By Mark Waghorn via SWNS
Vapes are getting kids as young as eleven hooked on nicotine, according to a new medical study.
Researchers at Massachusetts General Hospital for Children warn that they are more addictive than cigarettes, with some school-age users vaping within five minutes of waking up.
The problem is blamed on a smoother, more palatable form of the drug known as 'nicotine salts' or 'protonated nicotine.'
The corresponding author Professor Jonathan Winickoff said: "The changes detected in this survey may reflect the higher levels of nicotine delivery and addiction liability."
A shock government report last month revealed at least 2.6 million US children are hooked on e-cigarettes.
Prof Winickoff, of Massachusetts General Hospital for Children in Boston, explained: "Modern e-cigarettes that use protonated nicotine make nicotine easier to inhale."
The findings published in the journal JAMA Network Open are based on more than 151,000 sixth to 12th graders tracked between 2014 and 2021.
Prof Winickoff said: "Age at the initiation of e-cigarette use decreased and intensity of use and addiction increased.
"By 2019, more e-cigarette users were using their first tobacco product within five minutes of waking than users of cigarettes and all other tobacco products combined.
"Clinicians need to be ready to address youth addiction to these new highly addictive nicotine products during many clinical encounters, and stronger regulation is needed, including comprehensive bans on the sale of flavoured tobacco products."
In October the Centers for Disease Control and Prevention found use among middle or high school students had risen by 500,000 (24%) since 2021.
Super-strength disposable devices - like Elf bars - were the most popular (55%). Most children (85%) had used flavored e-cigs.
They are often sold in glossy displays and come in a variety of colors and child-friendly names and flavors such as bubble gum, jelly babies and strawberry milkshake.
Prof Winickoff said: "Early e-cigarettes did not deliver nicotine as efficiently as cigarettes because they delivered freebase nicotine that was hard to inhale.
"This situation changed with the 2015 introduction of Juul products which added benzoic acid to the nicotine e-liquid to lower the acidity and form protonated nicotine."
Juul, a San Francisco start-up, found the adjustment was more efficient at captivating users with the first hit.
It has reversed the long-term decline in US youth tobacco use - attracting many adolescents at low risk of initiating nicotine use with cigarettes.
Prof. Winickoff said: "Despite the pandemic leading to people being socially isolated, students being out of school, and the increased risk of adolescents and young adults contracting Covid with e-cigarette use, intensity continued to increase.
"This may reflect an increasing use of nicotine for self-medication in response to adolescent depression, anxiety, tic disorders and suicidality.
"The pandemic has also been a lost year for school-based prevention and treatment efforts, meaning abatement plans will need to be intensified to address the nicotine addiction in those adolescents who missed a year of contact with adults who might have otherwise helped them get treatment."
Clinicians should question all their patients about nicotine and tobacco product use.
Vaping has become a gateway to nicotine addiction for teens as most who start have never smoked before.
"Tobacco addiction is a chronic disease," Prof Winickoff said.
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