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E-cigarettes take off in Minnesota — and so does fight over regulating them

E-cigarettes take off in Minnesota
REUTERS/Toby Melville
While hundreds of studies have been conducted on e-cigarettes, there’s no evidence the devices cause cancer.

They can be fairly easy to spot in bars or restaurants – some light up white or blue, and all emit stream of vapor that’s often scented like melon or strawberries, the more popular flavors on the market.

These futuristic-looking cigarettes – better known as electronic-cigarettes or simply e-cigarettes – are gaining popularity across the country and particularly in states like Minnesota, where taxes on cigarettes went up to a $1.60 per pack last summer. Unlike traditional tobacco cigarettes, e-cigarettes deliver nicotine to users through a battery-powered coil that heats a flavored solution into a vapor, which is inhaled.  

Current conventional wisdom and some research suggests e-cigarette nicotine comes without the carcinogens in traditional cigarettes, and its similarity to the act of smoking is making it one of the more popular items on the market for smokers looking to quit. It doesn’t hurt that in cold-weather states like Minnesota, e-cigarettes users can smoke the devices inside most establishments. Bloomberg estimates the e-cigarette industry could hit $1.5 billion in sales this year and surpass traditional tobacco products as soon as 2023.

But the new and booming industry has so far avoided regulations from the Food and Drug Administration (FDA), a fact that has some worried about any possible unknown harms in the devices. While the FDA is currently drafting recommendations on e-cigarettes, some state legislatures have taken matters into their own hands. About 27 states, including Minnesota, ban e-cigarettes for minors, according to the National Conference of State Legislatures. Three states – North Dakota, Utah and New Jersey — ban smoking e-cigarettes indoors.

Minnesota could soon join the ranks: Rep. Phyllis Kahn, DFL-Minneapolis, has introduced a bill to add e-cigarettes in the Minnesota Clean Indoor Air Act, legislation she authored in 1975 to ban smoking on public property. In 2007, Minnesota lawmakers amended the act to also prohibit smoking in places of employment, restaurants and bars and in public transportation.

“One of the things that’s happening, and it’s a good reason to do it now, there are businesses that are starting to jump on this, so you want to slow it down before it gets too widespread,” Kahn said. “We are not banning it, we are just putting on the brakes to say, lets look at this a bit closer.”

‘A step backwards’

According to Kahn, another benefit of her bill is it will take pressure off of local governments. So far the battle over what to do with e-cigarettes has been waged on the local level. More than two-dozen Minnesota cities and counties have implemented restrictions on e-cigarette use in public places.

The latest city join the list is Mankato, where the City Council recently voted nearly unanimously to ban electronic cigarettes in most indoor places in the city. Hennepin County has banned smoking e-cigs on county property, and Metro Transit has banned e-cigarettes on all buses and trains. And there’s no so-called “vaping” allowed at Target Field, either.

Another proposal introduced this year by Rep. Laurie Halverson, DFL-Eagan, would make selling e-cigarettes to minors a misdemeanor, give local governments more power to regulate the devices and ban their use on public school campuses.

A major concern among skeptics is that e-cigarettes – sold in flavors like strawberry and bubblegum – are being marketed to children and could become a pathway to cigarettes. New data from the U.S. Centers for Disease Control and Prevention found use of e-cigarettes among middle- and high-school student went from 4.7 percent in 2011 to 10 percent in 2012. That has alarmed public health officials.

The Minnesota Department of Health is not working on any state-level policies to regulate e-cigarettes, but officials have supported local bans like in Duluth and support efforts currently introduced in the Legislature. Smoking cessation groups, like Clearway Minnesota, are against the use of e-cigarettes.

“We don’t feel like anyone should be exposed to the vapor until we know what’s in it,” said Clearway spokesman Mike Sheldon. “What we are looking at, if we are talking about allowing a substance with unknown harm into our air, that would be a step backwards.”

Better than tobacco?

But what exactly is in the so-called “e-juice” used in the devices? Nicotine is the key functioning ingredient, although e-cigarettes allow users to adjust the level of nicotine they inhale all the way down to none at all. The other main ingredients are fairly common: propylene glycol, which creates the vapor seen, and glycerine, which is used in many foods as a means of preservation.

While hundreds of studies have been conducted on e-cigarettes, there’s no evidence the devices cause cancer. In fact, a 2011 study published in the Journal of Public Health Policy found them to “be much safer than tobacco cigarettes and comparable in toxicity to conventional nicotine replacement products” like nicotine patches and gum.

But other possible harmful impacts are murkier. Dorothy Hatsukami, associate director for cancer prevention and control at the University of Minnesota’s Masonic Cancer Center, wants to help answer some of the lingering questions. She is leading a study examining exactly what smokers inhale when they use e-cigarettes and how toxic it is compared to regular cigarettes. Researchers are working with smokers who use only e-cigarettes, as well as those who use them alongside traditional cigarettes.

“There have been a lot of studies done on e-cigarettes, but not many have been done on the exposure of the individual themselves over a period of time,” she said. “There’s such a wide variety of e-cigarettes out on the market and some may have some unknown contaminants. Even though studies have shown there may be minimal amounts of chemicals from the vapor that’s released, there’s no guarantee.”

E-cigarette smokers head to St. Paul

But proposals to regulate their use would make Minnesota one of the toughest states on the growing industry. Oregon currently has the toughest restrictions, effectively banning the sale of two major e-cigarette brands in the state until they are FDA approved or scientific research can prove them safe.

Minnesota already imposes some regulations on e-cigarettes. For instance, Minnesota is the first state to label e-cigarettes as an “other tobacco product.” That means they can tax the devices – Minnesota uses an excise tax of 95 percent slapped on the wholesale cost of the product – and put that revenue directly in the state’s coffers. Minnesota generated about $27 million from excise taxes on other tobacco products in 2013. Minnesota also bans the sale of e-cigarettes to minors.

Matt Black will be taking the e-cigarette consumer argument to the Capitol next session on behalf of the Minnesota Vapers Advocacy group and the Minnesota League of Vape Shops, a trade industry group that represents about 50 storeowners. Since officially forming last August, the group has been battling on the local level.

Black, a former smoker who quit by using e-cigarettes, says it should be up to the individual bar or restaurant owner if they want to allow e-cigarettes in their facility. In the case of Duluth, which recently adopted restrictions on e-cigarettes, users are not even allowed to use the devices in e-cigarette shops.

“It doesn’t make sense to ban something or regulate something to death if there is no science giving you a reason to do so,” Black said. “But for many the impulse is, if it looks like smoke it must be smoke.”

What’s more, Black says it doesn’t make sense to ban a product that has helped many people quit smoking. “I don’t think anyone realizes the faces behind this movement. It’s people who want to quit smoking,” Black said. “They are not going out to get kids. We are fighting hard and it’s all because we’ve tried everything and nothing has worked until this. We don’t want to see that taken away from others.”

Rep. Jason Metsa, DFL-Virginia, is an e-cigarette user. He plans to vote against Kahn’s proposal if it comes before him for a vote. The bill’s first stop is in the Health and Human Services Policy Committee, in which the chairwoman, Rep. Tina Liebling, DFL-Rochester, is a co-author.

“I’ve been struggling every year to quit as a New Year’s resolution. I’ve found e-cigarettes more helpful than anything I’ve tried. At the end of the day there are no studies out there that say this is a harmful substance,” said Metsa. “I would want to make sure it’s as readily available as long as it’s not putting other people in harms way.”

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Comments (26)

I wonder what my clothes will smell like when I leave bars now.

Cancer or no cancer, considering all the hoopla a few years back against perfumes, cologne and body sprays, I shudder to imagine the reaction to a small bar bathed in multiple (and conflicting) vapor odors.

Then Stay Home

There is some sense to the idea that second hand smoke will harm others, so it should be kept out of public spaces. There is no sense at all to saying that others must stop what they're doing because you're afraid your clothes will smell funny.

Perfumes, colognes and body sprays are much worse

I have gagged on the second-hand odor from artificial body scents worn by people sitting or standing near to me, especially in a car or on an airplane. Yet these are not restricted, at least as far as I know. But I have never had that reaction to the glycol vapor in e-cigarettes.

odor

no odor is transmitted to your clothing.

Too many unknowns

The simple fact that there is no regulation of the "e-juice" means there is no way of knowing what people in the vicinity of a "vaper" are being exposed to for any given product. And as long as the companies insist on keeping these formulas secret, that situation will continue.

That is why I oppose the use of these products in places where I may be exposed to them.

Wait a Minute

We can measure what comes out in the vapor, can't we? Even without knowing what the formula is, we can do that. Didn't I read that in the article? Absent some studies that show harmful effects, there should be a presumption of safety here. Especially since there is overwhelming reason to think that they are safer than cigarettes and a useful aid to help smokers quit.

Two things

First of all - to my knowledge, these studies are not being done - or at least not in any comprehensive and scientifically valid way.

Second - There is no "the formula". Every company out there is free to put whatever they want into the product they sell. There is not telling what is included in any given company's "e-juice". And even the ones who say that besides the nicotine it's "just" ingredients such as propylene glycol and such are not being required to demonstrate any level of purity or lack of contaminants on the input ingredients they are using.

And why in the world should there be a "presumption of safety"? This stuff is being inhaled. From your lungs it goes straight into your bloodstream and then can impact every part of your body. It has the potential to do a lot of damage. This is not an insignificant risk and not an area where I want to be relying on a "presumption of safety" in the absence of data.

So given that there are no controls on formulations, no controls on product identification and purity, etc., no controls, period, we're supposed to just take all these companies' word for it? "Here, take this and vape it. It's safe. Really it is. Trust us".

Sounds like a win/win - for them.

Sorry. Not good enough for me.

I want data, and I want some level of accountability on the part of the manufacturers.

Until then, I want it kept away from my lungs.

Why a presumption of safety?

Instead of a presumption of potential harm?

I'm sure we can measure what comes out of whichever combination of device and "juice" we are testing. But that doesn't tell us much about other combinations, as there is no regulation or even visibility into the recipes.

If they are safer and useful for cessation, why are they not regulated like other cessation products or, as some others are, subject to a prescription? For current smokers, they may be better than cigarettes (we can't say that for sure because we don't know what's in each of them for sure), but that doesn't necessarily imply that we want to hand them out to everyone. They can and will be a pathway to smoking for others as well.

I respect your concern

I respect your concern regarding regulation of the content of e-liquid. I think it's a valid concern. Many e-liquid companies are small businesses, and many do in fact provide full lists of their ingredients. I am personally careful to buy liquid that is made in the U.S., with natural and organic ingredients, but I know not everyone is so cautious.

For that reason, I would support government regulation of the content of e-liquids. However, I think that a regulatory system would only make sense at the federal level, whether through the FDA or otherwise. I cannot see a state regulatory system being effective, though if the FDA delays too much longer it is certainly an option to be considered.

Although I would support federal regulation of e-liquid content, I cannot support a statewide ban on e-cigarettes akin to tobacco. Experience shows that laws, once enacted, are difficult if not impossible to undo, regardless of the evidence. This is an area where we need to move cautiously. E-cigarettes are the first-ever viable alternative to smoking, and each time a person chooses to vape instead of smoke it is a victory for public health. It would be a shame to reduce the positive impact of e-cigarettes with premature policy.

In the meantime, please take a moment to read this thorough review of the existing scientific literature: http://publichealth.drexel.edu/~/media/files/publichealth/ms08.pdf. The author concludes that there is no health concern for third-parties exposed to e-cigarette vapor. While I certainly hope that more studies are done in the future, I hope you take some comfort in this preliminary review.

This isn't just some benign inhalant

E-cigarettes are a nicotine, flavoring and fragrance delivery device. The nicotine is delivered in the form of a fine aerosol. That aerosol has to be fine in order to stay in the airstream long enough to reach the lungs, where the nicotine can be absorbed. Does all the nicotine in the aerosol get absorbed by the lungs. I rather doubt it. So now the user is delivering an addicting stimulant drug to anyone near them. That's the first problem I have with these things. Second, there really is no assurance what these things have in them. They are an unregulated product marketed by the same fine folks who've been marketing tobacco products for years. The same folks who have a history of adding all sorts of lovely and often toxic additives to tobacco.

Are e-cigarettes safe? That's a meaningless question. Are they probably less of a health risk for users and the people around them, than conventional cigarettes? Probably? Do we know what the risk level for users and others is from e-cigarettes? No, but I'd be shocked if it was a negligible risk. Suggest you read the following : http://www.medscape.com/viewarticle/820037?nlid=48343_1521

ecigs use

ecig users do not inhale into their lungs. no one who has weighed in criticizing their use including Rep. Hahn and some doctors assume we inhale into our lungs. We don't. we inhale into our mouths. At least figure out how the darn things are used before you decide to ban their use. and most users revert to no-nicotine fluid after they have used them for a time.

Lets be reasonable

Yup, nicotine is bad. But nicotine by itself is much less nasty than tobacco. I've tried forever to quit, with no success. I know from experience that it is much easier for an alcoholic to quit drinking than for a smoker to quit. At this point I'm having (sporadic) success with e-cigarettes. If they help me quit altogether, great, but even if I end up using them long term it would be an improvement. Sure, REGULATE them, but to ban them would be counter productive and not a little self righteous.

Concerned about health?

The Anti-smoking and anti-e- cigarette crowd are strangely quiet when it comes to a campaign against smoking pot.

Exposure

When the day comes that I cannot go to a bar or restaurant without inhaling marijuana-laden air, then I might have something to say about it.

LOL pot and cigars are cool

I wonder just what else the non-profits will find to keep themselves in business. Fighting tobacco - and its users - has been marketed so successfully that people can't bring themselves to say, "our work is done." So much pollution is critically important to public health, but the focus remains on cigarettes. Have you ever wondered why? Could it be that insurance companies put all their efforts into demonizing tobacco addicts so there would be no move to identify tobacco use as an addiction? They didn't want to pay for real treatment so they deliberately funded every study that proved what we already knew - tobacco is very bad for us. A proposal to study the effects of smoking on hangnails would get funded. Still, we have the greatest killer - stress and the multiple addictions it leads to - unexamined. And we direct virtually none of the billions garnered from taxes and the Tobacco Settlement to effective addiction treatment.

In addition to insurance companies, major polluters wanted attention on tobacco. Until recently, they had the audacity to claim diesel exhaust wasn't bad for us, oh certainly not. I wonder how many cancer deaths were attributed to tobacco when idling in rush hour traffic, going home to a house contaminated with radon, inhaling countless VOCs and eating chemically drenched foods also contributed.

Sure, Rep. Kahn can get riled up about anything (even allowing kids to vote). This Democrat stopped giving any contributions to political candidates and causes when our Legislature chose to double cigarette taxes and leave alcohol untouched. Alcohol kills. Its effects on the user are deadly, and its social costs are immeasurable - violent crime, spouse and child abuse, destruction of families and enduring psychological damage to victims. But too many folks like to drink and unions fought even the tiniest tax increase, so they left that alone. They didn't dare touch fats, sugar, and salt - which also kill and also create neural pathways of intransigent addiction - because most of us are overweight and love our steak and French fries. Yep, let's get outraged about e-cigarettes.

Ron

Have you ever smoked pot? Do you really think that pot smokers indulge with the same frequency that a cigarette smoker does? Not to mention in public? Legalization will never mean that people will be walking down the street smoking weed.

Personal Experience

I have a son who is so addicted to smoking that he smokes a pack a day even though it causes him chronic respiratory symptoms. I can't stand to be in a house where people have smoked or around smokers - my sinuses swell, my vocal cords swell - I soon feel as if I have a nasty cold, an effect that lasts for hours (luckily, my son smokes outside rather than in the house).

I'm also sensitive to many perfume bases with the same symptoms to the extent that my vocal cords swell sufficiently to give me laryngitis after just a few minutes in close proximity to anyone wearing a perfume that uses one of those bases (even though I actually like the fragrance of many of the perfumes to which I react).

Recently my son has been experimenting with e-cigarettes of various flavors and scents - even using them in their house. So far, I haven't reacted badly to ANY of them even after extended periods in close proximity. Furthermore, his respiratory issues have improved noticeably.

PLEASE don't be so anxious to (you should pardon the expression) tar and feather e-cigarettes with the same brush used for traditional tobacco products. At least in my experience, they represent a massive improvement for those of us who react badly to cigarette smoke and have loved ones who are addicted to smoking.

Sorry, but . . . . . . . .

Greg, as has been stated so many times here on comment threads over the years, "The plural of anecdote is not data".

I'm sorry, but until you can cite well run, peer-reviewed studies that quantify what is expelled into the air around "vapers" and that have also studied and quantified what harm - or lack therof - is posed to "non-vapers" who inhale it, one or a few person's experiences is just not good enough.

And for the same reason (exposure of non-vapers in the area) until there have been some controls put in place over what ingredients may and may not be included in "e-juice" as well as quality control measures for identity, purity and lack of contamination, then that also remains a huge unknown in this entire subject.

And that is just not good enough.

Nicotine vaporizers are lifesavers for some of us

Using these non-burning e-cigarettes has enabled me to totally quit smoking cigarettes after 50 years of addiction. Nothing else I tried worked for me.

The State of Minnesota should provide them free, or at low cost, for addicted smokers who need help quitting, not tax them at 95%, and not ban their legitimate, therapeutic use by people who need them.

If future clinical studies demonstrate that they are more harmful than smoking tobacco, then the government can restrict their use. But until then, the government should just leave us alone. Allow us to substitute a safer alternative to that proven killer, tobacco.

fan of ecigs

i used ecigs to quit smoking after being a lifelong smoker. the inhalant i use contains no nicotine and i do not inhale. the ingredients in the vapor are harmless which is probably why the FDA has not weighed in. There is no study to date which indicates any health problems whatsoever. My doctor is thrilled that after a lack of success using the patch and nicotine inhalers (yes, Rep. Hahn, those are used for smoking cessation too and i don't see you regulating their use) i am a non-smoker.

Typical

"We don't know enough about e-cigarettes, so let's ban their use indoors." Don't we usually wait for the evidence before making laws that restrict the freedoms of others? I've sat next to many an e-cigarette holder with no problems, and I quit smoking tobacco years ago after decades of addiction. Sitting too close to a smoker makes me jumpy in short order, but the e-cigarettes don't have this effect on me at all.

Is it really quitting?

If you just switch to a different delivery system? Sure, it's one with unknown risks rather than very large known risks, so maybe it's an improvement, but it doesn't seem like quitting.

Semantics aside, these products are devices to create nicotine addiction, and that's reason enough to regulate them. Tobacco companies are not moving into selling them because they think these products will lead to less smoking.

If e-cigs are truly a smoking cessation device...

...as the pro-vaping crowd contends, then maybe their distribution should be restricted by valid Rx through pharmacies just like Nicotine inhalers are.

E-cigs seem to be a convenient way for smokers to "light up" in places where tobacco cigarettes are banned. Until further scientific studies are done, I'd prefer myself, my wife or my child not to be subjected to inhaling something that may or may not have lasting consequences.

And the more I see Hollywood stars being paid to endorse e-cig use, and ads running in mainstream publications glamorizing the use of e-cigs (seemingly targeting young, impressionable and possibly non-smoking teens) the more I will believe that e-cig sales are all about creating a new customer base and less about helping people to stop smoking.

A review of the scientific literature shows no harm.

Dr. Igor Burnstyn, at Drexel University, recently completed a review of the existing scientific literature on e-cigarettes. The article is currently being published in the BMC Public Health journal. To all those who are frightened of e-cigarettes, or those in favor of Rep. Kahn's plan to ban them from indoor use like "analog" cigarettes, I strongly suggest you read this article. It may change your mind:

"By the standards of occupational hygiene, current data do not indicate that exposures to vapers from contaminants in electronic cigarettes warrant a concern. . . . Exposure of bystanders to the listed ingredients, let alone the contaminants, does not warrant a concern as the exposure is likely to be orders of magnitude lower than exposure experienced by vapers. . . . and thus there is no reason to expect it would have any health effects."
http://publichealth.drexel.edu/~/media/files/publichealth/ms08.pdf.

I am trying to cut down my smoking, and so I have been vaping for a few months now. I'm a reasonable person. I don't want to vape in an upscale restaurant, or at a sporting event, or otherwise be potentially obnoxious in a crowded space. Private establishments can determine what's appropriate and ask people to stop or to leave if necessary. The Twins, for example, have banned e-cigarettes from Target Field and have every right to do so.

But I do want to be able to vape quietly in my office at my workplace (after asking my co-workers if they're okay with it), and I do want to be able to vape in the local pub (assuming they allow it). I don't think that's too much to ask, but Rep. Kahn's plan would make this illegal. Please don't support this bill; this simply isn't an area where we need the state government telling us how to act like decent human beings.

Even if some rude people impose unwanted smells on strangers in an inappropriate venue, that doesn't justify a ban. We don't ban perfume. Even if some people are addicted to nicotine, that doesn't justify a ban. We don't ban gambling, or caffeine. The only thing that can justify a ban is health impact on third parties (like second-hand smoke), and that simply does not exist here. The existing literature points to the contrary.

voters

I am sure MN voters will move to regulate e-cigs properly. After all, we elected a wrestler for Governor, a comedian for Senator, etc

Get over it, we have allready given in once.

Oh, Please. The whiners have won enough. The E-Cigarette was created to allow equality after their whining made every smoker a homeless person. Now they are going to whine and whine and whine until they get E-Cigarettes banned also. How about we ban WHINING, in all public and private places.