“The manufacturers are claiming they are not cigarettes, but they do contain nicotine,” said Jill Leal, executive director of Tobacco Free Allen County, which is ramping up education about the products and the need for regulation of them.
E-cigarettes are not taxed like traditional cigarettes, they can be advertised in the media and can be used in places banning cigarette smoking. Indiana is one of only about 14 states prohibiting youths under age 18 from buying them, Leal said. The FDA plans to issue proposed regulations on e-cigarettes by the end of this month.
It is difficult to know just what chemicals are in e-cigarettes because they are not regulated by the U.S. Food and Drug Administration, Leal said.
Also in the cartridge is an atomizer that heats the liquid which may be flavored to give the taste of strawberries, bubble gum or cookies and cream. When the user, or “vaporizer,” inhales on the end of the e-cigarette, the chemical juice is drawn into the atomizer wicking and heats up to the point it becomes a vapor. The vapor is drawn up through the cylinder and out through the mouthpiece.
Though the initial cost outlay is usually greater than a pack of cigarettes, 700 or more puffs can be generated from one e-cig, explained Leal. One e-cig is claimed to be equivalent to a pack and a half of traditional cigarettes.
FDA tests have found nicotine levels higher in the vast majority at higher levels than what the manufacturer reported. Another chemical component found in some brands is tobacco nitrosamines, which are known carcinogens at certain levels.
“We really don’t know what the dose is you are getting,” Kathleen Gerhart said of the tobacco nitrosamines. Gerhart is coordinator of Lutheran Hospital’s Tobacco Intervention Program and is a member of the Tobacco Free Allen County Coalition.
A CDC report, released in September, found e-cigarette usage among high school and middle school students had more than doubled in just one year, from 4.7 percent in 2011 to 10 percent in 2012. Yet smoking of traditional cigarettes has declined in recent years.
The emergence of e-cigarettes is concerning to staff at the Fort Wayne Urban League, which in July became the minority-focused partner with Tobacco Free Allen County. The agency’s director of programming, Jamie Garwood, said she has not yet seen a lot of e-cigarette usage within Fort Wayne’s urban population but noted, “It’s really only a matter of time when they are marketed more extensively to the inner city neighborhoods we serve,” particularly as the price goes down.
That time may already have come. A large sign at one Parnell Avenue store is advertising free samples of e-cigarettes. On Wednesday, Bloomberg News reported Victory Electronic Cigarettes Corp. is going to start handing out one million free e-cigarettes this month in 50 cities across the country.
“They are trying to make these real trendy, so we need to go into gas stations and convenience stores in our neighborhoods and see how they are marketing them,” Garwood said. Trendy is right. At least one brand has a blue light on the end that shines when the device is activated. If others with the same brand are nearby, their e-cigs then also light up blue so users can find one another.
Some proponents say e-cigarettes are a good smoking cessation product. Gerhart disagrees, telling people, “It’s a nicotine delivery device. It’s just a different way to get nicotine,” which is highly addictive. Nicotine replacement and cessation products such as gum, lozenges and patches, and medications such as Chantix and Zyban, have been tested extensively. Not so for e-cigarettes.
“Using them mimics the whole pattern of smoking,” which comprises a “three-link chain of addiction: the physical, psychological and social,” Gerhart said. “All three of those things are interlinked with each other. If you are going to an e-cigarette, how are you ever going to break that addiction?”