AHA Calls for Stricter E-Cigarette Regulation

The government should ban the sale of e-cigarettes to minors, according to a policy statement from the American Heart Association.

Since e-cigarettes are also tobacco products, they should be subject to the same policy guidelines as the sale of regular cigarettes and smokeless tobacco products.

This recommendation is part of a 20-page report on the safety of electronic cigarettes and other nicotine delivery systems, calling for further research addressing the long-term effects of these products on public health.
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The report comes in response to concerns that the 7764 unique flavors (including chocolate, bubble-gum, and caramel) of e-cigarettes are designed specifically to attract young smokers to the habit., and the aggressive, unregulated marketing campaigns for these products suggesting that they are a harmless, safe alternative to smoking. 

The report also cites a lack of research into the efficacy of e-cigarettes as a smoking cessation tool in adult users, and into the overall safety of using e-cigarettes in general.

Researchers urge healthcare providers to encourage their patients to use conventional, tested smoking cessation methods before switching to e-cigarettes.

“If someone refuses to quit, we’re not opposed to them switching from conventional to e-cigarettes,” researchers cautioned. “Don’t use them indefinitely. Set a quit date for quitting conventional, e-cigarettes and everything else. We don’t think that will be the long-term or useful way to look at it because e-cigarettes may continue and fuel nicotine addiction. Nicotine is not innocuous—it’s known to be harmful and have cardiovascular effects.”

In addition to the recommendations, almost half of the 20-page paper is devoted to e-cigarette design, toxicology, and public health impacts, in order to provide physicians with as much information on the products as possible, given available research.

Researchers caution that, because e-cigarettes are not regulated, manufacturers may not disclose all ingredients present; further, exhaled vapor may in fact expose the smoker, and others, to dangerous, toxic chemicals. 

Due to the constantly changing designs of the products, long-term research into their safety has not been possible; the paper cites that “we must increase the pace of research and understand the full range of health consequences before we allow this Trojan horse of nicotine back into society.”

The complete policy statement is published in the August issue of Circulation.

—Michael Potts

Whitsel SP, Ribisl KM, Bullen C, et al. Electronic cigarettes: A policy statement from the American Heart Association.  Circulation. 2014 Aug 24. doi: 10.1161/​CIR.000000000000010

American Heart Association. AHA: E-cigarettes threaten to addict next generation of smokers; regulation, further study needed. http://blog.heart.org/aha-e-cigarettes-threaten-to-addict-next-generation-of-smokers-regulation-further-study-needed/. Published August 24, 2014. Accessed August 25, 2014.