A square-jawed, attractive man wearing a fitted suit and sporting a brilliant, pearly smile leans away from floating text that reads, "Rise from the Ashes ... I've made the switch, will you?" An attractive female model in jean shorts squats to the left of the word "Healthier" suspended in the air. The vapors around him are subtle, and the smoke from the girl's mouth is animated into flowers. The cigarette he's holding blends into the dark suit, and the one in the model's mouth is a part of the artistry. But wait a minute, isn't there a ban on the advertisement of cigarettes?
They look like, taste like and even release vapors like real cigarettes, but these are electronic versions. E-cigs for short, are part of a whole new generation. They contain no tobacco but can still provide the user with a burst of nicotine. In terms of looks, the major difference is that they have an indicator light at the tip that activates when the user inhales.
On the whole, E-cigs tend to resemble cigarettes or cigars in that they are long and cylindrical. Some are even styled to look nearly identical to a typical cigarette. These cigarettes function by atomizing the liquid within reloadable cartridges to create the classic smoke vapor aesthetic.
According to USA Today, the sale of E-cigs has increased by a factor of 100, going from 50,000 units to over five million units since 2008. The drop in cost during the same time period from over $200 initially to only $20 for a starter kit has also drawn many eager customers.
There is no doubt as to why the popularity of E-cigs has led to a nearly $2 billion per year industry, but there's a more sinister side to this story that needs to be considered.
Unlike traditional cigarettes, there is no federal law banning or even regulating the advertisement of E-cigs or necessitating warning labels regarding the cigarettes addictive properties of nicotine. While most states have put an age restriction on purchasing E-cigarettes matching that of their policy on tobacco, access to E-cigs is relatively simple, given there is no age verification on online orders or retail through third-party websites. According to a Centers for Disease Control and Prevention (CDC) report, between 2011 and 2012, the number of middle school and high school-aged children using E-cigarettes doubled to 6.8 percent. Here is where the problem lies.
Although E-cigs may not contain any of the harmful effects of tobacco and carcinogens, the dosage of nicotine parallels that of traditional cigarettes. Traditional cigarette companies have recognized the potential market and have created an influx of new flavors and styles targeted to younger consumers, ranging from cotton candy to root beer.
The danger here is that we are essentially normalizing the sale of a product that is physically identical to carcinogenic cigarettes while at the same time trying to inform our future generation of the dangers of smoking cigarettes. I am intentionally obscure with the use of "cigarette" because we could be in the midst of facilitating a regeneration of the use of traditional cigarettes in minors when the rate of new users 18 or younger is on a major decline.
The repercussions of having cigarettes popularized in the media, as they were in the 50s and 60s, hold a two-fold danger.
First, although non-nicotine-containing cartridges exist, the vast majority of units contain as much nicotine as a cigarette. E-cigs have created an avenue for experimenting with a highly-addictive chemical that may have lifelong impacts. Secondly, by blurring the lines on what is advertised as "healthy" versus what causes cancer, adolescents at highest risk for smoking may be negatively influenced into using cigarettes. All of the work of the past 20 years in terms of educating minors can be reversed by creating an option that provides the same addictive draw as cigarettes but misinforms users about any long-term harm.
Harm from addiction and dependence prevention for the next generation of children provides sufficient argument for media regulations. By allowing advertisements to make smoking "sexy" again, we are condemning future generations to a life of dependence they may have otherwise avoided.
Next month, the U.S. Federal Food and Drug Administration (FDA) is scheduled to give their recommendations for E-cigs to state legislatures. Because E-cigs are a relatively new development, there has not been sufficient time to run long-term clinical trials on what may be the new face of cigarette smoking for the 21st century.
The major argument presented to the FDA for E-cigs is that current smokers now have a cancer-free way of smoking. The concern is that while E-cigs may help some switch over, there is no reason to believe that E-cigs will free people of their addiction to cigarettes overall. E-cigs are not part of a program that slowly tapers the nicotine contained in the vast majority of cartridge types. E-cigs may simply be used as a nicotine tie over in areas where smoking may currently be banned. More importantly, with unrestricted advertisement, the unintentional social changes in the perception of smoking have the potential to carry a total reversal of the decline in the number of minors who choose to smoke.
It is easy to imagine a world where cigarette advertising becomes unrestricted again. If E-cigs are given free license, maybe smoking becomes the future of peer pressure as opposed to the past, and we're left with a society that condones addiction while touting moderation. In the midst of a battle over health care reform, it is sometimes these seemingly smaller battles that get pushed to the wayside, and in the end, it is ultimately the next generation that is going to pay.
Abhi Kapuria is a second-year medical student from Fairfax, Va.
Illustration by Priyanka Pai
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