As E-cigarettes soar in the US, could they really steer teenagers away from smoking?

The big question: Are e-cigarettes keeping young people away from traditional cigarettes - or taking them down the nicotine-addiction road?

About a quarter of all U.S. high school students and 8 per cent of middle school students — 4.6 million young people altogether — used tobacco in some form last year, the New York Times reported.

“The sharp rise of e-cigarettes, together with a substantial increase in the use of hookah pipes, led to 400,000 additional young people using a tobacco product in 2014,” the paper said.

The good news is that from 2011 to 2014, the share of American high school students who smoked traditional cigarettes declined substantially, to 9 per cent from 16 per cent. Cigars and pipes are also down.

The shift suggested that some teenage smokers may be using e-cigarettes to quit, said the Times.

Smoking is still the single-biggest cause of preventable death in the United States, killing more than 480,000 Americans a year. Most scientists agree that e-cigarettes, which deliver the nicotine but not the dangerous tar and other chemicals, are likely less harmful than traditional cigarettes.

The Times described the numbers as a surprise “and seemed to put policy makers into uncharted territory.

The Food and Drug Administration took its first tentative step toward regulating e-cigarettes last year, but the process is slow, and “many experts worry that habits are forming far faster than rules are being written.” In interviews, teenagers said that e-cigarettes had become almost as common at school as laptops.

A 15-year-old at a school in Westchester County, NY said, “It’s the healthy alternative taking over my school,” He said he started vaping to kick a smoking habit. He said about 70 percent of his friends now vaped.

Others told the Times they had never smoked but liked being part of the trend and enjoyed the taste. Two favourite flavours of teenagers interviewed were Sweet Tart and Unicorn Puke, which one student described as “every flavor Skittle compressed into one.”

James, 17, a senior in Virginia, said he and his friends started using e-cigarettes when he was 13, after his father abandoned the devices in a failed effort to quit smoking.

“It was something for us to do that was edgy and exciting,”

He liked the smoke tricks that his friends had become good at, like blowing out the vapor so that it spun like a tornado. His favourite flavor is called Hawk Sauce, which he described as “a berry menthol kind of thing.”

He has never smoked cigarettes and said he could not imagine ever starting. “There’s a harshness to cigarettes,” he said. “Girls think they’re gross.”

Last year’s rise,which was captured in the Centers for Disease Control and Prevention’s annual youth tobacco survey of about 20,000 schoolchildren, lifted e-cigarette use above that of traditional cigarettes.

However, anti-tobacco advocates warned that e-cigarettes are undoing years of progress among the country’s most vulnerable citizens by making the act of puffing on a tobacco product normal again, and by introducing nicotine, an addictive substance, to a broad population of teenagers.

“This is a really bad thing,” said Dr. Thomas R. Frieden, the director of the C.D.C., who noted that research had found that nicotine harms the developing brain. “This is another generation being hooked by the tobacco industry. It makes me angry.”

The decline in cigarette use among teenagers accelerated substantially from 2013 to 2014, dropping by 25 per cent, the fastest pace in years.

Anti-tobacco advocates have suggested e-cigarettes would become a gateway to cigarettes among youth. In Sweden and Norway, a rise in the use of snus, asmokeless tobacco product, was followed by a sharp decline in cigarette use.

“They’re not a gateway in, and they might be accelerating the gateway out,” said David B. Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies, an anti-tobacco group.

Selling e-cigarettes to minors is banned in many American states, and the rule the F.D.A. proposed last year would ban it nationally.

But the proliferation of vape shops and equipment for sale online has made access easy, said the NYT. Some teenagers said they simply clicked a button to indicate they were over 18 to be able to order a starter kit.

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