Electronic cigarettes considered a new public health threat

Dec 16, 2010

Just when you thought cigarettes were headed for obscurity, along comes the electronic cigarette.  The King County Board of Health is restricting these "e-cigarettes" in the name of protecting youth -- and keeping a stigma against smoking. 

E-cigarettes are battery powered devices, shaped like a cigarette, that deliver little puffs of nicotine – with no smoke.  They use a small capsule with nicotine suspended in a flavored liquid.  If you squeeze a button on the device (or with some models, just inhale), the liquid heats up and turns into a misty vapor to inhale.  Then it shuts off. 

"These are just a god-send for me ... I love them," says Amber Joy, 68, of Seattle.  She's been a cigarette smoker for 50 years.  She’s quit more than once, calls it a stupid habit, but can’t do without her smokes.  The electronic cigarette satisfies her craving, without most of the negatives.

"It doesn’t smell, it doesn’t bother my breath, it doesn’t bother anybody around me," she says.  That means she can use it in her smoke-free apartment.  "There's no odor to it."

Tobacco or medicine?  Legal or not?

She feels it’s healthier, because she’s only getting nicotine, not the rest of the chemicals in cigarettes. 

Is it smoking? Is it a medical device, like a nicotine patch?  Those questions are embroiled in federal lawsuits.  Earlier this month, a federal appeals court ruled the Food and Drug Administration (FDA) must treat it like a tobacco product, not as a drug.  That means it can't be banned outright. 

For now, the King County Board of Health is banning the sale of e-cigarettes to children under 18. 

"We know from a lot of scientific studies that nicotine is very addictive," says Bud Nicola, a doctor and member of the Board of Health.    Most lifetime smokers start before the age of 18, so the devices could ensnare a new generation of smokers. 

There’s no evidence, yet, that kids are buying the e-cigarettes – which typically cost $50 or more.  However, there are cheaper "starter" versions, and some are sold with flavors that appeal to kids, such as vanilla, coffee or cherry. 

King County is also banning e-cigarettes from bars, restaurants and other public places where smoking is currently banned.   The public health department says it's confusing -- and can trigger real smoking -- if people see someone else puffing the electronic version.   This has only been documented in two cases.  But, the e-cigarette makers are promoting them with phrases like "experience the freedom of smoking anywhere" and "looks, feels, and tastes like the real thing."

Earlier this fall, actress Katherine Heigl gave the products a marketing boost, by showing off her e-cigarette to David Letterman. 

The FDA has been studying e-cigarettes for the past few years and has a detailed analysis, along with this video from the FDA's media office.

Board of Health chair Julia Patterson said one reason she voted for the new regulations is to preserve the "social norms" against smoking, which she described as a hard-fought victory.  "I would like to see us protect public places from the image of someone sitting at their desk, with something that looks identical to a cigarette, and puffing on it.  That’s a very powerful subliminal message," she said.