A new revelation has added to the ongoing controversy over the health risks of e-cigarettes. Some commentators have viewed the use of this electronic delivery system for nicotine as a way for smokers to cut down on tobacco cigarettes or quit the habit altogether. Others have contended that e-cigarettes can be a "gateway" to smoking, and may actually increase the use of tobacco. Still others maintain that the jury is still out on the risks of nicotine inhaled through "vaping." And cases have been reported of young children ingesting the colorful nicotine liquids, posing serious risks to health and life.
E-cigarettes: A danger in the making
A new danger was revealed in an article in the New York Times on December 13: the unregulated manufacture of e-cigarettes in China poses significant health risks to consumers. The article notes that heavy metals, carcinogens and other dangerous compounds, such as lead, tin and zinc, have been detected in some e-cigarettes. The suspicion is that shoddy manufacturing practices contribute to this contamination.
The article notes that more than 300 million e-cigarettes from China are expected to be shipped to the United States and Europe this year. Some of the Chinese manufacturing plants are legitimate operations that produce name brands, while others are operated by counterfeiters. The industry is entirely unregulated in China at present, and in the U.S. the Food and Drug Administration (FDA) is moving slowly toward issuing rules that would require producers of e-cigarettes to provide details about ingredients and the manufacturing process.
Who should regulate e-cigarettes?
Despite the views of politicians who have strongly supported deregulation of industry in the United States, regulatory agencies exist to protect the health of the public. The FDA is responsible for overseeing the safety of many foods and all drugs, medical devices and biologicals; since 2009 the agency has also regulated the tobacco industry. The U.S. Department of Agriculture is in charge of monitoring the safety of meat, poultry and eggs. The Environmental Protection Agency has had the mandate to ensure safe drinking water in the country for the past 40 years. These agencies conduct activities that it would be impossible for consumers to carry out on their own. Without the scrutiny and actions of governmental regulatory agencies, public health would suffer a devastating blow.
The need for speed
This new information about risks posed by e-cigarettes from the manufacturing process underscores the need for the FDA to move swiftly. Recent studies have shown a significant rise in the use of e-cigarettes by high school students even as their use of tobacco cigarettes has declined. While such studies can help determine whether vaping increases, decreases or has no effect on the rate of tobacco consumption among young people, it is an open question whether the risks from poor manufacturing of e-cigarettes will reach the majority of users or prompt them to change their behavior.
The wheels of bureaucracy grind slowly in Washington, but we can only hope that the FDA can meet this new challenge with timely action to regulate the importation of e-cigarettes containing ingredients that are known health hazards.
This post was originally featured on The Doctor's Tablet, the blog of Albert Einstein College of Medicine.