Adam Goldstein: Very little research, clarity on e-cigarettes

May 23, 2013 

Very little research, clarity on e-cigarettes

Regarding the May 20 Point of View piece “Safer e-cigarettes can solve dilemma”: Everyone welcomes innovative efforts to reduce death and disease caused by smoking and other tobacco use. However, to ensure that public health efforts are real and not just a new gimmick by the tobacco industry to mislead the American people, innovative approaches must be supported by strong evidence and governed by appropriate safeguards.

The Point of View piece demonstrates a combination of hopeful wishing and the promotion of commercial interests over sound science. Both the federal government and the state of North Carolina have important roles to play in helping the public understand how best to protect public health over commercial interests.

At the federal level, the responsibility for regulating e-cigarettes falls to the FDA. If e-cigarette manufacturers want to claim their products can help smokers quit, they should be subject to the same rigorous scientific review as other smoking-cessation products, like nicotine patches or gum. If some want to claim that e-cigarettes are a healthier alternative to other tobacco products, a 2009 federal law tasks the FDA with ensuring any manufacturing claims are supported by multiple forms of scientific evidence that do not exist.

North Carolina has important laws to prevent tobacco use by young people, prohibit tobacco products in public school buildings and make many public buildings and worksites smoke-free. Sound policy dictates that e-cigarettes should be included in these laws until evidence emerges demanding a different approach.

Unfortunately, state legislators are considering SB 530, which would exempt e-cigarettes from many public health safeguards by defining e-cigarettes as “nontobacco products.” While this bill would prohibit e-cigarette sales to minors, it would otherwise leave e-cigarettes free of all state oversight. This bill would complicate the enforcement of state laws regarding tobacco products, while sending the wrong message to children.

Additionally, the bill, dressed up to look like a safeguard, is a tobacco-industry supported measure designed to protect e-cigarettes from reasonable public health protections. The public and the General Assembly should reject this wolf in sheep’s clothing measure.

This bill also raises doubts about the credibility of e-cigarette manufacturers when they claim they want to be part of the solution to the tobacco problem. When Congress debated the 2009 law giving the FDA authority over tobacco products, e-cigarette makers sought to be exempted. Later, when the FDA tried to regulate e-cigarettes as medical devices, e-cigarette companies claimed they were a tobacco product. Now in North Carolina they’re claiming not to be a tobacco product. Their answer to the question of what they manufacture depends on what answer delivers the least amount of oversight.

If e-cigarette companies truly want to be part of the solution to the tobacco problem, then they should end such shenanigans and comply with public health safeguards both at the federal level and in North Carolina.

Adam Goldstein, MD, MPH

Director, UNC Nicotine Dependence Program

Chapel Hill

The length limit was waived to permit a fuller response to the Point of View piece.

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