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Is Vaping As Harmful As Smoking Cigarettes? Here’s What You Need To Know

Vaping seems to have taken the mantle of becoming the healthier alternative to smoking, along with the fact that they were designed with the motive to help smokers eventually quit.

http://www.indiatimes.com/health/healthyliving/is-vaping-as-harmful-as-smoking-cigarettes-here-s-what-you-need-to-know-324703.html

In fact, the trend has caught on so rampantly that it’s set to outsell traditional cigarettes by the end of 2023!

With the FDA regulating these products since 2016, it comes as no surprise that vaping is due to become the norm, surpassing traditional smoking in time to come.

In a report on the use of e-cigarettes in Canada, a report previously stated that “Among those whose primary reason for use is to help to quit tobacco, a similar proportion no longer smoke (24%), and this may be considered the success rate for this method of smoking cessation.”

How is vaping different from smoking?

To differentiate itself from tobacco products, vaping is the process of smoking nicotine without inhaling the other harmful substances in tobacco—out of which there 70 known carcinogens. Some products contain little to no nicotine in them. Canada for instance still does not approve of nicotine-containing e-cigarettes.

These battery-powered devices heat the liquid that contains nicotine and/or other flavours, which in turn is inhaled as the vapour.

There is no smoke without fire, however

Since the key objective of switching to e-cigarettes is to cut down the number of cigarettes you smoke, researchers have been assessing the ‘relative harm’ vaping can cause to your tissues.

A study conducted by Jessica Wang-Rodriguez, a head and neck cancer specialist at the University of California at San Diego and her team found that cells lining human organs sustained up to twice the DNA damage seen in unexposed cells. They were also five to 10 times more likely to wither and die than unexposed cells even if the vapour contained no nicotine, the addictive ingredient in conventional and most electronic cigarettes, as reported in New Scientist.

“Without the nicotine, the damage is slightly less, but still statistically significant compared with control cells,” says Wang-Rodriguez, who led the research.

The toxins from the flavouring are another cause of concern

“E-cigarette vapour is known to contain a range of toxins which include impurities in the e-cigarette liquids and toxins generated when solutions are heated to generate vapour,” says John Britton, a toxicologist at the University of Nottingham, UK. “Some are carcinogenic, so it’s likely some long-term users of e-cigarettes will experience adverse effects on their health, and the authors fo the study conducted by Rodriguez and company are correct to point out that these products should not be considered risk-free,” he says. But if smokers can’t give up completely, e-cigarettes are safer than smoking, he says, as reported in New Scientist.

They caused considerable damage to your key blood vessels; similar to normal cigarettes

A study conducted by researchers at the European Society of Cardiology Congress in Rome states that vaping has an impact similar to the what normal cigarettes have on the stiffening of you heart’s aorta, as reported the Independent, UK.

The lead researcher, Professor Charalambos Viachopoulos of the University of Athens said, “We measured aortic stiffness. If the aorta is stiff you multiply your risk of dying, either from heart diseases or from other causes. “There could be long-term heart dangers. They are far more dangerous than people realise.”

The problem lies with the rising number of teens taking to smoking E-cigarettes

A 2014 high school survey conducted in the US found that 17 percent of 12th graders reported the use of e-cigarettes compared to 14 percent who smoked traditional cigarettes. The lower price points at which they are promoted, their perception of being safer than traditional cigarettes, the various flavours they come in and the fact they’re in trend make it a very attractive option for the youth.

Adolescents and young adults who try e-cigarettes are more than three times as likely to take up smoking traditional cigarettes as their peers who haven’t tried the devices, states a recent research review published in Reuters Health.

E-cigarette use, or vaping, was as least as strong a risk factor for smoking traditional cigarettes as having a parent or sibling who smokes or having a risk-taking and thrill-seeking personality, the researchers found.

“E-cigarette use among teens and young adults could increase the future burden of tobacco by creating a new generation of adult smokers who might have otherwise not begun smoking,” said lead study author Samir Soneji of the Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire.

“To the extent that e-cigarette use mimics the behaviour of smoking a cigarette—handling the e-cigarette, the action of puffing, and the inhalation of smoke—it sets the adolescent up for easily transitioning to smoking,” added Soneji. “Like transitioning from driving a Tesla to driving a Chevy.”

Dr Brian Primack, a researcher at the University of Pittsburgh stated that “Young people report that there is a lot of pressure among e-cigarette only users to smoke a ‘real’ cigarette,” Primack said by email. “It may be somewhat analogous to the fact that teens who use flavoured alcohol are often pressured socially to step up their game to harder forms of alcohol.”

Although e-cigarettes claim to be less harmful than conventional cigarettes it could make sense to pay heed to the lack of conclusive long-term evidence

Cigarette smokers are well aware of the perils of smoking normal cigarettes. The New England Journal of Medicine states that smoking tobacco reduces your life span by at least 10 years. But studies on smoking e-cigarettes remain largely inconclusive.

A review of studies published in the journal Tobacco Control reveals that the long-term effects of the vaporised form are not known yet. For instance, it is not known if the chemical propylene glycol, which is mixed with the other chemicals in e-cigarettes known to irritate the respiratory tract, could result in lung problems after decades of vaping, says Dr Michael Siegel, a tobacco researcher and professor of community health sciences at the Boston University School of Public Health in Live Science.

Besides, “because e-cigarettes have been on the market for only about 10 years, there have been no long-term studies of people who have used them for 30 to 40 years. Therefore, the full extent of e-cigs’ effects on heart and lung health, as well as their cancer-causing potential, over time is not known,” says Stanton Glantz a professor of medicine and the director of the Center for Tobacco Control Research and Education at the University of California, San Francisco to Live Science.

 

E-cigarettes and National Adolescent Cigarette Use: 2004-2014

https://www.ncbi.nlm.nih.gov/pubmed/28115540

Abstract

BACKGROUND:

E-cigarette use is rapidly increasing among adolescents in the United States, with some suggesting that e-cigarettes are the cause of declining youth cigarette smoking. We hypothesized that the decline in youth smoking changed after e-cigarettes arrived on the US market in 2007.

METHODS:

Data were collected by using cross-sectional, nationally representative school-based samples of sixth- through 12th-graders from 2004-2014 National Youth Tobacco Surveys (samples ranged from 16 614 in 2013 to 25 324 in 2004). Analyses were conducted by using interrupted time series of ever (≥1 puff) and current (last 30 days) cigarette smoking. Logistic regression was used to identify psychosocial risk factors associated with cigarette smoking in the 2004-2009 samples; this model was then applied to estimate the probability of cigarette smoking among cigarette smokers and e-cigarette users in the 2011-2014 samples.

RESULTS:

Youth cigarette smoking decreased linearly between 2004 and 2014 (P = .009 for ever smoking and P = .05 for current smoking), with no significant change in this trend after 2009 (P = .57 and .23). Based on the psychosocial model of smoking, including demographic characteristics, willingness to wear clothing with a tobacco logo, living with a smoker, likelihood of smoking in the next year, likelihood of smoking cigarettes from a friend, and use of tobacco products other than cigarettes or e-cigarettes, the model categorized <25% of current e-cigarette-only users (between 11.0% in 2012 and 23.1% in 2013) as current smokers.

CONCLUSIONS:

The introduction of e-cigarettes was not associated with a change in the linear decline in cigarette smoking among youth. E-cigarette-only users would be unlikely to have initiated tobacco product use with cigarettes.

COSH urges the Government to take full account of public opinions Enact Enlargement of Pictorial Health Warnings Promptly

http://smokefree.hk/en/content/web.do?page=news20170116

Hong Kong Council on Smoking and Health (“COSH”) urges the Government and Legislative Council to enact the enlargement of pictorial health warnings promptly in order to reduce the attractiveness of tobacco, motivate more smokers to quit and deter youth from trying the first cigarette. Mr Antonio KWONG, COSH Chairman remarked, “Results from survey conducted by COSH and two rounds of public consultations organized by the Legislative Council showed that majority of citizens and organizations supported the enlargement of pictorial health warnings to 85%. The Government and Legislative Council should take full account of public opinions and enact the proposed tobacco control measure as soon as possible.”

The Government briefed the legislative proposals to strengthen tobacco control on 18 May 2015, including enlarging the size of pictorial health warnings to at least 85% of the two largest surfaces of the packet, increasing the number of forms of health warning from six to twelve and adding the quitline 1833 183. The date of enactment is yet to be scheduled after more than one and a half years.

The Legislative Council collected views of the public and held special meetings on the enlargement of pictorial health warnings twice. Among the hundred submissions received in July 2015 regarding the increase in the size of pictorial health warnings, more than 80% supported. Besides, over 100 submissions were received for the special meeting of Legislative Council Panel on Health Services to be held tomorrow (17 January 2017), in which around 70% agreed the proposed measure.

The School of Public Health of The University of Hong Kong was commissioned by COSH to carry out the Tobacco Control Policy-related Survey 2016. It was found that public support on enhancing the pictorial health warnings was overwhelming, 79.5% of all respondents agreed to display more threatening messages about the health risks of smoking. About 72.5% of all respondents supported to increase the coverage of the health warnings to 85% while about half of the current smokers also supported. Majority of respondents opted for plain packaging* of cigarettes as well. In addition, COSH has collected over 26,500 signatures from citizens and organizations through street counters and online platform supporting the enlargement of pictorial health warnings since May 2015.

In recent years, many countries have successfully introduced more stringent measures to regulate tobacco packaging. Prof Judith MACKAY, Director of Asian Consultancy on Tobacco Control and Senior Policy Advisor of World Health Organization claimed, “Hong Kong ranked the 72nd in the world regarding the implementation of pictorial health warning and behind many developing countries like Laos, Myanmar and Sri Lanka. Hong Kong should enlarge and strengthen the pictorial warnings promptly in order to reduce the use of tobacco.” World Health Organization called for more countries to enlarge pictorial warnings covering more than 85% and implement plain packaging. “Get ready for plain packaging” was designated as the theme of World No Tobacco Day 2016.

Recently, some organizations opposed the proposed enlargement of warnings in the pretext that it would lead to a surge in cigarette smuggling activities. A recent study also claimed that illicit cigarettes composed for around 30% of cigarette consumption in Hong Kong. Prof LAM Tai-hing, Chair Professor of Community Medicine cum Sir Robert Kotewall Professor in Public Health, School of Public Health, The University of Hong Kong said, “the public should express reservation on the results of this tobacco industry-funded study. The data collection methods and calculations of the study were unclear using dubious methods.” The tobacco industry and its allies always express strong opposition against tobacco control measures proposed by the Government under the pretext that it will lead to a surge in cigarette smuggling activities. As recommended by the World Health Organization, the most effective measure against smuggling is tight control and aggressive enforcement.

With the Government’s multi-pronged tobacco control policies over the years, the smoking prevalence in Hong Kong has gradually reduced from 23% in early 80s to 10.5% in 2015. In view of the tobacco epidemic in Hong Kong and the international tobacco control trend, we urge the Government and Legislative Councilors to take account of public opinions and implement the enlargement of pictorial health warnings as soon as possible to safeguard public health. The Government should also actively consider adopting plain packaging within 2 to 3 years and develop long-term and comprehensive tobacco control policies including regulating the emerging tobacco products and e-cigarettes, raising tobacco tax substantially, expanding no-smoking areas, increasing resources on education, publicity, smoking cessation services and enforcement to further reduce the smoking prevalence in Hong Kong and protect people from the harms of smoking and secondhand smoke.

*Remarks: Plain packaging standardizes and simplifies the packaging of tobacco products. The pictorial health warnings on the main sides of cigarette pack are expanded. All forms of tobacco branding should be labeled according to the government prescriptions and with simple and plain format. This means that trademarks, graphics and logos are not allowed on cigarette packs, except for the brand name that is displayed in a standard font size, colour and location on the package. The packaging should not contain other colours and should include only the content and consumer information, such as toxic constituents and health warnings required by law. The quitline number should also be displayed at a prominent position. Australia was the first country to introduce plain packaging in 2012. The measure was also implemented in the United Kingdom, France and Hungary in 2016 and will be implemented in Ireland in 2017.

Bigger graphic health warnings on Hong Kong cigarette packs needed, anti-smoking group says

Survey finds most in favour of move, which advocates say can protect public health and encourage more to quit habit

http://www.scmp.com/news/hong-kong/health-environment/article/2062577/more-graphic-health-warnings-hong-kong-cigarette

An anti-smoking body has pressed the government to speed up legislation on cigarette pack health warnings after a survey revealed almost 80 per cent of people desired sterner messages on smoking risks.

The Council on Smoking and Health made the call ahead of another public hearing held on Tuesday in the Legislative Council to collect views on whether to implement the law.

The legislation will expand the size of health warnings on cigarette packs from the current 50 per cent to 85 per cent of the packaging surface.

The proposal was first submitted by the government in May 2015, and the first hearing was held in July in the same year.

According to a survey commissioned by the council and done between February and September last year, 79.5 per cent of 2,058 respondents – comprising smokers, non-smokers and ex-smokers – want cigarette packs to show clearer and more graphic warnings.

Another 72.5 per cent of them also want to see the graphic warnings enlarged to cover 85 per cent of the packaging surface, a move also supported by almost half of the smokers in the survey.

“The implementation work has dragged on for one and a half years. This measure can protect public health and help more people quit smoking.

“We hope that Legco will not procrastinate on the legislation any further,” council chairman Antonio Kwong Cho-shing said.

He said that Australia recorded a drop of 2.2 percentage points in average smoking rate after introducing plain cigarette packaging in 2012.

Of this amount, 0.55 percentage points, or 108,000 fewer smokers, were due directly to the new measure which only allowed brand names to be displayed in a standard font size, colour and position on the packaging, thereby making them less conspicuous and seemingly less desirable.

Professor Judith Mackay, a veteran tobacco control advocate and senior policy advisor for the World Health Organisation, said a larger graphic warning would have an even bigger visual impact and induce more smokers to quit.

According to a Canadian Cancer Society survey which studied the effectiveness of health warnings on cigarette packs worldwide, Hong Kong ranked 72nd out of 205 places.

“We used to be among the top 12 jurisdictions [in cigarette pack warnings] … now we are lagging very far behind from the international experience,” Mackay said. She has been working on tobacco control advocacy in the city for more than 30 years.

The survey done by the Canadian group looked at various factors, including whether graphic warnings existed on the packaging design, the sizes of the images and when the warnings were introduced.

Mackay attributed the city’s poor ranking partly to outdated warnings, which were first introduced in 2007, and the lack of information on helpline numbers for those seeking to quit the habit.

She said in the long run the government should also further increase tobacco tax to make cigarettes less affordable.

Kwong from the Council on Smoking and Health said it submitted a letter to the financial secretary late last year to suggest increasing tobacco tax to 100 per cent.

Not much proof that e-cigarettes can help people stop smoking

http://www.nst.com.my/news/2017/01/203391/not-much-proof-e-cigarettes-can-help-people-stop-smoking

As people become more aware of the dangers of smoking, many have taken steps to reduce the number of cigarettes smoked or to stop the bad habit. Public and private health centres and pharmacies provide smoking- cessation services, which include evidence-based treatment. These studies were based on large-scale population with medication that has been proven to be safe and effective. Nicotine replacement therapy (Nicorette) and Varenicline (Champix) have been used by those who wanted to quit smoking, and they have done so.

Interestingly, there is not much evidence supporting e-cigarette use as an alternative method for smoking cessation.

Recently, the Institute of Public Health, Health Ministry, conducted a survey on the use of e-cigarettes among adolescents and adults in Malaysia (The Tobacco and E-cigarette Survey among Malaysia Adolescents and The National E-Cigarette Survey 2016).

The results were disturbing. The majority of those who use e-cigarette are dual users. This means that they smoke cigarettes and e-cigarette. This is hazardous as it may result in nicotine overdose, which can lead to death. This can strengthen their addiction to nicotine, which hooked them to cigarettes in the first place.

Almost 70 per cent of the dual users stopped e-cigarette but continued smoking conventional cigarettes.

Most school children and adolescents started using e-cigarettes out of curiosity.

The main pull factors were the flavours and smell of e-liquids.

Many other dangerous substances can be introduced by drug pushers and dealers by just lacing the liquids.

Nearly 75 per cent of the study population felt that e-cigarettes were not useful to stop smoking and more than half wanted these to be banned.

DR RASHIDI MOHAMED PAKRI MOHAMED Nicotine Addiction Research Group, Universiti Malaya

Brand Loyalty Low Among Teen E-Cig Users

Half of surveyed users did not know which brand they used

Half of teens who use e-cigarettes reported vaping no particular brand, and about a third reported using e-cigarette devices for substances other than nicotine, according to an analysis of recent survey data by researchers from the CDC.

The most commonly reported e-cigarette used by the middle school and high school students participating in the 2015 National Youth Tobacco Survey (NYTS) was the heavily promoted brand ‘blu’, manufactured by Fontem Ventures-Imperial Brands (formerly Imperial Tobacco Group).

Roughly one in four surveyed teen e-cigarette users (26.4%) reported using that brand, while 12.2% reported using the next most popular brand, ‘VUSE’, manufactured by R.J. Reynolds.

The survey results were reported Thursday in the CDC’s Morbidity and Mortality Weekly Report.

“Electronic cigarettes are now the most commonly used tobacco product among U.S. youths; in 2015, 5.3% of middle school students and 16% of high school students reported using e-cigarettes in the past 30 days,” CDC researcher Tushar Singh, MD, PhD, and colleagues wrote, adding that not much has been known about the brands preferred by teens and the substances used in e-cigarette devices.

The analytic sample of the 2015 NYTS included 4,021 students who reported ever using e-cigarettes, “even once or twice.” Respondents were asked what brands of e-cigarettes they had used, with eight specific brands listed, and whether they had ever used an e-cigarette device for vaping a substance other than nicotine.

Data were weighted to account for the complex survey design and to adjust for nonresponse. Prevalence estimates were also reported for the type of e-cigarette ever used, brands, and whether e-cigarettes were used for substances other than nicotine.

A total of 13.5% of sixth through eighth graders and 37.7% of ninth through 12th graders reported ever-use of e-cigarettes.

Among the adolescents reporting ever having used an e-cigarette, 14.5% used only disposable e-cigarettes, 53.4% used only rechargeable/refillable e-cigarettes, and 32.1% used both types.

Half of the student respondents (50.7%, representing 3.18 million teens) did not know the brand of the e-cigarette they had used.

Use of e-cigarettes for a substance other than nicotine was similar among middle school (33.7%) and high school (32.2%) users, and it was higher among males than females (37.3% of high school male e-cigarette users versus 26.2% of high school female respondents).

In a separate survey of high school age e-cigarette users in Connecticut, reported last year in Pediatrics, 18% of respondents reported using cannabis in an e-cigarette device.

“In the present analysis, it is unknown whether students who had used an e-cigarette for a non-nicotine substance had also used an e-cigarette for nicotine, which might underestimate nicotine use,” Singh and colleagues wrote.

“Nicotine content in e-cigarettes is of public health concern because exposure to nicotine is the main cause of tobacco product dependence, and nicotine exposure during adolescence, a critical period for brain development, can cause addiction, can harm brain development, and could lead to sustained tobacco product use among youths.”

Study limitations cited by the researchers included the self-reported nature of the survey, the limited number of specific e-cigarette brands included in the survey, and the lack of data on which substances other than nicotine were being used.

The researchers concluded that increased monitoring of product types, brands, and ingredients preferred by adolescent e-cigarette users is warranted, “to guide measures to prevent and reduce use of e-cigarettes among youths.”

Tobacco corporations target Africa’s children

http://www.heraldlive.co.za/business/2016/12/08/tobacco-corporations-target-africas-children/

Children in Africa have become a target for tobacco companies‚ research by the African Tobacco Control Alliance (ATCA) has found.

The survey looked at the way in which tobacco companies in five African countries– Burkina Faso‚ Cameroon‚ Benin and Nigeria – get consumers to keep using their product.

It found tobacco use caused about six million deaths yearly‚ with 80% of them occurring in low- and middle-income countries.

Findings show that in Africa‚ smoking prevalence is about 21% among adult men and 3% among women.

About 21% of young boys and 13% of young girls use tobacco products.

“The aggressive sale and marketing strategies of the tobacco industry targeting young people will be among the key contributing factors to the growing epidemic of tobacco use in Africa‚” the report said.

Four strategies were identified as being used to lure children to smoke‚ a concern that was highlighted at the launch of the report in Johannesburg recently.

Advertising and promotion, the sale of single cigarettes, child-friendly flavoured cigarettes and noncompliance with existing tobacco control laws were the main causes for an increase in young children’s interest in smoking.

Sales of single cigarettes were found to be widespread near schools.

Ban on flavoured tobacco products will hurt business: Retailers

Retailers have strongly objected to a proposal to ban the sale of flavoured tobacco products such as menthol cigarettes, as it could hit their businesses hard.

http://www.todayonline.com/singapore/ban-flavoured-tobacco-products-will-hurt-business-retailers-0

A survey of 1,475 independent general trade retailers by a group of trade associations — such as the Foochow Coffee Restaurant & Bar Merchants Association and Singapore Mini Mart Association — found that 99 per cent of the respondents stated that such a prohibition would negatively affect their business, while 97 per cent were concerned that the move could lead adult smokers to turn to illegal sources.

The proposed ban was among a suite of tobacco-control measures — which also included raising the minimum legal age for smoking and enhancing graphic health warnings — put up for public consultation early this year by the Health Promotion Board, the Ministry of Health, and the Health Sciences Authority.

Pointing to how some stores had closed after they were badly affected by the new liquor laws, which started last year, Mr Hong Poh Hin, who chairs the Foochow Coffee Restaurant & Bar Merchants Association, said: “It is important to ensure any proposed tobacco-control measures are supported by evidence of effectiveness in reducing smoking incidence in Singapore, while addressing the impact on the affected retailers.”

“Our members, many of which are small- and medium-enterprises, have been bearing the brunt of escalating operating costs, manpower constraints and a flurry of increasing regulations that directly impacted their biggest sources of income,” he added.

Among other things, the new laws bar supermarkets and convenience stalls from selling takeaway alcohol from 10.30pm to 7am.

“We fear that such recurrent regulations will lead many more to shut down their businesses. This prompted our associations to launch this (survey),” Mr Hong added.

Other associations involved in the survey were Kheng Keow Coffee Merchants Restaurant and Bar-Owners Association, and Singapore Provision Shop Friendly Association.

Ninety-eight per cent of those surveyed said almost half of their customers who buy tobacco products only request the flavoured variants. The survey, which was conducted between July and September, also uncovered concerns that adult smokers would turn to illegal sources to have a puff.

Noting that the illicit cigarette trade is “substantial” here, Singapore Mini Mart Association chair Alan Tay said: “These illegal activities have a huge adverse impact on legitimate traders like us, that operate within the parameters of the law.”

The trade associations are also in the midst of another study on the efficacy and impact on trade of the proposed ban on flavoured tobacco products, and plan to share its results with the Government. KELLY NG

New evidence e-cigarettes are gateway to tobacco

http://6abc.com/health/new-evidence-e-cigarettes-are-gateway-to-tobacco/1594753/

There’s more evidence that electronic cigarettes may be enticing teens to try the tobacco ones.

A nationwide survey of teens who never smoked shows that nearly 60 per cent who tried the flavored electronic ones intend to start smoking tobacco.

And the majority of e-cigarette users started out with sweet, candy-like flavors.

“Due to a proliferation of e-cigarette flavors on the market, flavored e-cigarette use among youth in the U.S. has increased significantly,” study author Hongying Dai said.

The number of teens who use e-cigarette devices to “vape” has nearly quadrupled since 2013.

Flavored e-cigarettes aren’t prohibited in the United States.

Although the F-D-A has imposed new rules on electronic cigarettes, it doesn’t have legal authority to regulate the flavors.

Nearly 500 brand with more than 7-thousand flavors are currently on the market.

Dai’s team looked at the nearly 16,500 teens answering the survey who had never smoked cigarettes but used e-cigarettes.

The researchers also looked at more than 1,300 current smokers and assessed if they intended to quit. Finally, the investigators looked at nearly 21,500 teens to assess their perception of the dangers of tobacco.

The study found that just over 2,000 teens said they had used e-cigarettes in the last 30 days.

Among current tobacco smokers, 68 percent of those who also “vaped” said they had used flavored e-cigarettes.

Nearly two-thirds of smokers also use e-cigarettes, CDC says

http://www.omaha.com/livewellnebraska/health/nearly-two-thirds-of-smokers-also-use-e-cigarettes-cdc/article_bfd5256e-a2d8-11e6-a78c-5323b0e6b11c.html

Many American adults who use electronic cigarettes also smoke tobacco cigarettes, a U.S. Centers for Disease Control and Prevention survey reveals.

The survey found that in 2015, 59 percent of all adult e-cigarette users were also current cigarette smokers. The survey also showed that 30 percent of e-cigarette users were former smokers and 11 percent using the devices had never smoked.

Among young adults ages 18 to 24, 40 percent of e-cigarette users were never smokers, 43 percent were current smokers and 17 percent were former smokers.

“If there is a public health benefit to the emergence of e-cigarettes, it will come only if they are effective at helping smokers stop using cigarettes completely, responsibly marketed to adult smokers and properly regulated to achieve these goals,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids.

Altogether, 3.5 percent of all U.S. adults were e-cigarette users in 2015, down slightly from 3.7 percent in 2014, the CDC survey found.

Myers said these findings raise concerns that many adults using e-cigarettes are using the devices in addition to tobacco cigarettes, rather than in place of them.

Myers’ organization also said the finding that 40 percent of young adults who use e-cigarettes have never been smokers raises concerns that e-cigarettes may be introducing young nonsmokers to tobacco use and nicotine addiction.

There has been a sharp increase in use of e-cigarettes by youth. In 2015, 24 percent of high school students were current users of e-cigarettes, compared to 11 percent who smoked cigarettes, a previous CDC survey found.

E-cigarettes “will not benefit public health if smokers use them in addition to cigarettes instead of quitting or if they re-glamorize tobacco use among young people and attract nonsmokers,” Myers said in a Campaign for Tobacco-Free Kids statement.

Current evidence on whether e-cigarettes help smokers quit is limited and inconclusive, he said.