Why restricting flavoring in e-cigs is the right call

Although electronic cigarette use or vaping is often touted as the “healthier” or “safer” version of smoking cigarettes, e-cigarettes actually contain highly addictive nicotine and are marketed using enticing flavors that appeal to teens.

More than 3.5 million students in grades 6 through 12 used an electronic cigarette last year, making vaping products the most common form of tobacco used by teens. Because of the well-established harms of nicotine on the developing brain, my colleagues and I at National Jewish Health support the Stopping Appealing Flavors in E-cigarettes (SAFE) for Kids Act co-sponsored by U.S. Reps. Diana DeGette (D-Colo.) and Jamie Raskin (D-Md.) and Sens. Richard Durbin (D-Ill.) and Lisa Murkowski (R-Alaska). The proposed legislation would restrict the manufacture and sale of fruity flavors of electronic cigarettes.

{mosads}These new electronic nicotine delivery devices create an aerosol by heating up a liquid that typically contains nicotine, additives and flavorings with specific appeal to teens and young adults, like gummy bear and fruit medley.

Nicotine in e-cigarettes is detrimental to a young user’s health and since adolescence is an important period of brain development, young people should avoid consuming nicotine that alters the brain’s growth and maturation.

However, Tobacco companies have long known that flavors appeal to young people and encourage tobacco use. For nearly 90 percent of adults who smoke, tobacco use started when they were teens. Now, studies show that the vast majority of adolescents‘ first use of a vaping product is candy or fruit flavored — they mistakenly believe they are only inhaling flavored water vapor.

Studies have also found that nicotine is a key factor in priming the brain for future addictive impulses while increasing the risk of mood disorders, learning problems and impulsiveness. In fact, the resurgent use of nicotine among teens and young adults has even been rightly called an “epidemic” by the Food and Drug Administration and further proves the necessity of the legislation.

Little is known about the long-term health effects of vaping, even in the context of adults trying to quit smoking. There are fewer dangerous chemicals inhaled from electronic cigarette vapor than a combustible cigarette, however, given the more than 7,000 chemicals in tobacco smoke including at least 70 known carcinogens, this is an exceedingly low threshold to overcome. There may be some benefit if vaping helps an adult to completely stop smoking, but worrying trends suggest that most people who vape to quit continue to use both products. Even more worrying are new studies that suggest that dual use of electronic and combustible cigarettes may increase the risk of heart and lung health problems compared to either product alone.

At National Jewish Health, as the operator of the Colorado Quitline and several other state outlines for the past 17 years, we work to promote cessation and fight nicotine addiction with callers as young as age 12. It is imperative that we consider the threat nicotine in this new electronic form poses to younger generations.

The SAFE Kids Act will not only ensure that kid-friendly flavors of e-cigarettes are restricted, but also will give manufacturers a deadline to prove to the Food and Drug Administration that flavored products increase smoking cessation without increasing harm to the user and do not increase youth initiation. By regulating flavors used in vaping, we can begin to impact the use and sale of e-cigarettes to children.

This legislation is the first step toward a comprehensive plan that will help limit youth access to e-cigarettes. We urge lawmakers to pass the bill. Together, we can work to protect our youth from the dangers of vaping and prevent future nicotine addiction.  

Thomas Ylioja, PhD is the clinical director of health initiatives at National Jewish Health.