Monday, Sept. 30, 2013 | 2:01 a.m.
Next month, the Food and Drug Administration is expected to issue proposed regulations for e-cigarettes. Having been exposed to them during the summer, I’m hoping the rules are not overly restrictive.
My sister-in-law, with whom we traveled to Italy in June, is a pack-a-day smoker. In Perugia, she discovered a small vendor selling e-cigarettes. Her purchase was my introduction to e-cigs, or personal vaporizers, as they are known, or electronic nicotine delivery systems.
What I saw was a cartridge with a reservoir and a mouthpiece. A battery heats a liquid solution (which often includes nicotine), and an atomizer facilitates vaporizing. They look like fancy cigarettes, some with LED lights at the tip that resemble a conventional light. However, much to the relief of those in the company of someone “vaping,” e-cigs don’t produce smoke. They emit a mist that quickly disappears without a trace.
My sister-in-law argues that e-cigs are safer than cigarettes, can help you cut down or eliminate the habit, and don’t produce secondhand smoke. Detractors say that they attract new (potentially young) smokers and that the ones with nicotine still have an addictive quality.
E-cigs are still so new that my spell-check default thinks I am typing e-digs. But the Centers for Disease Control and Prevention says that sales in 2011 doubled from 2010. (It’s troublesome that teen usage has spiked.) And Big Tobacco sees the future. Altria, parent of Philip Morris USA and manufacturer of Marlboros, has premiered the MarkTen e-cig. R.J. Reynolds, maker of Camels, has the Vuse e-cig. And Lorillard (think Newports) owns Blu eCigs.
Into this debate will soon step the Food and Drug Administration, which could decide whether to ban e-cigs that are flavored, permit advertising, require warning labels, impose age restrictions and demand premarket approval.
Azim Chowdhury, a Washington attorney who specializes in food and drug law, agrees that e-cigs, which don’t burn tobacco, are less harmful than conventional cigarettes.
“One thing the FDA should address is the need for good manufacturing practices and quality-control standards for the ingredients used in e-liquid,” he told me last week. “These are necessary to ensure those ingredients are free of trace impurities, which could pose health hazards.”
Chowdhury said e-cigs were developed in 2003 by a Chinese company and introduced in the United States three or four years later. In 2009, with the enactment of the Family Smoking Prevention and Tobacco Control Act, the FDA was given the authority to regulate tobacco. The FDA could also “deem” other tobacco-based products to be within its jurisdiction, as long as there is a rule-making process. Some e-cigs qualify because the nicotine used in “e-liquid” is derived from tobacco. E-cigs without nicotine, or those with nicotine from nontobacco sources, aren’t covered under the FDA’s tobacco authority.
Research as to safety of e-cigs is thin, according to Andrew Strasser, the director of the Biobehavioral Smoking Laboratory at the University of Pennsylvania’s Perelman School of Medicine.
“It’s a newer product and the definitive clinical trials have not been conducted and there’s been some smaller-scale studies that have been done, but the results are kind of all over the place,” he said. “There are some reports that there’s a reduction in cigarette smoking when people adopt e-cigarettes. And there’s some support that some people will quit smoking, but at the same time there are some studies that show that people quit even with a very low-nicotine or no-nicotine cartridge, so a lot more has to be done.”
Strasser acknowledges the anecdotal evidence from those like my sister-in-law, who say they’ve been able to abstain from conventional cigarettes after trying e-cigs. Still, he said, “the real clinical trials have not been conducted yet.” In the meantime, he concedes that the presumption is that e-cigs are not as harmful as conventional cigarettes.
“So if we were to do a one-by-one comparison, an e-cigarette to a conventional tobacco cigarette, it seems like it’s very likely that the e-cigarette is less harmful,” he told me. “It’s not combusting and creating a lot of the toxins that we associate with disease and other health problems from conventional cigarettes.
“However, I think the sort of level of analysis you need to think about is: How do people use them? So if people are mixing use between e-cigarettes and commercial cigarettes ... (and) still smoking five to 10 cigarettes a day when they get the opportunity, they are still ingesting a lot of harmful toxins into their body. ... Some people may be using e-cigarettes to circumvent some of these workplace smoking restrictions, and so, at the end of the day, they are still smoking some cigarettes that are doing some harm.”
Of course he’s right. It would be best if everyone just quit. For years, my sister-in-law has tried. However, she is down to half a pack per day, filling the void with e-cigs, which are seemingly less harmful, don’t stink and don’t imperil others. It is hoped the FDA will not impede what seems to be helping.
Michael Smerconish writes for the Philadelphia Inquirer.