A large-scale survey of e-cigarette use among high school students in England has revealed one in five have accessed them, according to findings published Tuesday in the journal BMC Public Health.

More alarmingly, say academics, a large number of the 14 to 17 year-olds quizzed revealed e-cigarette was their first introduction to tobacco.

More than 16,000 students took part in the study carried out across a large area of England by researchers from Liverpool John Moores University.

In their findings, the researchers urgently call for controls on the promotion and sale of e-cigarettes to children.

E-cigarettes are marketed as an alternative nicotine delivery system that is said to be healthier than tobacco but has sparked a global debate around their safety and efficacy.

The researchers say a key concern with e-cigarettes is the potential to recruit children to nicotine dependence, with almost one-in-20 teenagers who had never smoked conventional cigarettes accessing e-cigarettes.

"Specifically for teenagers, glamorization of e-cigarettes in advertising, celebrity endorsement and the range of attractive designs and flavorings available are likely to be furthering their appeal," the researchers say in the paper.

They expressed concern at the number of non-smoking teens who decided to experiment with "what might be packaged to look like a safe attractive product but actually contains a highly addictive drug."

One of the authors of the study, Professor Mark Bellis said the research suggests people should be very concerned about teenagers accessing e-cigarettes.

"While debate on e-cigarettes has focused largely on whether or not they act as a gateway to tobacco cigarette use, e-cigarettes themselves contain a highly addictive drug that may have more serious and longer lasting impacts on children because their brains are still developing," Bellis said.

Despite being practically unheard of just a decade ago, e-cigarettes are now widely available, heavily promoted yet weakly regulated. Such rapid penetration into teenage culture of what is essentially a new drug use option is without precedent, according to the professor.

The team say the high prevalence of e-cigarette access among teenagers and their use among those who have never smoked conventional cigarettes, highlights an urgent need for age restrictions on the promotion and sale of e-cigarettes.

"Our findings highlight the urgent need for controls on e-cigarette sales to children. The longer such controls are delayed, the greater the number of children likely to want to access e-cigarettes illicitly once a ban on sales to children is imposed," the researchers conclude. Endit

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