E-cigarettes come under fire from state health experts

Owner Feras Kalieh smokes an e-cigarette while working at Vapor Smoke Shop in San Francisco in December. Owner Feras Kalieh smokes an e-cigarette while working at Vapor Smoke Shop in San Francisco in December. Photo: Michael Short / Special To The Chronicle Photo: Michael Short / Special To The Chronicle Image 1 of / 1 Caption Close E-cigarettes come under fire from state health experts 1 / 1 Back to Gallery

California health officials on Wednesday declared electronic cigarettes a public health threat, joining a growing number of medical experts around the country who are pushing back against the increasing popularity of the devices that advocates say offer a safer alternative to smoking.

In a 21-page report, the state Department of Public Health highlighted the potential dangers of “vaping” and said its intention was to begin a statewide public health campaign to correct “misinformation” about e-cigarettes as being a more healthful alternative to tobacco.

Supporters say e-cigarettes can help people quit smoking, but state health officials say the claim lacks evidence and they fear the devices, also known as “vape pens” and “e-hookahs,” could serve as a gateway into the smoking habit.

Over the past 25 years, California’s smoking rate has dropped to just 11.7 percent, the second-lowest of all states behind Utah. Meanwhile, e-cigarette use in the state has skyrocketed, particularly among young people, the report said. Vaping among people 18 to 29 years old has risen from 2.3 percent of that population in the state in 2012 to 7.6 percent in 2013. Critics are most concerned about new young smokers.

“E-cigarettes represent a new public health challenge and threaten to undo and reverse the progress we’ve made by renormalizing smoking behavior,” said Dr. Ron Chapman, state health officer and director of the Public Health Department, during a media call Wednesday.

The battery-operated devices, which often look much like real cigarettes, work by heating liquid nicotine and turning it into an aerosol that can be inhaled. The devices can be used to vape other fluids, typically flavors like bubble gum or gummy bear that typically also contain nicotine.

California poison centers are seeing a surge in calls related to exposures to “e-juice,” or the liquids inside e-cigarettes, in many instances involving youngsters who may be attracted to the flavors. Among children younger than five, incidents of e-cigarette poisonings from the liquid increased from seven in 2012 to 154 in 2014, according to the report.

The Public Health Department’s effort follows the introduction Monday of legislation by state Sen. Mark Leno, D-San Francisco, that would ban e-cigarettes from the same places that smoking is prohibited, including schools, work, restaurants, bars and other public spaces.

Three other states have already passed laws that treat e-cigarettes like a tobacco product, and more than 120 U.S. cities and counties, including San Francisco, have passed similar legislation. California bans the sale of e-cigarettes to minors, but further legislation to regulate the devices has been stalled.

The Bay Area Rapid Transit Board of Directors is poised to make a final decision on Feb. 12 to ban e-cigarettes from BART trains. The U.S. Food and Drug Administration proposed rules in April that defined e-cigarettes as tobacco products, but it’s unclear when those rules will be finalized.

Chapman said his department’s announcement is independent of the political efforts to regulate the devices. “The focus in our department is all about public education ... and this is just the beginning of that effort,” said Chapman, who offered few details about the public awareness campaign.

E-cigarette advocates criticized the department’s report, calling it “overheated rhetoric.”

“This report inappropriately paints this complex and important public health topic as a black-and-white issue,” said Gregory Conley, president of the American Vaping Association, which represents the vaping industry. “Despite the health officer’s false claims, there is ample evidence that vaping helps smokers quit and is far less hazardous than smoking.”

But Chapman said a growing amount of research shows e-cigarettes, which are largely unregulated and vary in content, to be unsafe and to pose secondhand risks. He pointed to research that shows e-cigarettes emit at least 10 chemicals that are found on California’s Proposition 65 list of chemicals known to cause cancer, birth defects or other reproductive harm.

“The reality is for many of these chemicals, such as benzene and formaldehyde, there really is no level that is safe,” he said.

Chapman said more research is needed.

“From all the evidence we have so far, e-cigarettes are not as harmful as conventional cigarettes, but e-cigarettes are not harmless,” he said. “They’re not safe.”

Victoria Colliver is a San Francisco Chronicle staff writer. E-mail: vcolliver@sfchronicle.com Twitter: @vcolliver