As Millions Vape, E-Cigarette Researchers Measure Puffs and Explore Facebook Insights

By Sharon Begley

NEW YORK (Reuters) – A team of researchers evaluating the dangers of e-cigarettes is measuring the puffs taken by volunteer “vapers.” Another group plans to analyze social media posts to see how individuals are modifying e-cigarettes for increased nicotine delivery. Additionally, a separate team is creating a virtual convenience store aimed at 13 to 17-year-olds to examine how e-cigarette displays and promotions affect minor purchases of these devices, which are becoming increasingly popular.

The U.S. Food and Drug Administration (FDA) is investing $270 million in this research and 45 other projects to understand the risks associated with e-cigarettes before more Americans become reliant on them.

“They want data and they want it quickly,” said Dr. Suchitra Krishnan-Sarin of Yale University, who is overseeing four studies. However, the results are still years away.

Final conclusions may not be available until after 2018, as researchers shared with Reuters. This timeline highlights the lengthy nature of scientific research, contributing to a lapse in regulation that permits e-cigarette manufacturers to market their products largely without opposition.

It’s important to note that studies on e-cigarettes not funded by the FDA are also ongoing and may inform future regulations. Nevertheless, the FDA selected these 48 research projects to address critical issues relevant to upcoming regulations.

The e-cigarette industry, projected to generate $2 billion in global sales this year, argues that the FDA should wait for these research results before implementing regulations, or risk damaging manufacturers with unfounded concerns about their products.

“There shouldn’t be regulations similar to those for traditional cigarettes without evidence of comparable health impacts, particularly since preliminary data appear favorable for the industry in comparing e-cigarette vapor to tobacco smoke,” stated attorney Bryan Haynes, who represents e-cigarette manufacturers.

Supported by major tobacco companies, the industry is rapidly expanding its marketing efforts nationwide. Over 14 million adults and nearly 2 million teens in the U.S. have tried e-cigarettes, with high school usage doubling from 2011 to 2012, according to the latest statistics.

The FDA affirmed its commitment to basing regulatory decisions on the best available science. An agency spokeswoman stated, “The FDA does not believe it will take many years to create the regulatory framework” once it has the fundamental authority to regulate these products, which could be established as early as next year.

Key scientific questions still remain, such as what compounds are present in e-cigarette vapor, and more complex issues like whether flavors such as butterscotch and bubble gum attract youth to vaping, and how e-cigarette displays in online stores affect teenagers’ purchasing decisions. Perhaps most importantly, researchers aim to determine whether e-cigarettes will lead to a reduction in smoking rates or create millions of new nicotine-dependent individuals.

For instance, the Yale team will investigate whether menthol and flavors such as chocolate and cherry enhance e-cigarette appeal, especially among smokers aged 16 to 18 or those who use both cigarettes and e-cigarettes. If they find evidence of increased appeal, it would bolster arguments for regulatory action.

“We’ll have the first results within two years” and complete findings in four to five years, Krishnan-Sarin mentioned.

As public health experiments go, e-cigarette usage rivals traditional tobacco smoking, which was adopted by half of American men and a third of women at its peak in the 1960s. The first Surgeon General’s report on smoking’s health risks was issued in 1964, long after many adults had already become addicted, ultimately leading to over 10 million smoking-related deaths in the U.S.

Research on e-cigarettes has progressed more rapidly, partly due to established knowledge from traditional tobacco studies that help understand the biological effects of vaping. The cartridge devices first appeared in the U.S. market in 2007, with blu currently leading the market.

Other prominent tobacco companies are also vying for a stake in the growing e-cigarette market, including R.J. Reynolds Vapor Co., which recently began nationwide sales of its Vuse e-cigarette, and Altria’s NuMark subsidiary, which plans to launch its MarkTen later this year.

The FDA gained authority to regulate both traditional and novel tobacco products with the 2009 Tobacco Control Act. In April, the FDA proposed restrictions on e-cigarette sales to minors, prompting calls from public health advocates for broader measures to curb online sales, advertising, and flavored products.

The FDA began its e-cigarette research funding in 2012. One FDA-supported project at the University of Louisville highlights the slow pace of scientific inquiries. Researchers there will analyze various e-cigarette brands for harmful compounds and their effects on lab mice, with results expected in 2015; however, translating those findings to humans may take an additional five years.

Another pivotal question researchers are investigating is the demographic of e-cigarette users; whether they are newcomers to nicotine, former smokers seeking a safer alternative, or current smokers trying to quit.

To gain insights into the population likely to use e-cigarettes, scientists at Georgia State University School of Public Health will conduct surveys of 6,000 individuals to understand their perceptions of e-cigarettes as being less harmful than traditional cigarettes, reasons for choosing e-cigarettes, and what contributes to their risk assessments.

“This research will inform the FDA’s regulatory process,” remarked Michael Eriksen, dean of the School of Public Health, who is leading three FDA-funded tobacco research projects.

The FDA’s proposed regulations would allow it to oversee the ingredients in e-liquid; however, they currently remain silent on vapor emissions. Research indicates that a specific type of e-cigarette called tank systems can heat up enough to release harmful substances, including formaldehyde.

“We want to know what’s in the emissions, not just the ingredients,” said Robert Balster, a toxicologist at Virginia Commonwealth University overseeing several FDA-funded projects.

To investigate this, VCU engineers are creating mechanical vaping devices to examine how different factors affect vapor emissions. They will also analyze online discussions to understand vapers’ temperature preferences. This combined approach aims to identify the emissions people may be exposed to.

“If we find that users are adjusting their devices to increase voltage and FDA regulations impose limits, that’s critical information,” Balster emphasized. While full results remain years away, researchers are keen on relaying information to the FDA promptly due to the mounting pressure for regulatory action.

(Reporting by Sharon Begley in New York and Toni Clarke in Washington; Editing by Michele Gershberg and Ross Colvin)