As the number of people using e-cigarettes wafts upward, health experts and researchers are scrambling to understand their health effects and the usage trends of the nicotine-vaporizing gadgets. Though many hope that e-cigarettes will offer smokers a healthier option and a path to quitting, experts fear their effects on children and adolescents.

Today, the American Academy of Pediatrics (AAP) is officially recommending that only people 21 years and older be allowed to buy e-cigarettes, or “electronic nicotine delivery systems” (ENDS), and all other tobacco products. “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,” the organization stated as part of a series of policy recommendations published in Pediatrics.

For adult smokers who switch entirely to e-cigarettes, “there’s little doubt that their health will be improved,” Tom Frieden, director of the Centers for Disease Control and Prevention, said during a recent presentation on e-cigarettes held by the agency. “On the other hand, if adolescents who would not have become smokers begin using e-cigarettes, there is a high likelihood that their risk of using combustible tobacco will be greater.”

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