Laird Harrison

November 04, 2016

SAN FRANCISCO — About half of adults don't know that e-cigarettes pose a risk to children through aerosols and residue on surfaces, a new survey shows.

"There are lots of misconceptions and outright falsehoods," said Robert McMillen, PhD, from the American Academy of Pediatrics (AAP) Julius B. Richmond Center of Excellence in Elk Grove Village, Illinois. Dr McMillen presented the finding here at the AAP 2016 National Conference.

The use of e-cigarettes is increasing, Dr McMillen reported, with a leap in the proportion of people who had ever tried them, from 1.3% in 2010 to 13.0% in 2013, and in the proportion of people who were using them, from 0.3% in 2010 to 6.8% in 2013.

Previous research has shown that e-cigarette aerosols contain harmful ingredients. "The toxins are not simply nicotine; there are other chemicals," said Dr McMillen. "A lot of the flavors in e-cigarettes are considered to be unsafe for consumption."

To see whether this information is guiding the way people use e-cigarettes, Dr McMillen and colleagues analyzed responses from the Social Climate Survey of Tobacco Control.

The survey was administered in 2015 to a nationally representative sample of 3070 adults.

The responses suggest some confusion, with only 37.1% saying they believe that e-cigarette "vapors" contain nicotine and leave nicotine deposits on surfaces. Most of the others said they "don't know."

Many people refer to the aerosols from e-cigarettes as "vapor," although they are not technically vapors, said Dr McMillen. And they refer to inhaling these aerosols as "vaping."

Asked if using e-cigarettes around children exposes the children to nicotine, 44.3% responded affirmatively, but 46.1% said they didn't know.

The uncertainty is reflected in responses to questions about the use of the e-cigarettes at home.

Percentage Prohibiting e-Cigarettes at Home

Overall 67.9
e-cigarette user 14.8
Nonuser 72.0
Less than high school education 46.9
High school education 60.5
College or more 76.2
A child at home 75.1
No child at home 64.2


The responses were similar when respondents were asked about allowing e-cigarette use in vehicles.

The survey showed that 83.7% supported a prohibition on the use of e-cigarettes in places where tobacco smoking is already not allowed. And 73.8% said that it is not acceptable to use e-cigarettes in front of children.

These responses suggest that many kids are exposed to the toxins from e-cigarettes, said Dr McMillen.

"Very young children crawl on surfaces, they put their hands in their mouths, and that's the group we're most concerned about," said Dr McMillen. "There is potential to educate parents about the harm."

Session chair Judith Groner, MD, from Columbus, Ohio, agreed that pediatricians should warn caregivers about using e-cigarettes. "Because we don't know enough about it, we should not assume that it's safe," she told Medscape Medical News. "Children are especially vulnerable because they're small."

When talking to caregivers, she advised that pediatricians use the word "vaping" instead of "smoking" because e-cigarette users don't consider what they are doing to be smoking.

The study was funded by grants from the Flight Attendant Medical Research Institute and the Truth Initiative to the American Academy of Pediatrics Julius B. Richmond Center of Excellence. Dr Groner and Dr McMillen have disclosed no relevant financial relationships.

American Academy of Pediatrics (AAP) 2016 National Conference: Abstract 319042. Presented October 22, 2016.

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