Cigarette marketing is tightly regulated, but not so a relatively new cigarette substitute, something called an electronic cigarette. These devices are heavily promoted as a way for smokers to inhale nicotine but not the toxins of tobacco cigarettes.
Health advocates are unconvinced and, according to a new poll, so are consumers.
The University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health found that 91 percent of adults in the U.S. think manufacturers should be required to test e-cigarettes for safety.
Likewise, an overwhelming majority -- 85 percent -- favor prohibiting the sale of e-cigarettes to minors and 82 percent think the Food and Drug Administration (FDA) should regulate e-cigarettes like other nicotine-containing products. According to the poll, 68 percent of adults think e-cigarettes should have health warnings like tobacco cigarettes and other nicotine products.
The FDA is already on record criticizing e-cigarettes as potentially toxic since they haven't been tested in FDA-recognized scientific trials. Also of concern: there are no age restrictions on sales of these new nicotine-containing products.
Warning letters
Last week the FDA issued warning letters to five e-cigarette distributors for various violations of the Federal Food, Drug, and Cosmetic Act (FDCA) including unsubstantiated claims and poor manufacturing practices.
Also, in a letter to the Electronic Cigarette Association, FDA said the agency intends to regulate electronic cigarette and related products in a manner consistent with its mission of protecting the public health. The letter outlines the regulatory pathway for marketing drug products in compliance with the FDCA. For a drug product to gain FDA approval, a company must demonstrate to the agency that the product is safe and effective for its intended use. The company must also demonstrate that manufacturing methods are adequate to preserve the strength, quality and purity of the product.
At least two state attorneys general -- Oregon's John Kroger and California's Jerry Brown -- have waged vigorous campaigns against e-cigarettes.
In January Brown sued the Florida-based e-cigarette retailer Smoking Everywhere for making what he said are "misleading and irresponsible" claims that electronic cigarettes are a safe alternative to smoking. He also said the company has targeted minors with its marketing.
Beginning last year, Kroger reached settlements with retailers and manufacturers not to sell or market the products in Oregon.
Unfettered promotion
While ads for cigarettes have been banned from the airways since 1970s, commercials for e-cigarettes as "stop smoking aids" show up regularly on radio and cable TV.
"It is clear from this poll that U.S. adults are not waiting for scientific evidence of adverse health effects of e-cigarettes before asking that they be regulated and restricted," said Matthew M. Davis, M.D., director of the poll and associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research Unit at the U-M Medical School. "Rather, they support restrictions on e-cigarettes based on potential risks -- not just immediate health effects, but also the possibility that e-cigarettes may lead youth toward later use of tobacco cigarettes."
E-Cigarettes are battery-operated devices that look like cigarettes but do not burn tobacco. Instead, e-cigarettes have replaceable cartridges of liquid containing nicotine, which is inhaled as a vapor along with flavors like tobacco and chocolate.
E-Cigarettes are available in stores, mall kiosks and over the Internet.
Davis said the poll adds to the mounting public dialogue about e-cigarettes, which he says has so far consisted of claims and counter-claims by opponents and proponents but minimal scientific data.
