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Are e-cigarettes a gateway drug for children?

MARKETWATCH 7:33 AM ET 04/16/14

Symbol Last Price Change
MO 38.445down +0.235 (+0.62%)
RAI 55.01down +0.54 (+0.99%)
LO 53.35down +0.49 (+0.93%)
QUOTES AS OF 10:43:56 AM ET 04/16/2014

Electronic cigarettes are supposed to be designed to wean adults off smoking traditional cigarettes, but a new report suggests that they may do the opposite for children.

The marketing and sale of e-cigarettes to children should be banned, according to a report released Monday by 11 Democratic members of Congress, and flavors that appeal to minors such as "Cherry Crush," "Chocolate Treat" and "Peachy Keen" should also be restricted. "From candy flavors to rock concert sponsorships, every single company surveyed in this report has employed a marketing strategy that appears to target youth," Senator Richard J. Durbin, an Illinois Democrat, said in a statement. "E-cigarette makers are starting to prey on kids, just like the big tobacco companies," added Henry J. Waxman, a Democrat from California.

Between 2011 and 2012, e-cigarette use more than doubled from 0.6% to 1.1% among middle school students and from 1.5% to 2.8% among high school students, a 2013 report by the Centers for Disease Control and Prevention found. Federal laws prohibit traditional cigarettes from being marketed to people under 18 years old, but there are no federal limits for e- cigarette makers. Roughly 28 states prohibit their sale to minors, and legislation is pending in several others. The Food and Drug Administration, meanwhile, has invited e-cigarette firms to cooperate with the agency on regulation.

Unlike tobacco products, e-cigarettes carry no child-warning labels. There's been a "dramatic" increase in calls to poison centers related to e-cigarettes, according to a report released earlier this month by the Centers for Disease Control and Prevention. The number of such calls rose from 1 a month in September 2010 to 215 a month in February 2014, the report said, while the number of calls each month involving conventional cigarettes did not show a similar increase during the same time period. "The liquid nicotine used in e-cigarettes can be hazardous," CDC director Tom Frieden said in a statement.

The American Lung Association is "very concerned" with the increase in e-cigarette use in general, especially among children, says Erika Sward, assistant vice president for national advocacy at the ALA, a non-profit organization in Washington, D.C. "The e-cigarette industry does include historic big tobacco and has ripped some of its tactics from the tobacco industry's playbook," like glamorizing the product with celebrity endorsements and advertising that encourages people to switch to e-cigarettes rather than quitting nicotine, she says. Recent e-cigarette commercials feature TV personality Jenny McCarthy and actor Stephen Dorff. Major tobacco companies Altria Group(MO) , Reynolds American(RAI) and Lorillard(LO) have all started producing e-cigarettes. The ALA has repeatedly called on the White House to give the FDA a green light to regulate these products, Sward adds.

The e-cigarette industry says it supports federal regulation -- up to a point. The Smoke-Free Alternatives Trade Association, which represents the vapor products industry, backs proposals to restrict the sale of e-cigarette products to minors, and says it will support any effort made by legislative agencies and organizations to keep vaporizers out of the hands of underage consumers. But Cynthia Cabrera, executive director of the association, says e-cigarettes are markedly different from other tobacco products, and should not be classified as such. "These products do not contain tobacco, but may or may not contain nicotine derived from tobacco," she says.

(Also see: 10 things e-cigarettes won't tell you http://www.marketwatch.com/story/10-things-e-cigarettes-wont-tell- you-2013-11-08.)

Applying the Tobacco Control Act (2009) -- which restricts the sale of tobacco cigarettes online and flavored cigarettes -- to e-cigarettes would be a mistake, Cabrera says. "Big tobacco would inherit the space," she says. "The majority of consumers switch from tobacco cigarettes because they have the opportunity to taste different flavors." The industry should look at naming conventions, she adds. One e-cigarette company, Five Pawns, gives vapor flavors chess- inspired names like "Grandmaster" and "Queenside." Flavors are an integral part of quitting and help people not return to smoking, says Carl V. Phillips, scientific director for The Consumer Advocates for Smoke-free Alternatives Association or CASAA.

Nicotine coupled with tobacco is far more dangerous than the "small amount" of nicotine in vaporizer products, Cabrera adds. However, some studies maintain that vaporizers have carcinogenic properties. Exposure to the nicotine vapor from e-cigarettes resulted in "strikingly similar" gene mutations in bronchial cells as those found in smokers, according to one study in January's "Clinical Cancer Research," a journal published by the American Association for Cancer Research. Nicotine strength in e-cigarettes varies from zero to one or two packs of cigarettes in a single device, CASAA's Phillips says. "You have however much you want and stop there," he adds.

"The world would be better off if nobody but scientists read studies like that," says Phillips, who is also a former professor of public health at the University of Alberta, Canada. These are technical studies that should lead to further scientific analysis, he says, "which is eventually useful for what happens in the real world. Trying to take one of these laboratory events and translate it into policy is almost always a mistake." A separate study published in "BMC Public Health," published by BioMed Central, a scientific publisher in the U.K., found no evidence that e-cigarettes contain harmful contaminants.

While e-cigarette makers contend that the rush to regulate the products could have a negative impact on an industry they regard as a healthier alternative to tobacco, the FDA has found that e-cigarettes vary widely in reliability and quality, and didn't always do what they said on the package. "The FDA found significant quality issues that indicate that quality control processes used to manufacture these products are substandard or nonexistent," the agency's consumer advice page states. Cartridges labeled "no nicotine" did contain nicotine, for instance, and three different e-cigarette cartridges with the same label emitted a markedly different amount of nicotine with each puff.

Other articles by Quentin Fottrell:

Diet soda may trim your lifespan

Cocaine use is going to pot

Treating hangovers is now a billion-dollar industry

-Quentin Fottrell; 415-439-6400; [e-mail]

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