Chances are you have seen the recent advertisements for electronic cigarettes on television, billboards and in magazines. Social media is littered with pop-up and banner ads featuring rugged, masculine men or glamorous starlets. Does it seem like deja vu to you? The tobacco industry used these same tactics to entice new users, many of whom now suffer health effects or worse, death.
Whether it is the act of smoking or the latest got-to-have-it gadget that draws people to e-cigarettes, it's the nicotine that keeps them there. The fact remains that no federal agency currently oversees how e-cigarettes are made, or how and to whom they are marketed and sold. There is no credible labeling, no testing, and therefore hold no hope of ending nicotine addiction.
While nicotine does not cause cancer, it impacts the cardiovascular system. Delivered in high doses, it can be lethal. There is no conclusive scientific evidence that e-cigarettes provide long-term cessation and in many cases serve as a tool for dual use - smoking cigarettes and e-cigarettes leads to increased nicotine consumption.
There are FDA-regulated nicotine replacement therapies, such as the patch or gum. These contain low doses of nicotine and are time-released slowly into the body. These are evidence-based, quality-controlled methods. E-cigarettes do not meet these criteria. Until such evidence can be provided on e-cigarettes, they should not be considered safe and should not be used as a cessation tool.
A recent study of quit line participants in several states found that people using e-cigarettes were significantly less likely to quit smoking compared with people who had never tried e-cigarettes. Overall, approximately 50 percent of Utah adults who use other tobacco products (other than cigarettes) also smoke cigarettes (Crankshaw et al, 2012).
Because they are not regulated, it is impossible to know exactly what is in the vapor. It took decades of studies and evidence gathering before a public health statement could be made about the danger of cigarettes. E-cigarettes, in various forms have only been around less than a decade. Meanwhile, many of the studies the e-cigarette industry presents to support its claims are funded by the very industry selling the product. Deja vu?
The top three tobacco manufacturers in the U.S. all sell e-cigarettes. The tobacco industry was a pioneer in commissioning apparently "independent" research as a strategy to support its public relations goals of protecting and advancing the industry's interests. In 1953, tobacco companies were advised that the best way to fight against the emerging evidence of the link between smoking and cancer was not to deny the research outright but to say more research is warranted, thereby creating doubt. Now they are banking on a limited body of evidence related to e-cigarettes and are claiming that the "research" they have is credible.
Worst of all, e-cigarettes are designed and flavored to be attractive to children and young adults. Youth are using e-cigarettes at unprecedented rates. In 2011, 1 in 20 Utah Students (grades 8, 10, and 12) had tried e-cigarettes. The Centers for Disease Control (CDC) recently showed that e-cigarette use has doubled since 2011, prompting CDC's conclusion that e-cigarette use is "condemning many kids to struggling with a lifelong addiction to nicotine." Moreover, in 2012, an estimated 160,000 students in the U.S. who reported ever using e-cigarettes had never used conventional cigarettes, showing a startling rate of youth initiation. It would seem the progress public health has made in reducing youth use of tobacco products is being undermined.
Public health agencies are responsible for informing the public about risks associated with tobacco products and promoting evidence-based tobacco cessation methods. The most proven methods address both the physiological and behavioral components of addiction; such as the patch in conjunction with behavioral counseling, such as the Utah Quit line. Through these methods we have seen tobacco use rates decline. E-cigarettes must not be marketed in ways that discourage smokers from quitting.
E-cigarettes ought to be regulated to control the amount of nicotine and other substances delivered by e-cigarettes to minimize the health risk to consumers. Until and unless the FDA approves an e-cigarette for the assistance of quitting tobacco, we do not support any health claims. We must avoid repeating history with e-cigarettes.
Anna Guymon is chairperson of the Weber-Morgan Tobacco-Free Coalition.