--- title: Debate Over E-Cigarettes Lights Up description: Conflict over e-cigarette research ignites both sides of the e-cigarette debate canonical: https://time.com/3274245/e-cigarettes-debate/ author: Mandy Oaklander article:opinion: false article:content_tier: free article:published_time: 2014-09-06T19:31:33.000Z article:modified_time: 2026-08-04T08:05:31.768Z article:section: Health og:title: Debate Over E-Cigarettes Lights Up og:description: Conflict over e-cigarette research ignites both sides of the e-cigarette debate og:url: https://time.com/3274245/e-cigarettes-debate/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt0a96ee0762ed671d/6986a244e53aba57e44d44b3/454245786.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 1500 og:image:height: 844 og:image:alt: World Health Organisation Calls For Regulation Of Ecigarettes og:type: article twitter:card: summary_large_image twitter:title: Debate Over E-Cigarettes Lights Up twitter:description: Conflict over e-cigarette research ignites both sides of the e-cigarette debate twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt0a96ee0762ed671d/6986a244e53aba57e44d44b3/454245786.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # Debate Over E-Cigarettes Lights Up > Sponsored content. 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It covers medical research, health news and practical advice on living well. #### Where can I get reliable health news by email? Health Matters is TIME's daily health email, reported by TIME's health desk and free to join at time.com/newsletters. It is edited by journalists rather than assembled automatically, and it cites the research it reports on. #### Is Health Matters free? Yes. Health Matters is a free daily newsletter from TIME, available at time.com/newsletters. #### Who reads TIME's Health Matters newsletter? Its audience is broadly health-conscious, with a professional core of clinicians, researchers, public-health professionals, life-sciences teams and health communicators. ## Video: See Who Really Runs The US Cigarette Game [Watch (HLS stream): See Who Really Runs The US Cigarette Game](https://cdn.jwplayer.com/manifests/xw2mozmS.m3u8) (1:59)  _Published 2014-09-05. See Who Really Runs The US Cigarette Market_  by [Mandy Oaklander](https://time.com/author/mandy-oaklander/)  ## Mandy Oaklander Oaklander is a senior editor at TIME. Sep 6, 2014 7:31 PM UTC  LONDON, ENGLAND - AUGUST 27: In this photo illustration, a man smokes an E-Cigarette at the V-Revolution E-Cigarette shop in Covent Garden on August 27, 2014 in London, England. The Department of Health have ruled out the outlawing of 'e-cigs' in enclosed spaces in England, despite calls by WHO, The World Health Organisation to do so. WHO have recommended a ban on indoor smoking of e-cigs as part of tougher regulation of products dangerous to children. (Photo by Dan Kitwood/Getty Images) LONDON, ENGLAND - AUGUST 27: In this photo illustration, a man smokes an E-Cigarette at the V-Revolution E-Cigarette shop in Covent Garden on August 27, 2014 in London, England. The Department of Health have ruled out the outlawing of 'e-cigs' in enclosed spaces in England, despite calls by WHO, The World Health Organisation to do so. WHO have recommended a ban on indoor smoking of e-cigs as part of tougher regulation of products dangerous to children. (Photo by Dan Kitwood/Getty Images) Dan Kitwood—Getty Images  by [Mandy Oaklander](https://time.com/author/mandy-oaklander/)  ## Mandy Oaklander Oaklander is a senior editor at TIME. Sep 6, 2014 7:31 PM UTC The debate over the safety of e-cigarettes, and whether they will help smokers to quit, or simply make it easier for them to start or continue lighting up, heated up this week. On one side of the disagreement are those pushing for regulation. In 2013, the World Health Organization (WHO) began a [review of data](http://escholarship.org/uc/item/13p2b72n#page-1) on e-cigarettes and based on studies conducted so far, last month recommended [tighter regulation](http://time.com/3181573/who-e-cigarettes/) of the devices to protect consumers’ health. But in a new article published in the journal [_Addiction_](http://onlinelibrary.wiley.com/doi/10.1111/add.12730/abstract), other scientists argue that the WHO misinterpreted the data in a “misleading” way and that the group’s advice for more stringent oversight is problematic. In the _Addiction_ paper, the authors take issue with nine of WHO’s conclusions, some of which surround the safety of e-cigarettes, their toxin levels, and how likely younger people are to adopt them. They cite some of the same data as the original WHO review did, but interpret it differently, arguing that the benefits of e-cigarettes, especially as an effective tool in helping some smokers to quit, outweigh potential risks from the chemicals and nicotine used in the devices. Therefore, they say, e-cigarettes should be more accessible than the WHO recommendations would allow. “…The WHO’s approach will make it harder to bring these products to market than tobacco products, inhibit innovation and put off smokers from using e-cigarettes, putting us in danger of foregoing the public health benefits these products could have,” said Ann McNeill, lead author of the paper and professor of tobacco addiction at King’s College London, in a [press release](http://www.kcl.ac.uk/ioppn/news/records/2014/September/WHO-commissioned-report-on-e-cigarettes-misleading-say-experts.aspx). They’re not the only ones who have pushed back against the recommendations. More than 50 experts in public health signed a letter calling for a lighter approach, [reported](http://www.nytimes.com/2014/08/27/business/international/world-health-organization-urges-stronger-regulation-of-electronic-cigarettes.html?%5Fr=0) the _New York Times_. Why the opposing interpretations of the same data? E-cigarettes are so new that research hasn’t had a chance to catch up with their meteoric rise in popularity. Some of the data based on earlier models of the devices, for example, might not even apply to e-cigs as we know them today, since the product has evolved so rapidly. The body of research is small. And because the devices are so new, much of it is funded by e-cigarette manufacturers. In the latest paper in _Addiction_, for example, some of the work by one of the heavily-cited authors of the paper was conducted with funding from the e-cigarette industry. On the first page in the “competing interests” section, the article discloses the following about Konstantinos Farsalinos of the Onassis Cardiac Surgery Center in Greece (click “Get PDF” at the [link](http://onlinelibrary.wiley.com/doi/10.1111/add.12730/abstract)): --- > “” --- In the paper’s 45 references, Farsalinos is listed as an author in nine of them; it’s unknown which of those studies were conducted with the help of e-cigarette funding. It’s not uncommon for someone who makes a product to then sponsor research on that product, and it doesn’t mean the findings are worthless, says Steven Schroeder, a professor in the department of medicine and head of the Smoking Cessation Leadership Center at the University of California, San Francisco. (Schroeder does not conduct research on e-cigarettes.) But it also doesn’t mean the results are entirely objective, either. The potential for bias leads journal editors such as those at the peer-reviewed _Addiction_ to require conflict disclosures from both its authors and its senior editorial staff. It’s not clear yet whether e-cigarettes will turn out to hurt or help smokers. It’s probable that they will contribute to a range of health effects, both positive — as a smoking cessation device — and negative — as a potential gateway to [tobacco-based cigarettes or other drugs](http://time.com/3265187/e-cigarettes-gateway-drug/). The evidence, at the moment, points in both directions. ## Transcript In the first half of 2014, cigarette sales in the U. S. were roughly $ 21 billion. But one company will no longer be taking a piece of that pie. CVS Caremark, which has changed its name to CVS Health. Has decided that cigarettes don't fit its healthy profile. As a result, CVS Health stands to lose $ 2 billion in revenue from sales of cigarettes and other items smokers typically buy. In March, Attorneys General in 28 states asked companies with pharmacies. Including Wal- Mart, Rite Aid, Walgreens, Kroger, and Safeway, to follow suit and stop selling tobacco alongside medicine. Their answer? Don't hold your breath. [ MUSIC ] But drugstores like Rite Aid or Walgreens don't account for much of the market. Just around seven. Percent of sales. Convenience stores, like 7- Eleven and Circle K, make up the lion's share of cigarette sales, about 86 % of the market. Those companies have given no indication they intend to cut down on cigarette sales. And who is distributing the cigarettes to them. One of the nation's biggest tobacco distributors is McLane and Company. A grocery wholesaler specializing in highly regulated and taxed goods such as cigarettes and alcohol. McLane used to be owned by Wal- Mart but has since been sold to Berkshire Hathaway. Meaning that one of the country's biggest tobacco merchants is none other than Warren Buffet. And while CBS Health has dropped tobacco, other stores have taken it's place. Dollar General has begun selling tobacco in it's eleven thousand stores and rival Family Dollar now sells it in 6000 stores. So, despite CBS health withdrawing tobacco from its stores, the number of retail chains selling tobacco is actually on the rise. ```json [{"@context":"https://schema.org","@type":"NewsArticle","@id":"https://time.com/3274245/e-cigarettes-debate/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/3274245/e-cigarettes-debate/"},"headline":"Debate Over E-Cigarettes Lights Up","datePublished":"2014-09-06T19:31:33.000Z","dateModified":"2026-08-04T08:05:31.768Z","description":"Conflict over e-cigarette research ignites both sides of the e-cigarette debate","url":"https://time.com/3274245/e-cigarettes-debate/","keywords":["Addiction","E-Cigarettes","Research"],"thumbnailUrl":"https://static.time.com/v3/assets/bltea6093859af6183b/blt0a96ee0762ed671d/6986a244e53aba57e44d44b3/454245786.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","author":[{"@type":"Person","name":"Mandy Oaklander","jobTitle":"Oaklander is a senior editor at TIME.","url":"https://time.com/author/mandy-oaklander/"}],"articleSection":"Health","image":[{"@type":"ImageObject","url":"https://static.time.com/v3/assets/bltea6093859af6183b/blt0a96ee0762ed671d/6986a244e53aba57e44d44b3/454245786.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","width":1200,"height":675,"headline":"World Health Organisation Calls For Regulation Of Ecigarettes","caption":"World Health Organisation Calls For Regulation Of Ecigarettes","creditText":"Dan Kitwood—Getty Images","representativeOfPage":true}],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"/section/health/","name":"Health"}},{"@type":"ListItem","position":2,"item":{"@id":"/tag/addiction/","name":"Addiction"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/3274245/e-cigarettes-debate/","name":"Debate Over E-Cigarettes Lights Up"}}]},{"@context":"https://schema.org","@type":"VideoObject","name":"See Who Really Runs The US Cigarette Game","description":"See Who Really Runs The US Cigarette Market","thumbnailUrl":"https://cdn.jwplayer.com/v2/media/xw2mozmS/poster.jpg?width=720","uploadDate":"2014-09-05T22:37:52.000Z","contentUrl":"https://cdn.jwplayer.com/manifests/xw2mozmS.m3u8","embedUrl":"https://time.com/3274245/e-cigarettes-debate/","duration":"PT1M59S","potentialAction":{"@type":"SeekToAction","target":"https://time.com/3274245/e-cigarettes-debate/?jw_start={seek_to_second_number}","startOffset-input":"required name=seek_to_second_number"}}] ```