The recent unexplained spike in serious illnesses and deaths associated with the use of e-cigarettes has the CDC and some state departments of health extremely concerned about the safety of these products.  The CDC is urging Americans to stop using e-cigarette products until it can determine the cause of these illnesses. New York Governor Cuomo recently encouraged the New York State Department of Health to follow suit.

Meanwhile, youth e-cigarette use is at its highest level ever, making the military’s recruitable population particularly vulnerable to these new health threats. In 2016, CNA published one of the first studies using a nationally representative sample that linked youth e-cigarette use to a higher rate of traditional tobacco use. In that report, we recommended that the Department of Defense (DOD) begin collecting data to identify those joining the military who were using e-cigarettes, since little was known about both the short and long-term health effects of these products. At that time, about 10 percent of youth were using e-cigarettes. Since the study’s publication, youth e-cigarette use has doubled to over 20 percent.  

Nevertheless, DOD did not begin collecting data on recruit e-cigarette use at the Military Entrance Processing Stations (MEPS). In fact, it is now collecting even less information at MEPS about recruit tobacco use than it was previously. Youth enlisting in the military must complete the Accessions Medical History Report (Form 2807-2). The 2011 version of that form asked about tobacco use (question 73), but did not have a check box for e-cigarette use, because e-cigarettes were not yet very popular in the US. The current version of Form 2807-2 does not have any questions about tobacco use. Although, the Health Related Behaviors Survey asks questions about e-cigarette use, it is given to a small proportion of servicemembers every 3 years. In addition, the responses are confidential and cannot be tied back to individual health records, and 2015 is the most recent available data from that survey.

There is no time like the present for DOD to be concerned about the growing trend in youth e-cigarette use. Based on the recent unexplained medical emergencies associated with e-cigarettes, we continue to urge DOD to collect information on the e-cigarette use by servicemembers and recruits. That way, DOD will know more about the population at risk for these illnesses and will be better prepared to assess whether it should create policies on e-cigarette use for both new recruits and current servicemembers. Our work also hypothesized that e-cigarettes can be a gateway drug to marijuana use, which can be a disqualifier for military service. As the risks of e-cigarette use become clearer, more data on military e-cigarette use will enable DOD and the Department of Veterans Affairs to better prepare for the costs those risks impose on military recruits, servicemembers, and our nation.