They’re touted as the safer, friendlier alternative to conventional smoking, a tool to help smokers quit: electronic cigarette sales are rising rapidly, but what’s not keeping pace with them is regulatory investigation. In fact, as those numbers climb and manufacturers scramble to come up with their own versions of the product to take advantage of the demand, no one really seems to know what’s really in the vapor produced by electronic cigarettes, whether they might cause health problems for users and bystanders, and how they should best be regulated to protect users as well as the general public.
One thing is for sure: despite what manufacturers may claim, the primary byproduct of electronic cigarettes isn’t a “harmless water vapor.” In an interview with Scientific American, Stanton Glantz noted a number of nasties that users inhaled directly, including acetaldehyde, nickel and cadmium. Like their conventional counterparts, electronic cigarettes also produce secondhand smoke, inhaled by both the user and people around her. Every puff comes with a load of formaldehyde, toluene and, of course, nicotine.
After spending years fighting to get these chemicals out of indoor environments and away from children, the United States seems poised to reintroduce them through the unregulated sale and use of electronic cigarettes. While they might offer a way for nicotine addicts to get their fix (and some researchers note that e-cigs themselves could be addictive), it’s not necessarily a safe way — for them or anyone else.
The FDA has no regulatory framework in place for handling them. Initially, it attempted to label them as “unapproved drug/device combination products,” arguing for a ban on imports from China in 2008. The decision was fought in court, allowing for the legal sale of electronic cigarettes, but the FDA still couldn’t regulate them. Though it claims to have plans to do so in the future and is undoubtedly conducting research and development behind the scenes, it’s contending with a growing lobby filling with powerful companies that aren’t appreciative of government intervention in their sales.
These firms maintain that their products are healthy alternatives to cigarettes, something researchers doubt given that many smokers use electronic cigarettes in tandem with conventional versions, continuing dangerous habits and never fully switching over. Furthermore, of course, the products contain their own payload of dangerous chemicals, and users may not be aware of them, making the assumption that the product is safe given the marketing language — a grim reminder of the dangers of marketing. Electronic cigarettes also don’t appear to help smokers quit, given data from studies on the subject.
Meanwhile, groups like the American Cancer Society are raising the alarm, asking for more investigation into electronic cigarettes with an eye towards possible regulation. Before any of the claims about electronic cigarettes can be fairly evaluated, it’s clear that nonbiased studies are critical, and such studies need to include comprehensive followthrough. It’s possible that regulators could be making the same mistake with electronic cigarettes that they did with traditional cigarettes, choosing a slow regulatory path in the face of strong evidence indicating serious health risks associated with their use. Dragging regulatory heels could cost lives, and for every month that the FDA delays making a decision on how to proceed, the electronic cigarette lobby, which includes many familiar faces from the tobacco industry, grows stronger.
The agency lies at a crossroads: it can confront the industry head-on and advocate for the health and safety of the public, or it can remained cowed by pressures from industry, its followers among the public, and lawmakers who favor decreased regulation in general when it comes to all industries in the U.S., even when involved in the production of medical devices and components.
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