On e-cigarettes, many questions but few answers

By Consumer Reports
Maybe a friend or family member uses one. Or maybe you’re using one yourself to try to kick a tobacco habit.
Whatever your experience with electronic cigarettes, it seems that the battery-powered devices, which deliver a form of nicotine and mimic the feel of traditional cigarettes, are here to stay, according to Consumer Reports. Sales grew from about $500 million in 2012 to an estimated $1.5 billion in 2013. That’s a fraction of the cigarette market — roughly $100 billion per year — but reflects a 200 percent growth, in contrast to the steady decline in tobacco sales.
E-cigarettes are marketed as a more socially permissible alternative to smoking. But what exactly are users — and the people around them — breathing in? Are the cigarettes safe? And with flavors such as Cherry Crush, Peach Schnapps, and Vivid Vanilla, to whom are they really marketed? Consumer Reports supplies answers to some key questions about electronic cigarettes.
What’s in them? The main component is a refillable or replaceable cartridge of liquid “juice” that contains nicotine, solvents, and flavors. When users draw on the device, it causes the battery to heat the liquid solution, which is then atomized into a vapor that can be inhaled. The claimed levels of nicotine vary. Blu e-cigs, for example, offer cartridges of different strengths, from no nicotine to approximately 13 to 16 milligrams, with each cartridge containing enough for 250 or more “puffs.”
How are they regulated? At the moment, they aren’t. The Food and Drug Administration is expected to release a proposed rule that would allow the agency to regulate them as they do other tobacco products. That could result in restrictions on advertising or sale to minors. It also would probably require companies to disclose ingredients and conform to certain manufacturing standards.
In the meantime, some states and municipalities — most recently New York City — have enacted bans on e-cigarettes in public parks and indoor venues where cigarette smoking isn’t allowed. You can find a list of local bans at no-smoke.org/pdf/ecigslaws.pdf.
Are they safe to use? We don’t know yet. They expose users and people around them to fewer toxins than tobacco cigarettes, but that doesn’t mean they’re risk free. Nicotine is very addictive, so e-cigs — especially the fruit and candy-flavored ones — could hook young people on the stimulant, or serve as a gateway to real cigarettes, health officials warn.
And because they’re unregulated, you don’t necessarily know what’s in them. In 2009 the FDA detected diethylene glycol, a toxic chemical used in antifreeze, in some e-cig samples and carcinogens called nitrosamines in others. Questions also linger over secondhand “vapor.”
Do they help smokers quit? They might, though Consumer Reports points out that they’re not approved for that by the FDA. And, as with approved quitting methods, the results aren’t that impressive. In a study of 657 smokers published last fall, e-cigs were about as effective as nicotine patches and were slightly better than placebo e-cigarettes, which contain no nicotine.
But the differences were minor, and the overall number of people who quit with any method was low. After six months, about 7 percent of those in the e-cigarettes group and 6 percent of those who used nicotine patches stopped smoking compared to 4 percent of those who used placebo e-cigs.
Bottom line. The main reason it’s so hard to say whether e-cigarettes are safe is that they simply haven’t been around long enough to know. If you’re trying to give up real cigarettes, stick with better studied methods: nicotine gum, patches, and counseling. And if you don’t smoke, don’t start with e-cigs just for fun.
Consumer Reports writes columns, reviews, and ratings on cars, appliances, electronics, and other consumer goods. Previous stories can be found at consumerreports.org.
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