Currently 59% of all individuals who have ever smoked are now former smokers. The concerted public health effort to encourage smoking cessation is one of the great public health successes of the last century. Population-based interventions, including tobacco price increases, comprehensive smoke-free laws, anti-tobacco mass media campaigns, and barrier-free access to tobacco cessation counseling and medications along with individual counseling by primary care physicians in their offices have made a fantastic impact on individuals’ decisions to stop smoking. Unfortunately, as cigarette use has decreased, e-cigarette use seems to be increasing. Among youth, the prevalence of past 30-day use was higher for e-cigarettes than regular cigarettes (2014: 13% vs 9%).¹ Since e-cigarette use leads to cigarette use in half of those who are using e-cigarettes, we may see a reversal in the decreasing trend of cigarette use unless the message of potential health problems with e-cigarettes becomes effectively communicated. — Neil Skolnik, MD

1. Arrazola RA, Singh T, Corey CG, et al. Tobacco use among middle and high school students—United States, 2011–2014. MMWR. 2015:64(14);381-385.