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Hollywood fad, or tobacco habits vapourised? The rise of e-cigarettes

Hollywood is hooked on e-cigarettes, and some health authorities in the United States believe they help people kick the tobacco habit. So why are they effectively banned in Australia?

With the notable exception of, well, any episode of Mad Men, a prominent Hollywood actress smoking on television, or in public for that matter, is a rarity. Particularly during a live network broadcast awards show.

Yet there was Julia Louis Dreyfus, blithely puffing away during last week’s Golden Globes ceremony (pictured). Her sunglasses and steely demeanour implied she was gently mocking the late Elizabeth Taylor. More notable was the fact  Dreyfus was not sucking on an old-fashioned dart, but an electronic device known as an e-cigarette.

E-cigarettes dispense nicotine without combusting tobacco; their key selling point is that they produce a vapour, not smoke. The devices are battery powered and work by heating nicotine, propylene glycol and glycerine into a vapor, which is then inhaled.

Hence the former Seinfeld star was not smoking, she was vaping.

While e-cigarettes remain something of a niche product in Australia, they are swiftly becoming mainstream here in the United States. The rapid growth is outpacing legal and social guidelines regarding their use.

With societal and legal etiquette not yet established and the product itself increasingly popular, e-cigarettes have become the centre of a public health debate that is swiftly turning aggressive. As with most matters of ethics and commerce in the US, several groups with vested interests are attempting to stake their claim on the issue.

As the US has shivered through a frigid winter, vaping has been a highly visible fixture in cars, living rooms, bars, restaurants, concert venues and almost any public building. A mostly unregulated cottage industry of manufacturers and distributors is seeking to exploit its growth.

Henleys, the first e-cigarette bar  — a self-proclaimed vaporium, if you will — has opened in New York’s Soho neighbourhood. The company is planning three more for the first half of this year. Celebrities such as John Mayer, Katy Perry, Courtney Love, Bruno Mars and Leonardo DiCaprio are out and proud vapists. Photos of Michelle Rodriguez vaping at a basketball game went viral.

Industry estimates put the value of the American tobacco market at about $90 billion a year. Although a fraction of that, the $2 billion of annual revenue generated by e-cigarettes is remarkable considering the brief time they have been on the market.

There are now more than 200 companies manufacturing and marketing e-cigarettes. The two most popular brands are NJOY and Blu, the latter of which is owned by tobacco conglomerate Lorillard (you may remember the company from Troy McClure-helmed skits in The Simpsons as Laramie Cigarettes). Camel Cigarettes maker Reynolds American and Marlboro owner Altria Group are also taking their e-cigarette brands national later this year.

The US Food and Drug Administration is expected to recommend the product is reined in by some regulation, however tepid. Several sources suggest a decision is pending (it was originally due last October, but was held up in the government shutdown).

Lorillard spent $30 million last year advertising its e-cigarettes on US television. NJOY will outlay the same amount in 2014. In 2012, the industry’s total spend was just $1.1 million.

Actor Stephen Dorff is currently featured in a series of television commercials promoting Blu. The ad’s theme is “take back your freedom”. It features the actor vaping in an airport, on a train and at a concert. And TV is far from the only medium: the group has also published full-page ads in The New York Times, in various magazines and on billboards atop of taxis.

We’re trying to do something very challenging: change a habit that is not only entrenched but one people are willing to take to their grave.”

Similar to Australia, tobacco companies have been banned from advertising cigarettes on US television since 1971. Like many traditional anti-smoking initiatives, e-cigarettes currently skirt this law. This alone has health groups concerned.

This week marks the 50th anniversary of the US surgeon general’s report into the hazards of smoking, published in 1964. Back then, 43% of Americans smoked; as of 2012, that figure had dropped to about 18%.

According to The Los Angeles Times, the FDA’s Center for Tobacco Products is collecting reports of adverse effects from e-cigarettes. Complaints include claims of eye irritation, headaches and coughing.

Three states — New Jersey, Utah and North Dakota — now ban e-cigarettes in smoke-free venues. A cluster of cities, including Boston, Seattle and Savannah do the same. Last September, 40 states came together and exhorted the FDA to regulate e-cigarette marketing.

Critics suggest rather than helping smokers quit, the product may be a sort of gateway drug teens will use on the way to taking up regular ciggies. With smokers now social outcasts, vaping, the Office on Smoking and Health at the Centers for Disease Control and Prevention says, could make “smoking” cool again.

Some 1.78 million teens and children are said to have tried vaping in the US last year. So concerned are educators in Miami, school boards are working on legislation to formally ban them from high schools. Extraordinarily, there is no age limit for buying the products.

On a recent Friday evening at the Mickey Byrnes Irish Pub in Hollywood, Florida, three locals sat at the bar vaping. To the outsider, it felt like something of a throwback. Aside from the odd double take, nobody seemed to mind. In fact, others subsequently fired up in other parts of the room. Bar staff did not bother them.

The pub’s co-owner Mark Rowe was pragmatic when asked by Crikey if he was concerned by the trend. “I don’t mind if people smoke them now, as I don’t have any evidence that they are harmful,” he said. “They are very popular. I’d like to know more before I give an opinion on whether they should be banned. [But] I’m sceptical about them as of now.”

A cluster of noted pro-vaping advocates, such as Times columnist Joe Nocera, say too many wowsers are diluting a key point: why should a product that will potentially help a lot of people quit smoking, and potentially increase their lifespan, be so demonised? Nocera quoted an industry advocate who noted anti-tobacco advocates had spent so many years arguing from “a total abstinence framework” that they hadn’t been able to move from that position. It may inadvertently drive popularity of e-cigarettes.

The industry also argues products such as nicotine gum and patches have done the same job with little public disquiet for many years.

In Australia, the laws are a little less fluid. Firstly, according to the Therapeutic Goods Administration, it is illegal to sell any e-cigarette that proclaims to bestow any therapeutic benefit (i.e. helping you quit smoking regular cigarettes). So that rules out the top-selling US brands. But if no benefit is claimed, at this stage, the product is legal. The department does offer a broad observation, however: “The Australian Government is concerned about the use of electronic cigarettes in Australia.”

Somewhat mischievously, daily deals site Groupon has been marketing them locally with a caveat that they cannot be ordered in Queensland, South Australia and Western Australia.

Back in the US, Craig Weiss, the head of NJOY, was very open about his company’s aims and challenges last year. “We’re trying to do something very challenging: change a habit that is not only entrenched but one people are willing to take to their grave,” he said.

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  • 1
    kd
    Posted Tuesday, 21 January 2014 at 1:10 pm | Permalink

    This short video of David Nutt talking about ecigs is interesting. It confirmed the research I have done on the product.

  • 2
    puddleduck
    Posted Tuesday, 21 January 2014 at 2:59 pm | Permalink

    Were it not for the public health costs, I wouldn’t much care if smokers killed themselves in pursuit of a puff. But what is the effect of eciggies on bystanders? Is there a passive vaping effect? If so, the same restrictions should apply as those applicable to cigarettes proper.

  • 3
    Peter Kington
    Posted Tuesday, 21 January 2014 at 3:05 pm | Permalink

    Interesting article - really interesting - but it was lacking because it didn’t include any analysis of the sale of e-cigarettes across Europe (where the European parliament made some important decisions around the e-cigarette, in mid December). Not to mention China and the developing world.

    Having just returned from France, I had the great pleasure (not) of sharing Paris metro carriages and restaurants across the country with e-cigarette smokers. Don’t be fooled by the hype - they are offensive to the non smoker, simply because they seek to perpetuate a habit that kills. Right across France there are dedicated e-cigarette shops - it’s a booming business in a country where one doesn’t smoke a cigarette, rather makes love to the vile thing.

  • 4
    64magpies
    Posted Tuesday, 21 January 2014 at 3:43 pm | Permalink

    Kd, thanks for the link to the interesting video. As a user the suspicion for me is that the whole anti-smoking movement has only a miniscule concern for health. There is so much money in it for governments’ and lobby groups’ and the tobacco industry that I suspect they will combine to smash this fledgling industry.

  • 5
    ShitsGottaStop
    Posted Tuesday, 21 January 2014 at 4:04 pm | Permalink

    I’ve been a user of e-cigarettes for a little over three months - that is, since the day I smoked my last tobacco cigarette. For me, e-cigarettes were the only solution to a 23-year addiction to tobacco. And, most importantly, they work as a smoking cessation device. They WORK. Unlike the patches, gums, sprays, and unlike the psych-drugs.
    Now I’m vaping, not smoking - so I’m happy. Happy to know that my e-cigs are sourced from companies NOT affiliated with the tobacco industry, and those b*stards no longer get any of my money. Happy to know that I’m no longer committing slow, drawn-out suicide. Happy to know that my new ‘habit’ is cheaper than the old one.
    Let the nay-sayers and the proponents of the ‘gateway to tobacco’ philosophy say what they will. They are now almost as bad as the tobacco giants - protecting their positions and their funding. The horse has bolted, and e-cigs are already everywhere.
    The only thing that should be regulated in this space is quality and safety, and (wishful thinking) keeping old dirty tobacco out of the e-cig industry. Let them die a slow painful death.
    Vape on.

  • 6
    Chris Hartwell
    Posted Tuesday, 21 January 2014 at 5:09 pm | Permalink

    @ShitsGottaStop - I’m not questioning their value, as you say, as a smoking cessation aid. Except unlike every other SCA (smoking cessation aid) they’re regulated as medical devices, rather than medicines. Effectively that is to say - they’re not regulated.

    If, like my mother, you’re using a non-nicotine containing vape fluid, whatever - you’re inhaling atomised candy water. Hell, I’ll even get in on that (mmm, peach schnapps flavour!) But if it’s a medicine - as all the other nicotine-containing SCAs are - they should be regulated as such. That’s the key part. It’s not enough to say they are safe - they have to be proven safe.

  • 7
    John Webster
    Posted Tuesday, 21 January 2014 at 5:20 pm | Permalink

    I’m sure that the way to discuss this article and similar ones is to substitute the word marijuana for e-cigarettes. Basing decisions on e-cigarettes, on your views about big tobacco is somewhat disingenuous as well as cynical.

  • 8
    AR
    Posted Tuesday, 21 January 2014 at 5:49 pm | Permalink

    Like PuddleDuck - I have no problem with the road to the grave chosen by anybody, as long as i don’t have to pay for their final traumas.
    Nicotine is not a cancer danger, it is the tars & other shit is the combusted cellulose.
    So, as long as the by-vapour doesn’t impinge upon me, go for it.
    And I take JohnW’s point - it is the ideal way to ingest THC for the immediate hit, for those who can’t appreciate the millennia old tradition of eating/drinking it before the return of Raleigh.

  • 9
    Matt Hardin
    Posted Tuesday, 21 January 2014 at 6:01 pm | Permalink

    I am not sure what you mean Peter. They are offensive because they look like smoking and the user gets nicotine? Or do they actually pose a health risk to you and spoil your surroundings with noxious fumes?

  • 10
    Deb Downes
    Posted Wednesday, 22 January 2014 at 1:29 am | Permalink

    You are all Crikey readers and therefore, presumably intelligent. How about doing some research before jumping on your respective band wagons? For links to plenty of research on e-cigs, Google Dr. Farsalinos. There is currently a research project on the safety of e-liquids being publicly funded by Vapers - that’s what we are - and we’re prepared to put our money where our mouth is.

    Ask yourselves the question “Who is/are the biggest losers if people stop smoking?”

    You’re all smart, I’m sure you’ll figure out the 4 key groups :)

    Oh, and I belong to the group who know that patches, gum, mind altering drugs, hypnotherapy and cold turkey are an extremely painful way to become a non smoker.

    And, as a Vaper, I would appreciate it, if our struggle to maintain access to an extremely effective means of becoming a non-smoker wasn’t stuffed up by people who want to muddy the waters by suggesting that this is an effective way to smoke dope!

    Thank you :)

  • 11
    Paul McNamara
    Posted Wednesday, 22 January 2014 at 2:58 am | Permalink

    Chris Hartwell, e-cigs are not medical devices. They are a consumer product like cigarettes - they are just orders of magnitude safer that’s all.

  • 12
    Chris Hartwell
    Posted Wednesday, 22 January 2014 at 9:10 am | Permalink

    @Paul - until the claim is made that they’re a Smoking Cessation Aid. That then carries a very different connotation. A consumer product that acts as a drug delivery system needs to be proven safe for that purpose.

  • 13
    Paul McNamara
    Posted Wednesday, 22 January 2014 at 11:21 am | Permalink

    @Chris Hartwell - you mean like cigarettes are proven safe? There is plenty of studies showing e-cigarettes are order of magnitude safer than cigarettes - http://publichealth.drexel.edu/~/media/files/publichealth/ms08.pdf

  • 14
    Chris Hartwell
    Posted Thursday, 23 January 2014 at 8:57 am | Permalink

    Where on earth did I say that cigarettes are safe? They’re demonstrably harmful. A lack of appropriate studies and regulations when they were first brought to market is precisely why we have the problem that is smoking that we do now. Please read what I have said rather than strawmaning it.

    Where a claim is made that something is a Smoking Cessation Aid - as some e-cig groups are wont to do - then they must be demonstrated safe for that purpose. Else we are just replacing one harm with another, rather than removing harm.

  • 15
    Chris Hartwell
    Posted Thursday, 23 January 2014 at 9:29 am | Permalink

    Incidentally Paul, your link notes that the majority of data compiled for study is of a poor quality, and otherwise calls for exactly what I do - that they be studied further to demonstrate fully the safety of the units in their own right for purposes of harm minimisation.

  • 16
    Paul McNamara
    Posted Friday, 24 January 2014 at 12:36 pm | Permalink

    Chris, you said “a consumer product that acts as a drug delivery system needs to be proven safe for that purpose.”

    Caffeine in coffee or soft drinks is a ‘drug delivery system’. Caffeine is a consumer product, it does not need to proven safe - whatever that means. Ecigs are a consumer product. They are not advertised by the retailers or makers as ‘smoking cessation devices’. That many people who have made the switch to ecigs are wont to sing its praises does not make it a ‘smoking cessation device’. Ecigs are a smoking alternative, they are a consumer product and hence do not require the medical testing done for NRT’s.

    The study I linked you to shows ecigs as being orders of magnitude safer than tobacco cigarettes. There is no question that they are much safer than tobacco cigarettes. Exactly how much safer may require further studies to ascertain. But anyone who claims otherwise is being dishonest.

  • 17
    Chris Hartwell
    Posted Wednesday, 29 January 2014 at 11:36 am | Permalink

    I contest that they’re not marketed that way Paul. In point of fact, I received an email from LivingSocial (y’know, daily deals type site) just yesterday that they had been instructed to inform their customers that they had acted unlawfully in the advertisement for a brand of e-cig they had been marketing. The full text reads as follows:

    RETRACTION:

    An advertisement for E-Flames Battery Powered Cigarettes, which we published on the Living Social website, should not have been published.

    In the advertisement we unlawfully made claims that the product could help consumers to quit smoking.

    A complaint about the advertisement was recently upheld by the Complaints Resolution Panel. LivingSocial and E-Products Online provided no evidence to support these claims, and the Panel found that the claims were unlawful, misleading, and unverified and breached the Therapeutic Goods Advertising Code.

    The Panel therefore requested that LivingSocial and E-Products Onine publish this retraction by email to you. Information about, and options for, smoking cessation can be found at www quitnow gov au [. removed for moderation]

    The full text of the Panel’s determination can be found at: www tgacrp com au/complaints”

    Make of that what you will. I note reference to the Therapeutic Goods Advertising Code.

    I fully agree that e-cigs are safer than real cigs - that isn’t in question. What is in question is how much safer. Replacing one harm with another does not a problem solve.

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