Blowing Smoke: The Truth About E-Cigarettes

Many experts believe that e-cigarettes are less harmful than tobacco cigarettes are, but e-cigarettes are so new that no independent research has studied the long-term health effects of the products.

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On Feb. 3, 2013, in the middle of Super Bowl XLVII, millions of Americans saw something that disappeared from the TV airwaves more than 40 years ago: a commercial for a smoking product.

The ad was a shock, because Federal Trade Commission banned traditional cigarette advertising on TV in 1971. However, the NJoy King that was in the commercial isn’t a cigarette; it’s an electronic cigarette.

American Cancer Society (ACS) and American Lung Association (ALA) condemned the commercial for glamorizing smoking, but no FTC regulations exist regarding e-cigarette advertising. For that matter, no federal regulations exist regarding e-cigarettes, period. Food & Drug Administration proposed regulations in April 2014 that would limit the sale of e-cigarettes and produce more product transparency, but those rules won’t go into effect until 2015 at the earliest.

One point was made clear by the Super Bowl ad: E-cigarettes were more than a fad. They were officially big business, vying for advertising time and sales alongside the largest companies in the world.

E-cigarettes have been around, but it wasn’t until 2006 that they began to catch on in the United States. Today, about 200 e-cigarette brands exist in the U.S. marketplace. E-cigarettes (and e-cigars and e-hookahs) come in a variety of designs, but they all contain the same basic components: a small reservoir that holds a liquid mixture of ingredients that’s called e-liquid, a heater and a battery. Instead of burning tobacco leaves, an e-cigarette heats up e-liquid into a vapor that’s inhaled and exhaled. E-liquid is composed of propylene glycol (a chemical used in fog machines) or vegetable glycerin (a thickening agent used in food and medicine). It typically also contains nicotine. E-liquid comes in a variety of flavors. Because no smoke is emitted, users call themselves “vapers” instead of smokers.

An e-cigarette starter kit, which typically includes a battery, a charger and an e-liquid cartridge, costs $30–$100, depending on whether it includes more than one rechargeable battery. A replacement e-liquid cartridge typically costs $9–$13 and provides 200–400 puffs before it must be replaced. It costs $600–$700 for a year’s worth of replacement cartridges to equal a pack-a-day tobacco-smoking habit, according to Tobacco Vapor Electronic Cigarette Association, which is an industry group.

A February 2014 Bloomberg study says the U.S. e-cigarette market hit $1.5 billion in sales in 2013. By 2015, U.S. sales are expected to reach $5 billion, Bloomberg predicts. By 2028, e-cigarettes will be a $56 billion industry, Bloomberg believes. That would represent 20 percent of a combined tobacco-product/e-cigarette market in the United States. An even more optimistic analysis by Wells Fargo predicts that in less than 10 years, the three largest tobacco companies—Altria Group, Lorillard and Reynolds American—will rake in more revenue from e-cigarettes than they will from cigarettes.

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Some public-health experts tell us that e-cigarettes have the potential to cut down on the number of people who smoke cigarettes.

“It’s the first product in 100 years that has a half a chance of making cigarettes obsolete in 10 years—if everyone plays their cards right,” says David Abrams, who is the executive director of Schroeder Institute for Tobacco Research & Policy Studies at American Legacy Foundation, which is a public-health nonprofit organization.

However, other public-health experts tell us that e-cigarettes are a gateway drug to tobacco. No mandatory manufacturing standards exist for e-cigarettes. Nothing requires manufacturers to post an ingredient list. Consumers have no way to know what e-cigarettes contain besides nicotine. Furthermore, the newness of e-cigarettes means that the long-term effects of using e-cigarettes are unknown. Some short-term health problems, such as mild throat and lung irritation, have been reported, but 7 years isn’t enough time to perform studies on the long-term health effects of the products, experts tell us.

“I’ve been involved in tobacco control for 35 years, and this is the single most disruptive technology and difficult issue we’ve had to deal with,” says Thomas Glynn, who is the director of cancer science and trends at ACS.

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