FDA tackles e-cigarettes: An important first step

You've probably seen someone walking down the street or sitting on an airplane smoking an electronic cigarette -- a smokeless electronic device that allows the user to imitate traditional smoking methods by inhaling a vapor of liquid nicotine. Tobacco companies have recently begun promoting e-cigarettes to hook young people on tobacco, claiming they're harmless and can even help people quit smoking.

But now the U.S. Food and Drug Administration (FDA) has stepped in, proposing new rules to regulate e-cigarettes as tobacco products.

"The reality is we have limited knowledge of what is in e-cigarettes, and if the actual nicotine content on the label is reflective of what's inside. There are no standards for reporting or measuring," says Paul Cinciripini, Ph.D., director of MD Anderson's Tobacco Treatment Program. "Regulation is welcome and further clinical research is needed before e-cigarettes can be promoted as a safe alternative to smoking or as an effective means to quit smoking."

Cracking down on e-cigarettes
E-cigarette sales have jumped from $500 million in 2012 to nearly $2 billion today. This is partly due to hip packing and flavoring options that make e-cigarettes attractive to a new generation of younger smokers. Our tobacco experts are concerned that e-cigarettes may become a gateway form of nicotine for never-smokers, while also preventing those who are trying to quit from kicking their nicotine addiction.

The FDA's proposed e-cigarette regulations would:

• ban the sale of e-cigarettes to Americans under 18 and require purchasers to show photo identification to prove their age
• ban the sale of e-cigarettes in vending machines unless they're in places that don't allow minors
• require e-cigarettes to include warning labels, stating that they include nicotine, which is addictive
• require e-cigarette manufacturers to disclose the ingredients in their products
  

"We expect the FDA to require companies to disclose the exact content and levels of nicotine in their products," says Maher Karam-Hage, M.D., addiction psychiatrist and associate medical director of MD Anderson's Tobacco Treatment Program. "It is also important for us to know what delivery system each e-cigarette has and what nicotine levels to expect in the blood stream as a result of vaping. There are many different models, some of which deliver much more nicotine than others and some that have no nicotine."

An important first step
With the rise in e-cigarettes' popularity, the danger of accidental poisonings has also risen. Earlier this month, the U.S. Centers for Disease Control and Prevention released a report revealing that more than 40% of calls to the U.S. Poison Centers related to e-cigarettes. More than half of these calls are about children under the age of five, who either ingest or inhale the liquid nicotine.

"The actions taken by the FDA represent an important first step that can help bring some order to a completely unregulated industry, and provide the public and scientists with important information to guide future research," says Cinciripini. "We need time to provide scientific data to the FDA regarding a range of issues surrounding e-cigarette use, including youth uptake, use of e-cigarettes among non-smokers and their effectiveness as a cessation tool."