The use of electronic cigarettes has far outpaced research, leading to gaps in understanding whether the devices are more, less or of comparable harm to their nonelectronic counterparts, state health leaders say.
Dr. Terry Cline, state health commissioner, said he remains concerned the increasing number of people using e-cigarettes are using them without enough information about their safety.
“You're putting vapor into your body, which we know contains chemicals, but because it's unregulated, there's a lot of variability,” Cline said. “There are over 250 of these products out there, and we don't really know what they contain. It's not consistent because it's not regulated in any form or fashion, and that then makes it more difficult to understand.”
Cline answered a few questions about his concerns over e-cigarettes, which have continued to rise in popularity among Oklahomans.
How are e-cigarettes currently regulated?
The U.S. Food and Drug Administration is expected to publish a ruling soon on how e-cigarettes should be regulated. Federal officials said the ruling was stalled by the federal government shutdown in October, but that has long since passed, Cline said.
Meanwhile, there are no laws in Oklahoma that ban selling e-cigarettes to minors. Data from the 2013 Oklahoma Youth Tobacco Survey show that 7.8 percent of Oklahoma high school students and 2.7 percent of Oklahoma middle school students who responded to the survey had used an e-cigarette in the past 30 days.
Cline said it's too soon to know how many teenagers start out with e-cigarettes and transition to cigarettes in adulthood.
“We've been very successful in bringing the smoking rates down and trending in the right direction, and part of that is, we've changed the social norm,” Cline said. “You expect to have clean air when you're going to get your hair cut or you're in the grocery store or you're in the movie theater or any of these other public places. With e-cigarettes, they may shift that norm.”
What role do tobacco companies play in the distribution of e-cigarettes?
There are at least three primary tobacco companies that own e-cigarette products, Cline said.
“It's now a $2 billion industry that's growing rapidly obviously across the country,” Cline said. “I think that they clearly have that investment, and it's one of their products.”
Cline said he is concerned in how e-cigarettes are being marketed. Similarities are beginning to emerge in how tobacco companies marketed cigarettes years ago and how e-cigarettes are presently being marketed, he said.
Many people argue that e-cigarettes can be used to help people quit smoking. How do you feel about that?
Cline said while nicotine replacement therapies, such as patches or gum, have been studied, the research on e-cigarettes as a smoking cessation product isn't there yet.
“If you're wanting to use this product as a tobacco cessation product, the first thing I would say is, I applaud anyone who's trying to cut down and quit their tobacco use — that's a laudable goal and objective,” Cline said. “But then I would say to that person, we have proven methods with nicotine replacement products and coaching, which you can get through the Oklahoma Tobacco Helpline.”
Cline said he is concerned that people who have never smoked might start smoking e-cigarettes because they're viewed more and more as socially acceptable.
“Again, the science isn't there, so I can't say that conclusively,” he said. “I would just say my concern is that some people will graduate from that to tobacco use, so it could actually end up going both ways — but I'm not going to make that claim, just like I'm not going to make the claim that it's a successful tobacco cessation product until we have the research and the data on that. I'm just expressing my concern, and as a public health official, really urging people to be cautious around these products.”