A tobacco control expert says there's plenty of evidence to justify regulating e-cigarettes immediately. Meanwhile, a new study says that e-cigarette advertising makes consumers crave -- guess what? -- tobacco.
Writing in the March issue of Food and Drug Law Journal, Georgetown Law Professor Eric N. Lindblom says enough is already known about e-cigarettes to regulate them effectively without any further research or delay.
"We already know that using e-cigarettes is less harmful than smoking, but more harmful than not using any tobacco or nicotine at all, and that's enough to figure out how to regulate them both to protect and promote the public health," says Lindblom, the former director of the Office of Policy at the Center for Tobacco Products at the U.S. Food and Drug Administration (FDA).
He says his approach would minimize the threats e-cigarettes pose to public health while still enabling them to potentially help reduce smoking.
"This approach could help to heal the current split in the public health community over e-cigarettes by addressing the concerns of both sides," Lindblom says.
"Because e-cigarette use, by itself, is neither beneficial nor benign to users and nonusers, the only public health justification for allowing their marketing would be if doing so would help smokers quit completely or provide them with a less harmful way to obtain the nicotine they crave, without causing any offsetting public health harms," Lindblom wrote.
Based on that observation, Lindblom suggests that an effective regulatory scheme would
1) make e-cigarettes less harmful to users and non-users;
2) increase their use as a cessation aid and as a less harmful alternative for smokers who would not otherwise quit; and
3) minimize e-cigarette use among everyone else.
Lindblom notes that the proposal faces challenges in the United States, primarily from First Amendment constraints on government action to regulate e-cigarette advertising. His paper suggests, however, that "some helpful text and established procedures in the Tobacco Control Act reduce those constraints in this context, providing the FDA with a tremendous opportunity to place the kinds of careful restrictions and requirements on e-cigarette advertising necessary to minimize their harmful aspects and maximize their potential to produce substantial net public health gains."
Advertising what?
As Lindblom notes, e-cigarette advertising is not currently regulated the way tobacco advertising is, and a new study by University of Pennsylvania researchers finds that TV advertisements for e-cigarettes may be enticing current and even former tobacco smokers to reach for another cigarette.
The researchers studied more than 800 daily, intermittent, and former smokers who watched e-cigarette advertising, and who then took a survey to determine smoking urges, intentions, and behaviors.
Using a standard test to measure the urge to smoke a cigarette, people who smoke tobacco cigarettes daily and who watched e-cigarette advertisements with someone inhaling or holding an e-cigarette ("vaping") showed a greater urge to smoke than regular smokers who did not see the vaping, as reported in the journal Health Communication.
Former smokers who watched e-cigarette advertisements with vaping had less confidence that they could refrain from smoking tobacco cigarettes than former smokers seeing e-cigarette ads without vaping.
The findings are significant, considering that tobacco advertising on television went up in smoke over four decades ago by way of a federal ban. Moreover, e-cigarette advertising is stoked by big tobacco companies. Estimates peg e-cigarette ad spending at more than $1 billion this year. That number is expected to grow at a 50 percent rate over the next four years.
"We know that exposure to smoking cues such as visual depictions of cigarettes, ashtrays, matches, lighters, and smoke heightens smokers' urge to smoke a cigarette, and decreases former smokers' confidence in their ability to refrain from smoking a cigarette," said Erin K. Maloney, Ph.D., one of the lead researchers.
Maloney and Joseph N. Cappella, Ph.D., pulled together more than a dozen e-cigarette advertisements via searches of Google, YouTube, and e-cigarette web sites.
Maloney and Cappella observed a trend that more daily smokers who viewed ads with vaping smoked a tobacco cigarette during the experiment than daily smokers who viewed ads without vaping and daily smokers who did not view ads.
Over 35 percent of the daily smokers in the condition that showed vaping reported having a tobacco cigarette during the study versus 22 percent of daily smokers who saw ads without vaping, and about 23 percent of daily smokers who did not see any advertising.
"Given the sophistication of cigarette marketing in the past and the exponential increase in advertising dollars allotted to e-cigarette promotion in the past year, it should be expected that advertisements for these products created by big tobacco companies will maximize smoking cues in their advertisements, and if not regulated, individuals will be exposed to much more e-cigarette advertising on a daily basis," Maloney and Cappella wrote.
A tobacco control expert says there's plenty of evidence to justify regulating e-cigarettes immediately. Meanwhile, a new study says that e-cigarette adver...