Originally developed in China, e-cigarettes were introduced to the U.S. market in 2007. They are battery-powered units containing a liquid nicotine cartridge and a heating element. The liquid is turned into a vapor that can be inhaled. Manufacturers claim that they are a safe alternative to regular tobacco cigarettes and can even help aid in smoking cessation. The Food and Drug Administration (FDA) has recently released new regulations to keep the public informed and safe.
Typically, the FDA Center for Tobacco Products regulates cigarettes, cigarette tobacco, roll your own tobacco, and smokeless tobacco. Yet in this rapidly evolving tobacco market, it has become evident that e-cigarettes must also fall under their jurisdiction. Under the new April 2014 proposal, manufacturers will be required to register with the FDA and report product and ingredient listing, only market new products after FDA research, and only make direct and implied claims if the FDA confirms that there is enough scientific evidence to support it. Also covered is a minimum age to buy and an ID requirement. This will help prevent sales to underage youth.
These regulations seem to be a step in the right direction, but opponents of e -cigarettes claim there is more to be done. Most agree that the science behind the claims of aiding smoking cessation is lacking. In fact, some wonder if they actually encourage smoking. Instead of switching from regular tobacco cigarettes to e-cigarettes, youth may use e-cigarettes as an introduction to cigarettes and a gateway to other substance abuse. Last year, the CDC reported that the percentage of high school students who reported using e-cigarettes more than doubled in one year. It jumped from 4.7% to 10% from 2011 to 2012. The teens call using an e-cigarette “vaping”.
The FDA did not address the use of flavors. The nicotine cartridges can be flavored with bubblegum, watermelon, thin mint, tootsie roll, etc. These seem to play to the taste preferences of youth and give the allusion of safety. In fact, the flavors hide the level of nicotine which can vary from comparable to regular tobacco cigarettes to levels closer to light cigarettes.
It is important to remember that although there is no tobacco in e-cigarettes, they contain nicotine. Nicotine is so toxic that it is used as a pesticide. Liquid nicotine sold in cartridges for e-cigarettes, can be lethal if ingested in amounts as small as one teaspoon. The poison control center reports 215 calls in the month of February 2014 alone and 51% of those calls involved children. So not only are there toxic side effects to many parts of the smokers body, but the cartridges themselves are a hazard.
As far as second and third-hand smoke with e-cigarettes, much remains unknown. Manufacturers of e-cigarettes want them to be enjoyed and available for use in smoke free zones, but there is an emerging science that suggests there are toxic effects from the vapor particulate matter which worsen indoor air quality and can contribute to cardiovascular and lung disease and cancer.
Many of us in the health industry feel we have made great strides in helping people break the highly addictive habit of smoking. E-cigarettes have been designed as a lesser evil, but raise many issues in regards to safety and purpose, particularly with the younger generation. As always, being informed on the latest science available will help you make the best decisions for you and your family. If you have questions, please do not hesitate to discuss this important topic with your Esse Health Provider.
By Dr. Kristen Terrill, Esse Health Pediatrician
