Tuesday, January 7, 2014

Regulating Smokeless Electronic Cigarettes

By Henry Curtis

In 2013 Hawaii passed Act 227 making it illegal to sell “an electronic smoking device to a minor under eighteen years of age.” (HRS §709-908)

 The Hawaii Department of Education classifies an electronic cigarette as a contraband item (Class D offense).

 In December 2013 the Hawaii Department of Health announced that it is banning the use of e-cigarettes at all DOH facilities. The policy will apply to all DOH employees, visitors, volunteers, contract workers and delivery personnel.

 State Law (per HRS 328J-15) permits counties to enact stricter smoking laws.

 On November 20, 2013 Big Island Billy Kenoi signed a law to regulate e-cigarettes. West Hawai‘i Councilmember Dru Mamo Kanuha wrote the bill which rose to the legal age to 21 for sale of all tobacco products. Bill 135 passed the Big Island County Council on November 20 by a vote of nine to zero. The bill was backed by the Campaign for Tobacco-Free Kids and the Coalition For A Tobacco-Free Hawai‘i (CTFH).

E-Cigarettes are a Recent Invention

In 1963 Herbert A. Gilbert invented "a smokeless non-tobacco cigarette." In 2003 Chinese pharmacist Hon Lik developed the prototype of the modern day Electronic Cigarette. In 2006 British brothers Umer and Tariq Sheikh developed the first modern e-cigarette by incorporated the "cartomizer" (cartridge and atomizer) into the e-cigarette. 

The Family Smoking Prevention and Tobacco Control Act (2009) amended the Federal Food, Drug, and Cosmetic Act (1938 et al). The new law gave the Food and Drug Administration the power to regulate the tobacco industry.

Between 2008 and 2010, the FDA determined that certain e-cigarettes were unapproved drug/device combination products and detained and/or refused to allow e-cigarettes to be imported.

In January 2010 by Federal District Court Judge Richard J. Leon overturned the FDA restriction, stating that “the devices should be regulated as tobacco products rather than drug or medical products.”

On December 7 2010, the appeals court ruled against the FDA in a 3–0 unanimous decision, ruling the FDA can only regulate electronic cigarettes as tobacco products, and thus cannot block their import.

New Jersey voted to treat the electronic cigarette in the same category as tobacco products. In New Hampshire and Maryland, the sales of e-cigarettes to minors are banned. On December 30, 2013 New York City mayor Michael Bloomberg signed a bill regulating e-cig usage in the same way as that of normal cigarettes.  States such as Utah, North Dakota, Arkansas and New Jersey have included e-cigarettes in indoor smoking bans

California Governor Arnold Schwarzenegger vetoed Senate Bill 648 which would have regulated the sale of electronic cigarettes. The Governor stated that "if adults want to purchase and consume these products with an understanding of the associated health risks, they should be able to do so."

On September 24, 2013 the National Association of Attorneys General (NAAG) sent a letter to the FDA requesting that the agency regulate the sale of e-cigarettes to minors. Fourty-one Attorney Generals have signed on.

 “As you know, e-cigarettes are battery-operated products designed to deliver nicotine to the user by heating liquid nicotine, derived from tobacco plants, along with flavors and other chemicals, into a vapor that the user inhales. 

The nicotine found in e-cigarettes is highly addictive, has immediate bio-chemical effects on the brain and body at any dosage, and is toxic in high doses. … 

Sales of e-cigarettes have grown rapidly in the United States, and after doubling every year since 2008, sales in 2013 are now accelerating even faster and projected to reach $1.7 billion. 

The cost of e-cigarettes has fallen dramatically, as well, making them more affordable, and thus more attractive to young people. 

Unlike traditional tobacco products, there are no federal age restrictions that would prevent children from obtaining e-cigarettes, nor are there any advertising restrictions.

Along with the growth of e-cigarette sales, there has also been a growth of e-cigarette advertising over the past year. 

For example, in this year’s Super Bowl broadcast, NJOY e-cigarettes purchased a 30-second television advertisement slot which reached at least 10 million viewers in certain markets and reportedly translated into a dramatic 30-40% increase in sales.

The advertisement depicted an attractive man smoking an e-cigarette that looked just like a real cigarette. Since then, advertisements for e-cigarettes have regularly appeared on primetime television, making it easier for those advertisements to reach children. 

Moreover, e-cigarettes are not being marketed as smoking cessation devices, but rather as recreational alternatives to real cigarettes. 

Consumers are led to believe that e-cigarettes are a safe alternative to cigarettes, despite the fact that they are addictive, and there is no regulatory oversight ensuring the safety of the ingredients in e-cigarettes.”

What are the real impacts?

Are e-cigarettes gateway drugs? Are they a method to gradually get off nicotine? Are they a new youth fad? Addicting? Are they beneficial? Will they supplement cigarettes by allowing their use in places that regular cigarettes are banned?

Vaping (smoking an e-cigarette) allows nicotine users to inhale without causing second hand smoke.

Since e-cigarettes are not regulated, their size, shape, structure and content can vary greatly.

Most contain a battery, a heating element, and a liquid that contains nicotine, propylene glycol and flavorings.

Many believe that are generally safer than regular cigarettes. The liquid components are unregulated and so there is no assurance of safety. Some allow the gradual reduction in the nicotine levels.

In July 2013 the World Health Organization (WHO) recommended that "consumers should be strongly advised not to use" electronic cigarettes until a reputable national regulatory body has found them safe and effective.”

The American Association of Public Health Physicians (AAPHP) suggested that those who are unwilling to quit tobacco smoking or unable to quit with medical advice and pharmaceutical methods should consider other nicotine containing products such as electronic cigarettes and chewing tobacco for long term use instead of smoking.

Centers for Disease Control and Prevention (CDC) is concerned about “the impact of e-cigarettes on long-term health must be studied” 

A 2013 report by the CDC analyzing the 2012 National Youth Tobacco Survey (NYTS), a survey including 24,658 US students, found that while electronic cigarette use among middle and high school students almost doubled from 2011 to 2012, use of certain tobacco products (bidis and krekets) were shown to have fallen over the same period.

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