Editorials

Study adds urgency to call for e-cigarette regulation

A man exhales a cloud of vapor from an electronic cigarette. A new study confirms teens who smoke e-cigs are more likely to try regular cigarettes.
A man exhales a cloud of vapor from an electronic cigarette. A new study confirms teens who smoke e-cigs are more likely to try regular cigarettes. The Associated Press

Last week, as meaningful e-cigarette regulation continued to languish, the Journal of the American Medical Association confirmed that kids who try e-cigs are far more likely to graduate to regular cigarettes.

The yearlong study, published in JAMA Pediatrics, found that e-cigarettes, which turn liquid nicotine into a vapor inhalant, are – as suspected – a gateway habit, opening the door to a public health menace that the nation has spent decades prying out of the hands of adolescents.

Even if e-cigs turn out to be, as fans claim, a less unhealthy vice than regular smoking, they need to be kept out of the hands of minors. The fairest and least confusing way to do this is to regulate them like other tobacco products, which can’t be marketed to children and, in California, are taxed highly and limited to adults.

Yet the U.S. Food and Drug Administration has been beyond pokey in finalizing rules it proposed more than a year ago (and counting) that would give it the authority to require e-cig manufacturers to submit products for federal approval. And it has yet to stop the advertising of e-cigs to minors or the sale of vaping products online, where minors can easily acquire them.

Meanwhile California lawmakers, who proposed numerous bills this year to raise taxes on e-cigarettes, raise the smoking age to 21, restrict the use of e-cigarettes in public places and otherwise treat e-cigs and regular “combustible” cigarettes the same way, saw most of their efforts stall, thanks to industry sympathizers in the Assembly Governmental Organization Committee.

Some of those bills may return as part of the Legislature’s ongoing special session on health funding, but in a body dominated by Democrats and in a state known for its leadership on health issues, the roadblock was telling.

It shouldn’t be this fraught for California to take the obvious steps necessary to prevent smoking from being rehabilitated and normalized again.

It shouldn’t be this fraught for California to take the obvious steps necessary to prevent smoking from being rehabilitated and normalized again.

Nicotine is extremely addictive, with risks to an adolescent’s developing brain no matter how it’s ingested. Other chemicals in e-cigarettes also carry potentially serious health risks. Though smokers of regular cigarettes swear by e-cigs as a way to wean themselves from a potentially lethal habit, their convenience has to take a back seat to the risks e-cigarettes pose to children. We’ve spent too much time and money teaching teenagers not to smoke.

Last week’s study showed, however, that the boom in e-cigarettes poses a clear and present threat to all the public health work. Tracking the habits of nearly 700 young people, the researchers at Dartmouth University, the University of Oregon and the University of Pittsburgh found that a teenager who had used e-cigarettes was nearly three times more likely to have tried regular cigarettes a year later than a teenager who hadn’t.

Between 2013 and 2014, e-cig use tripled among high schoolers. This trend has to stop.

The FDA needs to pick up the pace in finalizing and issuing the rules on e-cigs and do something about the marketing of this product to children. We hope its recent banning of certain regular cigarette brands is a sign that it will soon act on e-cigarettes.

State lawmakers, meanwhile, have all the rationale they need to raise the tobacco tax and the smoking age and extend regulations on tobacco to e-cigarettes.

“We do not need more research on this question,” the executive director of the Academy of Pediatrics, Jonathan D. Klein, wrote in a companion piece published with the article in JAMA. “What we still need is the political will to act on the evidence and protect our youth.”

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