'Electronic' cigarettes spark several concerns

Todd Charron began puffing on a battery-powered electronic cigarette as an alternative to his regular cigarettes and also to save a little money.
"I don't want to put a positive or negative spin on it," he said, referring to the e-cigarette, which delivers a preset dose of nicotine, but none of tobacco's tar, through a vapor mist.
"It's definitely not like smoking a cigarette, but it's not terrible," the Palm Bay resident said, describing his experience with the smokelike product during the past several months. "I'm still on the fence, though my wife, Heather, doesn't touch hers anymore."
The market for electronic cigarettes nationwide has grown rapidly, however, so much so the U.S. Food and Drug Administration joined other public health officials earlier this summer in issuing a warning about potential health risks. The federal agency said e-cigarettes lack federal regulation and have been inadequately studied for safety, so consumers have no way of knowing what, besides nicotine, may be inside them.
"Our biggest concern is the lack of safety data," said Siobhan DeLancey, a spokeswoman for FDA. "But we also have issues with how they are marketed" -- often in shopping malls and online -- and in flavors such as bubblegum, chocolate or peppermint, which might make them appealing to children or adolescents.
DeLancey said the agency's position is that electronic cigarettes, which contain cartridges filled with varying levels of nicotine from light to heavy, should be subject to regulation under the Food, Drug and Cosmetic Act as a drug-delivery device.
At least one electronic cigarette distributor is legally challenging that regulatory authority, along with the notion its products are smoking-cessation devices, rather than cigarette alternatives for adults, the company's claim.
"The issue is being fought out in federal court right now," DeLancey said, referring to the lawsuit.
Exactly how many manufacturers make e-cigarettes is hard to determine, but by one estimate, there probably are several hundred of them. And, after a preliminary analysis of two leading e-cigarette brands, the federal agency began halting dozens of shipments of the tobacco-free products from entering the country, a trigger behind the current litigation.E-cigarettes look like conventional cigarettes. But, because they don't have tobacco, they can be used wherever smoking is banned from offices and restaurants to bars, accounting, in part, for their popularity.
The average price tag ranges from $70 to $150 for a starter kit, which typically contains two electronic cigarettes, five to 10 replaceable cartridges of varying nicotine strength and extra batteries.
The cartridges contain the nicotine dose as well as propylene glycol, a liquid that vaporizes and produces the smokelike mist. When a user inhales and takes a puff, a sensor heats the cartridge, initiating the smoking process.
"It actually has a heavier sensation than a cigarette," said Charron, who first heard about e-cigarettes on the radio. "Have you ever breathed directly from a humidifier? It feels a bit like that. Vapor is what you're smoking."
Cheaper than regular cigarettes
Starter kits last as long as the battery and the atomizer work, according to Amy Linert, a spokeswoman and marketer for the Electronic Cigarette Association, a small group of about 15 manufacturers seeking to set national standards for the industry.
The cartridges must be replaced regularly, from "every couple of days to every couple of weeks," she said, depending on an individual's smoking habits.
Still, while the average smoker in Florida pays $5 to $6 for a pack of regular cigarettes, e-cigarettes are cheaper, she said, costing less than half that amount, or the equivalent of $2 a pack.
"This is for smokers who can't or don't want to stop smoking," Linert stressed.
Like the other manufacturers, she said, the association views electronic cigarettes as a safer alternative to regular cigarettes, not as smoking-cessation products, which often fail. The American Cancer Society estimates 440,000 people in the United States die each year from tobacco use, primarily from cancers of the lung, larynx, oral cavity, pharynx and esophagus.
Candylike flavors appeal to children
Although the association is not part of the lawsuit against the FDA, Linert said, the group recently addressed at least two of the agency's concerns and those of several medical organizations, including the American Cancer Society and the American Lung Association.
Revised bylaws, for example, now prohibit members from marketing any candylike flavors in e-cigarettes, to undercut their appeal to children or adolescents.
Also, Linert said, association members do not support the sale of e-cigarettes at kiosks or malls, preferring behind-the-counter sales where the age of customers can be monitored to ensure they are not too young to buy them.
As for the FDA analysis of e-cigarette products, Linert said, it showed only one manufacturer used about a 1 percent solution of diethylene glycol, an antifreeze ingredient toxic to humans, to make the vapor that smokers ultimately expel.
Members of the association use propylene glycol in their e-cigarette products instead, she said. And while propylene glycol also is used in commercial antifreeze, "it's a substance generally considered safe by the government," she said, and also can be found in makeup and food coloring, among other uses.