State warns about e-cigarettes

Ingredients emit pollutants, could poison kids if ingested

Matt Aten exhales while using an electronic cigarette last month. Aten had just purchased more flavoring for the device at Via Vapor Electronic Cigarette Emporium in Bentonville.
Matt Aten exhales while using an electronic cigarette last month. Aten had just purchased more flavoring for the device at Via Vapor Electronic Cigarette Emporium in Bentonville.

The Arkansas Department of Health issued a public-health warning regarding electronic cigarettes in early May alerting consumers that the products are not regulated.

The warning states that electronic cigarettes emit pollutants that could be harmful to users and to those exposed to the vapors secondhand. It also warns of poisoning risks for children who swallow the liquids used in the devices and says the devices have not been proven to help people stop smoking tobacco.

Health officials in Oklahoma, Tennessee and North Carolina have issued similar warnings.

Gary Wheeler, Arkansas Health Department branch chief of infectious disease, said the department has been tracking e-cigarettes for several years and that it was time to inform consumers about their potential dangers.

Electronic cigarettes use a heating element, such as a battery, to raise the temperature of the fluids and convert them into vapor that users inhale and exhale. The liquids typically contain glycerin, propylene glycocl and flavorings, according to a study conducted by the Roswell Park Cancer Institute and published in an Oxford Journal on May 15. Liquids with or without nicotine can be purchased.

The study found that heating the fluid causes its ingre- dients to produce carcinogens such as formaldehyde and acetaldehyde.

Vapors formed from devices that use lower-voltage batteries had fewer carcinogens than tobacco smoke, according to the study. However, it states that vapors formed from higher-voltage batteries, such as a 4.8-volt, had higher levels of carcinogens than traditional tobacco smoke.

The state’s warning came less than a month after the Food and Drug Administration proposed a rule to extend its tobacco-regulatory authority to include electronic cigarettes.

The proposed rule could force manufactures of e-cigarette liquids to report product and ingredient contents to the FDA. Companies also would need FDA approval before promoting any health claims, including that the product is safer to use than other nicotine products. Also, an age restriction for buying the products would be implemented.

Arkansas Act 1451 of 2013 prohibits selling electronic cigarettes to anyone under 18, and Arkansas Act 1099 of 2013 bans the use of nicotine products, including electronic cigarettes, on school property.

Jamie Thornton, project coordinator for Northwest Arkansas Tobacco Free Coalition, said his organization has started providing electronic-cigarette education to school groups after area high schools saw an influx of students using the devices.

“When we talk about it, we talk about how the main chemicals in antifreeze are also in e-cigarettes,” Thornton said. “If you drink antifreeze, you have to call poison control. If you drink e-cigarettes, you have to call poison control. Is that something you want to put in your body?”

Electronic-cigarette use in middle schools and high schools doubled from 2011 to 2012, according to a report from the federal Centers for Disease Control and Prevention in Atlanta. The CDC report states that in 2011, 4.7 percent of students involved in the National Youth Tobacco Survey reported trying electronic cigarettes. In 2012, 10 percent — or 1.78 million — of middle- and high-school students reported using e-cigarettes.

The youths “think they are just healthy and safe,” Thornton said of e-cigarettes. “Kids are so misinformed about these products that it is scary.”

Thornton said marketing from companies that sell the products is partly to blame. “They can market on TV,” Thornton said. “They are using all the old tricks that tobacco had to retire.” Some companies promote that electronic cigarettes emit only water vapor, Thornton said.

A study by the University of California published in the American Heart Association on May 12 says data are limited on emissions from electronic cigarettes. The study states that the devices can be a source of indoor air pollution. However, the long-term effects of exposure to the emissions are unknown.

Thornton said some companies advertise the products as being helpful in quitting tobacco smoking. However, he said, there are some concerns that the products increase smokers’ addiction. He said users could be getting more nicotine than with traditional cigarettes. That could send them back to traditional cigarettes, he said, and end up with them smoking more tobacco than they did previously.

Two recent studies showed different results regarding electronic-cigarette users’ success in quitting tobacco smoking.

A paper published in JAMA Internal Medicine earlier this month says 85 percent of smokers used electronic cigarettes to quit smoking, but their success rate in quitting was no higher than among nonusers.

A British study published in a Society for the Study of Addiction publication found that smokers who stopped tobacco use on their own were more likely to succeed in their efforts if they used electronic cigarettes.

But, another concern of electronic cigarettes is poisoning, Thornton said.

Documents from the Arkansas Poison Center show 30 cases of poisonings from electronic-cigarette fluids between January and March 21 of this year. Of those cases, 17 were children under age 4.

Wheeler said the danger with electronic-cigarette liquids is that they look and smell like things children would normally drink. Also, the bottles contain large amounts of chemicals, he said.

“They can get a huge dosage of nicotine in one swallow,” Wheeler said. “It is a much higher level of risk with the fluids.”

Thornton said many health organizations are advocating for child-proofing the bottles.

Shu Griffiths, owner of Via Vapor in Bentonville, said he sells only child-proof bottles to his customers. He said he refuses to carry products that are not child-proof.

Most electronic-cigarette shops in the region also won’t sell to minors and didn’t even before the Arkansas law went into effect, Griffiths said.

He has owned his business for nearly two years. He said he used to sell products online but stopped because he couldn’t verify the buyers’ ages.

Also, he said, he believes electronic-cigarette use is healthier than tobacco smoking, but he doesn’t tell clients that his products are risk-free or that they have health benefits.

Griffiths said he doesn’t oppose future regulation of electronic-cigarette companies. However, he worries that it could affect his business.

He sells nearly 135 flavors of electronic-cigarette liquids that are made locally by a small company. Flavors include traditional tobacco, tropical pineapple and blueberry-strawberry creme.

“People really want the local flavor,” Griffiths said. “It is sort of like having a bakery. We want to make unique flavors. That won’t be an option with regulation.”

The store sells bottles of liquids ranging in size from three-64ths of a cup to oneeighth of a cup. Prices range from $8 to $20, depending on the size of the bottle.

Matt Allen of Pineville, Mo., sat on a couch in the store Friday. He said he drives either to Joplin, Mo., or to the Bentonville store to get liquids for his electronic-cigarette devices.

“The gas stations have stuff but not the mixture that I want,” Allen said.

He said the bigger-brand liquids also don’t have labels that show the ingredients. He said he tries to avoid large amounts of glycerol in his liquids because they tend to give him a scratchy throat.

Matt Yockey, owner of Reflections Vapor in Bella Vista, is the main supplier to Via Vapors.

Yockey said all of the ingredients in his products are pharmaceutical-grade and can be found in many foods. He said the ingredients include propylene glycol, vegetable glycerin and flavoring, and all of the ingredients have been approved by the FDA for consumption.

However, regulation of the liquids could put him out of business, Yockey said.

“My concern is that the way that it is worded,” Yockey said of the FDA proposed rule. “I have went through it page by page. They are trying to get a list of ingredients of each product. I would have to submit each of my flavors.”

Yockey said he has heard from some advocacy groups that it could cost more than $1 million to get each flavor ingredient-tested.

“It means I will go out of business,” Yockey said.

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