Contact: Alan Burns

STARKVILLE, Miss.--E-cigarettes may be creating a new public health threat and researchers are calling for more regulation.

Robert McMillen, a research fellow at Mississippi State University’s nationally recognized Social Science Research Center and an associate professor in the Department of Psychology, is the lead author on an article that seeks to bring attention to e-cigarettes.

The article titled “E-Cigarettes: The Roles of Regulation and Clinicians” was printed Aug. 31 in The Journal of the American Medical Association’s Internal Medicine publication.

McMillen raises questions about the role of e-cigarettes and their effect on the health of the individuals that use them. While e-cigarettes are widely viewed as less harmful than normal cigarettes, their effects are still largely unknown.

The e-cigarette market started in 2007 and has since seen substantial annual growth in use among adults from 2010-2013. In the absence of federal regulation, e-cigarettes have created a divide within the medical and public health communities.

Some clinicians and public health advocates worry that the use of unregulated e-cigarettes may be seen as an adequate therapy by patients and could dissuade them from trying a full nicotine replacement therapy. 

On the other end, is the argument for the value of providing nicotine through any other means other than cigarette smoking.  

“The harm reduction debate over the potential of e-cigarettes for smokers, however, overlooks another issue. People who do not smoke may initiate and maintain e-cigarette use,” McMillen said.

In the article, McMillen points out that e-cigarettes can produce volatile organic compounds, heavy metals, and other aerosolized toxins, but at lower levels than combustible tobacco.

“E-cigarettes are not harmless to users and bystanders,” McMillen said. “They are simply less harmful than cigarettes. These products haven't been on the market long enough for any potential long-term harms to develop.”

The debate about e-cigarettes stretches far beyond just smokers. The real worry is within the unregulated appeal to nonsmokers. Due to a lack of federal oversight, the e-cigarette market is attracting a growing number of nonsmokers or people who have never used combustible tobacco.  

“The features and marketing designed to make e-cigarettes attractive to smokers are also likely to broaden their appeal to non-smokers, especially adolescents,” said McMillen. “In our research, we found that at least 20 percent of current users of e-cigarettes were not smoking when they started using e-cigarettes.”

In June of this year, McMillen testified in front of the Food and Drug Administration (FDA) addressing product design, flavors and marketing that appeal to younger individuals and non-smokers.

“E-cigarette regulations are needed to improve quality control, protect children from accidental poisonings, restrict marketing and appeal to youth, and protect non-users from indoor air pollution,” said McMillen.

While the FDA does not currently regulate the e-cigarette market, in 2010 a federal appeals court ruled that the FDA may regulate e-cigarettes as tobacco products, as an alternative to the more rigorous approval process for drug delivery devices.

However, as of July 2015, the FDA has yet to finalize its authority to regulate e-cigarettes as tobacco products. The regulation would allow the FDA to require health warning labels, restrict sales to people 18 years or older and prohibit free samples.

The regulation does not address marketing to people younger than 18 years, the use of menthols and other flavors in e-cigarettes that make the product more appealing, child safety issues, or prohibit the use of the devices in places that are smoke free.

For more information on the Mississippi Tobacco Control Unit, visit http://mstobaccodata.org/ or contact McMillen at 662-325-7127.