USC contributes to surgeon general’s first report on e-cigarettes and youth

U.S. Surgeon General Vivek Murthy has released a new report calling e-cigarettes “a major public health concern.”

“E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General,” the first comprehensive review on this public health challenge from the nation’s highest public health authority, features input from USC faculty.

The Dec. 8 report offers insights into youth e-cigarette use, which has more than tripled since 2011, and outlines dangers to which young people are uniquely vulnerable.

While recognizing the need for further research, the report finds that the aerosol inhaled by e-cigarette smokers may cause mood disorders, deficits in attention and cognition, and addiction to nicotine — and may also be harmful secondhand to non-users.

USC Distinguished Professor Jonathan Samet, director of the USC Institute for Global Health, contributed to the development of the chapter on e-cigarette policy. Samet is an expert in tobacco and public health and holder of the Flora L. Thornton Chair of the Department of Preventive Medicine at the Keck School of Medicine of USC. He was the senior scientific editor of the 2014 surgeon general’s report “The Health Consequences of Smoking — 50 years of Progress.”

The new report on e-cigarettes extensively cites research by USC faculty in the Department of Preventive Medicine. Their most recent study published in JAMA last month found that adolescents who regularly vape have a higher risk of more frequent and heavy smoking six months later.

An age of misinformation

Research is underway at USC and other institutions to better understand the health effects of e-cigarettes. However, it will be years before scientists can fully understand the risks because the products and patterns of usage are changing rapidly. In the meantime, Samet said he urges people not to assume that e-cigarettes are safe.

I concur with the surgeon general on the need for protecting adolescents and young adults from using tobacco products.

Jonathan Samet

“The scientific story is still incomplete for e-cigarettes and we are living in an age of misinformation,” Samet said. “The benefits of e-cigarettes for harm reduction and smoking cessation have been exaggerated by some, and I concur with the surgeon general on the need for protecting adolescents and young adults from using tobacco products.”

The report outlines ways to control young people’s use of e-cigarettes. It calls for increased tobacco-related surveillance; tactical and comprehensive research; strategies to protect youth; and other actions modeled after proven tobacco control methods. These include incorporating e-cigarettes into smoke-free policies, preventing adolescents’ access to e-cigarettes, taxation, regulation and more.

In November, the chief executive for Philip Morris International, the world’s largest global tobacco company outside of China, indicated that the company would eventually stop selling cigarettes in favor of alternative products.

But this shift is more concerning than comforting to researchers, given the risks to youth and their high exposure to e-cigarette advertising.

“It’s an entire renormalization of that imagery, of that advertising and marketing that we had worked for decades to take out of the public space,” said Heather Wipfli, associate director of the USC Institute for Global Health, in The Christian Science Monitor. Ranking e-cigarettes as safer than deadly cigarettes sets a low bar for health standards and is misleading, she said.

Samet and Professor Maryann Pentz lead the USC Tobacco Center of Regulatory Science (TCOR) for Vulnerable Populations, one of 14 centers in the United States conducting research to inform the U.S. Food and Drug Administration. The surgeon general’s report referenced findings from three USC TCORS studies.

“Thanks to the multidisciplinary strength of our researchers, USC is emerging as a leader in e-cigarette research,” said Rohit Varma, dean of the Keck School of Medicine. “We’re approaching this from every angle — from the clinical to the behavioral.”