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Author Response to: “E-cigarettes and the Youngest, Not a Problem in Europe: No Data Yet”

      Tobacco control faces a new challenge: the introduction of, and the increase in, using electronic cigarettes (e-cigarettes) that are claimed to be an aid for smoking cessation. This is the major motivation for our research on e-cigarette smoking initiation by age.
      • Chen X.
      • Yu B.
      • Wang Y.
      Initiation of electronic cigarette use by age among youth in the U.S.
      To date, it is still controversial whether e-cigarettes can help smokers quit. In 2016, Lancet published a systematic review and meta-analysis of 38 studies, including 20 with control groups and two clinical trials, which concluded using e-cigarettes makes smokers less likely to quit smoking.
      • Kalkhoran S.
      • Glantz S.A.
      E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis.
      In another systematic review and meta-analysis published in Nicotine & Tobacco Research, no conclusive result was obtained regarding the role of e-cigarettes in facilitating smoking cessation (including withdrawal symptoms and craving to smoke) based on 62 studies.
      • Malas M.
      • van der Tempel J.
      • Schwartz R.
      • et al.
      Electronic cigarettes for smoking cessation: a systematic review.
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      References

        • Chen X.
        • Yu B.
        • Wang Y.
        Initiation of electronic cigarette use by age among youth in the U.S.
        Am J Prev Med. 2017; 53: 396-399https://doi.org/10.1016/j.amepre.2017.02.011
        • Kalkhoran S.
        • Glantz S.A.
        E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis.
        Lancet Respir Med. 2016; 4: 116-128https://doi.org/10.1016/S2213-2600(15)00521-4
        • Malas M.
        • van der Tempel J.
        • Schwartz R.
        • et al.
        Electronic cigarettes for smoking cessation: a systematic review.
        Nicotine Tob Res. 2016; 18: 1926-1936https://doi.org/10.1093/ntr/ntw119
        • Braillon A.
        E-cigarette and the youngest, not a problem in Europe: no data yet.
        Am J Prev Med. 2018; 54: e79
        • Wipfli H.
        The Global War on Tobacco: Mapping the World’s First Public Health Treaty.
        Johns Hopkins University Press, Baltimore, MD2015
        • U.S. DHHS
        E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.
        U.S. DHHS, Public Health Services, Rockville, MD2016

      Linked Article

      • E-cigarettes and the Youngest, Not a Problem in Europe: No Data Yet
        American Journal of Preventive MedicineVol. 54Issue 4
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          Chen et al.1 provided frightening facts: “e-cigarette smoking is initiated as young as age 7 years while peak initiation of conventional cigarette is 14–15 years.” The term gateway appeared soon in titles of articles about e-cigarettes because nicotine, smoked or vaped, is a most potent addictive product, even more when associated with flavor.2 Nevertheless, no one expected initiation could have been so early. As the early age of smoking initiation is a major risk factor for smoking-related morbidities and all-cause mortality,3 Chen et al.’s finding needs robust and rapid responses.
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