Did you know that the first e-cigarette was patented in the 1960s? But the popularity of this device didn’t really kick off until the early 2000s. An increase in teen usage over the years has many parents, researchers, and educators concerned about how future generations will handle vaping and, more generally, whether or not smoking e-cigarettes is a worthwhile solution for traditional tobacco smokers to quit.

The Safer Alternative?

E-cigarettes have been marketed as a safer “alternative” for adults to kick their nicotine habit. However, the American Lung Association has cited several studies and professional findings that conclude that vape smoke may be more harmful to your lungs than smoking an actual cigarette. One such study by The University of North Carolina found that even the smallest dose of propylene glycol and vegetable glycerin (two primary components of e-cigs) can expose users to high levels of toxins, which could cause “irreversible lung damage.” But even this study admits that “the mid-to-long-term consequences of e-cigarettes are not yet known.” If there are so many unknowns when it comes to e-cig consumption, how can any solid conclusions even be made?

When compared to tobacco cigarettes, vaping does seem to be a healthier alternative since e-cigarettes do not contain tobacco or as many of the carcinogens that traditional cigarettes have. So the issue really becomes whether or not vaping is more helpful or harmful, not whether or not it’s bad for you. For your lung health, smoking anything will be bad for you, but in the case of traditional tobacco users who have been unsuccessful in their attempts to quit, the issue becomes relative and the statistics become unclear.

For example, the Director of Policy Research and Analysis for the Center on Addiction, Linda Richter, Ph.D., has observed that effects for those who have mild to moderate cases of asthma are “less risky” than traditional cigarette use. A different report, however, from the National Academies of Sciences, Engineering and Medicine, claims that there was an “increase in asthma exacerbations” for adolescents who use e-cigs. So which claim is closer to the truth?

That same report makes one conclusion that “exposure to nicotine from e-cigarettes is highly variable and depends on product characteristics (including device and e-liquid characteristics) and how the device is operated.” This finding suggests that, compared to the delivery methods of traditional cigarettes, e-cigarettes and the vaping liquid and pens that accompany them, need more attention and regulation. This kind of regulation becomes complex when you consider that while the role of the FDA is to regulate food and drugs, what is their responsibility when it comes to the tools that administer them? Should the regulation of pens and vaping liquid fall completely under the responsibility of the FDA if the exposure to nicotine “depends on product characteristics?”

Injuries and Explosions

The FDA has documented over 130 instances of e-cigarette explosions since these devices were brought onto the market in 2007, adding an additional concern to the inconsistency of these “product characteristics.” A new study conducted by Tobacco Control found that there are far more e-cigarette explosions and burn injuries in the United States than estimated in past reports. This study led by Dr. Matthew Rossheim in Mason’s Department of Global and Community Health used data from the U.S. Consumer Product Safety Commission and found an estimated 2,035 emergency department visits from e-cigarette explosion and burn injuries from 2015 to 2017. This number, in all likelihood, is an underestimate of total injuries since not all injured people report to emergency departments.

The lack of regulation in the e-cig industry has caused many people to become injured by the battery devices that are used to charge vape pens. This problem stems from the fact that different USB ports put on different levels of voltage and current, which can cause the E-cig battery to overheat. As a result, a reaction called “thermal runaway” occurs. The reaction can be devastating and even deadly.  Causes of e-cigarette explosions include the use of substandard batteries, faulty batteries, chargers that were not provided by the manufacturer and substandard batteries.

So is the real issue the technology behind how vape fluids are administered? If explosions and inconsistencies in nicotine exposure are constants among these products, then what can the FDA really do about that? What is the precedent for regulation on a technological product that is so intertwined with the responsibility of the FDA?  Another aspect that needs to be considered is the real intention behind the advent of e-cigarettes. Is it really to help existing smokers quit or at least consume a healthier alternative? If so, then what also needs to be examined is the marketing behind vape products.

Youth Prevention Efforts

In March, the American Lung Association and other health partners filed a lawsuit against the Food and Drug Administration over a delay announced last year in the regulations from August 2018 to 2022. The lawsuit claims that the FDA was not doing enough to educate the public on the harmful effects vaping and e-cigarettes cause to your lungs. The lawsuit is intended to highlight that the makers of e-cigarettes are using shady marketing tactics such as social media retargeting and candy-flavored “juice” to appeal to young kids. Flavors include cookie dough, grape, cherry, and even Fruit Loops infused vapor.

Studies have shown e-cig use among teens has increased by 900%. Data collected by the FDA shows that in 2017, 2.1 million middle school and high school students used e-cigarettes. Luckily, key findings from the 2017 National Youth Tobacco Survey shows that tobacco use decreased from 2011- 2017. So, what is more harmful? Teens vaping, or teens smoking cigarettes? Has teen smoking (e-cig or regular cigarettes) increased as a result of these new “candy-flavored” fluids?

New efforts by the FDA were made in 2018 to protect youth from the dangers of e-cigarette and tobacco use with “The Real Cost” campaign which urges teens to “know the real cost of vaping.”

Making a Plan

As general knowledge on the harmful effects of e-cigarettes grows, stricter regulations are being put into place and harsher penalties on tobacco companies with misleading information. Last month, the FDA issued a statement on their efforts to address the e-cigarette epidemic and curb youth tobacco use in the US: “We launched a multi-pronged Youth Tobacco Prevention Plan. We escalated enforcement against retailers who illegally sell ENDS (Electronic Nicotine Delivery Systems) products to minors. We partnered with the Federal Trade Commission to target e-liquid manufacturers whose products used misleading, kid-appealing imagery that mimicked juice boxes, lollipops, and other foods. We worked with eBay to remove listings for these products on their websites. We launched innovative campaigns, including “The Real Cost” Youth E-Cigarette Prevention Campaign, to educate teens about the consequences of addiction to e-cigarettes.”

While e-cigarettes aren’t a completely guilt-free solution to nicotine consumption, it can be hard to draw conclusions about e-cigarette devices when new and conflicting research is coming out all the time. In addition, sometimes this information can be misleading or doesn’t address the right questions.

Paving The Way For Change

Increased awareness through media campaigns and more funding for studies has not only given us clearer insight into both the harmful and potentially helpful effects of vaping, but it has allowed regulators to demand stricter laws on how big tobacco companies market their products. A smoke-free future might not be around the corner but progress is definitely being made to educate and inform the public on how to handle vaping teens and help nicotine-addicted adults.

Author: Alana Redmond is graduate from the University of California San Diego. She also works with The Law Offices of David A. Breston in Houston and focuses her writing on technology and consumer safety across the US.   https://www.davidbreston.com/