E-cigarettes:Untested & Unproven

By Kathy Garrett

First E-cigarette patent

1965

E-cigarette• Electronic cigarettes (or e-cigarettes) first began

appearing in American markets about 2009.

• E-cigarettes vaporize a nicotine solution when the user inhales, which gives a feeling similar to smoking.

• Models consist of a battery which powers the unit, an atomizer that vaporizes the nicotine, and a cartridge which houses the nicotine liquid (called e-liquid)

E-CigaretteComponents

E-Cigarette• E-cigarettes come in all colors, shapes and sizes. • This makes smoking very customizable.

Closed system

Open system

Store fronts

E-Juice• Nicotine cartridges house the e-liquid or e-juice

and can either be disposable or reusable.• The liquid is generally made up of four chemicals:

nicotine, propylene glycol, vegetable glycerin, and flavoring.

E-Juice: Health And Safety

Concerns

• The lethal dose of nicotine is 30-60mg for adults and 10mg for kids. Nicotine solutions in e-juice come in varied strengths and concentrations.

• According to the Utah Poison Control Center, e-cigarettes have sent 79 children ages 6 and under to hospitals since January 2012. There were 10 such poisoning cases in 2012, 48 in 2013 and 21 in 2014 so far.

• Nicotine can also be absorbed through the skin.

E-Juice: Health And Safety

Concerns

• Mixing procedures

• Sanitation

• Often imported from China

Additional Concerns

Conflicting nicotine concentrations

• Blue-what thebottle indicated• Red – what thebottle actuallyhad.

E-Cigarette Flavoring• While flavoring is illegal

for normal cigarettes, e-juice come in almost any flavor.

• The abundance of flavors may serve to lure youth to e-cigs, which in turn could result in youth eventually switching to regular tobacco. 

E-Juice Flavors• Root Beer• Cherry Bomb• Watermelon• Key Lime Freeze• Bubble Gum• Orange Dream• Very Strawberry• Chocolate• Cookies & Cream• Strawberry

Shortcake• Tutti-Frutti• Vanilla

Candy Cane Captain Crunch Hawaiian Paradise Mango Granny Apple Apple Pie Blue Coconut Gummy Bear Juicy Strawberry Pom-Pom Burst Tropical Splash Caramel Cream

Red Razzle Strawberry

Surprise Arctic Freeze Blue Razzleberry Grapelicious Juicy Blue Frost Maui Smooth Red Hots Strawberry

Colada Tigers Blood Blueberry Mountain Dew

E-Juice Flavors

E-Cigarettes• While e-cigarettes have been manufactured as a

nicotine delivery system, that hasn’t stopped many users from getting creative with them.

• E-cigarettes can be used as a delivery system for a large number of drugs besides nicotine – including THC (the active drug in marijuana), alcohol, and other drugs.

• (see the video at http://www.youtube.com/v/mzT7j7tWgq4

Advertising

Advertising• With a lack of advertising restrictions, companies

are re-introducing the highly stylized ads of traditional tobacco, featuring celebrity endorsements.

Electronic Cigarette Youth rates

• According to the CDC, the number of U.S. youth who used electronic cigarettes, but have never smoked a regular cigarette, has more than tripled in the past three years, from 79,000 in 2011 to over 263,000 in 2013.

• These same youth are nearly twice as likely to intend to smoke regular cigarettes as those who have never used e-cigarettes.

• In Utah, the percentage of Utah high school age students who use e-cigarettes tripled between 2011and 2013.

• Utah, data shows that 31.7% of students who reported ever using e-cigarettes say they have never tried conventional cigarettes.

E-Cigarette Regulation FDA is currently assessing the impact of e-cigarettes and

plans to announce proposed regulation.

Until the FDA proposals are announced, e-cigarette regulation will only exist at the state and local level.

The Utah Indoor Clean Air Act prohibits electronic cigarettes anywhere that traditional cigarettes are banned.

In Utah, the use of e-cigarettes is illegal for anyone under 19 years of age.

Regulation of retail tobacco specialty business.

Emerging Public Health Issue

• Because e-cigarettes are currently unregulated at the federal level, consumers do not have access to accurate information on e-cigarette ingredients, product quality, and safe product usage.

• Relatively little is known about the impact of electronic cigarettes, including the long-term health effects of breathing the vapor and their efficacy as a cessation device.

• Need more scientific investigation, possibly regulations/laws .

What Local Health Departments are doing

• Currently, all of the health departments in Utah are working towards a regulation that applies to Electronic Smoking Devices ESDs and E-Liquid samples, sold and/or manufactured.

• Main points:o Must contain warning labelo Have child proof capso Safety precautions when mixingo Nicotine level in E-liquid

National Policy Options

• Adding e-cigarettes to existing smoke-free laws• Limiting youth access• Licensing• Minimum sales age• Marketing regulation• Taxation• Limiting Free Samples, Rebates, Discounts,

Coupons• Restricting the sale of flavors.

Questions?