E-Cigarette Ads Spark Lawmakers’ Concern for Youths

This photo taken on Wednesday, March 2, 2011, shows Blair Roberts, a 22-year-old sales associate at Colorado E-Smokes as he demonstrates the use of a electronic cigarette and the smoke like vapor that comes from it at an E-Smokes store in Aurora, Colo. There's no legal age minimum for e-cigarettes in Colorado, and growing health concern that so-called "vaping" of nicotine is growing among kids has made Colorado the latest state to consider age requirements for the nicotine devices popping up at mall kiosks and convenience stores.
National Journal
Sophie Novack
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Sophie Novack
Sept. 29, 2013, 7:30 a.m.

An ad­vert­ise­ment for Blu elec­tron­ic ci­gar­ettes shows a glitzed-up, scantily clad Jenny Mc­Carthy seated in a club, smoking — or “vap­ing” — a sleek black tube with a blue glow at the tip. “Blu sat­is­fies me,” she says, as the cam­era pans out to show her chat­ting with an at­tract­ive male suit­or who is also hold­ing an e-ci­gar­ette. “I get to have a Blu without the guilt, be­cause it’s only va­por, not to­bacco.”

Blu is owned by Lor­il­lard, maker of New­port and oth­er to­bacco ci­gar­ettes. Lor­il­lard was one of nine re­cip­i­ents of a let­ter sent Thursday from 12 Demo­crat­ic sen­at­ors and rep­res­ent­at­ives ask­ing a series of ques­tions about the mar­ket­ing tech­niques of the e-ci­gar­ette com­pan­ies. The let­ter raised con­cerns that e-ci­gar­ette com­pan­ies are mar­ket­ing their products to chil­dren and teens. Lor­il­lard did not re­spond to a re­quest for com­ment from Na­tion­al Journ­al Daily.

E-ci­gar­ettes — which re­semble ci­gar­ettes but use bat­tery power to va­por­ize a nicot­ine-de­rived solu­tion that the user in­hales — are not sub­ject to the same reg­u­la­tions as tra­di­tion­al ci­gar­ettes, and their mar­ket­ing is not lim­ited by the re­stric­tions placed on to­bacco ci­gar­ettes in re­cent dec­ades. E-ci­gar­ette com­pan­ies can leg­ally sell to minors, run tele­vi­sion and ra­dio ads, and dis­trib­ute free samples.

“The mar­ket­ing of e-ci­gar­ettes is re-glam­or­iz­ing smoking and as­so­ci­at­ing young, at­tract­ive celebrit­ies with smoking,” Cam­paign for To­bacco-Free Kids Pres­id­ent Mat­thew My­ers told Na­tion­al Journ­al Daily. “Their par­ti­cip­a­tion in the last 12 to 24 months has used the ex­act same im­ages and tac­tics that made [tra­di­tion­al] ci­gar­ettes so ap­peal­ing to gen­er­a­tions of Amer­ic­ans.”

E-ci­gar­ettes are avail­able in a vari­ety of dif­fer­ent fla­vors, in­clud­ing cherry and cook­ies-and-cream milk­shake, and they may be pur­chased on­line and in mall kiosks. Crit­ics cite these mar­ket­ing tech­niques, along with the use of celebrit­ies such as Mc­Carthy, as evid­ence of tar­geted ad­vert­ising to­ward young people.

“[The ads] are vir­tu­al du­plic­ates of the Vir­gin­ia Slims wo­man from 40 years ago,” My­ers said. “That im­agery has been banned pre­cisely be­cause of its power­ful im­pact on kids.”

The is­sue of this tar­geted ad­vert­ising has re­ceived at­ten­tion fol­low­ing a Cen­ters for Dis­ease Con­trol and Pre­ven­tion re­port re­leased this month that showed dra­mat­ic in­creases in the use of e-ci­gar­ettes among middle- and high-school stu­dents. The per­cent­age of young people who have used e-ci­gar­ettes doubled in both groups from 2011 to 2012, jump­ing from 1.4 per­cent to 2.7 per­cent among middle-school stu­dents, and 4.7 per­cent to 10 per­cent among high-school stu­dents.

While e-ci­gar­ettes are of­ten presen­ted as the less harm­ful al­tern­at­ive to tra­di­tion­al ci­gar­ettes, law­makers worry that e-ci­gar­ettes could be­come a gate­way to nicot­ine ad­dic­tion and in­creased use of con­ven­tion­al to­bacco products. “It would be a ter­rible pub­lic health out­come if chil­dren and young adults who do not smoke thought it was safe to be­gin us­ing e-ci­gar­ettes be­cause they do not be­lieve that they pose a risk to their health,” Rep. Henry Wax­man, D-Cal­if., rank­ing mem­ber of the House En­ergy and Com­merce Com­mit­tee and an au­thor of the let­ter, wrote in an e-mail to Na­tion­al Journ­al Daily.

What has most wor­ried some crit­ics, however, is CDC’s find­ing that 80.5 per­cent of high-school stu­dents who use e-ci­gar­ettes also cur­rently smoke con­ven­tion­al ci­gar­ettes. “This is a fly in the oint­ment of people say­ing e-ci­gar­ettes are good for harm re­duc­tion,” said Stan­ton Glantz, pro­fess­or of medi­cine at the Uni­versity of Cali­for­nia (San Fran­cisco) and dir­ect­or of the Cen­ter for To­bacco Con­trol Re­search and Edu­ca­tion. Ac­cord­ing to Glantz, so-called dual users gen­er­ally smoke few­er tra­di­tion­al ci­gar­ettes each day, but smoking to­bacco means they are still suf­fer­ing the full car­dio risk. E-ci­gar­ettes still con­tain some car­ci­no­gens — al­beit less than to­bacco — and de­ter quit­ting, Glantz says.

These find­ings in­crease con­cern that the ad­vert­ising of e-ci­gar­ettes to young people will in­crease use of more-harm­ful to­bacco products, and the mar­ket­ing ef­forts are only grow­ing.

Ac­cord­ing to the Kantar Me­dia unit of WPP, the Blu e-ci­gar­ette brand spent $12.4 mil­lion on ads in ma­jor me­dia for the first quarter of the year, com­pared with $992,000 in the same peri­od a year ago, The New York Times re­por­ted. An­nu­al sales of all e-ci­gar­ettes are ex­pec­ted to reach $1.7 bil­lion by the end of the year.

Mean­while, the Food and Drug Ad­min­is­tra­tion does not over­see the in­dustry. The FDA’s Cen­ter for To­bacco Products has the au­thor­ity to reg­u­late only cer­tain cat­egor­ies of “to­bacco products.” The FDA “in­tends to pro­pose a reg­u­la­tion that would ex­tend the agency’s ‘to­bacco product’ au­thor­it­ies — which cur­rently only ap­ply to ci­gar­ettes, ci­gar­ette to­bacco, roll-your-own to­bacco, and smoke­less to­bacco — to oth­er cat­egor­ies,” an FDA spokes­per­son said.

The FDA can reg­u­late e-ci­gar­ettes only if the man­u­fac­tur­ers make a thera­peut­ic claim — in­clud­ing use as a ces­sa­tion device. Ac­cord­ing to the agency, none are cur­rently ap­proved for thera­peut­ic pur­poses.

“Many of the most overt claims as a ces­sa­tion device were made in earli­er years, but they’ve got­ten more soph­ist­ic­ated in re­cent years for fear of the FDA bring­ing reg­u­lat­ory ac­tion,” My­ers said. Com­pan­ies now tar­get adults by mak­ing the less dir­ect health claim that they are the safer al­tern­at­ive to ci­gar­ettes.

Law­makers hope the let­ter and their calls for hear­ings will bring over­sight not only to mar­ket­ing of e-ci­gar­ettes, but to the in­dustry more broadly. “Mar­ket­ing e-ci­gar­ettes to chil­dren is prob­lem­at­ic,” Wax­man wrote in the e-mail. “But FDA also needs to un­der­take a broad as­sess­ment of e-ci­gar­ettes, the risks they pose, and the reg­u­la­tion of these products that is ne­ces­sary to pro­tect the pub­lic’s health.”

If the FDA were to in­sti­tute broad­er reg­u­la­tions — something that has been dis­cussed for a while now — then a simple claim that e-ci­gar­ettes are safer than ci­gar­ettes would re­quire FDA ap­prov­al.

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