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It's way too easy for teens to buy e-cigarettes on the Internet, and too many of them are victims of teen violence. Two new studies on Healthcare Triage news.

For those of you who want to read more, go here:

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

It's too easy for teens to get their hands on e-cigarettes and too many of them are committing dating violence. We'll talk about two new studies here on Healthcare Triage News. 


We've already done a review of the literature on e-cigarettes. You should have watched that. Watch it now if you haven't. One of the biggest ongoing issues surrounding them is the relative lack of regulation. North Carolina passed a law in 2013 that mandated that internet e-cigarette vendors confirm a customer's age through a government records database when an order is placed. How's that working out?A new study in the Journal of Pediatrics wanted to check. It's called "Electronic Sales of Cigarettes to Minors Via the Internet." To the research! The authors got got 14 to 17 year olds together and watched them place orders on 98 of the 103 most popular online internet e-cigarette vendors. The minors were able to successfully get delivers of e-cigarettes from more than 75% of them. No attempts were made to check their ages, pretty much all of the deliveries were left at the door, so no age verification was made on delivery either. But it gets worse, 18 orders failed but for reasons unrelated to age verification, like the website broke or processing failed because of some site issue.

Of the remaining 80 orders that could go through, only five were rejected because of some sort of age verification. This means that at functioning websites, minors were easily able to purchase e-cigarettes online about 94% of the time. This is the kind of stuff that is giving e-cigarettes a bad name.

It’s the kind of stuff that even proponents of e-cigarettes could work to fix if they seriously believe in their harm reduction potential and not just their being a new easier way for many, including kids, to get their hands on nicotine products.

Our second story, also from The Journal for Pediatrics is entitled “Teen Dating Violence: Physical and Sexual, Among US High School Students.” Findings from the 2013 National Youth Risk behavior survey.

So the Youth Risk Behavior Survey is the CDC project that many researchers use to talk about what’s going on with kids and risks. My first question when I read this study was of course, how do they define teen dating violence? Because up until 2011, it was a single question and it read, and I’m quoting here, “in the last 12 months, did your boyfriend or girlfriend ever hit, slap, or physically hurt you on purpose?”

See here’s a story on that: when we tried to adapt this question into our clinical decision support system years ago, it lead to a heated argument in my research group. For instance, rough but totally consensual sex could get a yes to that question. It also only refers to a boyfriend or girlfriend and could leave out more casual acquaintances but now things are much more informative.

First they ask, quoting again, “during the past 12 months, how many times did someone you were dating, or going out with physically hurt you on purpose? Count such things as being hit, slammed into something, or injured with an object or weapon.”

Then they asked, quoting again, “During the past 12 months, how many times did someone you were dating or going out with force you to do sexual things that you did not want to do? Count such things as kissing, touching, or being physically forced to have sexual intercourse.” 

These questions are much more specific. The addition of “that you did not want to do” to the sexual questions, removes a lot of the ambiguity. So is the removal of boyfriend or girlfriend.
And the results that they found using these questions  are somewhat depressing. In 2013, about 21% of girls and 10% of boys reported some form of teen dating violence.
Females, had a higher prevalence of pretty much all combinations of physical and sexual teen dating violence. Students who experienced teen dating violence were more likely to have all other health risk behaviors as well. These data are much more reliable compared to those we have from the past. They also paint a picture of an issue in society that needs remedy. We know it exists, time for research to focus on reducing it.