Inside Medicine: E-cigarette a new product with same old strategy

09/12/2013 12:00 AM

09/10/2013 5:01 PM

It seems like some things never change — at least with tobacco companies. Given all the battles over cigarette marketing that spanned the last 60 years — and that fact that traditional cigarette smoking is at the lowest level in decades, it is more than upsetting that the makers of e-cigarettes (primarily the same companies who sell traditional cigarettes) are at it again.

To promote e-cigarettes these companies are again hiring movie stars, directing messages at impressionable teens, strategically placing TV commercials and Internet promotions, and sponsoring events likely to be watched by those most likely to try e-cigarettes, those teens. Because e-cigarettes contain no tobacco, they are not covered by tobacco laws that severely restrict marketing practices. So, companies are using the playbook previously used to sell traditional cigarettes. And the campaigns seem to be just as effective. According to the New York Times, e-cigarette sales will reach nearly $2 billion by year’s end.

What, you may ask, is an e-cigarette? It is part of a new electronic nicotine-delivery system that looks and feels like a real cigarette but delivers nicotine without any smoke.

What is inside an e-cigarette? We don’t really know, and that’s part of the problem, as there is no requirement for manufactures to divulge ingredients. The other concern is what we do know — e cigarettes clearly contain nicotine, which is highly addictive.

E-cigarettes come in many flavors, making them attractive to teens, and they can be purchased at convenience stores. The popularity of e-cigarettes is increasing about 500 percent a year. While the tobaccoless e-cigarette offers existing smokers a safer option than traditional smoking, the idea was not to create an entirely new generation of teens addicted to nicotine.

Currently the products are not regulated and there is no tobacco penalty tax — a tool that has proved extremely effective at driving up the cost of traditional cigarettes to help keep them out of the hands of young people. Yes, we need more research on the safety of these products, on addiction to them and on whether e-cigarettes are a gateway product to more dangerous tobacco products.

But this research will take time. In the meantime, we should push hard to consider these products as a drug-delivery system and thus subject them to strict FDA oversight. But the FDA is dragging its feet. With each passing day consumer demand increases as more people become addicted to the nicotine.

It took the medical and public health communities generations to enact laws to protect consumers and enforce those laws through crippling lawsuits against manufacturers. I guess it would be naive to think the public should expect better behavior this time around without the need to repeat that entire process.

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