E-Cigarettes—An Update

Illinois PTA covered the hazards of e-cigarettes to young children and the potential transition into using real 800px-510N_e-cigarette_and_e-liquidstobacco by teens in a previous article. E-cigarettes are not regulated by the FDA, and the health risks are still unknown. Vapors from some e-cigarettes contain chemicals known to cause cancer in addition to nicotine, and there is no way for users to know how much nicotine or other potentially harmful chemicals they are inhaling. E-cigarettes may be especially harmful if they lead to regular nicotine use or the use of other tobacco products. In high doses nicotine may be extremely toxic or even fatal, and poisonings can occur through ingestion, inhalation, or absorption of nicotine liquid on the skin. In Minnesota, child poisonings related to e-cigarettes increased sharply from 2011-2013. Symptoms have included nausea and vomiting.

New Laws in Illinois

While Illinois has passed House Bill 5689 (HB5689) and House Bill 5868 into law effective January 1, 2015 (Public Acts 98-1021 & 98-0983), the threats and potential for poisoning are still very much still there, particularly in the home.

  • PA 98-1021 (HB 5689): This new law provides that electronic cigarette liquids sold and marketed for the refilling of e-cigarettes may be sold only in special packaging. The Illinois Department of Public Health (IDPH) shall adopt rules establishing the standards for special packaging to be used for e-cigarette liquids.
  • PA 98-0983 (HB 5868): Amends the Display of Tobacco Products Act, providing that alternative nicotine products (electronic cigarettes) must be sold from behind the counter or in an age restricted area or in a sealed display case.

Increased Use by Teens

The popularity of e-cigarettes with their variety of flavors and greater social acceptance is leading to an increasing number of teens giving them a try according to a recent Pediatrics journal article. The average age of first use of e-cigarettes is between 14 and 15. This increase in teen e-cigarette use is leading these teens to eventually try real tobacco. Despite the packaging being changed and the accessibility restricted, teens have the will and will find the way to obtain e-cigarettes, just as they have with real tobacco products over the years (and don’t forget sales over the internet).

Rapid Rise in Nicotine Poisonings

Education is essential, especially in the home, about the risk of poisoning being a significant concern with e-cigarettes. The colors and smells of nicotine liquid refills attract small children who end up exposed to a very toxic substance. Poisonings can occur through ingestion, inhalation, or absorption of nicotine liquid on the skin. In high doses, nicotine may be extremely toxic or even fatal. The CDC reports the number of calls involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014. More than half of the calls received involved children under the age of 5, and about 42 percent involved adults. Developing strategies to monitor and prevent future poisonings is critical given the rapid increase in cases, and diligence in the home is crucial.

Surgeon General Recommendations

The United States Surgeon General has suggested other ways to discourage use, include the following:

  • Increasing in the price of tobacco. Price increases, including tobacco excise taxes, are effective in reducing youth tobacco use, as youth are sensitive to price increases.
  • Implementing smoke-free indoor air policies. In January of 2014, the Chicago City Council approved a ban of smoking of e-cigarettes in most indoor public spaces—including restaurants and bars—in addition to anywhere within 15 feet of a building entrance, joining New York City as the second major US city to treat e-cigarettes similarly to traditional cigarettes under the city’s existing indoor smoking ban.
  • Restricting youth access to tobacco products. Restrictions on sales, including state or local bans on entire categories of tobacco products, may reduce use. An Illinois law went into effect on January 1, 2014 that bans the use of alternative nicotine products, such as e-cigarettes, by those under the age of 18, with the reasoning that while electronic cigarettes do not contain tobacco, they do contain nicotine, an additive substance that makes smoking difficult to quit.
  • Restricting advertising and promotion of tobacco products. E-cigarettes are not subject to the same restrictions as conventional cigarettes and are advertised heavily on TV, radio, the Internet, and in convenience stores.
  • Get the word out about the potential risks to teens and young children. One step in the right direction can be found in the state of Utah, which developed a group called Outrage!, an anti-tobacco youth group who fight vigorously against the tobacco industry by creating policy that can stop or derail their marketing to youth. They will fight against the tobacco industry and now also the e-cigarette industry until they close their doors and stop selling products that kills 1,200 daily.