Many teenagers who vape are not aware that their e-cigarettes contain high amounts of nicotine, according to a new study.
Nearly 40 percent of adolescents who believed they only were using nicotine-free products did not realize those products actually contained the addictive substance, researchers from Stony Brook University found.
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Researchers surveyed 517 adolescents, ages 12 to 21, about their use of e-cigarettes, combustable cigarettes and marijuana. The researchers then compared the adolescents' responses against the results of urine tests looking for cotinine, a chemical indicating nicotine in the body.
About 14 percent of survey respondents reported vaping within the past week. Another 11 percent reported using marijuana within the same time frame. Only about 3 percent said they had used cigarettes.
For the most part, the survey respondents appeared to be honest about their substance use, researchers found. Only about 2 percent who said they didn't use tobacco, e-cigarettes or marijuana tested positive for those substances.
The biggest discrepancy came among vapers who thought they were using nicotine-free e-cigarettes, an indication that many are unaware the products contain nicotine.
"This is one of the first studies showing the amount of nicotine kids are getting from e-cigarettes, " lead author Dr. Rachel Boykan told NBC News. "They're getting a lot – as much or more than they would with traditional cigarettes."
The cotinine levels were highest among adolescents that used pod mods, a new vaping form that uses disposable cartridges. But the pods have the highest nicotine concentrations to date, researchers said.
Pod users had nearly the same levels of cotinine as tobacco smokers.
The study, published by the American Academy of Pediatrics, comes amid concerns that e-cigarettes could be addicting another generation of Americans.
About 4.9 million American youth were considered current users of tobacco last year, according to the U.S. Centers for Disease Control and Prevention's Vital Signs report. That marked a 36.1 percent increase from 2017 – a surge mostly attributable to increases in vaping.
The U.S. Food and Drug Administration has sought to crack down on underage tobacco use, deeming teen vaping a health epidemic.
In November, the FDA limited e-cigarette sales to brick-and-mortar stores that do not permit access to people under 18, effectively banning convenience stores and gas stations from selling e-cigarettes. It also increased age-verification requirements for online purchases.