It's become an emotional debate: Do e-cigarettes help people get off regular cigarettes or are they a new avenue for addiction?
Until now, there has been little solid evidence to back up either side. But a new study from the Centers for Disease Control and Prevention could help fill that void.
E-cigarettes work by heating up a fluid that contains the drug nicotine, producing a vapor that users inhale. The CDC found that nearly 48 percent of current tobacco smokers said they had tried e-cigarettes at least once. Among those who recently quit smoking, more than 55 percent said they'd tried the devices.
The survey of more than 36,000 U.S. adults marks the first time detailed federal data about e-cigarettes has become available, says Charlotte Schoenborn, a health statistician with the National Center for Health Statistics. The data were gathered as part of the National Health Interview Survey, an ongoing survey of a variety of health issues.
Among those still using the devices when surveyed, almost 16 percent said they were still smoking tobacco cigarettes, Schoenborn says, while 22 percent had recently quit.
The study found that the devices are most popular among young adults, ages 18 to 24. Nearly 22 percent of adults who reported ever trying an e-cigarette fell into that age group. In addition, among the nonsmokers, nearly 10 percent of people in that age group had tried e-cigarettes.
"The use by young adult never-smokers, I think, certainly is noteworthy," Schoenborn says. She also found it significant that e-cigarettes are largely being used by current and former smokers.
The survey did not ask smokers and ex-smokers whether e-cigarettes had helped them quit — only whether they had ever used the devices.
The appeal of e-cigarettes to young people has raised fears that the devices may hook a new generation on nicotine and lead them to eventually start smoking tobacco.
"What this survey shows is young adults who have never smoked are picking up electronic cigarettes in truly alarming numbers," says Matthew Myers, president of the Campaign for Tobacco-Free Kids.
Others worry that it remains far from clear how safe the devices are, and whether smokers are using e-cigarettes to quit, or just as a crutch to keep smoking.
"What we're seeing is that people are using e-cigarettes and smoking traditional cigarettes," says Erika Sward, assistant vice president for national advocacy at the American Lung Association.
"There is no evidence to suggest there are any health benefits associated with that," she says, "especially when they are continuing to use their regular cigarettes."
The e-cigarette industry interprets the survey results very differently.
"This is great news for public health," says Gregory Conley, president of the American Vaping Association. "This is a report showing barely any use of e-cigarettes among nonsmokers, and great usage — significant usage — among recent former smokers as well as current cigarette smokers who need to use these products to quit."
Conley says he thinks the data indicate many young nonsmokers experiment with the devices without getting hooked.
"E-cigarettes are something that people are willing to perhaps take a puff off of because it looks funny," he says. "But it's not something that is creating nicotine dependency in those that did not previously have it."
The latest NPR-Truven Health Analytics Health Poll, released Monday, shows broad public support for regulation of e-cigarettes by the Food and Drug Administration.
RENEE MONTAGNE, HOST:
We have new information about electronic cigarettes. The Centers for Disease Control and Prevention examined who uses them. Here's NPR's Rob Stein.
ROB STEIN, BYLINE: The new information comes from a survey of more than 36,000 Americans. Charlotte Shoenborn of the CDC's National Center for Health Statistics analyzed the data.
CHARLOTTE SHOENBORN: We found that about 13 percent of adults have ever tried any cigarette, that means ever tried at all - even one time - and about 4 percent are current users of e-cigarettes.
STEIN: But the big question is - who are these people? Turns out, a lot of them are smokers or people who recently kicked the habit.
SHOENBORN: Forty-eight percent of current smokers had tried an e-cigarette and 55 percent of recent former, meaning they quit smoking in the past year, had tried an e-cigarette.
STEIN: The survey also confirmed something that a lot of people thought about e-cigarettes - their biggest fans are young adults, those between the ages of 18 and 24, even if they've never smoked regular cigarettes.
SHOENBORN: The interesting thing there is that it's almost 1 in 10 of those young adults who had not taken up cigarettes, 1 in 10 had tried an e-cigarette. That's the most noteworthy.
STEIN: And that's the finding that alarms many public health advocates. Erika Sward of the American Lung Association says e-cigarettes are hooking a whole new generation on nicotine.
ERIKA SWARD: The results are very troubling. What we're really seeing is the e-cigarette industry targeting young people and potentially addicting them to a lifetime of tobacco addiction.
STEIN: And Sward and others argue it remains far from clear whether smokers are using e-cigarettes to quit or just as a crutch to keep smoking. The e-cigarette industry has a very different interpretation of the new survey. Gregory Conley of the American Vaping Association says the data are clear. E-cigarettes are mainly used by smokers to quit or cut back. And young non-smokers who try them are just experimenting without getting hooked.
GREGORY CONLEY: E-cigarettes are something that people are willing to perhaps take a puff off of because it looks funny, but it's not something that is creating nicotine dependency in those that did not previously have it. So I'd say that that's good news that this is a product that people can try and they don't go back to it.
STEIN: The Food and Drug Administration is in the final stages of trying to decide how to regulate e-cigarettes. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.