Jen Rini

The News Journal

Twenty-year-old Grant Haloeran is a bit of an electronic cigarette connoisseur. He knows how to bargain for the best deals and can customize an e-cigarette tank with spool and yarn.

E-cigs are lighter, taste better and don't leave you feeling disgusting, Haloeran said. Though they contain bits of nicotine, they are healthier than full-on tobacco cigarettes.

"It always crosses my mind," he said, thinking about the potential health risks of e-cigs at the pipe shop Frolic in downtown Newark Thursday.

"But there's no way it could be worse than smoking cigarettes."

The debate surrounding electronic cigarettes, or e-cigs, has been especially heating up over the past year as public health officials, scientists and advocacy groups have been scrambling to formulate a concrete policy on their health impact.

The U.S. Food and Drug Administration has proposed adding e-cigarettes to its list of federally regulated tobacco products, joining rolled cigarettes as well as smokeless tobaccos. The new regulations would encompass e-cigs, cigars, pipe tobacco, dissolvable tobacco, gels and waterpipe tobacco.

The FDA has issued a public comment period on the rule through Aug. 8.

The Delaware Division of Public Health has major concerns with the lack of regulations on e-cigarettes, said Dr. Karel Rattay, division director.

Electronic cigarettes essentially look like battery-operated cigarettes, filled with glycerol, nicotine and flavor for taste. The flavor can range from tangerine to fruit-loop. But the mechanism churns out an aerosol instead of smoke.

"It's the Wild West as to what's contained in e-cigarettes," she said.

Scientists have found that the propylene glycol and vegetable glycerin-based liquids in e-cigarettes can negatively impact stem cells, cause pulmonary irritation and cancer-causing propylene oxide.

"Because it's so unregulated there's a lot of variability in some of the other potential toxins," Rattay said. "Right now people don't know what they are getting."

Though there is no smoke emitted with an e-cigarette, she said that bystanders can still be exposed to the toxins through the aerosol. Toxins which, she said, are particularly harmful to pregnant women and young children.

More troubling for public health officials in the state, however, is the instances of e-cigarette use among high school students.

The most recent Delaware data finds that in the 2012 Youth Tobacco Survey, 58 percent of current e-cigarette users say they will "definitely or probably be smoking cigarettes five years to now." Also 84 percent of youth e-cigarette users are more likely than other students to use tobacco products.

"For youth it's been a gateway to a lifetime of nicotine addiction, and the last thing we want is more youth addicted to nicotine," Rattay said.

Rattay cited a compilation of 84 studies on e-cigarettes from the University of California, San Francisco as the latest research on the products.

The California researchers submitted one of the studies for comment by the FDA on Monday that looked at nicotine use in a sample of mostly high school baseball athletes. The study found that in the past 30 days, 18 percent of the athletes had used smokeless tobacco, 13 percent had used e-cigarettes and 12 percent had smoked hookah.

Dr. Stanton Glantz, one of the lead researchers on the study, said that industry clearly markets such products to young adults, and especially plugs the different flavors. Hookahs, he said, are the most toxic, since they are heated with charcoal.

"It's a sexy, hip, desirable way to get nicotine. It's having the effect of keeping people smoking," Glantz said.

However, he doesn't doubt that some individuals successfully use e-cigs as a way to kick a smoking habit, though it hasn't been proven.

For 30-year smoker Julie Woessner, e-cigarettes were a godsend. She's been cigarette-free since 2009 and touts cigarette alternatives as the current president of the Consumer Advocates for Smokefree Alternatives Association.

"There's a fundamental misunderstanding out there about what it is about e-cigarette smoking that is so harmful," Woessner said.

There are 17,000 registered CASAA members who feel the same.

"It's really easy to focus on the nicotine," she said. "It's not what causes the whole host of really physically devastating [health issues]. There's not combustion. As soon as you remove combustion from the equation, you already have a substantially safer product."

E-cigarette shops have been growing in popularity since 2008. In Newark there is even a shop that has an e-cigarette bar, with a menu of e-liquids.

All in all, Woessner said, the proposed FDA regulations are misguided.

"Our hope is the FDA will step back and realize they don't understand the products well enough," she said.

Glantz, on the other hand, thinks the FDA has not gone far enough. He's unsure how the regulations would get enforced and supported by The White House.

In any case, states are being proactive on their own terms. Thirty-eight states, including Delaware, prohibit the sale of e-cigarettes to minors. Starting Aug. 1, the University of Delaware will enforce a new tobacco ban, including the use of e-cigarettes, on campus and all university-owned facilities.

Delaware lawmakers attempted to add e-cigs to the state's Clean Indoor Air Act to prohibit their use in public places, but after swift passage in the state House of Representatives, the Senate failed to take the measure up on the Legislature's final night.

From a public health perspective, Rattay said, the ban on e-cig sales to minors was a great first step. They will continue to educate the public in an effort to add the electronic cigarettes to the Clean Indoor Air Act. Rattay said it will take time, maybe years.

"But I would prefer not to wait 20 or 30 years to do something about it," she said.

Jen Rini can be reached at (302) 741-8250 or jrini@delawareonline.com. Follow @JenRini on Twitter.