Things You Should Know about E-Cigarettes

The FDA is taking more aggressive steps to rein in some aspects of e-cigarette marketing in its finalized rule, including a ban on sales to minors. The new regulations also require health warnings in ads and on product packages, prohibits the distribution of free samples, and requires manufacturers to show that the products meet applicable public health standards before receiving authorization from the FDA.

But e-cigarettes can continue to be on the market for three years while their manufacturers submit — and the FDA reviews — their new tobacco applications and the products are not bound by the same advertising restrictions that regular tobacco cigarettes must follow. In the meantime, use among teens is increasing even though the U.S. Surgeon General has called the products a significant health risk to youngsters. Here’s some key issues to be aware of regarding e-cigarette marketing:

1. Unknown risks: While much of the marketing of e-cigarettes has centered around the claim that vaping products are a safer alternative to tobacco cigarettes, the jury is still out on that. In fact, California issued a health warning about their “toxicity” and advised residents not to smoke them. The FDA maintains that the risks associated with e-cigarettes have not been fully studied. At issue is the nicotine in the products and the chemicals in the vapor that is emitted. Despite this health concerns, a TINA.org review of more than 150 e-cigarette websites found that half indicate in some way that vaping products are safe or a healthy alternative to tobacco.
2. Potentially poisonous liquid: A study by the Centers for Disease Control found that the number of calls to poison centers regarding liquids containing nicotine used in e-cigarettes is dramatically rising. More than half involved children under 5 and 42 percent involved consumers aged 20 and over. “The report shows that e-cigarette liquids containing nicotine have the potential to cause immediate adverse health effects and represent an emerging public health concern,” the CDC said. Callers reported vomiting, nausea and eye irritation. Some consumers have also reported the products blowing up. 
3. Court challenges: Several e-cigarette companies have been hit with legal actions alleging deceptive advertising claims, including one major e-cigarette manufacturer in the U.S., NJOY. The suit, filed by a California consumer, alleges that the Arizona-based company uses deceptive tactics to market its products as safe though the e-cigarettes contain some of the same carcinogens found in traditional cigarettes. A study by the California-based Center for Environmental Health found high levels of the cancer-causing chemicals  in vaping products made by 21 out of 24 companies whose products were tested. The group is taking legal action against the companies. NJOY has since filed for bankruptcy.
4. Scams: E-cigarette companies are out in force –  proliferating especially on the Internet — trying to capitalize on consumer interest, some offering free trials and special deals. But many of these special deals are not deals at all and hundreds of consumers say they’ve gotten ripped off, with companies repeatedly charging their credit cards and wiping out their bank accounts. Federal officials have received more than 600 complaints from consumers about scams involving e-cigarette companies.
5. Smoking cessation claims:  Any product claiming to be a smoking-cessation device must have approval from the FDA and the agency has not approved any e-cigarette as a smoking cessation therapy. Despite this, a TINA.org investigation found that many sites are indicating e-cigarettes can help people quit tobacco. The FDA has opened a probe into smoking cessation claims made by e-cigarette marketers following the TINA.org investigation. The announcement came after five health advocacy organizations urged the agency to take prompt action based on TINA.org’s findings.
6. Smoke anywhere? And while we are talking about claims to be wary of, add this to the list. Though many e-cigarette marketers say the products can be smoked anywhere, which may have been true at one point, it’s not anymore. Dozens of local municipalities, big cities and states are banning their use in public areas. Hawaii has banned e-cigarette and tobacco cigarette sales to minors.
7. Europe takes strong steps: The European Parliament approved a ban on the marketing of e-cigarettes, warning labels on the packaging, and a limit on the amount of nicotine in the products and regulators in the U.K. have a host of restrictions on the marketing of the products and have already started banning some advertisements.
8. Risks to minors: U.S. Surgeon General Vivek Murthy in a report released in December 2016 said that “e-cigarette use poses a significant — and avoidable — health risk to young people in the U.S.”  The report noted that not only is nicotine harmful to developing brains, but other chemicals in e-cigarettes, such as heavy metals and flavorings, also pose a risk. Use of e-cigarettes has risen from 1.5. percent of high school students in 2011 to 16 percent in 2015, according to the CDC. Though the new FDA regulations ban sales of vaping products to children under 18, many advocates are urging further action, including restrictions on marketing aimed at teens and bans on sweet-flavored e-liquids, such as bubble gum and gummy bear, that appeal to kids. The American Academy of Pediatrics has called for strict regulation, including recommending extending the ban on sales to anyone under 21, prohibiting the use of e-cigarettes in all public places, taxing them at a rate no less than traditional cigarettes, banning Internet sales and ads in any media that can be viewed by youth as well as prohibiting flavors.
9. FTC report: In March 2022, the FTC issued its first-ever report on e-cigarette products based on industry data from 2015 to 2018 provided by six of the largest domestic e-cigarette manufacturers, including JUUL, NJOY and R.J. Reynolds Vapor Company. Among other things, the report found that e-cigarette sales increased from $304.2 million in 2015 to $2.06 billion in 2018, as sales of fruit, candy and dessert flavors popular with youth for the first time eclipsed those of tobacco-flavored e-cigarette products. During the same three-year period, spending on advertising and promotion more than tripled from $197.8 million to $643.6 million, with spending on celebrity endorsers, social media influencers, brand ambassadors and others promoting e-cigarettes increasing 15-fold. The report also found a large increase in the concentration of nicotine in e-cigarettes sold between 2015 and 2018, making the products more addictive.

Read more of TINA.org’s coverage of e-cigarettes here.

UPDATE 5/3/17: The FDA under the Trump administration has delayed several deadlines for the finalized rules including the requirement that manufacturers submit the list of ingredients in e-cigarettes.