E-cigarette use among middle school children has doubled in just one year. Last month, the Centers for Disease Control and Prevention (CDC) announced that e-cigarette use also doubled among high school students in one year, and that 1 in 10 high school students have used an e-cigarette. Altogether, 1.78 million middle and high school students nationwide use e-cigarettes. Yet, the Food and Drug Administration (FDA) still is not regulating e-cigarettes. The absence of regulatory oversight means the tobacco industry is free to promote Atomic Fireball or cotton candy-flavored e-cigarettes to our children. Clearly, the aggressive marketing and promotion of e-cigarettes is reaching our children with alarming success.
It is well known that nicotine is a highly addictive substance, whether delivered in a conventional cigarette or an e-cigarette. The use of sweet flavors is an old tobacco industry trick to entice and addict young children to tobacco products, and the entrance of the nation’s largest tobacco companies into this market clearly is having an impact. Why does Big Tobacco care about e-cigarettes? Tobacco use kills more than 400,000 people each year and thousands more successfully quit. To maintain its consumer ranks and enormous profits, the tobacco industry needs to attract and addict thousands of children each day, as well as keep adults dependent. Big Tobacco is happy to hook children with a gummy bear-flavored e-cigarette, a grape flavored cigar or a Marlboro, so long as they become addicted. We share the CDC’s concern that children who begin by using e-cigarettes may be condemned to a lifelong addiction to nicotine and cigarettes.
In addition, the American Lung Association is very concerned about the potential safety and health consequences of electronic cigarettes, as well as claims that they can be used to help smokers quit. With no government oversight of these products, there is no way for the public health and medical community or consumers to know what chemicals are contained in an e-cigarette or what the short and long term health implications might be. That’s why the American Lung Association is calling on the FDA to propose meaningful regulation of these products to protect to the public health.
The FDA has not approved e-cigarettes as a safe or effective method to help smokers quit. When smokers are ready to quit, they should call 1-800-QUIT NOW or talk with their doctors about using one of the seven FDA-approved medications proven to be safe and effective in helping smokers quit.
According to recent estimates, there are 250 different e-cigarette brands for sale in the U.S. today. With that many brands, there is likely to be wide variation in the chemicals that each contain. In initial lab tests conducted by the FDA in 2009, detectable levels of toxic cancer-causing chemicals were found — including an ingredient used in anti-freeze — in two leading brands of e-cigarettes and 18 various e-cigarette cartridges. That is why it is so urgent for FDA to begin its regulatory oversight of e-cigarettes, which must include ingredient disclosure by e-cigarette manufacturers to the FDA.
Also unknown is what the potential harm may be to people exposed to secondhand emissions from e-cigarettes. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (a well-known carcinogen) coming from those secondhand emissions. While there is a great deal more to learn about these products, it is clear that there is much to be concerned about, especially in the absence of FDA oversight.
Ross P. Lanzafame is the American Lung Association National Board Chair. Harold Wimmer is the American Lung Association National President and CEO.