This editorial appeared in Wednesday's Washington Post.
Is the rising popularity of electronic cigarettes a public health problem or a way for smokers to get their nicotine in a safer form? Right now, e-cigarettes appear to be both.
The Centers for Disease Control and Prevention (CDC) announced last week that the number of youth who have tried e-cigarettes doubled between 2011 and 2012. One-tenth of high school students inhaled the devices' vapor last year. About three-quarters of those who admitted using e-cigarettes currently also smoked traditional cigarettes. But roughly 160,000 students in the National Youth Tobacco Survey last year said they had tried only e-cigarettes.
E-cigarettes contain small amounts of liquid that an atomizer vaporizes for inhalation. They aren't regulated heavily, so there isn't much public information available on what's in them, and the contents probably vary widely by brand. But they clearly contain nicotine, which is highly addictive. Public health advocates warn that e-cigarette makers are using the same strategies that tobacco companies employed to attract young people to start smoking: candy flavorings such as "Atomic Fireball," for example. Lax state-level regulations also make it easy for young people to buy them.
If flavorings, advertising and easy access result in lots of students committing to a lifetime of addiction to nicotine products — and the CDC's latest results suggest that might be happening — e-cigarettes could serve as a dangerous gateway drug. The Food and Drug Administration (FDA) has the power to demand information from companies on e-cigarettes' ingredients, regulate their contents and control their sale, and it has expressed interest in doing all that. But the agency has taken its time. It should get going.
Yet public health advocates also should appreciate the other side of e-cigarettes — their potential value to those already struggling with addiction. For those who are unwilling or unable to give up nicotine, e-cigarettes offer something akin to the experience of smoking a real cigarette without the same profusion and concentration of toxins. This point, too, argues for more government oversight. If the FDA asserts its authority over e-cigarettes, it can ensure that they are a less unhealthy tobacco alternative, at least as far as that's possible.
We would be the last ones to hope that any tobacco product succeeds. Nicotine addiction is not be wished on anyone. But if the FDA can get more addicted smokers onto e-cigarettes without encouraging children and teenagers to take up smoking, it would do some good.
© 2013, The Washington Post