Otolaryngologists play a vital role as educators in addressing the health risks associated with tobacco products, including e-cigarettes. Many adolescents are unaware that e-cigarettes contain highly addictive nicotine. Nicotine exposure during adolescence is associated with increased risks of addiction, depression, anxiety, and hyperactivity.
To protect youth, the American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) recommends the following measures:
- Stricter enforcement of age restrictions
- Bans on online sales
- Elimination of advertising targeting youth
- Bans on menthol and flavored e-cigarettes, which disproportionately appeal to teens
- Mandatory child-resistant packaging for e-liquids to prevent accidental ingestion
Public education on the risks of vaping and e-cigarette use must remain a top priority.
At the same time, e-cigarettes may serve a role in helping adult smokers reduce or quit traditional tobacco use. For some adults, high-nicotine e-cigarette products could offer a less harmful alternative, though such products should be tightly regulated—potentially requiring a prescription. Dual use of cigarettes and e-cigarettes should be strongly discouraged, as it may reinforce nicotine dependence and impede cessation efforts.
Further research is necessary to better understand the long-term health impacts and effectiveness of e-cigarettes as cessation tools.
Otolaryngologists are positioned at the intersection of public health and clinical care. While we advocate for minimizing harm—especially among youth—we must also recognize that, in specific cases, e-cigarettes may play a role in tobacco harm reduction for adult smokers.
Originally Published: November 2019
Important Disclaimer Notice (Updated 7/31/14)
Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal,
