By | Updated Nov 4, 2016 9:38 PM UTC

Who’s that behind the glowing blue light? A smoker? Then what’s he doing in the office, in restaurants, in my living room? And what’s with the cigarette commercials popping up on American TV? Weren’t those banned in 1970? (Yes.) Cigarettes, in modern electronic guise, are bidding for respectability again. Employers and governments are struggling to adapt to e-cigarettes, devices that deliver a hit of stimulating nicotine without the tobacco of the traditional burning stick. Some health advocates are pressing for curbs on e-cigarettes 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 e-cigarettes as the best tool yet for addicts to quit smoking, and thus as a means for accelerating that fight.

The Situation

Of about 70 countries that regulate e-cigarettes, three — Cambodia, Jordan and the United Arab Emirates — ban their use altogether. Twenty six, including Brazil, Greece and Thailand, prohibit sales. Twenty one, such as Belgium, Honduras and the Philippines, bar their use in enclosed public spaces or public transportation, as do eight states and more than 500 municipalities and counties in the U.S. The U.S. Food and Drug Administration announced the first national e-cigarette regulations in mid-2016. They bar sales to minors, prohibit free samples and require nicotine-addiction warnings. A few days earlier, the European Union's Court of Justice upheld e-cigarette regulations banning advertising and limiting nicotine content. The research company Euromonitor estimated global sales of e-cigarettes and related paraphernalia at more than $5 billion in 2015, up from $2.8 billion in 2014. The devices are sold by big tobacco companies such as Altria and Reynolds American, as well as by specialty producers like the Miami-based V2 Cigs. Some analysts think increased costs associated with new regulations will push smaller competitors out of the market. The U.K. Royal College of Physicians warned in a 2016 report that the involvement of tobacco sellers threatens smoking-reduction efforts because their interest lies in marketing e-cigarettes as a complement to rather than a substitute for regular cigarettes.

The Background

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. E-cigarettes 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. They all work the same way: 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 (thus the popular nickname for e-cigarette smokers: “vapers.”) There’s no burning tobacco and thus no smoke or tar.

The Argument

The Campaign for Tobacco-Free Kids is among the health groups that say e-cigarettes may be a gateway for youth to start smoking cigarettes, especially as some ads feature celebrities who make vaping look cool. 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. The 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. 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. E-cigarette devices contain metal which can show up in vapor as particles small enough to be breathed in. The level of danger remains unclear.  

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

To contact the writer of this QuickTake:
Emma Orr in New York at eorr6@bloomberg.net

To contact the editor responsible for this QuickTake:
Lisa Beyer at lbeyer3@bloomberg.net