Center for Tobacco Products News

LANCASTER, Pa. (AP) — Robert Cioffi has smoked since he was 13 — he is now 62. He struggled with breaking the habit many times. After being diagnosed with chronic bronchitis and emphysema, he has finally quit, he says, with the help of the electronic cigarettElectronic cigarettes are one of the “hottest things to hit the smoking industry in a long time,” according to Tobacco Palace owner Gary Linn.

Although there is controversy about e-cigarettes, they are being used as a smoking cessation tool, according to Linn.

According to a New York Times news article, e-cigarettes generate $100 million in sales annually.

These battery-operated devices come in rechargeable or disposable styles. Starter packs of rechargeable electronic cigarettes retail at $50 and up and will include nicotine cartridges, an electronic cigarette, an atomizer and a rechargeable battery. Refill cartridges cost about $25.

In automatic models, when a user inhales through the device, air flow is detected by a sensor, which activates a heating element that vaporizes a flavored liquid solution stored in the cartridge, which may contain nicotine.

There are several nicotine levels of cartridges — zero, low, medium and high.

Linn, who is a nonsmoker, said he sees some of his customers start with the high-level cartridges and work their way down to the zero level.

On manual models, the user must depress a button to activate the heating element to produce vapor, which is then inhaled by the user. On most models an LED light on the opposite end of the device is activated during inhalation, which serves as an indicator of use.

“It is also all designed to make the person feel as if they are smoking,” Linn said.

There are still studies being done to determine the amount of nicotine that may be released as secondhand smoke from electronic cigarettes. According to the Food and Drug Administration’s website, www.fda.gov, there are concerns that “different brands of the battery-operated device delivered markedly different amounts of nicotine vapor with each puff.”

The e-cigarette has been banned on air flights and even in some local restaurants.

Within the past year, Linn said he has witnessed the sales of electronic cigarettes triple at his business. He stocks an array of rechargeable devices that range from those that resemble cigarettes to others that come in various colors and designs.

Smoking wasn’t just a habit for Cioffi, it was a lifestyle. He and his wife, Bambi, who is a casual smoker and is also using the electronic cigarette now, collected everything to do with smoking.

“We had collections of lighters, cigarette cases, designated smoking areas in the house, you name it,” Bambi said. “We upgraded the house and removed a lot of that stuff, and my husband has been nonsmoking since Dec. 26.”

Users of the e-cigarettes say that by using the product, they are still able to fulfill their physical habit of “smoking” something and putting the hand to the mouth to do so.

Robert Cioffi is one of those people and said he went “cold turkey” with the e-cigarette and started it at a level zero.

Jennifer Barney, smoking cessation counselor at Lancaster General Hospital, says there are healthier ways to break the habit, and she is concerned about reports of harmful chemicals being found in the e-cigarette vapors. The lack of studies of the e-cigarette’s long-term effects also concerns Barney.

“Do you really want to use something that doesn’t have a lot of research behind it?” Barney said. “Look where smoking cigarettes has gotten a lot of people. We didn’t know the effects of smoking back when we started.”

Admitting that nicotine addiction is very hard to quit, Barney suggests alternative methods such as the FDA-approved nicotine patches, sucking on cinnamon sticks, straws or menthol cough drops.

“The idea is to get away from that behavior,” Barney said.

Dr. Samuel Kerr, hematologist and oncologist at Lancaster General Hospital, is concerned about the e-cigarette marketing tools that may attract younger smokers.

“These could just be a gateway to smoking for a younger generation,” Kerr said.

Available also in flavored cartridges, the e-cigarette could be attractive to younger children, Kerr said.

Because of the legal battle at categorizing the e-cigarette by the FDA, each state is responsible for its own decision on selling e-cigarettes to minors. Pennsylvania has begun legislation that would prohibit the sale of e-cigarettes to anyone under 18.

Kerr does see potential for the e-cigarette to be a helpful cessation tool if used properly by adults who are informed. He would also like to see more studies and regulation of the products.

The FDA has yet to evaluate the electronic cigarette but has issued warnings to five electronic cigarette distributors of violation of the Food, Drug and Cosmetic Act. The act prohibits a company from claiming that its drug can treat or mitigate a disease, such as nicotine addiction, unless the drug’s safety and effectiveness have been proven, according to a press release from the FDA in September 2010.

“Yet all five companies claim without FDA review of relevant evidence that the products help their users quit smoking,” the release stated.

Electronic cigarette company owners say they fall under the tobacco laws because they are a nicotine product, but the FDA says they fall under the FDCA because these companies are claiming the e-cigarettes have health benefits.

According to the FDA, electronic cigarettes meet the definition of both a drug and device and electronic cigarette firms will have to comply with the FDCA and work in cooperation with the FDA to lawfully market the products.

However, Judge Richard J. Leon of the Federal District Court in Washington, D.C., ruled that the devices should be regulated as tobacco products rather than drug or medical devices. If ruled as medical devices, companies must perform clinical trials for the e-cigarettes, according to a New York Times news article. The FDA appealed this decision and its appeal was rejected on Jan. 24.

According to the appeal, manufacturers proved that their products are marketed