TABLE 1

Range of Potential Options to Address Rising E-Cigarette Use in Adolescence

SolutionsInterventionsSpecific LocationsStrategic Points to Consider
School-basedEducate in health classMiddle and high schoolPresent the science of early nicotine exposure and gateway drug phenomenon; inoculate against industry marketing messages, promotions, and images that make youth susceptible to e-cigarette use
Enact tobacco product free zoneElementary, middle, high school, and college groundsInclude e-cigarettes in tobacco free campuses. Include high schools in tobacco free campus movement.
Clinical care-basedScreen and counselInpatient and outpatient health care settingsScreening for parent and adolescent e-cigarette use will ensure opportunity for family and household level intervention
Policy-basedIncrease minimum age of sale to 21Town and city, county, state, and federal level actions are possibleMake sure tobacco age of sale laws include e-cigarettes and any e-cigarette laws include traditional tobacco products
Increase the priceState and federal-level taxes and feesAdolescents are very price sensitive: the higher the price the greater the effect on use
Restrict sale locationsTown and city, county, state, and federal level actionsRestricting sales location to stores for ≥21 y olds would eliminate tobacco product sales in pharmacies, gas stations, malls, grocery and convenience stores.
Ban e-cigarette use wherever combusted tobacco use is prohibitedIndividual venue, town, city, county, state, and federal level actionsRestrictions should be added to existing and nascent regulations, including workplaces, multiunit housing, all indoor locations