Smoking, in modern electronic guise, is bidding for respectability again. As the traditional practice declines worldwide, a new version is booming: vaping. Using an e-cigarette or an alternative device, vapers get a hit of stimulating nicotine without resorting to a burning stick of tobacco. Cigarette companies are capitalizing on the trend as governments figure out how to adapt to it. Some health advocates are pressing for curbs on the products where they don’t already exist, out of safety concerns and fear the popularity of the devices will reverse gains made in the war on smoking. Other medical specialists see vaping devices as an important tool for addicts to quit smoking, and thus as a means for accelerating that fight.
The U.S. Food and Drug Administration announced a plan in mid-2017 effectively embracing vaping — at least for now — as a way for smokers to quit. The plan delayed until 2022 regulation of vaping devices beyond a current ban on sales to minors and a requirement for nicotine-addiction warnings. Meanwhile, the agency will consider lowering the nicotine allowed in traditional cigarettes to non-addictive levels, news that sent tobacco stocks plunging. To preserve their revenues, big tobacco companies have spent billions of dollars developing alternatives to regular cigarettes. The market for e-cigarettes and so-called heat-not-burn products is estimated at $7 billion a year and growing rapidly. Of about 70 countries that regulate e-cigarettes, six — Cambodia, Jordan, Nepal, Panama, Turkmenistan and the United Arab Emirates — ban their use altogether. Twenty seven, including Brazil, Greece and Thailand, prohibit sales. Thirty nine, such as Belgium, Honduras and the Philippines, bar their use in enclosed public spaces or public transportation, as do twelve states and more than 500 municipalities and counties in the U.S.
A Chinese pharmacist and smoker named Hon Lik gets credit for developing the e-cigarette in 2003. It went on sale in the U.S. and Europe in 2006, according to the E-Cigarette Forum, a website for e-cigarette smokers. Vaping products take many forms. They come in various colors and contain different levels of nicotine, an alkaloid present in tobacco that is addictive. Early versions looked like regular cigarettes or were housed in sleek, metallic tubes. More recent models are more like elaborate pipes. In e-cigarettes, a battery heats nicotine liquid that comes in flavors ranging from tobacco to bubble gum to cinnamon cookie. The puffer inhales nicotine and exhales vapor. Heat-not-burn products contain tobacco that’s heated to significally less than the temperature at which a regular cigarette combusts. They’re said to approximate the taste of and nicotine boost from traditional cigarettes better than e-cigarettes. In both cases, there’s no burning tobacco and thus no smoke or tar.
The Campaign for Tobacco-Free Kids is among the health groups that say vaping products may be a gateway for youth to start smoking cigarettes. A U.S. government survey of teenagers recorded a significant increase in the use of e-cigarettes from 2011 to 2015. However, the rise was counterbalanced by a drop in the use of conventional tobacco products. A Royal College of Physicians report concluded that e-cigarettes were used in the U.K. almost exclusively by confirmed smokers to reduce the harm to themselves or others. Vaping may be as effective as nicotine patches for smokers trying to quit, according to the first physician-run trial to compare them. The practice is too new for there to be a significant body of research on long-term health ramifications. However, a 2016 scientific paper examining 22 studies concluded that exclusive use of vaporized nicotine products produces only 5 percent of the mortality risks associated with smoking. The effects on humans of nicotine without tobacco are not well-studied, although trials have shown neither an association between nicotine gum and cancer nor adverse effects from the use of nicotine patches.
The Reference Shelf
- The U.K. Royal College of Physicians report on e-cigarettes.
- The FDA’s Center for Tobacco Products’ website gives its position on e-cigarettes.
- The Public Health Law Center's interactive map shows e-cigarette regulation in each U.S. state.
- The Tobacco Vapor Electronic Cigarette Association is a trade group that endorses adoption of the devices.
First published Dec. 19, 2013
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