Significant E cigarette health concerns
There is virtually no scientific evidence that E-cigarette use is safe and harmless. On the contrary. The March, 2014 article in the New York Times, “Selling a Poison by the Barrel”, highlighted the fact that the “e-liquids” used as the key ingredient in e-cigarettes is a powerful neurotoxin. This liquid is nicotine in its potent, liquid form and it is easy to obtain with virtually no restrictions. Tiny amounts, such as a teaspoon, of even highly diluted e-liquid can kill a small child. And the fact that this liquid can be flavored and colored raises many alarms about the use and abuse of the substance by children. E-cigarette use among high school students in the U.S. more than doubled from 4.7% in 2011 to 10% in 2012, according to the Centers for Disease Control and Prevention’s National Youth Tobacco Survey. At least 160,000 students who never tried traditional cigarettes, used e-cigarettes.
Wild Wild West
Unlike nicotine gums and patches, e-cigarettes, as well as their ingredients, are NOT regulated. The Food and Drug Administration has yet to impose rules on e-liquids’ sale. Without regulations, it continues to be the Wild West for e-cigarette companies. They continue to roll out more brands in many different varieties and flavors and advertise heavily on high profile television shows, like the Super Bowl.
As early as 2010 the AMA Council on Science and Public Health (CSAPH) recognized the hazards of E-cigarettes to public health and recommended the following:
- E-cigarettes be classified as (nicotine) drug delivery devices and should be subject to FDA 49 regulation with appropriate standards for identity, strength, purity, packaging, and labeling with instructions and contraindications for use, including age of the user.
- State legislatures prohibit the sales of e-cigarettes and all other nicotine devices that are not FDA-approved
- As currently marketed, e-cigarettes be included in smokefree laws but separately from defined from tobacco products
E-cigarette Regulation is needed — now!
American Medical Association (AMA) has taken an even more aggressive stance recently. In June, 2014 the AMA made the following recommendations in regard to E-cigarette regulation:
- Minimum purchase age restrictions
- Disclosures regarding the design, content and emissions;
- Child-proof and tamper-proof packaging and design;
- Enhanced product labeling;
- Restrictions related to flavors that appeal to minors; and
- Prohibition of unsupported marketing claims as a tobacco cessation tool.
- Further development of strategies to prevent marketing of electronic cigarettes and nicotine delivery systems to minors and stem the negative health effects of nicotine on minors.
As the debate rages on, big tobacco investors are buying up e-cigarette companies. The are now more than 100 e-cigarette companies jockeying for market share of both smokers and non-smokers. As stated in the May, 2014 article published in Scientific American, “Smoke Screen: Are E-cigarettes safe?” — the success of all these companies rests on the claim that e-cigarettes are healthier than traditional cigarettes. And, that simply has not been proven.
Something has to be done now, before the ship has sailed too far down what is now an open channel. The government needs to pass legislation regarding the sale and consumption of e-cigarettes. And, the FDA needs to step in and put regulations into place to protect the safety of public health including imposing rules on the sale of e-liquid.
Information about CSAPH and E-cigarettes can also be found at scienceandyourhealth.com
Houston Facial Plastic Surgeon, Russell Kridel, MD, is currently a member of the AMA Board of Trustees and the immediate past chair of the AMA Council on Science and Public Health.
Any views expressed on this blog should be considered personal views of Dr. Kridel and are not official statements of AMA policy (which is set by the AMA House of Delegates) nor are they official descriptions of actions of the AMA Board of Trustees.