U.S. adults support restrictions on e-cigarettes based on potential risks

According to the makers of electronic cigarettes, they are new devices that allow users to inhale nicotine but not the toxins of tobacco cigarettes. Advocates hail e-cigarettes as a possible quit-smoking aid.

But e-cigarettes have been criticized by the United States Food and Drug Administration as potentially toxic since they haven't been tested in FDA-recognized scientific trials. Also of concern: there are no age restrictions on sales of these new nicotine-containing products.

According to a report released today by the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health, public concern about e-cigarettes is already quite high. In fact:

•91 percent of adults in the U.S. think manufacturers should be required to test e-cigarettes for safety
•85 percent favor prohibiting the sale of e-cigarettes to minors
•82 percent think that the FDA should regulate e-cigarettes like other nicotine-containing products
•68 percent of adults think e-cigarettes should have health warnings like tobacco cigarettes and other nicotine products.

"It is clear from this poll that U.S. adults are not waiting for scientific evidence of adverse health effects of e-cigarettes before asking that they be regulated and restricted," says Matthew M. Davis, M.D., director of the poll and associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research Unit at the U-M Medical School. "Rather, they support restrictions on e-cigarettes based on potential risks—not just immediate health effects, but also the possibility that e-cigarettes may lead youth toward later use of tobacco cigarettes."

e-Cigarettes are battery-operated devices that look like cigarettes but do not burn tobacco. Instead, e-cigarettes have replaceable cartridges of liquid containing nicotine, which is inhaled as a vapor along with flavors like tobacco and chocolate. e-Cigarettes are available in stores, mall kiosks and over the Internet.

This latest information from the poll adds to the mounting public dialogue about e-cigarettes, which has so far consisted of claims and counter-claims by opponents and proponents but minimal scientific data, Davis says.

Last week, the FDA sent letters to five manufacturers of e-cigarettes, warning them of violations of federal laws regarding new drugs. The FDA stated that the companies claim that e-cigarettes can help tobacco smokers quit but offer no data recognized by scientific experts.

In this latest poll conducted by Davis and his colleagues, 42 percent of adults are very concerned that it's easy for youth under 18 to buy e-cigarettes. About half of adults (49 percent) are very concerned that e-cigarettes may increase nicotine and tobacco use among children, and 17 percent of parents are very concerned their children will try e-cigarettes.

"Adults' high level of concern—especially about the chance that e-cigarettes will lead to use of nicotine and tobacco by youth—largely explains their broad support for many potential new laws and regulations," says Davis, who is also associate professor of public policy at the U-M Gerald R. Ford School of Public Policy.

According to Davis, this latest poll indicates widespread public support for initiatives that are being considered by some state and local jurisdictions, including warning labels on e-cigarettes, bans on e-cigarette sales to minors, advertising restrictions in youth media and limits on indoor smoking of e-cigarettes.

"Given these results," says Davis, "in order to gain more public support, makers of e-cigarettes will need to provide more detailed evidence about safety and make clear their intentions about marketing to youth. Meanwhile, critics of e-cigarettes may want to move now on legislation, while they have strong public backing."