Last updated: May 03. 2014 11:31PM - 2509 Views
By Bill O’Boyle boboyle@civitasmedia.com

Mark Sweeting of Primal e-cigarette store in the Pine Mall off Kidder Street in Wilkes-Barre stands in front of a display case of e-cigarette merchandise.
Mark Sweeting of Primal e-cigarette store in the Pine Mall off Kidder Street in Wilkes-Barre stands in front of a display case of e-cigarette merchandise.
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CDC data on E-cigarettes

• E-cigarette experimentation and recent use doubled among U.S. middle and high school students during 2011–2012, resulting in an estimated 1.78 million students having used e-cigarettes as of 2012.

• In 2012, an estimated 160,000 students who reported ever using e-cigarettes had never used conventional cigarettes. This is a serious concern because the overall impact of e-cigarette use on public health remains uncertain.

• In youths, concerns include the potential negative impact of nicotine on adolescent brain development, as well as the risk for nicotine addiction and initiation of the use of conventional cigarettes or other tobacco products.

• During 2011–2012, current use of e-cigarettes among all students increased from 1 percent to 2.1 percent; among high school students increased from 1.4 percent to 2.8 percent; among middle school students increased from 0.5 percent to 1.1 percent.

In 2012:

• 7.2 percent of high school students who had ever used e-cigarettes said they had never smoked conventional cigarettes.

• 20.3 percent of middle school students who had ever used e-cigarettes said they had never smoked conventional cigarettes.

• 76.3 percent of all students who were current e-cigarette users said they also smoked conventional cigarettes.

• 0.5 percent of all high school students who were current e-cigarette users said they also smoked conventional cigarettes.

• 61.1 percent of all middle school students who were current e-cigarette users said they also smoked conventional cigarettes.

FDA Statement on e-cigarettes

• Jenny Haliski, press officer for the FDA in Washington, D.C., issued a statement regarding e-cigarettes:

“Electronic cigarettes are battery-operated products that turn nicotine, which is highly addictive, and/or other chemicals into a vapor that is inhaled by the user. The FDA regulates electronic cigarettes that are marketed for therapeutic purposes as drugs or devices. The FDA intends to propose a regulation that would extend the agency’s “tobacco product” authorities — which currently only apply to cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco — to other categories of tobacco products that meet the statutory definition of ‘tobacco product.’ Further research is needed to assess the potential public health benefits and risks of electronic cigarettes and other novel tobacco products.”

In a release from the CDC, Director Tom Frieden, MD, MPH, said, “E-cigarette use is growing rapidly. There is still a lot we don’t know about these products, including whether they will decrease or increase use of traditional cigarettes.”

CDC’s position is although e-cigarettes appear to have far fewer of the toxins found in smoke compared to traditional cigarettes, the impact of e-cigarettes on long-term health must be studied. The CDC says research is needed to assess how e-cigarette marketing could impact initiation and use of traditional cigarettes, particularly among young people.

WILKES-BARRE — Electronic cigarettes have lit up the local scene and they have ignited a discussion around the country as to their popularity and safety.

Ted Cross, Wilkes-Barre’s director of health, has researched the non-tobacco smoking industry and found pros and cons about the e-cigarettes and the lack of knowledge of the phenomena.

“We’ve really seen an increase in the use of e-cigarettes in our region,” Kross said. “A lot of experts have been crying out for some regulations and guidelines for the sale and consumption of these products.”

The federal Centers in Disease Control (CDC) in Atlanta defines electronic cigarettes, or e-cigarettes, as battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol. Depending on the brand, e-cigarette cartridges typically contain nicotine, a component to produce the aerosol and flavorings like fruit or chocolate.

CDC says:

• Potentially harmful constituents also have been documented in some e-cigarette cartridges, including irritants, genotoxins, and animal carcinogens.

• E-cigarettes that are not marketed for therapeutic purposes were recently regulated by the Food and Drug Administration, but in most states there are no restrictions on the sale of e-cigarettes to minors.

•Use of e-cigarettes has increased among U.S. adult current and former smokers in recent years; however, the extent of use among youths is uncertain.

According to the website The Smokers Angel, an estimated 300,000 to 500,000 cigarette smokers in the U.S. switched to e-cigarettes in the past two years. And up to $200 million of e-cigarettes and related equipment and supplies were sold in the U.S. in 2009.

The website also says e-cigarettes cost about half the price of smoking cigarettes.

Estimates say the industry is growing rapidly and if e-cigarette usage and sales continue growing at similar rates in future years, the number of e-cigarette users and sales could surpass smokeless tobacco products in several years, and could surpass tobacco cigarettes within a decade.

Kross said there are many concerns with e-cigarettes: the nicotine levels in the “juice” used to generate the smoke; the other ingredients used in the flavored juices; the effects on the smoker and second-hand smoke generated; the tendency for users to “progress” to tobacco or other smoking products; the lack of warning labels and/or childproof caps on the juices.

“We need safety measures taken as soon as possible,” Kross said. “The problem is that the research has not caught up to the usage.”

Kross said there is a positive side that he has found. He said he has read some research that revealed through a population study that e-cigarette users are more likely to remain abstinent from smoking compared to those who purchase nicotine replacement therapy products, such as the patch or over the counter products.

“It’s much better to be off tobacco,” Kross said. “When you light up a cigarette, the combustion causes the release of hundreds of different chemicals, including carcinogens, that are inhaled into the lungs and absorbed by the body.”

Kross said by using the juices in e-cigarettes, nicotine is taken in, but there is no exposure to the harmful products found in tobacco.

Despite the initial perception that e-cigarettes are better for you than tobacco, many cities and several states are treating them like tobacco by banning their use in public places — at least until more is learned about them and their effects on health.

“The cities that have banned are being proactive,” Kross said. “Wilkes-Barre is not looking at banning them right now, but we reserve the right to look at that as an option in the future.”

Scientific adviser

Brian King, senior scientific adviser to the CDC’s Office on Smoking and Health, said e-cigarettes were first introduced in 2007 and in the last seven years there has been a significant uptick in use among adults and young people.

King said usage has doubled from 2011 to 2012 among middle and high school students — from 3 percent to 7 percent, which represents approximately 2 million students across the country.

“The increase is not surprising,” King said. “The e-cigarettes are marketed heavily, particularly by television, which is ironic since tobacco advertising on TV has been banned for decades. And the flavors that are offered are very appealing to young people.”

King said there is still not much research on the public impact of e-cigarettes.

“We’re not sure if they are a promise or a peril,” King said. “There are a lot of issues to consider — do they delay smokers from quitting tobacco, could use of e-cigarettes lead to relapse among former smokers, do they encourage young people and non-smokers to start smoking?”

King said at this time there is no conclusive scientific evidence that shows e-cigarettes are effective for long-term smoking cessation.

The U.S. Food and Drug Administration recently proposed rules that would ban sales of e-cigarettes to anyone under 18, add warning labels and require FDA approval for new products. The FDA followed that up with proposing to extend its authority to regulate cigars, hookahs, nicotine gels and pipe tobacco.

King said 25 states have prohibited youth from purchasing e-cigarettes and six states have have banned them from use in public places.

“The primary primary driving factors for the bans relate to potential dangers from aerosol or vapor and potentially hazardous ingredients. They also contain nicotine, which is not without risk,” he said.

King said e-cigarette users often use them more than they smoked tobacco.

Potential toxins

King said some studies have found a host of potentially hazardous toxins and various other ingredients, such as metals, in e-cigarette products.

“There is also concern over the exposure to e-cigarette aerosol products,” King said. “Whatever is in them, when exhaled also exposes bystanders. Anything inside the cartridge could be cause for concern. Second-hand exposure is a legitimate concern.”

King said there have been other reports of people putting other ingredients inside, such as THC (marijuana) which can be inserted and used in areas where e-cigarettes are permitted.”

King said the FDA’s decision to propose rules was long-awaited. He said there is a sense of urgency to regulate the e-cigarettes because of the rapid increase in use of the products and the advertisement.

“It’s really become a Wild West in the market,” King said. “People should err on the side of caution until we have more scientific information and regulation.”

While most people agree that banning the sale of e-cigarettes to minors would be a step in the right direction, health experts still aren’t certain whether the products help smokers kick the tobacco habit, or put non-smokers and former smokers on track to return to tobacco.

King said some health experts believe that inhaling the vapors from e-cigarettes without the presence of tar and other products could help people quit tobacco.

Locally, e-cigarettes are being sold in specialty shops, such as Primal in Wilkes-Barre and Fog in the Gateway Shopping Center, Edwardsville. An e-cigarette store is slated to open in downtown Wilkes-Barre in the near future.

These shops sell the higher-end devices and juices, while lower priced variations can be purchased in convenience stores, gas stations and newsstands.

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