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IU health experts welcome new FDA rules for e-cigarettes

May 18, 2016

The Food and Drug Administration recently announced that e-cigarettes will be subjected to rules and regulations previously imposed on tobacco cigarettes, including a ban on selling e-cigarettes to minors.

That is welcome news to some Indiana University health experts who cite the lack of research on the long-term effects of e-cigarettes and concerns about the devices' appeal to young people.

jon macy

Jon Macy, assistant professor at the IU School of Public Health-Bloomington | PHOTO COURTESY OF JON MACY

"I think it's good to have uniform regulations across the country such as prohibiting the purchase of e-cigarettes by individuals under 18," said Jon Macy, assistant professor at the IU School of Public Health-Bloomington. "The new regulations will also protect the public's health by requiring the disclosure of all ingredients and requiring all products that contain nicotine to carry an addiction warning label."

E-cigarettes, battery-operated devices that deliver nicotine and other chemicals in vapor instead of smoke, were introduced almost 10 years ago and have continued to grow in popularity.

The new rules, which take effect in August, will require e-cigarette manufacturers to register with the FDA; provide a detailed account of their product's ingredients and manufacturing process; and apply for FDA permission to sell their products. The new rules will also ban the sale of e-cigarettes to anyone under 18 and require adults under the age of 26 to show a photo identification when buying them.

 The FDA's announcement added fuel to an already contentious debate between those who think e-cigarettes are a safe alternative to tobacco cigarettes and can help tobacco smokers quit smoking and those who are concerned with e-cigarettes' long-term effects and think they might lead younger people to smoke tobacco cigarettes.

There is no doubt e-cigarettes have become a draw to young people. In 2014, e-cigarettes surpassed conventional cigarettes as the most commonly used nicotine-delivery product among youth, according to the Centers for Disease Control and Prevention. About 16 percent of high school students and 5 percent of middle school students reported using electronic cigarettes in 2015, according to data by the CDC and the FDA.

That trend also rings true in Indiana. In August 2015, the Indiana Prevention Resource Center at the IU School of Public Health-Bloomington released the results of the 25th Indiana Youth Survey, which showed a high level of e-cigarette use among Indiana youth.

According to the survey, which included questions about electronic vapor products for the first time, Indiana 12th-graders reported using electronic cigarettes at a rate of 24.8 percent, significantly higher than the national rate of 17.1 percent. Electronic cigarettes, or vape pens, were also the most prevalent nicotine-containing substance used by youth in the month before the survey was administered.

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Jim Wolf, research associate at the Indiana Prevention Resource Center | PHOTO COURTESY OF JIM WOLF

Jim Wolf, a research associate at the Indiana Prevention Resource Center and program coordinator for the FDA Tobacco Inspection Program in Indiana, said e-cigarettes appeal to young people because they are new and high-tech and have appealing flavors such as bubble gum and gummy bear.

But with a lack of research and no prior regulations, Wolf said the public, especially young people, should be wary of what he calls a false perception of e-cigarettes being "harmless vapor."

"The reality is, this is an industry that has exploded on the scene and embraced by the young and is touted as being safer than cigarettes," Wolf said. "The downside is that these are devices that deliver nicotine, an addictive substance that is very hard to stop using and is known to be significantly related to chronic hypertension and heart disease. There is simply no justification for thinking that there are no consequences for repeated use of electronic nicotine delivery systems."

Macy, who has spent his career studying tobacco use behaviors and how public health policy influences those behaviors, said the jury is still out on the relative benefits and harms of e-cigarette use. There has been decades of research on tobacco cigarettes, he said, but comparatively little research on e-cigarettes, which only contributes to the debate about their potential harm and appeal to young people.

But one thing Macy expects tobacco cigarettes and e-cigarettes have in common: Their makers will push back on potential regulations.

"What both products have in common is that the industry that is trying to make money from their sale will almost surely use legal action to delay implementation of new regulations for as long as possible — this is what happened with the FDA's proposed warning labels for cigarette packs," he said.

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