e-cigarettes in a 2011 National Youth Tobacco survey.