E-cigarettes have risks but they also offer public health benefits

Editorial Board
April 10
Washington Post Editorials
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IF ELECTRONIC cigarettes, known as e-cigarettes, live up to their potential, millions of nicotine addicts in the United States will use them. To some public health advocates, that sounds terrible. People should kick nicotine rather than cultivate their dependence with a barely regulated product that seems designed to addict children. The concentrated, nicotine-laced liquid that these devices vaporize is also toxic when inappropriately consumed. The Centers for Disease Control and Prevention just reported that, with the rise in the use of e-cigarettes over the past several years, the number of calls to poison control centers stemming from misuse of e-cigarette liquid also has increased, from about one a month in 2010 to 215 a month now. “These poisonings will continue,” CDC Director Tom Frieden ominously warned.
But, in the fight against the profound misery and death that conventional cigarette smoking causes, even an imperfect tool is worth welcoming if it can reduce smoking. The CDC news does not disqualify e-cigarettes from helping — as long as the government regulates them.
The CDC also has reported that nearly half a million Americans die of illnesses caused by conventional cigarette smoking every year. Some 8.5 million Americans live with serious smoking-related illnesses. Nonsmokers who reside in states that lack public smoking bans have to endure roomfuls of noxious fumes simply to go out on a Saturday night. Decades of effort have pushed the national smoking rate far down, but 42.1 million Americans still light up despite clear evidence of the risks. E-cigarettes offer smokers a reliable nicotine-delivery mechanism that simulates the act of smoking without exposing users and bystanders to the toxin-filled cloud conventional cigarettes produce.
But there are a variety of potential problems, aside from poisonings caused by mishandled e-cigarette liquid. Some people might replace a cigarette or two but not all of their daily smokes with vapor. The CDC recently found that e-cigarettes were becoming more popular with middle school and high school students, perhaps because the vapor comes in candy-like flavorings. Nicotine can harm adolescent brains, and some children and teenagers might move on to more dangerous drugs. Though e-cigarette vapor is almost certainly less toxic than cigarette smoke, the government also does not have comprehensive information on what it contains.
Good thing, then, that several years ago Congress gave the Food and Drug Administration wide latitude to regulate the production and sale of products made of or derived from tobacco. Once the agency begins regulating — and it soon will, it said — it can make e-cigarettes less attractive to teenagers, require childproof containers on e-cigarette liquid, demand appropriate warning labels on packaging and figure out what is in e-cigarette vapor. More serious regulation of combustible cigarettes — from the FDA and from the states — is also necessary to maximize the potential public health benefits and minimize the drawbacks.