E-Cig, Marijuana Risks Unclear to Teenagers

Marcia Frellick

June 23, 2015

Teenagers are clear on the dangers of cigarette smoking, but the messages they get about e-cigarettes and marijuana come less often and are often incorrect, according to a small study by researchers at the Stanford University School of Medicine in California.

Lead author Maria Roditis, PhD, a postdoctoral scholar in adolescent medicine at Stanford, and Bonnie Halpern-Felsher, PhD, professor of pediatrics in adolescent medicine at Stanford, studied 24 adolescents (nine girls, 15 boys) who attended high school in a Northern California school district known to have high rates of substance use.

They asked the students in small-group discussions about the risks and benefits of cigarettes, e-cigarettes, and marijuana and how they learned about these products. The findings were published online June 23 in the Journal of Adolescent Health.

When asked about benefits, the teenagers listed only "relaxation" as a benefit of smoking cigarettes. They also mentioned several negatives such as yellowed teeth, bad breath, disease risk, and social disapproval. However, for marijuana, they listed getting high as a benefit and saw it as less addictive than tobacco. They also said marijuana has benefits in relieving stress and reducing pain. In addition, teenagers stated e-cigarettes had a number of benefits, including making you look good and being good for you.

Teenagers need to hear a strong message from care providers, schools, parents, and the media about marijuana and e-cigarettes that includes the addictive potential of both products; the risks of smoking any form of plant matter, which is similar between traditional cigarettes and marijuana; that e-cigarettes contain nicotine; and that flavorants in e-cigarettes may raise the risk for obstructive lung disease, the authors write.

Information Sources Vary

Sources of information reported by the students varied for the three products. For cigarettes, the messages came primarily from parents, teachers, and the media. Marijuana information often came from peers, along with pressure to use it, and the teenagers got little information anywhere about e-cigarettes, with some of it coming from relatives using them to try to quit traditional cigarettes.

The authors write, "[A] lack of information regarding e-cigarettes and marijuana may be resulting in a false sense that these products are risk free, especially when contrasted with the vast amount of messages regarding risks of conventional cigarettes."

Knowing the risks may help stem the rise in use of e-cigarettes and marijuana, the authors say.

Although the numbers of teenagers smoking cigarettes has stayed the same or declined over the years, the numbers using marijuana in this age group are rising, and e-cigarette use is soaring.

A recent study from the Centers for Disease Control and Prevention shows that middle and high school students' use of e-cigarettes tripled from 2013 to 2014, bumping them up to the most commonly used tobacco product in this age group.

Clinicians should talk with their adolescent patients about the risks of all three products, the authors conclude.

"Students hear a lot of talk about conventional cigarettes, some about marijuana and very little about e-cigarettes," Dr Halpern-Felsher said in a university news release. "That gap needs to be filled in classrooms and by health-care providers, parents and the media. We don't want to leave one product behind and leave teens with the impression that, 'Maybe this is the product I can use.' "

The study was funded by National Cancer Institute and California's Tobacco-Related Disease Research Program. The authors have disclosed no relevant financial relationships.

J Adolesc Health. Published online June 23, 2015. Abstract


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