Waiting for the Vapor to Settle

In an educational environment where the slide rule, the overhead projector, and even the blackboard have been rendered obsolete, there’s always new technology for Principal Paul Bower to think about. One of his newest concerns is electronic cigarettes. “We’re seeing a lot more of them and they can be smoked right inside class,” said Bower. “It’s definitely a huge issue for us, and it’s getting bigger.”

Electronic cigarettes differ from their traditional counterparts primarily in that they contain no tobacco. E-cigarettes typically consist of a metal tube which contains a battery, a heat source, and a cartridge filled with nicotine- infused “e-juice.” When a smoker draws on the mouthpiece, the battery supplies power to the heat source which rapidly warms the e-juice until it begins to evaporate.

E-juice is the tobacco analogue of e-cigs. Cigarettes have historically come in two flavors: regular or menthol. E-juice cartridges come in a myriad of flavors, colors, and nicotine concentrations. Vape Dudes, an online e-juice vendor, currently boasts “pumpkin cheesecake” as its flavor of the month.

With such appealing flavors, it’s easy to draw parallels to how traditional cigarettes were marketed to children in the 1930s and 40s. In fact, America has been in this exact spot before. In September of 2009, the Family Smoking Prevention and Tobacco Control Act made it illegal to sell flavored cigarettes.

E-cigarette manufacturers, have dodged both the classifications of “cigarette” as well as “tobacco product” and are not subject to regulation by the FDA.  When asked whether there was any regulatory body governing the sale of e-cigarettes, FDA spokesperson Jennifer Haliski replied, “not at the Federal level.”

This could all change however. The FDA has announced that it intends to review and potentially expand its definition of tobacco products to include electronic cigarettes.  If electronic cigarettes could be classified as a tobacco product, they would fall into the FDA’s jurisdiction. The agency had estimated that a decision would be reached by October of 2013. As of December 5th, no ruling has yet been released.

Suzaynn Schick, a professor of medicine at University of California, San Francisco, and a researcher for Center for Tobacco Control Research & Education isn’t optimistic that the FDA will ever get involved with e-cigarettes. “The FDA is being asked to regulate them as a drug, but I doubt they will just because there’s so much pushback from vested interests,” said Schick. It’s a situation she’s seen before from the FDA with regard to menthol cigarettes. “The FDA has been sitting on top of evidence that menthol contributes to the toxicity of cigarettes for a couple of years now, and they haven’t done squat to regulate it. They just sit there while more people die and more people become addicted.”

Many advocates have speculated that electronic cigarettes could represent a safer alternative to tobacco. From a hypothetical standpoint, there seems to be merit in this argument. A well-established body of science shows that the vaporization of THC is considerably healthier than traditional means of smoking whole cannabis. The same could be true for electronic cigarettes. Accordingly, the FDA and other independent groups are currently investigating the health risks associated with electronic cigarette use, but until those data are released, nothing definitive can be said. “I just think people are being very premature in making health claims. They may be better than cigarettes, they likely are, but we just don’t know,” said Schick.

The same unknowns surround e-cigarettes as a tool for quitting smoking, but preliminary studies suggest that e-cigs are less effective than traditional cessation devices like the patch or nicotine gum. The Tobacco-Related Disease Research program recently concluded, “more often than not individuals persist in using both e-cigarettes and regular cigarettes, what is commonly called “dual use”.  Another study by the Alere Wellbeing Inc concluded that people using e-cigarettes as a cessation device were actually less likely to successfully quit (by “about 1/3”) compared to participants who had never tried e-cigarettes.

Right now there are a million questions surrounding the e-cigarette industry and about zero answers. Paul Bower is worried about his high school students, so for him, the decision to ban e-cigarettes was an obvious one. “At the school level we treat it as any other tobacco product,” said Bower matter-of-factly. If the federal government could operate with the effectiveness of an Arizona High School, it would seem progress could be achieved. While everybody waits for the smoke surrounding e-cigarettes to settle, there’s one thing that’s still perfectly clear: The safest thing to do is not to smoke at all.

Check out more data and charts regarding the growth of the electronic cigarette industry and the prevalence of e-cig usage in high schoolers and middle schoolers

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