TIME Addiction

E-Cigs Are Smokers’ Favorite Quitting Tool

A patron demonstrates an e-cigarette at Vape store in Chicago, April 23, 2014.
A patron demonstrates an e-cigarette at Vape store in Chicago, April 23, 2014. Nam Y. Huh—AP

"The fact that there isn't industry-wide, definitive proof that e-cigs help all smokers quit for good may be irrelevant to smokers"

Electronic cigarettes are a more popular tool for smokers trying to quit than nicotine gums and patches, according to a new study of consumer behavior from Kantar Media. As e-cigarettes have exploded from niche product to $2 billion-plus industry, big tobacco isn’t the only industry facing disruption. E-cigarettes are shaking up the pharmaceutical business too.

Of the adults who used a product to help them quit smoking in the past 12 months, 57% chose e-cigarettes, compared with 39% who used a prescription drug like Chantix and 39% who used other over-the-counter methods including nicotine gum and patches, according to the study. The study’s results are based on more than 20,000 responses to a questionnaire about health-related behavior mailed to a random sample of about 50,000 American households. The results do not show whether or not e-cigarettes are effective at helping people quit — just that people are trying them.

E-cigarette makers are legally prohibited from making claims that their products can help smokers quit. Among scientists, the question of whether or not e-cigs can really help smokers quit remains unanswered. A highly publicized study of almost 6,000 smokers trying to quit in England, published in the journal Addiction in May, showed that they were more likely to successfully quit if they used e-cigarettes than products like nicotine patches and gum. But the quit rate, while better than other options, was still relatively low — and this was among a group of smokers highly motivated to quit. The health effects of electronic cigarettes are also largely unknown.

But the Kantar Media study results show that right now, for smokers, the science on e-cigs may not matter. “The fact that there isn’t industry-wide, definitive proof that e-cigs help all smokers quit for good may be irrelevant to smokers,” reads Kantar Media’s summary of the findings. And, whether or not the science supports it, e-cigarettes make their users feel better about their health. E-cigarette users are 35% more likely than all adults to say their current health is much or somewhat better than it was a year ago, according to the study. Cigarette smokers were, unsurprisingly, less likely than most adults to think their health had improved. Interestingly, e-cig users were more likely to report feeling healthier than were people using other smoking-cessation methods.

The study also offers a window into the typical e-cigarette consumer. According to the study, almost 6 million adults in the U.S. use e-cigs, compared with the 44 million who use a tobacco or nicotine product (including cigarettes). E-cig users tend to be young and male and have lower household incomes than the national average and are more likely than other adults to play video games and poker, more likely to watch reality TV, and go to bars and nightclubs. E-cig users are also more likely to live in the South. In the region including Alabama, Kentucky, Mississippi and Tennessee, the ratio of electronic-cigarette users to traditional cigarette smokers is nearly 2 to 1, according to the study.

In light of the demographic findings, it maybe isn’t surprising that so many e-cigarette users prefer them to other methods of quitting. For young guys having fun, it’s more fun to “vape” than to do nothing at all.

TIME tobacco

E-Cig Benefits Outweigh Their Harms, New Research Says

A patron demonstrates an e-cigarette at Vape store in Chicago, April 23, 2014.
A patron demonstrates an e-cigarette at Vape store in Chicago, April 23, 2014. Nam Y. Huh—AP

That doesn't mean you should hop on the bandwagon

The debate over e-cigarettes—now a$2 billion industry in the U.S. and growing—is constantly up in smoke.

The primary problem is that we simply do not know what e-cigarettes’ long-term health impacts are, with some people heralding it an effective smoking cessation while others say it’s just more nicotine products on the market—and not smoking, no matter what you inhale, is your best bet. Some early research found that adolescents smoking e-cigarettes will also smoke regular tobacco products, and that there’s an increase in e-cigarette related calls to poison centers around the nation.

But this week, a new paper looking at over 80 studies on e-cigarettes’ safety and their effects on users plays devil’s advocate.

The researchers found that based on the evidence, e-cigs are much less harmful to smokers and bystanders compared to conventional cigarettes. They are becoming more popular, but the numbers—so far—don’t suggest that they are being regularly used by non-smokers or kids. Finally, the researchers found that e-cigs can help some users cut down on their use of regular cigarettes and even quit. As regulating bodies around the world make decisions about how to deal with e-cigs, the researchers conclude that letting e-cigarettes compete with traditional tobacco on the market might actually decrease smoking morbidity and mortality.

“Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to [e-cigarettes] as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use,” the Queen Mary University of London researchers write in their study, published in the journal Addiction.

When it comes to the question of what’s safer, e-cigs or cigarettes, no one is in disagreement. E-cigarettes win. While they still provide smokers with nicotine, which is highly addictive, users do not inhale the toxic smoke and chemicals from regular cigarettes.

Public health experts are split on what role e-cigarettes will play in the nation’s health, but more evidence and further research from both sides of the debate will hopefully keep policy members informed about where the current science stands.

TIME Companies

This Big Tobacco Merger Would Unite 2 Major E-Cig Brands

A salesman waits for customers as he enjoys an electronic cigarette at a store in Miami, Florida on April 24, 2014.
A salesman waits for customers as he enjoys an electronic cigarette at a store in Miami, Florida on April 24, 2014. Joe Raedle—Getty Images

Two of the three biggest tobacco companies, Reynolds American and Lorillard, sent shockwaves through the financial world Friday when they announced they were in talks about a possible merger. If the deal goes through, Reynolds, the maker of Camel cigarettes, would buy Lorillard, best known for its popular menthol cigarette, Newport.

It’s a complex deal with many factors at play, and there’s always a chance it won’t be completed. But the most surprising thing about the potential deal is that it marks the first time electronic cigarettes were one of the driving factors in merger talks between two tobacco companies.

“This transaction in our view will be very positive for the global tobacco industry and could be the just the beginning of future transactions with e-cigs/vapor being the underlying catalyst,” wrote Wells Fargo analyst Bonnie Herzog of the deal. That’s a pretty big milestone when you consider that the first patent for electronic cigarettes was awarded just a decade ago.

Each of the two companies has an electronic cigarette brand. Lorillard acquired its brand, Blu Ecigs, in April of 2012, and it’s the stronger of the two. With the help of celebrity spokespeople Stephen Dorff and Jenny McCarthy, Blu now has about 40% of the retail market share in the U.S. Reynold’s brand, Vuse, which stands out mostly because of its fancy engineering, has yet to be tested on the national market, having gone on sale nationwide only just last month after a trial period in select markets.

Less competition might be bad for smokers of traditional cigarettes, as it could mean higher prices and fewer options. But the merger, if it happens, could be good for smaller players in the electronic cigarette industry. The e-cig business is still small compared to traditional smokes, at roughly $2 billion in U.S. sales compared to tobacco cigarettes’ approximately $100 billion. The merger talks bring awareness and credibility, says John Weisehan Jr, the CEO of Mistic Electronic cigarettes. And J. Andries Verleur, the chief of VMR Products, the market leader in online sales of e-cigs, adds: “The more aware consumers are of the category, the better we do.”

 

TIME E-Cigarettes

Snuff and E-Cigs Are Not Harmless, Say Scientists

New research casts doubt on nicotine's safety—even if you aren't smoking

New research from the American Heart Association journal Circulation shows that patients who stopped using smokeless tobacco after a heart attack had improved life expectancy—similar to that of people who quit smoking. The finding offers new information about the dangers of smokeless tobacco, the risks of which are not as well understood as cigarettes’.

“That was a big surprise for us,” said Dr. Gabriel Arefalk, lead researcher and a cardiologist at Uppsala University Hospital in Uppsala, Sweden. “For smoking, it has been known for decades now that people benefit from discontinuation, especially after having suffered a heart attack, but for snus we had no idea what to expect.”

The researchers reviewed data on 2,474 heart attack survivors under 75 in Sweden who used snus (oral snuff) from 2005 to 2009. About 675 quit. During the two years of follow-up, 69 of those who continued using snus died, compared with only 14 quitters. Based on this data, researchers determined that those who quit snus had almost half the mortality risk of those who didn’t quit, which is similar to the benefit of smoking cessation, according to a release from the American Heart Association

Dr. Arefalk, who is also a clinician, said the researchers wanted to study the problem because they didn’t know what to tell patients about the risks of using snus after a heart attack. He cautioned that the study was small and far from enough to determine a causal relationship, but added “It’s the best evidence we’ve got so far, so from our perspective at our clinic, [the advice to patients] is probably that you should discontinue all kinds of tobacco,” if you’ve had a heart attack, Dr. Arefalk told TIME.

The study is one more piece of evidence that ads to our understanding that smokeless tobacco carries its own risk. Though the study was about snus, it has implications for other kinds of nicotine delivery systems, including e-cigarettes.

The FDA is currently taking comment from experts over the next few weeks as the agency tries to determine the best rules to regulate the nascent e-cig industry, which is approaching nearly $2 billion in U.S. annual sales. And though there isn’t yet enough information or scientific research to back this up, common sense says that e-cigs, which do not burn and contain fewer chemicals than regular tobacco cigarettes, must be better for a smoker’s health. Yet, some cardiologists, as TIME learned, are reluctant to see electronic cigarettes as harm-reduction tools.

For starters, nicotine is not a benign substance, especially when it comes to cardiovascular health. As Dr. Steven Nissen, Department Chair of Cardiovascular Medicine at the Cleveland Clinic, put it, nicotine has “profound effects on the heart.” The highly addictive drug can lead to surges in heart rate, constriction in the blood vessels, and spikes in blood pressure—the very effects that heart medications are designed to counteract.

“To come up with new diabolically clever way to addict Americans to nicotine is a terrible idea,” says Dr. Nissen. “[E-cigarette companies] are pitching very hard that they can make smoking safer. [But] nicotine is an addictive drug, no matter if you smoke it or ‘aerosolize’ it. Why you would want to addict another generation to nicotine is beyond me. Public health suggests we should fight electronic cigarettes the same way we fought tobacco.”

Another concern, beyond the possible impact of nicotine, are concerns about small, potentially toxic, particles and what they can do to the sensitive cardiovascular system, says Dr. Aruni Bhatnagar, a professor of medicine at the University of Louisville and spokesperson on electronic cigarettes for the American Heart Association.

Dr. Bhatnagar is studying the toxic effects of e-cig vapor on mice. Like all doctors, he is careful to point out that we don’t know enough about these devices. But he says that wishful thinking about harm reduction could be especially problematic when it comes to cardiovascular health. The risk of cardiovascular disease for a person who smokes only 2-3 cigarettes a day is already 80 percent of the risk to a pack-a-day smoke. “Very low levels of smoke are very dangerous for cardiovascular tissues. Cancer is more linear—you have to smoke a large amount for a very long period of time to get lung cancer,” he says. “But reducing harmful levels is not going to mitigate the cardiovascular risk. That is why we are greatly concerned about e-cigarettes when it comes to the high sensitivity of cardiovascular tissues to a low level of these pollutants.”

Electronic cigarette manufacturers and their customers often point to the low levels of particles in electronic cigarette smoke as compared to the appropriate levels of air pollution determined by agencies like OSHA. But, Dr. Bhatnagar says, these claims can be misleading because the thresholds take into account the necessity of polluting the air to some degree—they aren’t an endorsement of a safe level of pollution. From a cardiovascular perspective, he says: “There is no threshold, there is no level of these particles that you can say is safe.”

For now: Smokers—and snuffers, and e-cig smokers—beware.

TIME Advertising

What to Say to Your Kids About E-Cig Ads

A woman smokes an e-cigarette.
A woman smokes an e-cigarette. PAUL J. RICHARDS—AFP/Getty Images

What parents can do to offset the impact of a steep rise in TV ads for electronic cigarettes aimed at teens and young adults.

If your kids watch “The Bachelor,” “Big Brother” or “Survivor”—and there is a good chance that they do—odds are growing fast that they are seeing ads for one of the most controversial products to hit the market in years: e-cigarettes.

It’s time for parents to strike back.

A study published today in Pediatrics suggests that e-cigarette makers are aiming their products at young people, ages 12 to 24, by increasing advertising during the shows (such as those above) and on the channels (including AMC, Country Music Television, Comedy Central and TV Land) they watch most.

“If current trends in e-cigarette television advertising continue, awareness and use of e-cigarettes are likely to increase among youth and young adults,” says the study, which was conducted by a team from the nonprofit research institute RTI International and the Florida Department of Health.

The impact of e-cigs, devices that vaporize an addictive nicotine-laced liquid solution into an aerosol mist that simulates the act of tobacco smoking, is hotly debated. On one side are those who argue that e-cigs are much safer than conventional tobacco cigarettes and help people addicted to them to quit. On the other side are those who say e-cigs still pose serious risks, including from liquid nicotine.

What can be said, with great certainty, is that we don’t know nearly enough about the long-term health effects of e-cigs to let young people get hooked on them. And as a parent, this is precisely why the study in Pediatrics and other analyses that have shown e-cigarette companies are spending tens of millions of advertising dollars targeting our kids are so alarming.

So, in the absence of any government regulation of e-cig advertising, here are a few things parents can do:

For starters, as always, the best thing we can do is talk to our kids. Let them know that e-cigarette companies have them in their sights and, as I’ve written, are trying to reel them in with fun flavors and sexy ads that are designed to make them feel all grown up. Tell them that these companies have a vested interest in promoting the idea that e-cigs aren’t bad for them—but the fact is, we aren’t really sure. And share that some experts are concerned that because they contain nicotine, e-cigs may be a gateway to real cigarettes.

Second, set clear expectations. We need to make sure that our kids understand that we don’t want them to vape and will be disappointed if they do. The Campaign for Tobacco-Free Kids has found that “parental attitudes, opinions, and feelings about their kids’ smoking status greatly influence whether or not kids will smoke, even when the parents smoke.” Vince Willmore, the organization’s vice president of communications, says the same principle is sure to hold true for vaping.

Third, set a good example. You should certainly express to your kids your own struggles to quit cigarette smoking, if that’s the case, but don’t vape around them. If you do, they may think it’s something to emulate—especially given the onslaught of ads reinforcing that vaping-is-cool message.

The Pediatrics study found that 50% of youth, ages 12 to 17, were exposed to an average of 21 e-cigarette ads from October 2012 to September 2013, and half of young adults, ages 18 to 24, were exposed to an average of 35 e-cigarette ads during the same period.

That’s a sharp rise from just a couple of years earlier, according to the study. In all, youth exposure to e-cigarette ads on TV increased 256% from 2011 to 2013, and exposure for young adults jumped 321%. More than 80% of the advertisements were for the brand blu eCigs.

The tactic seems to be working. The Centers for Disease Control reported last year that 1.8 million middle- and high-school students said they had tried e-cigarettes in 2012—double the number from the previous year.

“When I give talks about e-cigs I call them ‘Back to the Future’ because I feel like I’ve gotten into a DeLorean and gone back in time,” says Stanton Glantz, a professor of medicine at the University of California, San Francisco and the director of the Center for Tobacco Control Research and Education. “E-cig marking today looks a lot like what conventional advertising for tobacco looked like in its heyday.”

That shouldn’t be surprising. Many of the same companies that have long sold tobacco products—including R.J. Reynolds, Philip Morris parent Altria and Lorillard—have now gotten into the e-cigarette business.

Which leads me to the last thing that parents should do: Advocate. You can begin by writing in and supporting the Food and Drug Administration’s proposed new rules that include banning the sale of e-cigarettes to anyone under 18. But we need to go even further. Urge lawmakers and the White House to ban e-cigarette advertising from television—as has been the case with cigarette ads since 1971.

With e-cigs, tobacco companies are clearly taking a page out of their old playbook. It’s time for regulators to do the same.

 

 

 

TIME E-Cigarettes

E-Cig Ads Luring Teens and Young Adults Jumps 321%

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Ary—Getty Images

E-cigarette marketing has increased dramatically on programming catering to young people

In the last several years, advertising for e-cigarettes has spiked. And since the product is not yet regulated in the same way as conventional cigarettes, that means some particularly impressionable populations are being targeted: young people.

Marketing has increased during programming that caters to adolescents and young adults, according to a new report published in the journal Pediatrics shows—something that has had activists and lawmaker up in arms for some time.

Advertising exposure for e-cigarettes increased 256% for young people ages 12 to 17 from 2011 to 2013. During the same period, exposure for young adults ages 18 to 24 spiked 321%. Over 75% of this advertising was shown on TV networks that cater to these age groups including AMC, Country Music Television, Comedy Central, WGN America, TV Land, and VH1. Over 80% of these ads were for the e-cigarette brand, blu eCigs.

Specifically, the researchers report advertising was present on the top rated shows, “The Bachelor,” “Big Brother,” and “Survivor.” More than 80% of the advertisements were for a single brand, blu eCigs.

Also troubling is the fact that the study authors noted a lack of public health messaging against e-cigarettes. This off-balance poses health risks, they propose.

There is still much we don’t know about the safety of e-cigs, or about how well they work to help people quit (see our recent 5 sketchy things we still don’t know about e-cigs), but recent reports have shown they produce carcinogens, and another recent report found they had only a modest impact on helping highly motivated people to quit.

The FDA recently announced the agency is expanding its jurisdiction to cover e-cigarettes (which thrilled the makers of such devices, as we reported). It proposed a first-time ban on their sale to minors and a requirement for health warnings on products nationwide. However, at the current time, advertising for e-cigs are not regulated like conventional cigarettes.

TIME

E-Cigs Still Produce Carcinogens, Study Shows

New research suggests that some e-cigarettes get hot enough to produce cancer-causing compounds

Vaping may not be the benign drug-delivery system some have thought. E-cigarettes are touted by some to help people curb smokers’ conventional cigarette habit, but new research suggests e-cigs can still produce carcinogens.

E-cigarettes are considered healthier than conventional cigarettes, since smokers are inhaling vaporized nicotine instead of carcinogen-filled smoke. But soon to be published research shows that some popular e-cigarettes can get so hot that they produce some of the same carcinogens as traditional cigarettes. The study looked at higher-voltage e-cigarettes—referred to as “tank-style”—which are heated with larger batteries compared to smaller disposable brands. The new study, which will be published in the journal Nicotine and Tobacco Research, found that tank e-cigarettes can produce the carcinogen formaldehyde when the liquid nicotine is heated at high temperatures, which users can inhale. “This finding suggests that in certain conditions, [e-cigarettes] might expose their users to the same or even higher levels of carcinogenic formaldehyde as tobacco smoke,” the Roswell study says, according to the New York Times.

In April, the U.S. Food and Drug Administration (FDA) announced that it extended its regulatory jurisdiction over more tobacco products, including electronic cigarettes. The agency said it plans to crack down on e-cigarettes by proposing a ban of their sale to people under 18 and by requiring health warnings on packaging.

The trouble with e-cigarettes is that their risks and benefits are still unknown. It remains uncertain whether they help people quit, or if they’re servings as a gateway to regular cigarettes for young people. According to data from the National Youth Tobacco Survey, the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012. There are also questions over whether liquid nicotine is dangerous when put in the wrong hands, given that some tobacco control agencies have seen an uptick in poisonings.

There’s an overall lack of research on e-cigs, but researchers are beginning to fill that hole, and lately, the findings haven’t looked good for e-cigarettes.

 

TIME

E-Cig Execs Are Actually Thrilled With New FDA Regulations

Customers at Henley Vaporium in New York, Dec. 2013.
Customers at Henley Vaporium in New York, Dec. 2013. Timothy Fadek—Redux

E-cigarette makers have hailed the Food and Drug Administration's proposed regulations for new tobacco products—including electronic cigarettes, pipe tobacco and hookah, among others—as fair and moderate and a sign of a business-friendly approach

“It’s a great day,” says Christian Berkey, CEO of Johnson Creek, a leading maker of electronic cigarette liquid based in Wisconsin.

Berkey was referring to the FDA’s issuance Thursday of proposed federal regulation of electronic cigarettes, a nascent industry that has grown to nearly $2 billion a year in U.S. sales. The move extended the FDA’s authority to regulate new tobacco products, including electronic cigarettes, pipe tobacco, and hookah, among others.

The FDA will take comments from various stakeholders on the rules over the next 75 days, and it could be a year or more before the regulations take effect, but today’s proposed rules were a big step toward bringing the e-cig wild west under control. Currently, there are no federal rules governing e-cigarettes (though many states prohibit the sale to minors).

“People worried the regulations would be unreasonable and onerous,” says Berkey. “What we are seeing is they are not.” Upon seeing the FDA’s proposed rules today, the businesses are cheering. They see the proposal as a signal that the agency plans to take a business-friendly approach.

Craig Weiss, the President and CEO of NJOY, a popular e-cigarette maker, was even more ecstatic in a press statement: “By resisting calls to regulate ahead of – and indeed in opposition to – the science and data, today the FDA has brought NJOY a giant step closer to achieving its corporate mission of obsoleting cigarettes.”

“I would say that there were certain people that went into this thinking the FDA would be a foe — an irrational, illogical opponent to these devices,” says Miguel Martin, president of Logic Premium Electronic cigarettes, another top e-cigarette manufacturer, “[But] they’ve hit the ball right down the middle of the fairway. It is early, I might change opinion,but the original set up on the process seems extremely fair.”

The proposed regulations would ban the sale of e-cigarettes to minors and in vending machines where minors are allowed, require labels that list the ingredients and warn of the addictive properties of nicotine, and require companies to register new products with the FDA with a rigorous application process before they can put them on the market.

The FDA has not yet proposed to ban flavors, which some anti-smoking advocates say appeal to kids, nor have they banned internet sales or advertising of e-cigarettes. And the FDA has given electronic cigarette companies a two-year window after the regulations go into effect to keep their products on the market while they apply to register new products.

Currently, it is illegal for e-cigarette companies to make health claims that their products are healthier than regular cigarettes or can help people quit—a question that needs more thanks to a court decision ruling in 2009. But in today’s deeming regulations, the FDA opened a pathway for companies to make health claims by submitting supporting research to the FDA.

“I suspect that many companies are going to take a run at that,” says Martin.

The proposals are really just a starting point. Mitchell Zeller, the director of the Center for Tobacco Products at the FDA, called the proposed rules “foundational” today in a call with reporters, signaling that future regulations could ban or restrict things like internet sales, flavors, or advertising. And after the first two year grace period, e-cigarettes will still be subject to potentially long application processes for new products that might hurt business, say manufacturers.

“It’s not time for a victory lap,” says Martin. “A lot can change.”

TIME Addiction

5 Sketchy Things We Still Don’t Know About E-Cigarettes

The FDA has cracked down on e-cigs by asserting its regulatory power and proposing a ban on sales to minors

On Thursday, the U.S. Food and Drug Administration (FDA) flexed its regulatory muscles and extended its authority over more tobacco products, including the highly debated electronic cigarettes, or e-cigarettes. In the announcement, the agency said it now has jurisdiction over items that meet the statutory definition of tobacco products—which includes e-cigarettes, pipe tobacco, and hookah tobacco, among others. The FDA says it also plans to crack down on e-cigarettes by proposing a ban of their sale to people under 18 and by requiring health warnings on packaging.

The UK already has stiff regulations on e-cigarettes and some cities in the U.S., like Los Angeles, have banned them in several public places. The trouble with e-cigarettes is that they are so new, and there’s not enough evidence to definitively determine either how effective they are at helping people quit smoking—or the health risks associated with inhaling vaporized nicotine. Here are five things we are still scratching our heads over.

1. Do e-cigarettes actually help people quit—or are they a gateway for new smokers?
Some e-cigarette brands claim that they can help people wean themselves off regular cigarettes by supplying would-be quitters with nicotine (but without the carcinogens in conventional cigarette smoke). However, recent research is questioning whether they really help people quit. A recent study published in the journal JAMA Internal Medicine looked at self-reports from 949 smokers–88 of whom used e-cigarettes at the start of the study–in order to determine if e-cigarettes were helping people kick or cut back on nicotine. Researchers found that e-cigarettes did not help people quit, concluding, for now at least, that the case for e-cigarettes as a cessation tool is flimsy at best. (The study size was small, signaling a need for more research.)

There’s also the worry that e-cigarettes are tempting people into trying the real thing. Another study published in March found that adolescents who use e-cigarettes are more likely to smoke other tobacco products and regular cigarettes, which suggests that e-cigarettes are not always the lesser of two evils, but instead, just another vector for nicotine exposure. According to data from the National Youth Tobacco Survey, the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012. Of course, there are still not enough studies to reach a firm conclusion that e-cigarettes make people more likely to smoke tobacco—and the FDA says this is not yet determined.

2. How dangerous is liquid nicotine?
The health risks associated with the liquid nicotine used in e-cigarettes are not fully understood. A recent New York Times article found that the liquid could be linked to poisonings; the number of poisonings linked to e-cigarette liquids rose to 1,351 in 2013, which is a 300% increase from 2012. The CDC also released a report earlier this month that showed what they called a “dramatic” rise in e-cigarette-related calls to U.S. poison centers. The spike went from one call a month in September 2010 to 215 calls a month in February 2014. Over half of the calls involved kids age five and under, and 42% involved people ages 20 and older. Known symptoms of liquid nicotine ingestion include vomiting, nausea, and eye irritation.

3. Are the vaporizers safe?
Though the numbers are small, there have been a few cases of e-cigarettes exploding and harming users and the people around them. E-cigs contain a small lithium battery that heats up the liquid inside. The liquid is made up of nicotine dissolved in a colorless liquid called propylene glycol, with added synthetic flavor and sometimes dyes. When an e-cigarette exploded in a Florida man’s face, Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, told the Associated Press that the industry does not know of issues with the cigarettes or batteries exploding.

4. Is propylene glycol dangerous?
Propylene glycol is a a clear, colorless liquid that becomes vapor when it’s heated. It can also be found in food, cosmetics, and pharmaceutical products, and the small amounts people are typically exposed to are largely believed to be benign. However, it’s uncertain whether inhaling propylene glycol could come with unique health risks. “As for long-term effects, we don’t know what happens when you breathe the vapor into the lungs regularly,” Thomas Glynn, the director of science and trends at the American Cancer Society told ABC News. “No one knows the answer to that.”

5. Can you get addicted to e-cigarettes?
As the FDA says, nicotine is “highly addictive.” The FDA says they still don’t know how much nicotine or other potentially harmful chemicals are being inhaled during e-cigarette use. Therefore, it’s hard to tell how much or little damage is being done.

 

TIME tobacco

E-Cigarettes Don’t Discourage Smoking Among Teens

E-Cigarettes Become Increasingly Popular Amongst Smokers
Consumers smoke electronic cigarettes at a mall on June 30, 2013 in Manila, Philippines. Dondi Tawatao—Getty Images

Adolescents who use e-cigarettes are more likely to smoke other tobacco products and regular cigarettes, a new study finds, suggesting that e-cigarettes may not be the lesser of two evils that some had hoped

Are e-cigarettes the lesser of two evils, or just another method of nicotine exposure?

It’s a question public health experts are debating. Some question the benefits of steering smokers towards less harmful products on the nicotine product spectrum. And a new study published in JAMA Pediatrics suggests what medical experts dread: that people who use e-cigarettes are also likely to be regular cigarette users.

Adolescents who use e-cigarettes are more likely to smoke other tobacco products and regular cigarettes. The researchers surveyed 17,353 middle and high school students in 2011, and 22,529 young people in 2012 as part of the National Youth Tobacco Survey.

Youth who reported ever using e-cigarettes or currently using them had a greater likelihood of experimenting with regular cigarettes, smoking on a regular basis, or being a current cigarette smoker. Among young people who had used tobacco cigarettes, trying an e-cigarette was linked to being an established smoker. The researchers also found that teens who used e-cigarettes were more likely to want to quit smoking the next year, but they were also less likely to abstain from cigarettes all together.

The study didn’t look at whether young people are initiating smoking with regular cigarettes and then switching to e-cigarettes, or the other way around. However, e-cigarettes aren’t “discouraging use of conventional cigarettes,” the researchers say.

In September, numbers from the CDC showed that the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012.

“While much remains to be learned about the public health benefits and /or consequences of [electronic nicotine delivery systems] use, their exponential growth in recent years, including their rapid uptake among youths, makes it clear that policy makers need to act quickly,” Frank J. Chaloupka of the University of Illinois at Chicago wrote in a corresponding editorial.

Most recently, Los Angeles extended its city-wide smoking ban to include e-cigarettes.

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