Electronic Cigarettes: Q&A
FDA proposes to crack down on e-cigarettes, other tobacco products.
Q: When do these rules take effect, if finalized?
A: The next step is a 75-day comment period. It's difficult to estimate how long it will take to review those comments and issue a final ruling, says FDA Commissioner Margaret Hamburg.
Once that happens, the ban on sales to minors and from vending machines goes into effect in 30 days. For the rest, companies will have 24 months to meet the new rules. They can continue marketing their products during that time.
Q: Who is using e-cigarettes?
A: "At this point we have far more questions than answers about who is using e-cigarettes and how they are being used," Zeller says. There is some evidence, he says, that hard-core cigarette smokers may turn to e-cigarettes when they can't light up.
In that case, he says, e-cigarettes are not helping them stop smoking, but merely serving as a bridge from the last regular cigarette to the next.
Young people represent a growing group of e-cigarette users, and that concerns public health experts. Between 2011 and 2012, the number of middle and high school students who used e-cigarettes doubled, reaching 1.78 million, CDC statistics show.
Anti-tobacco experts are concerned that the e-cigarettes will lead the teens to become regular cigarette smokers. Most smoked both types of cigarettes.
Q: What are the health effects of e-cigarettes?
A: The FDA and other experts are still trying to find that out, Zeller says.
The FDA has funded numerous studies to look at the health effects of e-cigarettes, he says. Nicotine, the main ingredient, is addictive, but little research exists on its effects.
A recent study with 1,000 smokers in “real world” conditions found that e-cigarette use did not help people quit smoking.
Another study funded by The Consumer Advocates for Smoke-Free Alternatives Association says e-cigarettes pose no health concerns for the average person. They evaluated 9,000 samples from vapors of e-cigarettes.
And earlier this month, the CDC reported that calls to poison control centers about the nicotine in e-cigarettes rose dramatically in the past several years. More than half of the calls involved children under 5. The liquid nicotine is toxic, and children can be poisoned by swallowing it, inhaling it, or absorbing it through the skin.
Q: What is the industry reaction to the proposed ruling?
A: At least two makers of e-cigarettes released statements supporting the proposed regulations.
Lorillard, which produces blu eCigs, says it applauds the FDA efforts and that it has already initiated some proposed measures, such as limiting minors' access.
NJOY, another e-cigarette maker, says its mission is to make regular cigarettes obsolete. It contends that e-cigarettes are better alternatives that can reduce cancer and heart disease.
Q: What is the public health reaction to the proposed ruling?
A: Many public health organizations, including the American Lung Association, welcome the FDA’s plan.
“It's a major step," says Roy S. Herbst, MD, PhD, chief of medical oncology at Yale Cancer Center and chair of the American Association for Cancer Research Tobacco and Cancer Subcommittee.
"It's getting a message out, even if the regulations don't start right away, about the harm these products can have in getting youngsters and others hooked on a nicotine-addictive product."
The e-cigarettes may play a role in helping people quit, he says, ''but have them be governed by the same FDA regulation.''