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E-cigarettes ignite debate over regulation, sales

LANSING, Mich. (AP) — Banning the sale of electronic cigarettes to kids may seem like a no-brainer, yet Gov. Rick Snyder’s administration and a number of health advocacy groups oppose legislation that does just that. They say it doesn’t go far enough.
Players on both sides of the state’s e-cigarette debate agree that the nicotine-dispensing devices should be kept away from minors, but opinions differ when it comes to regulating the relatively unstudied vaporizers.
Tobacco companies support two bipartisan Senate bills prohibiting the sale and use of e-cigarettes and other devices that deliver nicotine if the buyer is younger than 18 years old. Sen. Glenn Anderson, D-Westland, said he is sponsoring the legislation because it’s “outrageous” that a minor can legally buy and use a highly addictive product. The bills unanimously passed the Senate Thursday.
But Snyder’s administration and health advocates say the bills would give e-cigarettes a “special status” and protect them from standard tobacco regulations. They want e-cigarettes to be treated like traditional cigarettes, not only in regards to minors, but taxes and public use laws as well. Such regulations would ban e-cigarette use in workplaces or restaurants, a restriction that’s currently left up to individual businesses.
“The appropriate thing to do in Michigan now is to act to help protect the population against the potential health risks of e-cigarettes, about which we know very little,” said Dr. Matthew Davis, chief medical executive for the Community Health Department.
Electronic cigarettes are cylindrical battery-powered devices that heat a liquid to produce vapor. While the liquid often includes nicotine, which can be derived from tobacco, e-cigarettes have not been officially designated as tobacco products. The U.S. Food and Drug Administration regulates cigarettes and smokeless tobacco and has said it intends to propose changes to its authority to regulate e-cigarettes, too.
Twenty-seven states ban the sale of e-cigarettes to minors, according to the National Conference of State Legislatures. Most of those state laws are similar to the Senate legislation.
Opponents are countering with a House bill that would treat e-cigarettes as tobacco products.
Rep. Gail Haines, R-Lake Angelus, introduced the bill Wednesday after working with the administration and health groups such as the American Cancer Society and American Lung Association. She declined to comment before the bill was assigned to a committee.
Anderson said an effort to designate e-cigarettes as tobacco products would fail ahead of the FDA’s decision.
“Most of us would prefer for the FDA to make the decision, and they are going to do it probably sometime this year, but I don’t want to wait,” bill sponsor Sen. Rick Jones, R-Grand Ledge, said. “I want to stop the sale to children now, immediately.”
E-cigarettes are often produced by the same parent companies as traditional cigarettes and have grown increasingly popular over the past few years. U.S. middle and high school students’ use of e-cigarettes more than doubled from 2011 to 2012, the Centers for Disease Control and Prevention reported in September. The share of high school students who had used e-cigarettes in the past 30 days increased from 1.5 percent to 2.8 percent in the survey. More than 1.78 million middle and high school students tried e-cigarettes in 2012.
“As I read to a fourth grade last week, one of the children said, ‘My friends and I bought some and we played with them,'” Jones said on the Senate floor.
Mark Bilger, 18, asked his mother to contact Anderson about concerns over e-cigarettes in September after studying them for his debate club. Bilger, a senior at Detroit Catholic Central High School, said he noticed e-cigarettes were “becoming a real problem in my school” and that students occasionally use them in class “when the teacher’s back is turned” without getting caught “because there’s no smell, there’s only vapor.”
“I think it’s a step in the right direction,” Bilger said about the Senate legislation. “But I think they need some of the same regulations traditional cigarettes have, where you regulate what you put in it and have more testing on it.”
Lance McNally, 39, is one of Jones’ constituents who began using e-cigarettes in December. He owns three e-cigarettes and still smokes traditional cigarettes. He wants to transition fully to vaporizers because “there’s no stench.”
While McNally only uses tobacco-flavored e-cigarette liquid, he said his wife goes for more unusual flavors.
“Strawberry, cheesecake — those are the two main ones,” he said.
McNally said he’s not worried about flavors or advertisements appealing to minors because “I’m not seeing an inundation of marketing.” E-cigarette legislation is unnecessary because many retailers already won’t sell them to minors, he said.
“I don’t think they should be regulated like cigarettes,” McNally said. “I’m kind of a deregulation guy to begin with. I don’t see where the government needs to be wasting its energy and time and my money on another product.”
http://www.usatoday.com/story/news/nation/2014/03/07/e-cigarettes-regulation-sales/6181091/

Teenage E-Cigarette Use Likely Gateway to Smoking

By Caroline Chen, Bloomberg News
E-cigarettes facing municipal bans and scrutiny by U.S. regulators received a new slap on the wrist from scientists: A report today suggests the devices may be a gateway to old-fashioned, cancer-causing smokes for teens.
Youths who reported ever using an e-cigarette had six times the odds of smoking a traditional cigarette than those who never tried the device, according to a study published today in the journal JAMA Pediatrics. E-cigarette use didn’t stop young smokers from partaking in regular cigarettes as well.
The global market for e-cigarettes may top $5 billion this year, according to Euromonitor International Ltd. estimates. Makers of the devices, including Altria Group Inc. (MO), the largest U.S. tobacco company, market them online and on TV, where traditional tobacco ads are banned, and some have added flavors such as bubble gum to the nicotine vapor that may have extra appeal for youths. That allure is why the U.S. Food and Drug Administration needs to restrict the devices, opponents say.
“The FDA needs to act now,” Vince Willmore, spokesman for the Washington-based Campaign for Tobacco-Free Kids, said in a telephone interview. “We think it’s overdue.”
Concerns about underage use of e-cigarettes were raised last year when the U.S. Centers for Disease Control and Prevention in Atlanta reported that use of the devices by youths doubled in 2012 from a year earlier.
“E-cigarettes are likely to be gateway devices for nicotine addiction among youth, opening up a whole new market for tobacco,” said Lauren Dutra, a post-doctoral fellow at the University of California at San Francisco and the report’s lead author. “We’re most worried about nicotine addiction initiation in youth.”

Enticing Product

E-cigarettes “are enticing for kids,” said Donovan Robinson, dean of students at Chicago’s Lincoln Park High School. He said today’s findings weren’t surprising. “They’ll say, ‘Hey, now let’s try the real thing.’”
Children in middle and high school, the target of the research, don’t think about health consequences, he said.
“Everything is a fad with teenagers,” Robinson said. They use e-cigarettes “because it looks cool. Teenagers see somebody doing something cool, and they want to do it.”
The latest research analyzed data from the 2011 and 2012 National Youth Tobacco Survey, conducted by the Centers for Disease Control and Prevention. Almost 40,000 middle and high school students from about 200 schools across the U.S. participated in the survey. Students were asked about their frequency of use of e-cigarettes, conventional cigarettes, cigars, pipes, and other tobacco products.

No Tar

While battery-powered e-cigarettes enable the ingestion of heated nicotine, users avoid the tars, arsenic and other chemicals common in tobacco products that have been linked to cancer, supporters have said.
The study today shows correlation, not causation, said Cynthia Cabrera, executive director of Smoke-Free Alternatives Trade Association, the Washington-based e-cigarette association.
“I’ve yet to see any science that shows there’s a gateway effect,” Cabrera said in a telephone interview. “We want to work with facts and science, we don’t want to make knee-jerk decisions based on emotional responses.”
Cabrera warned against drawing inferences on teen use based on the use of flavors in e-cigarettes.
“We do know that thousands of people were able to switch over to vapor products because of the flavors,” she said in a telephone interview. “Would we deny people who were in a group who could die from tobacco to use flavors that helped them get off killer tobacco?”

Nicotine Effects

Opponents have countered that nicotine alone is so toxic it’s been used in the past as a pesticide. They say the health effects of nicotine, which has proven to be habit forming, are unclear and deserve more study. Until that’s done, they’ve said, advertising of the devices should be closely monitored to make sure it isn’t aimed at underage smokers.
“We’re concerned that the marketing for e-cigarettes risks re-glamorizing smoking” among youths who won’t make the distinction between electronic and conventional cigarettes, Willmore said.
In December, a billboard in Miami used Santa Claus to market e-cigarettes and in the recent Sports Illustrated bathing suit issue there was an ad for one of the devices “right in the middle of a bikini bottom,” he said.
“You couldn’t design an ad more appealing to a teenage boy,” Willmore said.

Pivotal Year

This is expected to a pivotal year for producers of electronic cigarettes, with all major tobacco companies either launching new products or expanding their e-cigarette sales exposure, said Kenneth Shea, a Bloomberg analyst. Altria, Reynolds American Inc. and Lorillard Inc. are all expected to pursue U.S. exposure for their e-cigarettes, while closely held Logic Technology Development LLC and Sottera Inc., the maker of the e-cigarette NJoy, try to keep pace, Shea wrote in a report this month.
While tobacco companies have been under the FDA’s watchful eye since Congress gave the agency authority over the $90 billion industry in 2009, e-cigarettes haven’t been subject to the same oversight. The agency is now in the process of readying new rules for the industry designed to establish clear manufacturing standards and set boundaries for how the products can be marketed.
Federal regulators aren’t the only government officials moving to control use of e-cigarettes. On March 4, the Los Angeles City Council voted to join New York and Chicago in banning the use of the electronic products in in workplaces, restaurants and many public areas.

Bans Criticized

The municipal restrictions were criticized by Miguel Martin, president of Logic Technology, the second-largest independent e-cigarette maker in the U.S. Localities should wait for the FDA to make its views known before taking action, Martin said in an interview before the council vote.
“I find it odd that everybody looks to the FDA for guidance on everything else, but because it’s politically expedient, they don’t on this,” Martin said.
http://www.bloomberg.com/news/2014-03-06/teenage-e-cigarette-use-likely-gateway-to-smoking.html

Health Minute: Doctors weigh in on e-cigarettes

(CNN) — Tobacco-less cigarettes called e-cigarettes are gaining popularity in this country.
They can help people quit smoking, but some fear they can get others hooked on nicotine.
Peter Chugaev has been smoking for 45 years and for the past 15 he’s been trying to quit.
“You have a cup of coffee, you go on the deck, you have a cigarette,” Chugaev said.
Now he’s turning to electronic cigarettes to try to quit. Users inhale, but there’s no smoke. Taking a puff triggers a heating coil, which warms up liquid nicotine, in a plastic filter, resulting in nicotine-filled vapor.
But hardcore smokers aren’t the only ones seeking out e-cigarettes.
Young people are as well and this has some health experts concerned because these products are not federally regulated and there is limited research on their safety.
Dr. Sharon Bergquist, with the Emory School of Medicine said, “The greatest concern is that between 2011 and 2012 the rate of use between middle school and high school kids has doubled.”
These products come in flavors that may appeal to young people.
Dr. Thomas Frieden, Director of the Centers for Disease Control says, “Well, there are not a lot of adults who would smoke a cotton candy e-cigarette.”
Health experts worry that once addicted to the nicotine in e-cigarettes, young people may branch out and try tobacco products.
Manufacturers say they don’t market to kids and maintain that electronic cigarettes are a good alternative to conventional cigarettes.
And for Peter, e-cigarettes seem to be helping. He is down from a pack a day of regular cigarettes to about half that and hopes to kick the habit by the end of the year.
http://fox44.com/news/health-minute-doctors-weigh-e-cigarettes

Slick ways tobacco companies are targeting youth

By Carrie McDermott • Wahpeton Daily News

Although the tobacco industry states its marketing only promotes brand choices among adult smokers, they appear to be targeting youth with candy and fruit flavored tobacco products. Tobacco companies spend more than $1 million per hour in the United States alone to market their product, according to the U.S. Surgeon General’s Office.
Tobacco companies spend nearly $10 billion annually to advertise and promote their products in convenience stores, gas stations and other retail outlets. The marketing is very effective because two-thirds of teenagers visit a convenience store at least once a week, according to Tobacco Free Kids.
The Wilkin County Youth and Community Prevention Coalition recently shared examples of tobacco products packaged to mimic gum, candy and mints during its board meeting this month. Part of the group’s mission is to prevent and reduce tobacco usage by youth.
Naomi Miranowski, co-coordinator with YCPC, presented trays of candy, gum, breath mints and tobacco products, showing how closely the colors and packaging match.
“Tobacco companies are studying candy marketing to make their products appear safer,” she said. “One of my favorites is the new Camel Snus Frost. It looks like Ice Breakers Frost gum. Young people may think the Snus is okay as it resembles the gum in mom’s purse.”
Snus is a smokeless, moist powder tobacco product, similar to chew, consumed by placing it under the upper lip. The user gets a nicotine buzz on par with that of a cigarette. Unlike chew or dip, the user swallows the by-product rather than spitting it out. Snus is often produced in teen-friendly flavors such as cherry, apple and citrus.
Miranowski held up a recently redesigned box of Marlboro Black menthol cigarettes that uses the same mint green color packaging as Wrigley’s gum.
“They’re doing this purposely,” she said. “The general coloring is the same, bright green like the Mike and Ike’s candy. There are pinks, oranges and yellows that match candy colors.”
Skoal named one of their chews X-tra Mint, similar to Wrigley’s Extra gum. Other new smokeless tobacco products, which are dissolvable and easily concealed, include sticks, strips and orbs, that look like mints, breath strips and toothpicks.
She held up a three-pack of cigarillos that come in a bright pink package and are strawberry flavored. Another pack, grape flavored cigarillos, is bright purple and white. Even a cigar brand, Santa Fe, has a bright purple box.
Cigarillos are small cigars with sweet flavors, colorful packaging and cheap pricing. Brands include Swisher Sweets and Sugarillos, and come in flavors including peach, apple, grape and cherry.
Miranowski said she purchased the tobacco, candy and gum from the local Walmart and explained what she was doing to the clerk, who told her that young tobacco users, those who have recently turned 18 — the legal age to purchase tobacco – usually buy the fruit-flavored tobacco products.
“‘That’s what they go for,’ she told me,” Miranowski said. “They sell out of these things. Kids buy these because they’re cool.”
The YCPC board also examined an e-cigarette in black packaging.
“Stop ‘n’ Go sells a candy that matched the refills almost exactly,” she said. “It’s been eye-opening.”
She said she will use the examples to share during the Hidden in Plain Sight event that’s held at local high schools during their parent-teacher conference nights.
“I want these to be set out so parents can see what these are and how these tobacco products are not safe,” she said.
http://www.wahpetondailynews.com/news/article_92ec8fe0-a094-11e3-9da1-0019bb2963f4.html

To the Editor: Curbs on E-Cigarettes

To the Editor:

Re “Hot Debate Over E-Cigarettes as Path to Tobacco, or From It” (“The New Smoke” series, front page, Feb. 23):

As you note, the health effects of e-cigarette use remain unknown, and their use may actually be leading to greater smoking of traditional cigarettes, especially among children.

In fact, a recent study of 76,000 South Korean teenagers indicates that users of e-cigarettes were less likely to succeed in quitting smoking and were more likely to be heavy smokers.

The availability of e-cigarette flavored vapors (mango and watermelon) enhances the attraction. The troubling increase in the use of e-cigarettes among American teenagers found in the survey by the Centers for Disease Control and Prevention, also reported in the article, suggests that e-cigarettes are a gateway to tobacco addiction.

The American Thoracic Society, as a member of the Forum of International Respiratory Societies, supports an age restriction and government regulation of the sale of e-cigarettes, which in many states do not exist. Until more research is done, it is dangerous to promote their widespread use.

PATRICIA FINN
Chicago, Feb. 24, 2014

The writer is president of the American Thoracic Society and chairwoman of the department of medicine at the University of Illinois Chicago.

http://www.nytimes.com/2014/02/28/opinion/curbs-on-e-cigarettes.html?_r=0

Candy Flavors Put E-Cigarettes On Kids' Menu

By Jenny Lei Bolario
Electronic-cigarettes are often billed as a safe way for smokers trying to kick their habit. But it’s not just smokers who are getting their fix this way. According to the Centers for Disease Control and Prevention, 1 in 5 middle schoolers who tried one say they’ve never smoked a cigarette. And between 2011 and 2012, e-cigarettes doubled in popularity among middle and high school students.
At a middle school in the San Francisco Bay Area, 8th grader Viviana Turincio noticed some kids smoking in class– or at least, that’s what it looked like.
“There was a group at the table and they were just smoking on the vape pen and the teacher was right there, and the teacher didn’t even notice,” she remembered.
That’s because her classmates were smoking an electronic cigarette, sometimes called a vape pen. It’s a hand-held, battery-powered device that vaporizes a liquid, which is often infused with nicotine. You inhale the vapor through a mouthpiece, and exhale what looks like smoke. In this case the smoke smelled like candy.
“My favorite flavor is gummy bears because it tastes really good,” Viviana said.
Vapor liquids come in various flavors but teens prefer dessert-inspired ones, which are more appealing than the smell and taste of burning tobacco. Marleny Samayoa, also in the 8th grade, thinks traditional cigarettes taste too bitter. “It has kind of a weird taste to it, like coffee without sugar,” she explained.
E-cigarettes are easier for kids to buy than regular cigarettes. There’s no federal age limit for how old you have to be. But some states, including California, prohibit the sale to minors. That’s why middle-schoolers turn to sites like E-bay, where independent sellers don’t ask for your age.
“A lot of kids are getting them online and they’re just introducing it to a lot of other kids and it just keeps going from there,” explained Marleny.
She has noticed the growing popularity of e cigs on social media sites like Instagram. Look up #Vapelife and the pictures are endless. “I take pictures and do tricks, like blowing O’s, blowing them on flat surfaces and making tornadoes,” Marleny described.
Swirling clouds of vapor are touching down in theatres, restaurants and malls, while health professionals are trying to catch up with this new fad.
Dr. Cathy McDonald runs a center for Tobacco Dependence, Treatment and Cessation for Alameda County in California. She admitted that, “right now we don’t have as much information as we would like.” What researchers do know, Dr. McDonald explained, is “ten minutes of smoking an e-cigarette for a person who has never smoked a cigarette does cause a noticeable increase in airway resistance in the lungs.”
But, she conceded, “it’s probably better than smoke and I say that because smoking a cigarette is 4000 chemicals, 400 are poison, 40 cause cancer.”
Researchers haven’t had the time to do long-term studies comparing traditional cigarettes to electronic ones. But at least among my friends, the ones who’ve made the switch have noticed a positive change. My boyfriend, Gray Keuankaew, is one of them.
“Within the two months that I’ve been vaping, my body feels a little bit more healthy,” he said. “I’m a runner, so I’m able to run a bit longer without having to catch my breath. So if it’s gonna be any type of positive benefit, then I’m definitely gonna stick to it.”
I’m glad it’s easier for him to run, but he hasn’t outrun his nicotine addiction. E-cigarettes still have nicotine – you choose what amount you want. The Tobacco Vapor Electronic Cigarette Association estimated that e-cigarette sales will surpass $2.5 billion dollars this year. Geoff Braithwaite owns Tasty Vapor, a company in Oakland that sells and distributes liquids for e-cigarettes.
“Our target customer base is those people who felt doomed to a life of smoking,” said Braithwaite. But he admits that adults aren’t the only ones who may be jumping on this new trend. “There’s going to be that novelty around it, it’s a brand new thing, it’s an electronic device. That kind of stuff will always appeal to kids, it would have appealed to me.”
Anti-smoking campaigns spent decades and billions of dollars to make smoking lessappealing to youth– helping cut teen smoking by 45%. But cheap prices for brightly colored e-cigs, sweet flavors, and the ability to vape anywhere is putting nicotine back on the kids menu. The Food and Drug Administration has said it plans to regulate e-cigarettes, but so far the agency hasn’t issued any rules.
http://www.huffingtonpost.com/youth-radio-youth-media-international/candy-flavors-put-e-cigar_b_4833286.html

Candy Flavors Put E-Cigarettes On Kids' Menu

by JENNY LEI BOLARIO, NPR Youth Radio
Electronic cigarettes are often billed as a safe way for smokers to try to kick their habit. But it’s not just smokers who are getting their fix this way. According to a survey published by the Centers for Disease Control and Prevention, 1 in 5 middle school students who’ve tried one say they’ve never smoked a “real” cigarette. And between 2011 and 2012, e-cigarettes doubled in popularity among middle and high school students.
At a middle school in the San Francisco Bay Area, Viviana Turincio, an 8th grader, recently noticed some kids smoking in class — or at least, that’s what it looked like.
“There was a group at the table,” she remembers. “And they were just smoking on the vape pen, and the teacher was right there — and the teacher didn’t even notice.”
Kids as young as 13 purchase e-cigarettes, or “vape pens,” online, where independent sellers don’t necessarily ask a buyer’s age.
That’s because her classmates were smoking an electronic cigarette, sometimes called a “vape pen.” It’s a hand-held, battery-powered device that vaporizes a liquid that is often infused with nicotine. You inhale the vapor through a mouthpiece, and exhale what looks like smoke. In this case the smoke smelled like candy.
“My favorite flavor is gummy bears because it tastes really good,” Viviana says.
Vapor liquids come in various flavors, but teens often prefer dessert-inspired ones, which are more appealing than the smell and taste of burning tobacco. Marleny Samayoa, also in the 8th grade, thinks traditional cigarettes taste too bitter. “It has kind of a weird taste to it, like coffee without sugar,” she says.
E-cigarettes are easier for kids to buy than regular cigarettes. There’s no federal age restriction for how old you have to be to buy them. But some states, including California, prohibit the sale to minors. That’s why middle-schoolers turn to online sites like E-bay, where independent sellers don’t necessarily ask for your age.
“A lot of kids are getting them online,” Marleny explains. “And they’re just introducing it to a lot of other kids, and it just keeps going from there.”
She has noticed the growing popularity of e-cigs on social media sites like Instagram. Look up #Vapelife and the pictures are endless. “I take pictures and do tricks, like blowing O’s,” Marleny says, “blowing them on flat surfaces and making tornadoes.”
Swirling clouds of vapor are touching down in theaters, restaurants and malls, while health professionals are trying to catch up with this new fad.
Dr. Cathy McDonald runs a center for tobacco dependence, treatment and cessation for Alameda County, California. She admits that, “right now we don’t have as much information as we would like.” What scientists do know, she says, is that “ten minutes of smoking an e-cigarette — for a person who has never smoked a cigarette — does cause a noticeable increase in airway resistance in the lungs.”
But, McDonald concedes, “It’s probably better than smoke. And I say that because smoking a cigarette is 4,000 chemicals — 400 are poison, 40 cause cancer.”
Researchers haven’t had the time to do long-term studies comparing traditional cigarettes to electronic ones. But at least among my friends, the smokers who have made the switch say they’ve noticed a positive change. My boyfriend, Gray Keuankaew, is one of them.
“Within the two months that I’ve been vaping, my body feels a little bit more healthy,” he tells me. “So if [there’s going to be] any type of positive benefit, then I’m definitely going to stick to it.”
I’m glad it’s now easier for him to run, but he hasn’t outrun his nicotine addiction. E-cigarettes still contain nicotine — you choose what amount you want. The Tobacco Vapor Electronic Cigarette Association estimates that e-cigarette sales will surpass $2.5 billion dollars this year. Geoff Braithwaite owns Tasty Vapor, a company in Oakland that sells and distributes liquids for e-cigarettes.
“Our target customer base is those people who felt doomed to a life of smoking,” Braithwaite says. But he admits that adults aren’t the only ones who may be jumping on this new trend. “There’s going to be that novelty around it — it’s a brand new thing, it’s an electronic device,” he says. “That kind of stuff will always appeal to kids; it would have appealed to me.”
Anti-smoking campaigns spent decades and a lot of money to make smoking less appealing to youth – and that helped cut teen smoking by 45%. But cheap prices for brightly colored e-cigs, sweet flavors, and the ability to vape anywhere are putting nicotine back on the kids’ menu. The Food and Drug Administration has said it plans to regulate e-cigarettes, but so far the agency hasn’t issued any rules.
http://www.npr.org/blogs/health/2014/02/17/276558592/candy-flavors-put-e-cigarettes-on-kids-menu

E-cigarettes: Are manufacturers using flavors to lure minors to vape?

By Ivey DeJesus | idejesus@pennlive.com , The Patriot-News, Central PA

To understand the concern that the marketing of electronic cigarettes might lure minors into a life of nicotine addiction, consider some of the flavors: cherry, bubble gum, cola, milk chocolate and sugar cookie.
Since their introduction into the U.S. market in 2009, e-cigarettes have grown exponentially in popularity and sales, to the tune of $1.7 billion. Legions of lifelong users have converted to vaping, trading the tar and carcinogens of cigarettes for the seemingly safer alternative.
But with such an aforementioned variety of flavors in e-cigarettes, health experts, substance abuse prevention officials and lawmakers are increasingly concerned that e-cigarette manufacturers are targeting teens.
“They are adding all these interesting flavors and they are pandering to people who are nonsmokers or more specifically kids,” said Dr. Richard Bell, a Berks County pulmonologist and a member of the Pennsylvania Medical Society. “I’m not sure an adult would be attracted to a bubblegum flavor cigarette.”
Bell echoes widely held concerns in the public health community that Big Tobacco is increasingly marketing the electronic devices to minors — using many of the same promotional techniques it used to hook generations to cigarettes — with television and magazine ads, sports sponsorships and cartoon characters.
“Whether e-cigarettes can safely help people quit smoking is also unknown, but with their fruit and candy flavors, they have a clear potential to entice new smokers,”The American Medical Association recently opined.
E-cigarettes are not subject to the federal ban on television advertising. Those calling for action say that much the same same way Big Tobacco used the Marlboro Man, Joe Camel and attractive celebrities to promote their product, e-cigarette manufacturers are doing with modern-day celebrities. 
The market saturation amazes Linda Doty, prevention specialist with the Cumberland Perry County Drug and Alcohol Commission. Doty recently Googled e-cigarettes near her Carlisle office and learned that between the West Shore and Newville, there are 100 e-cigarette retailers, the majority of them convenience stores, which draw heavy traffic from young people stopping in for sodas and snacks.
Doty said she is concerned that the increase in young e-cigarette users is playing out amid a dearth of medical evidence regarding their safety. She said a recent study by the the Smoking and Health Behavior Research Laboratory at the Pennsylvania State University found that 20 percent of middle school students who had tried e-cigarettes said they had never smoked regular cigarettes.
“Even e-cigarette manufacturers recommend that breast-feeding women and those with health complications not use the products,” Doty said. “To me that’s an acknowledgment that this could have potential for harm.”
Indeed, a study last year by the U.S. Centers for Disease Control and Prevention found that use of e-cigarettes among teens in 2012 had more than doubled from the previous year. However, at the same time, cigarette smoking among teens continued to decline.
Currently, no federal or state law governs the sale of e-cigarettes. A bill in the state Senate would restrict the sale of the devices to people 18 and older.
Harrisburg resident Keith Kepler challenges the notion that e-cigarettes — and their fruity, candy flavored choices — will lure kids into smoking.
“I’m 57 and, doggone it, I still like strawberry and chocolate,” said Kepler, who began to smoke at 14 and recently quit with the help of e-cigarettes. “That’s the most ridiculous thing I’ve heard of. I still chew bubble gum. You’re telling me we can’t have things flavored bubble gum, because it will lure kids? I don’t get that.”
http://www.pennlive.com/midstate/index.ssf/2014/02/post_662.html

E-Cigarette Makers Give Public the Finger

Rob Waters, Contributor, Forbes
With Sarah Mittermaier and Lily Swartz
In 1964, smoking was everywhere: on television, on airplanes, in workplaces and movie theatres, college campuses, doctors’ offices, restaurants and bars. In the 50 years since the first Surgeon General’s report on smoking and health was released, smoking has gradually faded to the margins of public life. TheMarlboro man was bounced from the airwaves, comprehensive smoking bans were passed in hundreds of cities and 28 states, and smoking rates were cut almost in half. The struggle to protect the public’s health is far from over—and shocking disparities in tobacco use and exposure to tobacco marketing remain—but we’re now reaping some rewards, with eight million lives saved over the past half-century.
But now a new threat is emerging. The use of e-cigarettes is rising rapidly, with teenagers a key target of marketing efforts. “Vaping” is making smoking acceptable—even cool—once again as the tobacco industry returns to its old ways, putting e-cigarette commercials back on the airwaves for the first time since the 1970s.

Right now, e-cigarettes exist in what tobacco control researcher Stanton Glanz calls a regulatory “Wild West,” with no federal regulation of the manufacturing, marketing and sales of these products. This regulatory vacuum threatens to undo the hard-won victories of the past 50 years in tobacco control.
E-cigarette companies are taking a page right out of Big Tobacco’s old-school playbook: marketing their products with sex appeal, celebrity endorsements, even cartoons. The companies argue that “vaping” is safer than traditional smoking and that may or may not be true—there are far too few studies to back up that claim or refute it. But it’s also a smokescreen.
The tobacco industry is out to hook kids, and it’s working. E-cigarettes come in an array of kid-friendly flavors, from“Cherry Crush” to “Coca Cola.” And unlike conventional cigarettes, e-cigarettes can legally be sold to kids in most US states. Data released last year by the Centers for Disease Control and Prevention showed that e-cigarette use more than doubled among middle and high school students in the previous year. For 20 percent of the middle schoolers, e-cigarettes were their first experience with smoking, raising concerns that e-cigarettes may act as a gateway to the use of other tobacco products.
E-cigarettes also threaten to reintroduce smoking to workplaces, restaurants, bars and other public spaces where hard-fought public health campaigns have succeeded in banning cigarettes. These policies have changed our communities from the ground up, creating new expectations and norms around smoking. The science is still out on whether e-cigarettes threaten non-smokers with toxic exposure, but their use in public legitimizes their use, making them seem acceptable, even Golden Globes-glamorous. We can’t let e-cigarettes undo the hard work tobacco control advocates have achieved over the past 50 years.
Some cities and states are pushing back against e-cigarettes, taking steps to regulate the sale and public use of e-cigarettes. Over the past few months, New York and Chicago city councils voted to regulate e-cigarettes as tobacco products, extending existing smoking bans to cover vaping. The Los Angeles City Council voted unanimously to regulate the sales of e-cigarettes. Boston has banned e-cigarette smoking in workplaces. States such as Utah, New Jersey, and North Dakota ban the use of e-cigarettes in indoor public spaces.
These local and state efforts should be followed—and strengthened—by federal action. Attorneys general from 40 states have called on the Food and Drug Administration to regulate e-cigarettes as tobacco products, a move that would give the FDA the power to impose age restrictions and limit marketing of e-cigarettes. Proposed rules drafted by the agency have not yet been released publicly.
We can’t wait years for scientists to conduct new studies on the health risks of vaping before we take action. We know better than to trust the tobacco industry’s health claims about their products—or to trust the industry with our children’s future. The time for action is now. To paraphrase one anti-cigarette commercial in California: “Some people will say anything to sell (e-) cigarettes.”
http://www.forbes.com/sites/robwaters/2014/01/27/e-cigarette-makers-give-public-the-finger/

Are e-cigarettes dangerous?

By Harold P. Wimmer
Editor’s note: Harold P. Wimmer is the president and CEO of the American Lung Association.
(CNN) — For the makers of electronic cigarettes, today we are living in the Wild West — a lawless frontier where they can say or do whatever they want, no matter what the consequences. They are free to make unsubstantiated therapeutic claims and include myriad chemicals and additives in e-cigarettes.
Big Tobacco desperately needs new nicotine addicts and is up to its old tricks to make sure it gets them. E-cigarettes are being aggressively marketed to children with flavors like Bazooka Bubble Gum, Cap’n Crunch and Cotton Candy. Joe Camel was killed in the 1990s, but cartoon characters are back promoting e-cigarettes.
Many e-cigarettes look like Marlboro or Camel cigarettes. Like their old-Hollywood counterparts, glamorous and attractive celebrities are appearing on TV promoting specific e-cigarette brands. Free samples are even being handed out on street corners.

A report from the Centers for Disease Control and Prevention shows the promotion of e-cigarettes is reaching our children with alarming success. In just one year, e-cigarette use doubled among high school and middle school students, and 1 in 10 high school students have used an e-cigarette. Altogether, 1.78 million middle and high school students nationwide use e-cigarettes.

The three largest cigarette companies are all selling e-cigarettes. Because tobacco use kills more than 400,000 people each year and thousands more successfully quit, the industry needs to attract and addict thousands of children each day, as well as keep adults dependent to maintain its huge profits.
Nicotine is a highly addictive substance, whether delivered in a conventional cigarette or their electronic counterparts. The potential harm from exposure to secondhand emissions from e-cigarettes is unknown. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (a well-known carcinogen) coming from those secondhand emissions. We commend New York City recently for banning the use of e-cigarettes indoors.
No e-cigarette has been approved by the FDA as a safe and effective product to help people quit smoking. Yet many companies are making claims that e-cigarettes help smokers quit. When smokers are ready to quit, they should call 1-800-QUIT NOW or talk with their doctors about using one of the seven FDA-approved medications proven to be safe and effective in helping smokers quit.
According to one study, there are 250 different e-cigarette brands for sale in the U.S. today. With so many brands, there is likely to be wide variation in the chemicals — intended and unintended — that each contain.
In 2009, lab tests conducted by the FDA found detectable levels of toxic cancer-causing chemicals — including an ingredient used in anti-freeze — in two leading brands of e-cigarettes and 18 various e-cigarette cartridges.
There is no safe form of tobacco. Right now, the public health and medical community or consumers have no way of knowing what chemicals are contained in an e-cigarette or what the short and long term health implications might be.
Commonsense regulation of e-cigarettes by the U.S. Food and Drug Administration is urgently needed. In the absence of meaningful oversight, the tobacco industry has free rein to promote their products as “safe” without any proof.
A proposal to regulate e-cigarettes and other tobacco products has been under review at the White House Office of Management and Budget since October 1, 2013. The Obama administration must move forward with these rules to protect the health of everyone, especially our children.
The opinions expressed in this commentary are solely those of Harold P. Wimmer.
http://www.cnn.com/2014/01/06/opinion/wimmer-ecigarette-danger/