U.S. Sen. Dick Durbin (D-IL) hopes a report issued Monday detailing the marketing tactics used by electronic cigarette companies will coerce the Food and Drug Administration (FDA) to take regulatory action on the products.
E-cigarettes are currently free from numerous sales, marketing and product regulations at the federal level that apply to traditional cigarettes.
Durbin and 11 other Democratic lawmakers from the U.S. House and Senate launched a joint investigation into the marketing practices of nine companies that make commonly sold e-cigarette brands including MarkTen, Vuse, NJOY King, Eonsmoke, LOGIC, V2 Cigs, VaporCouture, Blu, Green Smoke and White Cloud. The investigation's findings were revealed Monday. The report shows a recent uptick in e-cigarette marketing, including tactics that Durbin says appeal to minors.
"E-cigarettes are a candy-flavored addiction, which is dangerous to our young people across America," the senator said on a press call Monday morning about the new report. "It is growing in popularity among children and sadly poses serious public health threats."
The report "makes clear that e-cigarette companies, and the tobacco companies that own some of them, have a determined effort to market their product, to pass out samples and to lure children into this nicotine addiction," Durbin added. "It's time for the FDA to step up and to regulate this product to protect our children across America."
The new e-cigarette marketing report comes on the heels of the Chicago City Council's decision to place restrictions on the devices. Back in January, the city council outlawed their use in places where where tobacco smoking is prohibited. At the state level, Springfield lawmakers are also weighing legislation that seeks to regulate e-cigarette packaging.
U.S. Rep. Henry Waxman (D-CA,33) joined Durbin on Monday's press call, during which the congressmen repeated their desire for the FDA to issue "deeming regulations" that would expand the agency's authority to regulate e-cigarettes in the same manner in which traditional cigarettes are controlled. Over the last five months, the White House's Office of Management and Budget has reviewed a proposed rule that would expand the FDA's regulatory authority to include e-cigarettes.
"We want [the] FDA to go further and study the harmful effects and to learn a lot we don't know about the risks of using these e-cigarettes and the benefits," Waxman explained. "We don't really know the benefits. All we have are claims of benefits ... We're seeing the risk very clearly."
When asked whether federal lawmakers have a legislative strategy related to e-cigarette regulations, Durbin said, "I'm a realist, and I know that the likelihood of revisiting this similar issue of FDA authority is not very strong either in the House or in the Senate."
"Trying to re-fight the battle over tobacco and cigarettes, I don't think that's in the cards," the congressman added.
Victoria Vasconcellos, owner of the e-cigarette store Cignot, which has locations in Elmhurst, Hickory Hills, Lisle and Wauconda, said she is not opposed to e-cigarette regulations, but would like to see them imposed at the federal level, rather than by states or municipalities.
"If they start doing what is happening now at the local and state level, throwing out all kinds of restrictions, it makes it difficult for our suppliers to comply," she said. "I would have to box something some way to one state and [another way] to a different municipality. It just couldn't be done. So it does need to be even."
E-cigarettes are battery-operated devices that vaporize liquid, known as e-liquid, that can contain different concentrations of nicotine and other chemicals. E-liquid is available in a variety flavors such as cherry, chocolate, mint and others.
"We fought for decades to set strict rules for the marketing of traditional cigarettes by tobacco companies, but e-cigarette manufacturers don't have to play by the same rules," Waxman stressed. "For example, e-cigarette makers are free to sponsor youth-oriented events or use flavors that appeal to kids, and that is exactly what's happening."
The new report found that seven out of the nine e-cigarette companies surveyed use radio and television advertisements played during events and programs, "including those with youth viewership." Six respondents reported sponsoring or providing free product samples at a total of 348 events in 2013, many of which were youth-oriented such as music festivals, according to the investigation. E-cigarette companies also commonly use social media to market their products.
Moreover, e-cigarette manufacturers have "significantly increased marketing spending, more than doubling expenditures between 2012 and 2013," the report reads. In 2013, six e-cigarette companies cited in the report that provided marketing expenditure data spent a collective $59.3 million to market their products.
"Without advertising restrictions, these manufacturers have targeted adolescents by using celebrity endorsements in order to glamorize e-cigarette use," Waxman stressed. "These are the same tactics once used by the major cigarette manufacturers before they were banned."
As part of the survey, e-cigarette companies including Altria, LOGIC, Lorillard, NJOY, R.J. Reynolds, and VMR stated support for some type of e-cigarette regulation, such as restrictions on the sale and marketing to children and teenagers as well as a ban on using television for their advertisement, to name a few.
Vasconcellos, who relies on word of mouth to advertise her stores, said she has mixed feelings about regulating e-cigarette marketing and promotion.
"We need a way for cigarette smokers to know about this," she said. "I don't know if [e-cigarette companies are] targeting youth. There has been no studies that show the proliferation of e-cigs amongst youth that are not already tobacco users ... I would have to see that data, and I have not seen any data that I find convincing that the marketing is actually being done towards children."
But, she added, if there is one age group that "should be saved from the ravages of cigarette smoke, then the younger smokers should be targeted before the likes of me who have been smoking for 33 years and have already incurred significant damage to my body," Vasconcellos argued. "The sooner someone can stop smoking the better. And absolutely the best way to keep kids from starting is to take it out of the home. If we can get every parent to do e-cigs in lieu of smoking, fewer children will smoke. That begins at home."
Waxman asserts that e-cigarette marketing tactics that target young people "unfortunately, appear to be working."
"E-cigarette use among teenagers is growing rapidly, according to Centers for Disease Control, and CDC Director Dr. Tom Frieden has warned about the potential for e-cigarettes to serve as a gateway to cigarette use and a lifetime of nicotine addition," the congressman stressed.
Back in September, the Centers for Disease Control and Prevention (CDC) issued a study that saw the increase in high school students who had used e-cigarettes jump from 4.7 percent in 2011 to 10 percent in 2012.
Vasconcellos acknowledged that electronic cigarette use has recently exploded.
But, she added, if it was a gateway to cigarette smoking, "We would see at least a maintaining of cigarette smoking or an increase, right?"
"Well, last year Philip Morris saw a drop of 4 percent in [U.S. volume of] cigarette sales," she noted, adding that Reynolds American also reported that domestic cigarette industry volume was down 4.6 percent last year. "That's a drop in sales, so unless they've had some really great new [nicotine] patch come out, or something ... the only thing that has occurred is e-cigarettes."
Earlier this month, the CDC issued another study that showed an uptick in the total number of calls to poison centers involving e-cigarette use. According to the CDC, the number of calls to poison centers related to e-cigarettes increased from one per month in September 2010 to 215 per month this past February. During that overall time period, some 2,405 e-cigarette and 16,248 regular cigarette exposure calls were reported to poison centers.
More than half of the calls to poison centers related to e-cigarettes involved children under age 5, while about 42 percent involved people age 20 and older. According to the CDC, nicotine poisoning related to e-cigarettes can occur if too much e-liquid is ingested, inhaled or absorbed through the skin or eyes. Callers who reported adverse e-cigarette health effects most commonly cited vomiting, nausea and eye irritation.
“This report raises another red flag about e-cigarettes – the liquid nicotine used in e-cigarettes can be hazardous,” CDC Director Tom Frieden said in a statement. “Use of these products is skyrocketing and these poisonings will continue. E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.”
Vasconcellos contends that opponents of e-cigarettes are over hyping the number of poison calls.
"Toothpaste had over 20,000 [poison calls in 2012]," she said. "Why are we not banning toothpaste?"
Supporters of e-cigarettes argue that the devices help smokers kick the habit.
But Durbin said that is a "weak argument."
"We know the opposite is true," the senator said. "We think it really operates in the opposite direction. It really is a gateway to tobacco addiction, which we know is deadly."
Vasconcellos made a point to stress the reality that nearly a half a million people die every year in the United States as a result of traditional cigarette smoking or exposure to secondhand smoke.
"Are there some concerns maybe with e-cigs that we're going to find," she asked. "Maybe. But I am going to die if I continue to smoke, so any legislation that slows the proliferation of electronic cigarettes to smokers is murder."
In other tobacco-related news, the retailer and health care company CVS decided in February to discontinue the sale of cigarettes and other tobacco products at its stores. That announcement came one month after the Chicago City Council agreed to put in place e-cigarette regulations. In addition to outlawing the use of e-cigarettes in places where smoking is off limits, the ordinance bans sales to minors, mandates the products be placed behind retail counters, and requires e-cigarette dealers to be licensed.
"I applaud CVS for taking an important step today to protect public health," Chicago Mayor Rahm Emanuel said in a prepared statement following the CVS announcement. "Just a month after Chicago passed legislation to protect kids from flavored cigarettes and tobacco and regulate e-cigarettes; this important step shows that the private sector can play an important role in ensuring a healthier America."
Meanwhile, some lawmakers at the state level are also looking to take action on e-cigarettes.
Legislation working its way through the legislature seeks to require special packaging for bottles of e-liquid used to refill e-cigarette devices. The state measure, HB 5689, sponsored by State Rep. Robyn Gabel (D-Evanston) and State Sen. John Mulroe (D-Chicago) in their respective chambers, would task the Illinois Department of Public Health with creating the e-liquid packaging requirements. The pending regulatory measure would not apply to liquid e-cigarette cartridges that are sealed, already filled or can be thrown out after they are used. Any future e-cigarette regulations from the FDA would replace the state requirements, if approved, Gable recently told the Chicago Tribune.
Vasconcellos explained that the state measure lacks specifics regarding its potential impact on businesses.
"(Gabel) has said on her webpage that (the measure) is only for childproof caps. That's all they want ... But that's not what it says," she noted. "What is says is they're going to turn over how to label [and] to package the e-liquid to the Illinois health department, and it's effective immediately. So that doesn't tells us what do we do with stuff on our shelves. It doesn't say we can continue to sell it. It doesn't call out childproof caps."
Vaconcellos, who sells e-liquid bottles that already have childproof caps, does not understand why pre-filled cartridges would be exempt under the proposed measure, as they could also pose harm if ingested.
"I think if their intent really were to protect children, they would be addressing that as well because that could be an issue," she stressed.
Image: AP Photo / Tim Ireland, PA