By Gretel Johnston


Anti-smoking organisations in the US are watching the spread of e-cigarettes warily, cautioning smokers against placing too much faith in them as a safe alternative to regular cigarettes. The devices, which resemble cigarettes, complete with glowing red tip, contain no tobacco and release only a scentless vapour.
They have been around for about a decade, having first appeared in China. Despite their slick and stylish appeal, they still contain some of the same carcinogens and additives that are found in cigarettes, anti-smoking groups warn.
Another cause for their concern is that after years of work chipping away at cigarette advertising, they now face a new challenge. It’s been 42 years since advertisements for cigarettes have aired on US television.
But now e-cigarette ads are cropping up, raising concern that smoking again will be glamourised by them. E-cigarettes — the E stands of electronic — are battery-operated devices designed to mimic the sensation of smoking a real cigarette. They contain cartridges filled with chemicals, including nicotine, but no tobacco and there is no combustion.
Sales in the United States have been soaring. They are projected to reach $1bn this year, an increase of more than 50% over the $600mn in sales last year, according to research by the US bank Wells Fargo. Just two years ago US sales totalled just $300mn.
Major US cigarette makers, including Philip Morris USA, maker of Marlboro, want a piece of the action. Altria Group, owner of Philip Morris USA, entered the e-cigarette business in June when it unveiled its new MarkTen e-cigarette brand, which the company begins distributing in one US state, Indiana, in August, the company said.
 “The (electronic cigarette) category is in its early stages and time will tell how it will evolve,” Altria chief executive Marty Barrington told investors when MarkTen was unveiled.
The $1bn in sales that e-cigarettes are expected to achieve this year still pales compared with the $46-bn US cigarette market. But Barrington said e-cigarettes already are having an impact on traditional cigarette sales.
“I know everyone is acutely interested in this,” Barrington said during a conference call with reporters in June. “I continue to believe it’s having some effect, obviously, because people who are trying e-vapour products are adult smokers, so you’d expect some effect.”
Altria has not yet determined what the impact will be, but the company’s motivation in introducing the MarkTen was to make sure Altria had a competitive product, Barrington said.
It was already lagging behind RJ Reynolds, maker of Camel, Kool and Winston cigarettes, which began selling its e-cigarette, Vuse, last year in limited markets.
Currently, there are no restrictions on the marketing or advertising of e-cigarettes, but that could change.
The US Food and Drug Administration has the authority to regulate all tobacco products, but it has not yet asserted its jurisdiction over e-cigarettes. The FDA says the reason is further research is needed to assess both the potential public health benefits and the risks of electronic cigarettes. Most observers are sceptical about the benefits.
 “Simply put, e-cigarette users cannot be sure of what they are inhaling, since e-cigarettes have not been subjected to thorough, independent testing,” said Dr Thomas Glynn in a health blog at the American Cancer Society’s website.
The FDA has said that it found cancer-causing substances in half the samples when it studied 18 samples of e-cigarette cartridges from two leading e-cigarette brands.
The FDA also found inconsistencies, such as varying nicotine levels inhaled per puff even when cartridges were labelled as having the same amount of nicotine. It also found the chemical diethylene glycol, an ingredient used in antifreeze that is toxic to humans, in one cartridge.
Erika Sward of the American Lung Association agreed there is not enough known about e-cigarettes and said there is inconsistency across the brands. “We can’t say that one company’s e-cigarettes have the same chemicals that another company’s has,” Sward said.
While the products have been billed as tools to help smokers quit, some health professionals are wary about telling patients they are non-toxic. Sward also warned about those claims. “Buyer beware,” she said, adding that people who are hoping to quit should find ways that have been tested and proved effective.
She said her organisation as well as other anti-smoking groups face the same challenges they faced with cigarettes, not only in advertising, but also in trying to prevent them being marketed to children. They come in different flavours, for example, such as chocolate and mint, which make them appealing to young people. There also are e-hookahs mimicking hookah pipes. Donna Lindsey, 33, enjoyed a melon-flavoured e-hookah recently on a break from her job in downtown Washington, DC. “This one lasts for more than 300 puffs,” said Lindsey, adding that she has enjoyed the e-hookah inside public buildings and in restaurants without being asked to go outside. There’s no secondhand smoke and it gives her the same sensation as smoking.
But users like Lindsey might feel more and more pressure to leave their offices when they want to “puff” because of concerns about residual nicotine.
Americans for Nonsmokers’ Rights said in a 2010 report that nicotine is exhaled by e-cigarette users in an invisible vapour cloud. Nicotine is a sticky substance that remains on surfaces for days and weeks, the association said. People therefore continue to be exposed to it. To Sward, concern over residual nicotine, cigarette advertising and marketing to young people sound more than familiar after decades of fighting them.  
“I would hope that e-cigarettes would ultimately not have the same awful impact that regular tobacco products have had, but the jury is still out.” – DPA


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