State’s Opening Salvo On E-Cigarettes
The California Department of Public Health issued a scathing report on electronic cigarettes Wednesday, calling them unsafe, overtly tempting to children and woefully underregulated.
The agency, which also issued a formal health advisory on electronic cigarettes -- commonly known as e-cigarettes -- warned that their increasing popularity threatened to undo decades of successful smoking cessation efforts in California.
The action taken by the CDPH – which sets a large proportion of health policy in the nation’s most populous state – is a first by a government entity since e-cigarettes began being sold in the U.S. about a decade ago and commonly marketed as a more publicly palatable alternative to tobacco.
“E-cigarettes represent a new health challenge. They're re-normalizing smoking behavior and tempting users,” CDPH Director Ron Chapman, M.D., said at a press conference on Wednesday. He added that the candy-like flavorings used to market e-cigarettes, such as bubble gum and cotton candy, made them particularly enticing to children. A sobering statistic cited by Chapman – that 20% of California's young adults who have used e-cigarettes had never tried the traditional tobacco version – was used as proof of that trend.
According to Chapman, 11.7% of Californians currently smoke -- half of the rate it was when the state began its first official smoking cessation campaign 25 years ago. But he said that increasing market penetration by electronic cigarette makers and a fivefold increase between 2011 and 2013 of retailers selling the product in California threatened to derail those efforts.
Among all adults in California in 2013, 3.5% had used an e-cigarette within the past 30 days, according to CDPH data. That compares with a 1.8% recent usage rate in 2012. Among adults between the ages of 18 and 29, cigarette usage more than tripled during that one-year period from 2.3% to 7.6%.
Chapman said that the claim by manufacturers and marketers of e-cigarettes that they only give off harmless vapors is a “myth.” He noted that the liquid-filled containers that are used to create the vapor inhaled by users contains as many as 10 chemicals on a state-maintained list of substances that cause birth defects and cancer. They include formaldehyde, benzene and tourene -- not to mention the nicotine added to make them a tobacco alternative.
The report also concluded that the vapor produced by e-cigarettes often contain heavy metals such as lead and nickel. “Research confirms that e-cigarettes are not emission-free and their pollutants could be of health concern for both users and those exposed to the secondhand aerosol,” the report said.
Chapman noted that unlike distributors of tobacco, e-cigarette makers and retailers are not required to publicly disclose exactly what substances are in their products.
The report also questioned any suggestions by e-cigarette manufacturers and distributors that they can be used to quit tobacco smoking, which has been one of its biggest marketing claims. Some
“There is no scientific evidence that e-cigarettes help smokers successfully quit traditional cigarettes,” the report concluded. It cited a 2014 study that concluded among those who began using e-cigarettes to quit smoking, 89% were still using the devices after one year.
The e-cigarette lobby blasted the report, calling it a war on its products.
“This report inappropriately paints this complex and important public health topic as a black and white issue,” said Gregory Conley, president of the New Jersey-based American Vaping Association. Conley also contended that Chapman's contention that e-cigarettes do not help traditional smokers quit tobacco as a false claim. “There is ample evidence that vaping helps smokers quit and is far less hazardous than smoking,” Conley noted.
Chapman did concede during a question-and-answer session with reporters that e-cigarettes are not as dangerous overall as their tobacco counterparts, which directly lead to the deaths of more than 500,000 Americans each year. But he maintained they present a public health hazard.
The 32-page report illustrated some perils posed by e-cigarettes that tobacco does not.
The biggest one is that e-cigarette cartridges can leak or even explode and are not child-proof. The report concluded that such incidents put children at risk of being directly exposed to concentrated levels of thesubstances contained in such liquids.
“In California, from 2012 to 2013, the number of calls to the poison control center involving e-cigarette exposures in children ages 5 and under increased sharply from seven to 154,” the report said, suggesting that many such cases were the result of direct exposures to e-cigarette liquids. “By the end of 2014, e-cigarette poisonings to young children tripled in one year, making up more than 60% of all e-cigarette poisoning calls.”
The report contended that the liquid in a single cartridge contained enough nictotine and other hazardous substances to be fatal to a young child.
Moreover, devices intended to refill e-cigarettes have been mistaken for medications such as eyedrops, creating another potential avenue for hazardous exposures, the report concluded.
The pending release of the CDPH report this week prompted Sen. Mark Leno, D-San Francisco, on Monday to introduce a bill that would make e-cigarettes the functional equivalent of tobacco, which would essentially ban its use in many public places and closely regulate the way it is marketed and sold.
“No tobacco product should be exempt from California’s smoke-free laws simply because it’s sold in a modern or trendy disguise,” Leno said. “Addiction is what’s really being sold. Like traditional cigarettes, e-cigarettes deliver nicotine in a cloud of other toxic chemicals, and their use should be restricted equally under state law in order to protect public health.”
Chapman said his agency does not have significant powers to regulate e-cigarettes on its own, but it would launch a public awareness campaign on the potential dangers of the product in the coming months. No specifics on the campaign were immediately available.
