10 things e-cigarettes won’t tell you

7. “Kids love us.”

If there’s one thing that the e-cigarette industry and the public health community agree on, it’s that e-cigarettes are not for children. Kids, on the other hand, seem to disagree, judging by the surging interest in e-cigs among adolescents and teens. The proportion of middle-school and high-school kids who have used e-cigarettes doubled to nearly 7%, or almost 2 million students, between 2011 and 2012, according to a recent report by the CDC. What’s more, “there’s a substantial concern that e-cigarettes will serve as a gateway product to nicotine addiction for a new generation of young people,” Fiore says. Indeed, more than 76% of students currently using e-cigarettes also reported smoking regular cigarettes. (E-cigarette defenders say the statistic can be interpreted the opposite way, too, illustrating that students who already smoked are switching to e-cigs.)

A crackdown on the way e-cigarettes are designed, marketed and sold is sorely needed, say critics. Flavored e-cigarettes, with labels touting flavors like gummy bear, fruit loop and cotton candy, are particularly offensive-especially since the FDA forbids regular cigarettes from being flavored, says Feinberg. (The e-cigarette industry says it wants to keep the products out of children’s hands, and people should only be able to buy them after showing they are of legal age. Altria and Reynolds American add that their e-cigs, like cigarettes, only come in regular and menthol.) Other chief complaints include e-cigarette ads in music magazines and celebrity endorsements in pop-culture tabloids. “We’re concerned that our youth is going to grow up thinking e-cigarettes are cool and they’re going to get addicted to nicotine,” Feinberg says.

10 things e-cigarettes won't tell you Until the FDA sets age restrictions on e-cigarettes, children will continue to be able to buy them in many states without being carded, though some local lawmakers have enacted their own rules. Massachusetts State Rep. Jeffrey Sanchez (D), for one, is advancing a bill to prohibit sales to minors. “Right now my 7-year-old could go to the convenience store and literally take it off the shelf and buy it, and the store owner could sell it to them,” he says.

8. “We’re bringing smoking back inside…”

As new bans have pushed cigarette smokers ever further out into the cold - often as far as 25 feet from the entrance of restaurants, bars, and even outdoor spaces like parks and beaches - e-cigarettes have found a haven indoors. The devices, which emit vapor that is less noticeable and odorous than smoke, and don’t use a flame or smoldering butts that could pose a fire hazard, have largely been tolerated if not fully welcomed in places where smoking is banned, including workplaces. Some e-cigarette users reportedly even took drags while attending a recent New York City council meeting about raising the purchasing age of cigarettes as well as e-cigs. Indeed, part of the allure of e-cigarettes is that people can use them discreetly, without having to brave the cold or stink up their home, says Herzog: “There are a lot of smoking bans, and it’s easier to use these in many places that are difficult to smoke. There’s no real smell.”

Anti-smoking advocates, however, argue that observers can’t tell the difference between electronic cigarettes and the real thing. Inviting e-cigs into no-smoking zones threatens to undo public-health progress in making tobacco taboo, says Feinberg of the NYC Coalition for a Smoke-Free City. Some policymakers have recently stomped out e-cigarettes, applying smoke-free laws to e-cigs, too, and Amtrak prohibits them in stations and trains. The University of California, where researchers recently called for more studies on e-cigs’ impact on bystanders after finding that e-cig vapor released higher concentrations of some disease-causing elements also produced by cigarette smoke, has banned both products at all of its campuses.

Electronic cigarette makers, however, oppose banning them anywhere but schools, playgrounds and child-care facilities, saying the devices emit vapor, not smoke. Still, research on the secondhand risks of vapor is scant, and Altria’s May says the company supports restrictions in cramped, enclosed spaces - such as a packed subway car or elevator: “In small confined places, people might not want to be around the vapor; people might find it inappropriate.”

9. “... and back into aircraft.”

Lately, airlines have had to chastise not just passengers, but their own flight attendants for smoking - er, “vaping”- e-cigarettes on planes. After the flight attendants union for a regional branch of US Airways realized over the summer “that there are some crewmembers that are using electronic cigarettes on the aircraft,” it reminded members that the Department of Transportation’s blanket ban on airplane smoking also applies to e-cigarettes. The DOT, however, acknowledges that its current ban, which does not explicitly prohibit e-cigs, hasn’t been clear enough, with travelers and even flight staff using the devices openly in their seats, or in the airplane bathrooms. “This issue does come up occasionally and when it happens, a flight attendant will inform the passenger of current regulations to clear up any confusion,” and “that there is no-smoking of any kind in the aircraft,” says Corey Caldwell, spokesperson for the Association of Flight Attendants-CWA, a national union. (The Federal Aviation Administration finally approved the use of portable electronic devices like tablets and cellphones on airplanes, but the new policy, announced in October, doesn’t sanction puffing electronic cigarettes on planes.)

The DOT plans to issue new rules prohibiting using e-cigarettes on planes by mid-2014, and many airlines have specifically banned them. In the meantime e-cigarette proponents disagree about whether it’s okay to vape on planes - and some say they’ve been able to get away with it anyway, and don’t see a problem, as the battery-powered devices can’t start a fire. Caldwell, however, says it’s important to minimize any potential health risks for fellow passengers as well as the flight crew: “Right now the biggest question is, what are the effects of use?”

10. “E-joints and e-crackpipes are the new e-cig.”

The season premiere of Saturday Night Live in September included a mock commercial for “e-meth.” The skit parodied some of the arguments championing e-cigarettes, only instead of a nicotine substance, the devices supposedly contained the illegal drug crystal meth: “It produces vapor instead of smoke. And that means I can ride the ice pony anywhere I want,” said one actor. “Thanks to e-meth, I can now even smoke inside my favorite restaurant.”

The spoof was funny because it seemed outrageous, but e-cigarette experts say that using the devices to vaporize illegal drugs isn’t so farfetched after all. Some users say e-cigarettes can easily vaporize a liquid form of marijuana (now legal for medical uses in almost half of the country), and health advocates worry that it’s nearly impossible to tell what people are inhaling from the devices. “It sure concerns me that there are new methods to deliver illegal substances particularly to young people,” Fiore says, citing reports that the products could not only contain marijuana, but even crack cocaine. Industry spokesmen say they don’t endorse using e-cigarettes beyond their intended purposes; Reynolds American’s e-cig won’t work with anything other than its own vapor cartridge, and Altria has no plans to sell marijuana-based products. But a few companies are marketing devices for whichever substance their customers prefer, whether or not it’s legal. The $10 mCig, for one, is billed as the “cheapest eCig on the market that allows for heating of a variety of plant materials.” The eponymous company, trading over-the-counter as MCIG, is based in Washington state (which recently legalized pot), and says it is betting on two trends “sweeping the globe”-the legalization of medical and recreational marijuana, and the adoption of electronic cigarettes by the more than 1 billion smokers around the world.

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By Jen Wieczner

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