Rush to Regulate Is Reckless, Says CASAA

Push to control electronic cigarettes without enough data could destroy effective alternative

Published in CSP Daily News

WASHINGTON -- Last week, several anti-tobacco organizations sent a joint letter to President Obama, asking him to order the U.S. Food & Drug Administration (FDA) to promptly assert authority over all tobacco products not currently under its jurisdiction. The organizations imply that the delay is resulting in negative health consequences; however, they never mention any specific consequences, and for a good reason: They are proposing a "solution" where no problem exists. Instead, enacting regulations without sufficient scientific evidence has the potential to do a great deal of harm to public health, said the Consumer Advocates for Smoke-free Alternatives Association (CASAA).

The CASAA has written the President to urge him to advise the FDA to take the time needed to develop science-based regulations that will serve the interests of public health. CASAA is a nonprofit organization that works to ensure the availability of low-risk alternatives to smoking and to provide smokers and nonsmokers alike with truthful information about such alternatives.

In 2009, four of the organizations that signed last week's letter--the Campaign for Tobacco-Free Kids, the American Lung Association, the American Cancer Society Cancer Action Network and the American Heart Association--jointly pressured the FDA to remove electronic cigarettes from the market. The FDA tried to do so until a federal court judge ruled that e-cigarettes cannot be regulated (and thus banned) as a drug unless therapeutic claims are made.

"Had these organizations succeeded in their efforts to prevent the sale of e-cigarettes in the U.S.," said CASAA president Elaine Keller, "hundreds of thousands of former smokers would still be lighting up. Almost all e-cigarette consumers are former smokers who tried to quit by using some or all of the products and methods these organizations tout and kept relapsing. The option to switch to a low-risk product that is a satisfying substitute for smoking has made a smoke-free life possible for those who had almost given up all hope of ever being able to quit smoking."

In their letter to the president, the organizations cite the recent report on youth use of e-cigarettes by the Centers for Disease Control & Prevention (CDC) as proof that students in grades six through 12 are taking up use of e-cigarettes at an alarming rate. This misrepresents the findings, said CASAA.

Only 2.1% of the youth had taken so much as one puff from an e-cigarette recently. As far as we know from that survey, none of them are using e-cigarettes daily, in contrast with the millions of youth who are known to smoke. The CDC did not report the daily use statistics for e-cigarettes, or even whether the e-cigarettes being tried contain nicotine.

CASAA asked, how do these statistics compare to recent smoking of conventional cigarettes? The Substance Abuse & Mental Health Services Administration (SAMHSA) has published, "Results from the 2012 National Survey on Drug Use & Health: Summary of National Finding." According to the SAMHSA report, past-month cigarette use among youths aged 12 to 17 fell from 9.1% in 2009 to 6.8% by 2012 for males and from 9.3% to 6.3% for females. Furthermore, the rate of initiation of smoking among youths in the same age group fell from 6.3% to 4.7% for males and from 6.2% to 4.8% for females.

"Those who want to ban e-cigarettes make up any claim they can think of, regardless of whether there is evidence to support it. If e-cigarette use really caused kids to start smoking and there really was an alarming use of e-cigarettes by youth, we would see an increase in kids smoking, the opposite of the actual trend," CASAA's scientific director, Dr. Carl V. Phillips, said.

"Someone who would try an e-cigarette but would avoid smoking presumably is motivated by avoiding the risk of smoking," he added. "The only reason I can see for someone to make the unfortunate transition from e-cigarette use to smoking would be if e-cigarettes were to become less accessible or deliberately made less attractive, which, ironically, could be the result if the type of excessive regulations urged by these organizations is enacted."

The CDC provided no data to suggest that youth were using candy or fruit flavors at all, let alone that those flavors have particular appeal to youth, said CASAA. Yet the organizations that have been trying to stop the sale of e-cigarettes claim that pleasant flavors are a clever ploy to attract youth to use the products. They tie this claim to the CDC results even though those results are completely silent on the issue and, indeed, there are no data to support the claim at all.

CASAA also noted that most adults begin using tobacco or menthol flavor e-cigarettes, trying to match the taste of their favorite brand of conventional cigarettes. Many who give up on this (usually unreachable) goal of perfectly mimicking cigarettes switch to more interesting flavors, and soon find that they no longer enjoy tobacco and/or menthol flavors. This appears to be an important part of why so many who have transitioned completely to e-cigarettes find they have no longer have any urge to smoke, even if they eventually wean all the way off nicotine.

"A rush to regulate, without having gathered sufficient scientific data, would have a devastating impact on public health," said Keller. "Anything that would reduce the availability of the e-cigarettes to adults or reduce their acceptability as a replacement for smoking will cost lives, not save them."