By Wendy Sue Swanson, MD, MBE, FAAP |

Grim news out. E-cigarette use in teens has doubled in a year.

The CDC reports that 1 in 10 high school students admitted to ever using an e-cigarette in 2012. The rate of use doubled for middle school students as well. Although I’m not surprised, I remember just weeks ago tweeting about my dismay with Jenny McCarthy’s new job– advertising e-cigarettes. I took flak. Some advocates for e-cigs felt I was shortsighted and not valuing the potential benefits of these electronic nicotine-laden vapor tubes. All I could think of was her image, the lure she may create for teens, and the likelihood that teens would peek in on e-cigs with greater fervor.


Ever Electronic Cigarette Use ~ National Use Tobacco Survey, 2011-2012

Just a month ago we learned that smokeless tobacco use is steady with teens (5%) and many teens are now turning to novel sources of nicotine (dissolvable tobacco, snuff, snus) in addition to tobacco cigarettes. I consider myself fairly up to date, and until the AAP report came out in August I’d never once heard of snus. You?

Some people are wed to the concept that e-cigs may reduce the burden of illness and smoking-related morbidity from tobacco cigarettes. Even if you believe in harm-reduction for adults (switching from tobacco cigarettes to e-cigs to reduce use or quit) this is an entirely different issue for our middle and high-school students. A nice summary of the data for e-cigs from pediatrician, Dr Aaron E Carroll, with numerous associated comments helps frame the issue.

I wish I could remain agnostic about these devices, but I can’t. This is pretty easy to say:

I don’t recommend e-cigarettes for a teen.

Compare two stats: One in five adults who smoke has used an e-cig with one in ten of ALL high school students have tried an e-cig. Teens aren’t wired to conceptualize the power of nicotine addiction.

The e-cig really does feel like the gateway to the gateway drug.

There is still a lot of unknowns about e-cigarettes. More research will come out and the FDA is likely to regulate e-cig use shortly.

In the meantime, check in with your teens, look around, and I urge your to support regulation of e-cigs and advertising of e-cigs to teens. This just can’t be good.


Wendy Sue Swanson, MD, MBE, FAAP, author of Seattle Children’s Hospital Seattle Mama Doc Blog, is working to revolutionize health communications by using social media to bridge the gap between parents and doctors. As one of the first pediatricians to blog for a leading children’s hospital, she works diligently to offer patients and parents relevant, practical and timely health information in accessible formats. In October 2013, she founded the Center for Digital Health at Seattle Children’s Hospital in efforts to expedite implementation of digital technologies in health care delivery. Swanson now serves as the executive director.

Dr. Swanson believes that a growing community of online physicians can empower parents and patients to make informed decisions based on science. This new approach to medicine can morph the patient-doctor relationship into one that is more interactive and informed. Tackling issues from vaccines to work life balance, Dr. Swanson provides a voice of reason, not only as a pediatrician but also as a parent, helping parents gain clarity and eliminate fear when making decisions for their children.

Dr. Swanson is an executive committee member of the American Academy of Pediatrics Council on Communications and Media. She is also on the Board of Advisors for Parentsmagazine and is on the board for the Mayo Clinic Center for Social Media. She is a weekly medical contributor with NBC affiliate KING 5 News in Seattle and is a practicing pediatrician with The Everett Clinic. Dr. Swanson is an advocate on the topic of vaccines and she was named a CDC Childhood Immunization Champion in 2012. She was named to TIME Magazine’s Best Twitter Feeds of 2013.

Dr. Swanson graduated with Honors in Psychology from Kenyon College. She earned an MD and MBE (Master’s in Bioethics) at the University of Pennsylvania School of Medicine and then completed her residency at Seattle Children’s Hospital. In addition to her blog, she can be found on Twitter (@SeattleMamaDoc) and Facebook (www.facebook/seattlemamadoc).