E-Cigarettes Remain Controversial as New Federal Law, Yale Academic Study Weigh In

Even as new federal rules restricting the sale of e-cigarettes take effect, advocates in Connecticut continue to urge state lawmakers to impose tougher restrictions on electronic cigarettes and vapor products when they reconvene next year.  They warn that a growing number of young people are using these electronic delivery systems to "smoke" what could be harmful and addictive substances. The U.S. Food and Drug Administration announced rules earlier this year that will forbid e-cigarette shops nationwide from selling the products to people younger than 18 and will require staff to ask for identification that proves customers are old enough to buy.  The rules – which take effect this month - would also extend long-standing restrictions on traditional cigarettes to a host of other products, including e-cigarettes, hookah, pipe tobacco and nicotine gels. Minors would be banned from buying the products.

Teens who initially tried e-cigarettes because of their low cost had significantly stepped up their use of e-cigarettes by the time researchers checked in six months later, according to a study that senior researcher Suchitra Krishnan-Sarin, a professor of psychiatry at Yale University School of Medicine, told WebMD in an article published last week.  The low cost of the devices and the promise they can help teens quit smoking tobacco are the two strong predictors of continued use, she said.

In addition, teens who tried e-cigarettes to quit smoking were more than 14 times more likely to keep using e-cigarettes than those who did not consider this a reason to try the devices, the findings showed.  However, e-cigarettes didn't seem to help the kids quit. Four out of five teens who tried e-cigarettes to quit smoking were still puffing regular cigarettes six months later, the investigators found.

"Even though they said they were using e-cigarettes to quit smoking, it doesn't appear to have necessarily helped them," Krishnan-Sarin said.

Jennifer DeWitt, executive director of the Central Naugatuck Valley Regional Action Council, told members of the General Assembly's Public Health Committee this spring that every principal in the 12-town region her organization covers "has a desk drawer of these items that were confiscated from teens this year," including some retrofitted to smoke marijuana, the Associated Press reported.

"Tobacco is a success story for us in the overall picture of prevention. However, we will take a back-slide if electronic nicotine delivery devices continue to be available in the ways that they are currently," DeWitt said.  She said 7.2 percent of Connecticut high school students are e-cigarette users, marking a higher usage rate than all tobacco products combined.

According to the CDC, nationally, 7 out of 10 middle and high school students who currently use tobacco have used a flavored product. In addition:

• 63% of students who currently use e-cigarettes have used flavored e-cigarettes (1.6 million)
• 61% of students who currently use hookah have used flavored hookah (1 million)
• 64% of students who currently use cigars have used flavored cigars (910,000)

Beginning this month, retailers are prohibited from selling the tobacco products to those under 18, placing them in vending machines or distributing free samples, under the new FDA rules. While nearly all states already ban sales of e-cigarettes to minors, federal officials said they will be able to impose stiffer penalties and deploy more resources to enforce the law. The FDA action comes five years after the agency first announced its intent to regulate e-cigarettes and more than two years after it floated its initial proposal, according to published reports.

“Millions of kids are being introduced to nicotine every year, a new generation hooked on a highly addictive chemical” Health and Human Services Secretary Sylvia Burwell said. “We cannot let the enormous progress we’ve made toward a tobacco-free generation be undermined by products that impact our health and economy in this way.”

The CDC indicated that in 2013, more than a quarter million middle and high school students who had never smoked regular cigarettes had used e-cigarettes, a number that had grown three-fold in just two years. A high proportion of middle and high school students saw e-cigarette advertisements (in 2014) from one or more of the following four sources: retail, Internet, TV/movies, and Magazines/newspapers. Overall, 66% of Middle School Students and 71% of High School Student.

The New Haven Register reported that Dr. Roy Herbst, chief of medical oncology at the Yale Cancer Center and Smilow Cancer Hospital, said state and federal policy-makers should do more to rein in the spread of the devices.

“It didn’t go as far as we would’ve liked but it’s a good step in the positive direction and allows for more research,” Herbst said of the new federal rule. “I think now that we finally have this regulation, it will begin to stem the rapid use of e-cigarette use that is running rampant in the United States and around the world.”