Clearing the air about e-cigarettes

With the rise in popularity of electronic cigarettes, a once declining — and reviled — industry is making a comeback.

Taking a page from the history
books, e-cigarette manufacturers
are using film stars such as 
Stephen Dorff in advertisements.
credit: trinketsandtrash

Featuring flashy packaging and popular flavors such as vanilla, cherry and piña colada, e-cigarettes are marketed as a “safe” alternative to cigarettes. How they work: Heated by a battery-operated device, liquid nicotine is turned into an inhalable smokeless vapor. They deliver an unregulated amount of nicotine — a highly addictive chemical — in every puff. 

“The absence of smoke, which is replaced by the odorless vapor, gives smokers a false sense of security that there’s less risk involved with using e-cigarettes, known as vaping,” says Paul Cinciripini, Ph.D., a behavioral scientist at MD Anderson and director of its Tobacco Treatment Program. “Because e-cigarettes aren’t regulated by the Food and Drug Administration (FDA), we have no evidence to prove they’re safe.

“Unbiased studies must rigorously investigate e-cigarettes because, if these products are regulated and their safety is ensured, there’s considerable potential benefit for nicotine addicts,” he says.

The average smoker attempts to quit at least seven times during his or her lifetime. And for the more than 42 million smokers in the United States, promoting e-cigarettes as a safer alternative may ignite a temptation for those trying to quit. It may also send the wrong message about the dangers of smoking to those who still smoke or possibly become a gateway to smoking for young people.

Currently, more than 3 million middle and high school students and one in four high school seniors in the U.S. smoke. The U.S. Department of Health and Human Services estimates that if more isn’t done to stop the epidemic, 5.6 million children eventually will die prematurely from tobacco-related diseases.

“Passing e-cigarettes off as safe and harmless not only is misleading, it’s irresponsible,” says Alexander Prokhorov, M.D., Ph.D., a tobacco prevention behavioral scientist at MD Anderson and director of the Tobacco Outreach Education Program. “Tobacco companies are well aware that kids are impressionable, and glamourizing ‘vaping’ as the new thing to do will lure a younger generation of smokers along with a new adult population of smokers.”

A recent study conducted by the Centers for Disease Control and Prevention showed e-cigarette use among middle and high school students more than doubled between 2011 and 2012. “This should be a major red flag to everyone because nicotine is very addictive and most smokers start the habit before the age of 18,” Prokhorov adds.

At this time, there are no regulations to stop e-cigarette advertisements on TV, and manufacturers are adopting marketing tactics from long ago, such as paying celebrities to endorse their products. The distribution and promotion of e-cigarettes likely will continue to increase as big tobacco companies such as Lorillard (Newport), Altria (Marlboro) and Reynolds American Inc. (Camel) enter the market.

With these developments and the surge in use — an estimated jump in sales from $500 million in 2012 to $1.5 billion in 2013 — tobacco cessation experts Cinciripini and Prokhorov see an urgent need to regulate the product before more smokers become lifelong addicts.

“It’s encouraging that the FDA recently announced plans to include e-cigarettes as part of the tobacco products it regulates,” Cinciripini says.