A crack down is nearing. June 2024, the United States Food and Drug Administration announced they are leading the charge to remove harmful e-cigarettes from the market. In a joint initiative involving the Bureau of Alcohol, Tobacco and Firearms (ATF), the Federal Trade Commission (FTC), United States Marshals and the United States Postal Inspection Service, the FDA plans to eliminate sales of unapproved vaping devices and vape juice.

In a press release, the FDA’s Dr. Brian King, director of the Center for Tobacco Products said, “Enforcement against illegal e-cigarettes is a multi-pronged issue that necessitates a multi-pronged response. This ‘All Government’ approach – including the creation of this new Task Force – will bring the collective resources and experience of the federal government to bear on this pressing public health issue.”  

Nico-teens

E-cigarettes and vaping devices are everywhere and increasingly available in child-friendly candy-like, fruity flavours. This alone is worrying to health officials. With ten percent of high school students and five percent of middle-school kids admitting to using e-cigarettes in the 2023 US National Youth Tobacco survey, it’s clear that manufacturers have hit on a way to lure youngsters into nicotine dependency. While many of these tempting tobacco products are easy to find on the shelves of head shops and on the Internet, the FDA has authorized only 23 e-cigarette products for sale in the US and all of them are tobacco or menthol flavoured.

US government agencies are betting on the idea that teens won’t reach for menthol or tobacco flavoured e-liquid or cartridges, and are focusing their efforts on eliminating sales of sweet-smelling e-cigarette refills. “Unauthorized e-cigarettes and vaping products continue to jeopardize the health of Americans – particularly children and adolescents – across the country,” says Benjamin C. Mizer, Acting Associate Attorney General in a press release for the FDA. “This Interagency Task Force is dedicated to protecting Americans by combatting the unlawful sale and distribution of these products. And the establishment of this Task Force makes clear that vigorous enforcement of the tobacco laws is a government-wide priority.”

Helping Hand?

E-cigarettes can be a helpful product to assist people in their efforts to wean themselves off cigarettes. With many of the negative health effects of cigarette smoking being associated with inhaling smoke rather than the nicotine, e-cigarettes seemed like a sure-fire winner. The road to hell, however, is paved with good intentions. Cigarette smoking amongst under 19s had declined dramatically between 1991 and 2021. The CDC collected data showing that frequent smoking rates had dropped from 12% to 0.7% of kids in Grade 9 through 12. The advent of e-cigarettes reversed this trend. In 2023, 2.1 million children reported that they had been vaping. 

Toxic Traits

While these kids may not be exposing themselves to the toxins associated with inhaling burned tobacco, paper, fibreglass and other chemical preservatives, e-cigarettes also come with a health warning. Firstly, nicotine is extremely addictive no matter how it gets into your body. In young people under 25, this is especially problematic. With their brains still under construction, youths are more susceptible to becoming hooked on tobacco. Just as concerning are the health risks intrinsic to vaping itself. 

Diacetyl, a chemical used by food manufacturers to deliver flavourings, is commonly used in vape juice and e-cigarette cartridges to add the adolescent-attracting flavours. In food diacetyl is safe to eat, but inhaling it is a different matter. Inhaling diacetyl can cause a serious lung condition, bronchiolitis obliterans, often called “popcorn lung” as it was first noticed in popcorn factories. The propylene glycol or vegetable glycerine carrier fluid is clinically proven to cause irritation to the airways when combusted and inhaled, and both these carrier fluids may also produce suspected carcinogens. They can also cause occupational asthma. Many of the production methods introduce metals into the e-juice that can accumulate and cause long-term damage.

E-cigarettes are a great tool in efforts to reduce harm from tobacco products, but if they are used by people who would otherwise not pick up the habit, they become a harm in themselves.

References

Bhatt JM, Ramphul M, Bush A. An update on controversies in e-cigarettes. Paediatr Respir Rev. 2020;36:75-86. doi:10.1016/j.prrv.2020.09.003

FDA Authorized E-Cigarette Products – Tobacco Education Resource Library Print Materials & Downloads. Accessed June 24, 2024. https://digitalmedia.hhs.gov/tobacco/print_materials/CTP-250?locale=en

Mejia MC, Adele A, Levine RS, Hennekens CH, Kitsantas P. Trends in Cigarette Smoking Among United States Adolescents. Ochsner J. 2023;23(4):289-295. doi:10.31486/toj.23.0113

White AV, Wambui DW, Pokhrel LR. Risk assessment of inhaled diacetyl from electronic cigarette use among teens and adults. Science of The Total Environment. 2021;772:145486. doi:10.1016/j.scitotenv.2021.145486