“We recognize and applaud the many Tennesseans who have made resolutions to be healthier in 2017, particularly those who are battling a dependence on nicotine,” said TDH Commissioner John Dreyzehner in a statement. “We know some may consider the use of electronic cigarettes to quit conventional tobacco products.
“Both current and potential users of all electronic nicotine delivery systems should be aware e-cigarettes are not approved as smoking cessation devices by the FDA or CDC, and their use may create a variety of dangers.”
Specifically, the advisory includes warnings against e-cigarettes, saying: their primary ingredient — liquid nicotine — can be fatal if ingested or absorbed through the skin; that e-cigarettes have been known to explode, earning a ban from the U.S. Department of Transportation; that their use by the nation’s youth is a potential public health threat; that exposure to nicotine can have long-term health effects on babies born to mothers who use e-cigarettes; and that sharing these devices can lead to a variety of illnesses and have been used as a way to deliver the date rape drug gamma-Butyrolcatone.
The chemicals used in e-cigarettes, the Tennessee Department of Health warns, produce emissions that may be harmful to both humans and pets.
Dr. Hadii Mamudu, an associate professor with East Tennessee State University’s College of Public Health, predicted there will be more heavy-handed public advisories like this one as more and more evidence comes out against e-cigarettes.
“The evidence is strong to suggest that TDH has to take some steps,” Mamudu said. “TDH has been taking steps to attack tobacco use in the state as the evidence has been becoming clearer, clearer and clearer.”
Mamudu is part of a team of researchers who stay on top of public health trends related to tobacco and nicotine use in Tennessee and beyond.
E-cigarettes’ unregulated FDA status is a big issue for Dr. David Kirschke, medical director for the Northeast Tennessee Regional Health Department.
“You don't necessarily know exactly what you are getting with unregulated drugs, so it is usually safer to use an FDA approved option for treatment, because they are regulated and have safety data,” Kirschke said.
Nicotine gum, patches and prescription inhalers are FDA-approved cessation products Kirschke recommends.
But owners of two local vaping businesses disagree with Kirschke, Mamudu and Tennessee’s health experts.
Dave Nelson, who owns Johnson City’s Rocky Top Vapor, and Donnie Grayer, who owns Volunteer Vapors near Milligan College, both charge the government with spreading misinformation as it pertains to e-cigarette studies.
“I understand the reasons for state health care experts to question the issue of vaping, but I wish they would focus more on studying the facts instead of spreading misinformation,” Nelson said.
Both said the government should look at the United Kingdom’s Royal College of Physicians report from April 2016.
This paper looks at the harm reduction of e-cigarette use, all the while stating that e-cigarettes should be used “as an aid to quitting smoking” and that “E-cigarettes are not currently made to medicines standards and are probably more hazardous than (nicotine replacement therapy).”
Based on the information available at the time the report was constructed, it concludes by saying, “in the interests of public health it is important to promote the use of e-cigarettes, NRT and other non-tobacco nicotine products as widely as possible as a substitute for smoking in the UK.”
Across the pond, Mamudu said the Royal College of Physicians report fails to recognize the issue faced by the U.S. as top-down anti-e-cigarette studies have come from the government and public health experts.
“The issue is not about adults, but the youth,” Mamudu said.
For example, in 2015, it was reported by the CDC that e-cigarette use tripled over the course of one year for high school students, and all subsequent information since then has suggested a growing problem with youth brought into the nicotine-addicted market.
Mamudu said through curiosity, peer pressure and marketing from the vaping industry — especially through introducing sweet flavors like bubble gum — youth who likely wouldn’t start smoking traditional cigarettes will get hooked on nicotine through e-cigarette use. Many of those youths who wouldn’t have started smoking or vaping in first place, Mamudu said, would graduate to traditional cigarette smoking and, in turn, erase public health progress made in combatting tobacco use.
Grayer would prefer e-cigarettes be seen as an aid to quit smoking, rather than part of the problem, saying he’s seen hundreds, if not thousands, of people quit smoking.
“E-cigs should certainly be listed as a smoking cessation device,” he said.
The state’s top health official, Dreyzehner, emphasizes those other CDC-approved methods for quitting smoking and recommends avoiding e-cigarettes.
“Our ongoing review of research gives us significant concerns about the negative impacts e-cigarettes and similar devices can have for those who use them, for those who are exposed to second-hand emissions and for children who may swallow chemicals or batteries,” Dreyzehner said. “Our recommendation is that people who are considering them for smoking cessation should instead use CDC-approved methods. Those who are thinking about them for recreational purposes should know they are placing themselves at risk for developing a life-long nicotine addiction or exposing themselves and others to substantial harm.”
Email Tony Casey at [email protected]. Follow Tony Casey on Twitter @TonyCaseyJCP. Like him on Facebook at www.facebook.com/tonycaseyjournalist.