The growing use of electronic cigarettes is sparking serious debate among health professionals, regulators, users and the public.
E-cigarettes, which contain nicotene but not tobacco, are battery-powered devices that use heat to produce a vapor and smoking sensation designed to be similar to regular cigarettes.
But are they an effective smoking substitute and cessation device? Are they just the opposite, a gateway product that leads to real smoking? Is the vapor they emit harmful to second-hand inhalers?
These are some of the questions that have been the focus of recent studies and news reports on e-cigarettes.
The city, which has aggressively regulated the use and sale of traditional cigarettes, and has more legislation in the pipeline, has no regulation against the use of e-cigarettes in places like bars and restaurants where regular smoking is banned.
A notice on NYC311, a city website, reads in full:
“There is no regulation in the City that prohibits the use of electronic cigarettes (e-cigarettes) by patrons in food service establishments or individuals in other private businesses. It is up to individual establishments to set rules about whether e-cigarettes may be used on their premises. However, food establishment workers are prohibited from smoking any substance in food service establishments. E-cigarettes may not be sold to minors under the age of 18 anywhere in New York State.”
That could change, however, under two pieces of legislation that have been sitting in the City Council — if the warnings from a group called the Consumer Advocates for Smoke-Free Alternatives Association are correct. The CASAA says the bills “would effectively outlaw e-cigarettes by regulating them into extinction.”
They would do that by redefining “tobacco products” to include e-cigarettes and related components, parts and accessories, the group said.
How dangerous e-cigarettes are is up for debate, however. While some studies have noted that the vapor contains harmful chemicals, a new analysis by Drexel University says the concerns are overblown.
According to the Drexel study, the exposures to chemicals from e-cigarette vapor “fall well below the threshold for concern for compounds with known toxicity. That is, even ignoring the benefits of e-cigarette use and the fact that the exposure is actively chosen, and even comparing to the levels that are considered unacceptable to people who are not benefiting from the exposure and do not want it, the exposures would not generate concern or call for remedial action.”
The study cited other evidence that e-cigarettes are not harmful, but did say that exposure to two chemicals used in them, propylene glycol and glycerin, warrants further study because “the magnitude of the exposure is novel.”
The study was funded by the CASAA.
On the other end of the spectrum is the American Cancer Society, which contends that e-cigarettes may be harmful on their own or could lead to the use of traditional cigarettes.
“There is no scientific evidence that e-cigarettes are a safe substitute for traditional cigarettes or an effective smoking cessation tool,” Russ Sciandra, the ACS New York State director of advocacy said in a recent web post on the topic. “In fact, they may entice young people into trying traditional cigarettes. We also have questions about the safety of these devices. In lab tests, the FDA found some samples contain carcinogens and other toxic chemicals. Using e-cigarettes can be like trading one deadly behavior for another.”
In the middle, perhaps, is The Clinical Advisor, a magazine and website geared toward nurse practitioners and physician assistants.
“Although e-cigarette vapor is likely less toxic than cigarette smoke, calling it safe is a stretch,” a report posted to the site on July 16 said.
The author’s suggestion? More research.