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American Heart Association Editorial on E-Cigarettes

Written by Nancy Brown
Chief Executive Officer, American Heart Association

American Heart AssociationDallas, TX – The American Heart Association recently issued new policy recommendations on the use of e-cigarettes and their impact on tobacco control efforts.

Based on the current evidence, our position is that e-cigarettes containing nicotine are tobacco products and therefore should be subject to all laws that apply to tobacco products.

Nancy Brown; Chief Executive Officer, American Heart Association
Nancy Brown; Chief Executive Officer, American Heart Association

We are also calling for strong new regulations to prevent access, sales and marketing of e-cigarettes to youth, and for more research into their health impact.

In recent years, the popularity of e-cigarettes has increased dramatically. In fact, today there are more than 460 brands on the market, and more than 7,700 unique flavors such as mint, chocolate, strawberry, vanilla and apple, which appeal to children and adolescents.

Some predictions have e-cigarette sales margins surpassing conventional cigarettes to become a $10 billion dollar industry by 2017. We are very concerned by the fact that e-cigarettes are an additional entry point for nicotine addiction, especially among young people.

Although marketing for e-cigarettes began primarily online, ads are now on television, radio and in print media; regular cigarette ads have been banned on these mediums since 1971. A survey found that 48 percent of participants cited television as where they have heard about e-cigarettes.

Youth exposure to e-cigarette advertising, according to a study in Pediatrics, skyrocketed over 250 percent from 2011-2013, effectively reaching 24 million young people during the two-year period.

A recent study of 40,000 middle and high school students found that e-cigarettes appeal to adolescents because they view them as high-tech, easy to buy, and convenient, especially in places where smoking cigarettes is not allowed. Because these products can be obtained through websites across state lines, it’s important that federal regulations be developed that would ban their sale to minors.

We also recommend that there be strict laws to curb the intense marketing and advertisement of e-cigarettes, as well as laws that ban flavorings in these products.

In addition, we believe that e-cigarettes should be included in current state smoke-free air laws. Nicotine is a dangerous and highly-addictive chemical substance. If smoking e-cigarettes is allowed in places where conventional smoking is prohibited, it could hamper efforts to enforce smoke-free laws and turn back the clock to the days when lighting up in public was viewed as normal behavior.

Finally, regarding the current debate about the use of e-cigarettes as a tool for smoking-cessation therapy, there is insufficient evidence at this time to support the claim that e-cigarettes are effective in helping people to quit smoking.

Therefore, we support the use of e-cigarettes only as a last-resort approach to smoking cessation, after repeated efforts with conventional treatment have failed, and with a specific and firm quit-date established to avoid prolonged use.

Until there is a more solid base of evidence, we remain extremely cautious about the use of e-cigarettes and their impact on health. Clearly, there is a need for comprehensive and continuous research on these products, their marketing and the risks they pose to our well-being.


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