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E-Cigarettes: Expert Q&A With the CDC

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WebMD Health News

“Vaping” is a new form of inhaling nicotine that the CDC would like to seriously curb.

It’s what you do with an e-cigarette, and it’s gaining in popularity. The battery-powered cylinders deliver nicotine with a puff of hot gas, minus the smoke.

E-cigarette use doubled among middle and high school students, along with adult smokers, from 2011 to 2012, the recent National Youth Tobacco Survey found. Altogether, in 2012, 1.78 million middle school and high school students had tried e-cigarettes. Three quarters of the students who used e-cigarettes in the previous 30 days also smoked cigarettes during the same period.

The federal government has no authority to regulate e-cigarettes, although that is expected to change soon. The FDA has proposed rules that would allow it to regulate them like other tobacco products.

Tim McAfee, MD, talks to WebMD about why the agency is concerned about their growing use, despite a lack of research on the health risks. McAfee is the CDC’s director of the Office on Smoking and Health.

Q: What do you find most alarming about the findings of the National Youth Tobacco Survey?

A: We don’t like to see kids using any form of nicotine, because nicotine is not a good thing for a developing adolescent brain. ... It’s introducing them to a behavior that is very similar to smoking. The thing that got them interested was mass advertising that glamorizes the act of vaping. It looks comparable to smoking. We’re worrying that the line of separation of smoking e-cigarettes and cigarettes is sufficiently vague, and it will result in more kids smoking.

Q: What do you make of the University of Oklahoma study (researchers surveyed 1,300 college students -- average age 19 -- about their tobacco and nicotine use) that found that electronic cigarettes are not a gateway to cigarette smoking? That the majority of students who were asked said they used them to quit conventional cigarettes?

A: It’s not really relevant to adolescents. It was conducted in college students, average age 19. Until it’s peer-reviewed and published, it shouldn’t be something used to make policy decisions about whether or not (e-cigarettes) have an impact on kids.

Q: But is it bad if people use electronic cigarettes as a nicotine replacement product, a way to quit smoking?

A: It’s illegal for e-cigarettes to be marketed as a smoking cessation aid. A [U.S. District Court of Appeals] judge said if they make medical claims, like the product helps people quit smoking, they’d need to go through a formal FDA process.

In the meantime, there are implied claims and a lot happening in social media, but most of the marketing is taken from the cigarette marketing playbook of 40 years ago -- as sexy and glamorous, a form of rebellion, and as a way to get around secondhand smoke laws. It’s working, unquestionably, because we’ve seen the doubling of use among adults. We certainly think we have enough evidence that if someone switched from a pack of cigarettes to e-cigarettes, it would likely be an improvement in their health. However, it’s important to realize the majority of smokers in the U.S. who experiment with these e-cigarettes continue to smoke and use e-cigarettes sporadically in social situations where they can’t smoke.

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