E-cigarettes have eCigs-AmieVanderfordsurpassed tobacco cigarettes among teens for the first time, according to a national study.

The findings come from the University of Michigan’s Monitoring the Future study, which tracks trends in substance use among students in 8th, 10th and 12th grades. This is the first time the annual survey of 40,000 to 50,000 U.S. students included e-cigarettes, which many experts say are becoming the nicotine delivery device of choice.

“This survey’s statistics on kids and e-cigarettes should set off alarm bells at the Food and Drug Administration,” said American Heart Association CEO Nancy Brown, whose organization has urged the agency to regulate e-cigarettes. “A new generation of American teens is taking up nicotine via e-cigarettes, which remain unregulated. How many more of our children will fall prey to these high-tech devices before the FDA acts?”

E-cigarettes deliver a nicotine-containing aerosol popularly called vapor by heating a solution usually made of glycerin, nicotine and flavoring agents. They’re dangerous because they target young people, can keep people hooked on nicotine and threaten to “re-normalize” tobacco use, according to an American Heart Association’s policy statement.

Nine percent of 8th-graders reported using an e-cigarette in the past 30 days, while 4 percent reported smoking. In 10th grade, 16 percent said they used an e-cigarette and 7 percent reported smoking. And 17 percent of 12th-graders reported using an e-cigarette, with 14 percent smoking.

Only 15 percent of 8th-graders think regular use of e-cigarettes is harmful, according to the study, but 62 percent think smoking one or more packs of cigarettes a day can be harmful.

“As one of the newest smoking-type products in recent years, e-cigarettes have made rapid inroads into the lives of American adolescents,” said Richard Miech, a senior study investigator and research professor at the Institute for Social Research at the University of Michigan. “Part of the reason for the popularity of e-cigarettes is the perception among teens that they do not harm health.”

Use of tobacco cigarettes is at a historic low, but e-cigarettes are “the one fly in the ointment,” said Lloyd Johnston, principal investigator of the project and principal investigator at the Institute for Social Research at the University of Michigan.

One important cause of the decline in cigarettes is that many fewer young people today ever started smoking, according to the report. In 2014, only 23 percent of students had ever tried tobacco cigarettes, compared to 56 percent in 1998.

Research has shown that nicotine exposure enhances the rewarding effects of other drugs and could be a gateway drug, said Nora D. Volkow, M.D., director of the National Institute on Drug Abuse.

Experts don’t yet know if youths who use e-cigarettes exclusively later go on to become tobacco cigarette smokers, but the question is a concern for the health community. Cigarettes are the leading preventable cause of death, killing nearly half a million Americans a year and leaving 16 million others suffering from smoking-related illnesses.

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