E-cigarettes with nicotine need restrictions, American Heart Association declares

E-cigarettes that contain nicotine should be regulated as tobacco products, including under state smoke-free laws, the American Heart Association says.

The group issued new policy recommendations on Monday that recommend a U.S. ban on e-cigarettes for minors, strict laws on marketing and advertising the products and a ban on flavourings.

"They should be included in smoke-free laws," Dr. Elliott Antman, president of the American Heart Association, said in a video statement. "An important reason for this is it's not clear if the vapour from electronic cigarettes is safe. We do know that nicotine can have harmful effects not only on the user of an electronic cigarette, but also those who are exposed to high concentrations of nicotine in the vapours if they are in an enclosed space."

The group reviewed current evidence in areas such as regulation, design and operation of the devices, preventing youth access, advertising to youth, public health, safety, nicotine content, health effects, secondhand exposure and counselling for cessation.

The policy statement is published in the heart journal Circulation.

Health Canada says e-cigarettes with nicotine or e-cigarettes with a health claim are not authorized for sale in Canada.
The paper’s authors say the sale of e-cigarettes is prohibited in Australia, Brazil, Mexico, Panama, Singapore and Switzerland and allowed in most others, including the United States.

Aruni Bhatnagar, the paper’s lead author and chair of cardiovascular medicine at the University of Louisville, said e-cigarettes have caused a major shift in the tobacco-control landscape.

Proponents of e-cigarettes say the products offer a public health benefit if individuals who smoke conventional cigarettes either switch or greatly cut back their cigarette smoking habit.

Millions Use Electronic Cigarettes Invented by a Chinese pharmacist in 2003, electronic cigarettes are now used by millions worldwide as an alternative to smoking. But the devices are not regulated, and the World Health Organization has called for studies on their effects on human health.

In the new study, the researchers compared the heart function of 20 daily smokers before and after smoking one tobacco cigarette to that of 22 e-cigarette users before and after using the device for seven minutes. The people studied were healthy and varied in age from 25 to 45.

Heart function got worse in the tobacco smokers, and their blood pressure and heart rate rose. People using e-cigarettes experienced only a slight elevation in blood pressure.

American Heart Association spokesman Russell Luepker, MD, of the University of Minnesota in Minneapolis, says that because they "light up," electronic cigarettes may be preferred over other smoking cessation aids by some people trying to quit.