The U.S. surgeon general on Thursday called for action to reduce the use of e-cigarettes among young people, noting they have overtaken cigarettes to become the most commonly used tobacco products among this group.
The nation's top doctor, Vivek Murthy, weighing in on the subject for the first time since e-cigarette use took off, said young people are more vulnerable to the negative consequences of nicotine exposure than adults.
"These effects include addiction, priming for use of other addictive substances, reduced impulse control, deficits in attention and cognition, and mood disorders," he said in a preface to the report.
The report recommends that e-cigarettes be incorporated into existing smoke-free policies, including preventing youth from accessing e-cigarettes, implementing price and tax policies that discourage use and encouraging federal regulation of e-cigarette marketing.
"We know a great deal about what works to effectively prevent tobacco use among young people," the report says. "Now we must apply these strategies to e-cigarettes."
The report is likely to infuriate those who argue that e-cigarettes are considerably less dangerous than cigarettes and that a refusal to recognize that removes an opportunity to help reduce the burden of death and disease from smoking.
Between 2011 and 2015, use of e-cigarettes among U.S. middle school students rose to 5.3 percent from 0.6 percent, according to the Centers for Disease Control and Prevention.
But as use of e-cigarettes has risen, traditional smoking has gone down. Between 2011 and 2015 the use of combustible cigarettes among U.S. middle school students fell to 2.3 percent from 4.3 percent.
E-cigarette use among high school students rose to 16 percent in 2015 from 1.5 percent in 2011. Over the same period, 9.3 percent of high school students reported smoking traditional cigarettes compared with 15.8 percent in 2011.
There is no proof that the drop in cigarette smoking was caused by increased e-cigarette use. Neither is there conclusive data to support claims that e-cigarettes are a gateway to the use of regular cigarettes.
"More studies are needed to elucidate the nature of any true causal relationship between e-cigarette and combustible tobacco product use," the report said.