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Better Safe than Sorry?
Despite an increasing number of users who swear that vaping has helped them quit cigarettes, any manufacturer or retailer who tells potential customers that e-cigarettes can help them stop smoking could find himself in trouble. The FDA has not yet ruled on how e-cigarettes should be regulated, which means they can’t be advertised as a smoking cessation product (unlike nicotine gum and nicotine patches, which each underwent the FDA’s approval process years ago). The federal agency has said it will issue e-cigarette regulations this year, but has so far failed to do so.
The lack of federal guidance has left some states scrambling to instate their own regulations, including Utah. The State Legislature has banned sales of e-cigarettes or related products to people under 19, and last year it passed a law banning e-cigarette use in any of the public places regular cigarettes are banned (newspaper ads and full-sized billboards along I-15 paid for by the Utah Department of Health alert drivers to that fact).
This year a bill was introduced, but defeated, to tax e-cigarettes and e-juice at 86 percent, the rate at which tobacco products and supplies are taxed.
The lack of significant testing has led the Utah Department of Health to take a position against e-cigarettes. In the absence of federal regulation, hundreds of companies have popped up that create and sell e-cigarettes and e-juice, says Adam Bramwell, marketing manager for the Department of Health’s Tobacco Prevention and Control Program. “Every company under the sun that could possibly churn out one of these things is doing it,” he says, including some that are willing to cut corners at the expense of safety.
In such an environment, it’s impossible to verify if any given product on the market is safe, Bramwell says. For example, e-juice suppliers label bottles with the percentage of juice that is nicotine, but without regulation it’s impossible to verify whether the labels are correct. Also, e-cigarettes use electricity and batteries, and if not manufactured properly they could fail, causing burns or other injury.
“Ultimately what we’re about is erring on the side of caution,” Bramwell says. “If they were to go through the same regulation procedures, it’s possible we could approve them.”
“What we know about e-cigarettes is that we don’t know enough,” says Dr. Shamus Carr, a thoracic surgeon and assistant professor of surgery at the University of Utah. Because of the newness of e-cigarettes, few scientific studies have been conducted on their health effects, and no studies have examined the long-term effects of breathing e-cigarette vapor, Carr says. Until the FDA declares them to be safe and effective as a smoking cessation device, Carr says he won’t recommend them to his patients who are trying to quit smoking.
But he wouldn’t discourage a patient from using e-cigarettes if they were keeping him off of regular cigarettes, he says. He doubts research will ultimately show e-cigarettes to be as damaging as smoked tobacco. “In general, I think they’re probably healthier than a real cigarette, but it’s not free and clear. It’s not like breathing air.”
For many committed vapers, a shortage of peer-reviewed studies and the state’s warnings mean little when weighed against their own experiences. Hall says she’s noticed a huge improvement in her own health since she replaced most of her cigarette smoking with vaping. After just a few weeks without inhaling the smoke of dozens of cigarettes daily, she noticed her sense of taste and smell had improved. Soon, she no longer woke up coughing, as she had every morning for years, and she could exercise without struggling to breathe.
She acknowledges there may be some health concerns, but compared to the known risks of tobacco smoke, it’s a risk she’s willing to take. “The difference in how my body reacts makes me certain it can’t be as bad for me,” she says.
Especially Not for Youth
Much of the concern surrounding e-cigarettes centers on children and teens. Some worry that decades of effort to dissuade kids from starting cigarettes may be undermined by a new wave of flashy electronic nicotine-delivery systems that appeal to gadget-loving youth. The numerous flavors, as well, seem to have been created to appeal to youngsters, with flavors ranging from mango to maple syrup.
Many states, including Utah, have placed an age limit on e-cigarette sales, but use among minors has increased in recent years. A survey by the Centers for Disease Control and Prevention released in September showed that 10 percent of high school students nationwide had tried e-cigarettes in 2012, up from 4.7 percent in 2011, while the percentage of middle-schoolers who had used them increased from 1.4 percent to 2.7 percent.