The anti-e-cigarette camp

Critics point out e-cigarettes come in kid-friendly flavors such as gummy bear, atomic fireball candy and cookies and cream. It makes them worry that e-cigarettes will become a gateway to encourage kids to develop a lifelong nicotine addiction - or worse, try the real thing.

Only about 20 states specifically forbid the sale of e-cigarettes to children.

Tobacco use has been on the decline with kids; it’s about half what it was in the mid-1990s. But the latest CDC study shows a growing number of middle and high school students have tried e-cigarettes.

One in 10 high school students surveyed said they had tried e-cigarettes last year. That’s double the number from 2011. One high school in Connecticut banned them after the principal said administrators dealt with at least one incident involving e-cigarettes every day.

CDC director Tom Frieden characterized this trend as “deeply troubling.”

But as far as risky behavior goes, it’s still a tiny fraction of students. The survey showed about 3% of these kids said they had used one in the last 30 days. By contrast, 39% of students said they drank some amount of alcohol in the past 30 days, 22% binge drank and 24% rode with a driver who had been drinking.

The real problem is that 88% of adult smokers who smoke daily said they started when they were kids, according to the CDC. Kids who start down the path to using e-cigarettes may stick with them for life.

“So much is unknown about them and what the long-term complications could be with their use,” said the American Lung Association’s Erika Sward. “Bottom line, we don’t know what the consequences of using them are, and we are very troubled that kids would find them attractive.”

E-cigarettes are unregulated in the United States; no laws make manufacturers tell you what you are actually inhaling. The unknown is one of the many qualities of e-cigarettes that the American Lung Association doesn’t like.

It’s “a complete unregulated Wild West,” Sward said. She wants the FDA to move quickly with regulatory oversight, which she says would make manufacturers disclose what the actual ingredients are in each of the 250 or so brands available.

In 2009, a FDA test on a small number of e-cigarette samples found “detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed.” They found diethylene glycol in one cartridge at a 1% level; this is an ingredient used in antifreeze and can be toxic to humans in large quantities. Diethylene glycol is also found in some dental products and in some pharmaceuticals.

After that study, the FDA banned the sale of e-cigarettes. They warned e-cigarette smokers that they were inhaling “toxic” and “harmful” chemicals. However, in 2010, a court ruled that “the FDA had cited no evidence to show that electronic cigarettes harmed anyone,” and stores could go on selling them.