Officials Crack Down on Nicotine Products

Tobacco product, electronic cigarette recommendations issued by the American Academy of Pediatrics

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) The American Academy of Pediatrics (AAP), a leading authority on children's health issues, is looking to clear the air on tobacco product use.

In a set of policy statements, the AAP has issued new recommendations to protect US children and teens from the harmful effects of tobacco and nicotine products.

In what may be the most striking recommendation, the AAP now says the minimum age to purchase tobacco products — including electronic cigarettes (e-cigs) — should be raised to age 21 nationwide. E-cigs are battery-powered devices that heat a nicotine solution the user inhales. Nicotine is the primary addictive chemical in tobacco.

"Tobacco use continues to be a major health threat to children, adolescents and adults," said Karen M. Wilson, MD, chair of the AAP Section on Tobacco Control, in a press release. "The developing brains of children and teens are particularly vulnerable to nicotine, which is why the growing popularity of e-cigarettes among adolescents is so alarming and dangerous to their long-term health."

The AAP's new recommendations are contained in three policy statements. In the first policy statement, the AAP urged the US Food and Drug Administration (FDA) to apply the same regulations to e-cigs and other electronic nicotine delivery systems (ENDS) that tobacco products already receive. This includes age restrictions, taxes, bans on advertising targeted at youth and bans on flavored products.

According to the AAP, it's imperative that policymakers at the international, national, state and local levels take action to protect children and teens from exposure to all tobacco products.

The AAP also called for mandatory child-resistant packaging on e-cig and ENDS products to protect children from ingesting liquid nicotine. According to the AAP, liquid nicotine is toxic. As little as half a teaspoon can be fatal to a toddler.

In 2014, there were more than 3,000 calls to US poison control centers for liquid nicotine exposure in children, according to the AAP.

In the second policy statement, the AAP called for smoke-free laws (designed to reduce secondhand smoke exposure) to be expanded to include e-cig vapor. According to the AAP, the vapor from e-cigs should not be considered harmless. It contains a variety of toxic chemicals.

Smoking and the use of any product that produces a toxic emission should also be banned from all workplaces, bars, restaurants and health care facilities, according to the AAP.

To reduce youth smoking and e-cig use, the AAP also called for price increases on these products.

In the third policy statement, the AAP gave clinical guidance to doctors in an attempt to curb e-cig, ENDS and tobacco product use among children and teens.

Pediatricians are recommended to screen children and teens for e-cigs and ENDS use, counsel parents and caregivers about strategies to reduce exposure to these products, and counsel children and teens about the potential harms and the importance of remaining a nonuser.

"ENDS use is rapidly increasing among youth and, according to the most recent data, ENDS are the most common tobacco product used among youth," read the statement. "The increasing use of ENDS among youth threatens five decades of public health gains in successfully deglamorizing, restricting, and decreasing the use of tobacco products."

According to the AAP, there is no safe level of tobacco use or tobacco smoke exposure.

These three statements were published Oct. 26 in the journal Pediatrics.

Review Date: 
October 21, 2015
Last Updated:
October 26, 2015