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E-Cigarettes Increasingly Banned in Public // Causing Epidemics Among Young Children and Teens
E-cigarette use has already been banned in indoor public places in New York City, Los Angeles, Chicago, and Philadelphia as well as in many smaller jurisdictions, says public interest law professor John Banzhaf, who helped lead the fight for the initial bans in Suffolk County, NY, and in the state of New Jersey.
Meanwhile, there has been a reported 10-fold increase in reported pediatric exposures to the nicotine in e-cigarettes and their cartridges in California from January 2013 through February 2014.
E-cigarette vials of nicotine - a very addictive drug and a highly potent neurotoxin - have been characterized by the New York Times as "Selling a Poison by the Barrel." It noted that it is available in such high concentrations that just one tablespoon could kill an adult.
Meanwhile, according to the Centers for Disease Control [CDC], the use of e-cigarettes doubled from 2011 to 2012 among both high school and middle school students. Florida found that more than 4% of middle-schoolers, and fully 12% of high-schoolers, had tried e-cigarettes - figures that have risen dramatically over just the past two years.
As the CDC warned: "Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.”
This danger seems to be borne out by a recent study. It shows that both middle and high school students who used electronic cigarettes were more likely to smoke real cigarettes, and less likely to quit, than students who did not use the devices. They were also more likely to smoke heavily.
The study concluded that “the use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.”
Indeed, e-cigarettes permit both teens and adults to become and to remain tobacco smokers, because it allows them to continue to satisfy their craving for nicotine in settings like schools and workplaces where conventional cigarettes are banned; i.e., where they otherwise might have to quit entirely.
Those who use e-cigarettes emit into the air a vapor which consists primarily of two substances, but which has also been found to also include some heavy metals and other known carcinogens.
These two main substances are nicotine, a very addictive drug and a highly potent neurotoxin, and propylene glycol, a respiratory irritant. Experts have warned that propylene glycol should not be inhaled because it can cause respiratory irritation, convulsions, and gastrointestinal distress.
Nicotine, even when inhaled in small amounts by nonsmokers, can be deadly. That's why the CDC has warned that nonsmokers seated in the no-smoking sections of restaurants, and inhaling only the nicotine in the small amount of smoke which drifts to their table, nevertheless increase their risk of a heart attack to that of a smoker in as little as 30 minutes.
Anecdotal evidence suggests that even the small amount of propylene glycol inhaled by those around an e-cigarette user can trigger major respiratory problems, especially among the almost 100 million Americans who have serious conditions like asthma, allergies, sinusitis, and other respiratory conditions which make them especially sensitive.
The major argument in favor of e-cigarettes is that they help smokers quit, but many studies seem to refute this premise. In any event, it is undisputed that this hasn’t yet been shown, to the satisfaction of the Food and Drug Administration [FDA] which has jurisdiction over them, that the products are useful in helping smokers quit. In stark contrast, such evidence did prove to the FDA that nicotine chewing gum, nicotine patches, and nicotine sprays and inhalers are not only safe, but also effective in helping smokers quit.
Meanwhile, while the public waits for the FDA to issue long-delayed rules to regulate this new product, it is instructive to see what many other countries are doing.
In some countries, such as the United Kingdom and New Zealand, e-cigarettes are regulated as medicines - as nicotine gums, patches, and inhalers are in the U.S. - and can be purchased only in pharmacies. In Denmark, Canada, and Australia, they are subject to restrictions on sale, import, and marketing. Complete bans are in place in Brazil, Norway, Singapore, and other countries.
Experts worry that, even if e-cigarettes are somewhat less hazardous to users than conventional cigarettes - something which hasn’t been established to the satisfaction of any government body, nor to any major national health organization - their widespread use could nevertheless imperil public health.
This is because smokers who might otherwise quit because of smoking bans can remain smokers. Moreover, smokers who might otherwise quit because of health concerns may be lulled into a false sense of safety by claims about e-cigarettes which totally ignore the risks of heart attacks from nicotine - a risk much greater than the more wisely known risk related to lung cancer caused by chemicals in burning tobacco.
Ironically, despite the epidemic of children being poisoned by nicotine, the e-cigarette trade association has refused to endorse the concept of child-proof containers for the nicotine, similar to those generally accepted for much less dangerous products like aspirin and even mouth wash.
JOHN F. BANZHAF III, B.S.E.E., J.D., Sc.D.
Professor of Public Interest Law
GWU Law School
202 994-7229 // 703 527-8418