On October 14th, according to foreign news reports, after about 15 years of sales on the US market, e-cigarettes were authorized by the US Food and Drug Administration for the first time.

The government agency announced on October 12, 2021 that three products from the e-cigarette company Vuse have been approved for listing, as well as a device with approved cigarettes.

Although the scope is limited--the authorization only covers tobacco-flavored e-cigarettes, not the broader taste of young consumers as critics say--the FDA's move is seen as a major development in the e-cigarette industry. At present, many e-cigarette manufacturers are in a state of stagnation, and their products are still waiting for official authorization.

The FDA said that its decision on VUSE products was based on data showing that e-cigarettes helped adult smokers to switch to e-cigarettes. But this move was made after years of arguing about the advantages or harms of e-cigarettes.

Benefits for smokers

The FDA emphasized the role that e-cigarettes can play in quitting harmful cigarettes for smokers with nicotine tumors. This is to some extent consistent with recent research.

Jamie Hartmann-Boyce and Nicola Lindson of the University of Oxford reviewed the evidence from 50 studies, including more than 12,000 participants. Help people to quit smoking better than other alternative aids and tools such as chewing gum or patches. The review also found no evidence that e-cigarettes containing nicotine are seriously harmful.

Hartmann-Boyce and Lindon pointed out that the limited data means that such hazards cannot be ruled out.

Two Oxford scholars concluded that e-cigarettes containing nicotine are not without risks, but the harm is far less than smoking. When translated into action, it means: if you don’t smoke, don’t start using e-cigarettes. If you smoke, please consider switching.

Harm to young people

But it was concerns about non-smokers-especially teenagers-smoking e-cigarettes for the first time that sparked the debate. Tammy Chang and Marika Waselewski of the University of Michigan pointed out that between 2011 and 2019, the use of e-cigarettes among high school students soared from 1.5% to 27.5%.

The two surveyed more than 1,000 people between the ages of 14 and 24 to understand the reasons behind the surge. When asked why they think their peers smoke e-cigarettes, the respondents’ responses were social pressure, the desire to try, and the attractiveness of the product. Most people are aware of the danger.

Although most young e-cigarette users will choose flavored e-cigarettes, which include fruits, menthol, mint, candies and desserts, Chang and Waselewski found that only 5% of young respondents mentioned flavor as the reason for e-cigarettes.

Taste problem

Even though not many young people mention that taste is the reason to start smoking e-cigarettes, the taste of attracting young audiences has always been a key strategy for the e-cigarette business.

Leah Ranney, director of tobacco prevention and evaluation at the University of North Carolina at Chapel Hill, believes that the company deliberately uses flavorings and other strategies aimed at young people to attract young non-smokers to use e-cigarettes.

"The use of attractive packaging and flavors has a significant impact on young people, making them believe that these tobacco products are less harmful, and thus making them more likely to try and continue to use tobacco products." She concluded.

Other hazards

Concerns about e-cigarettes are not limited to how it guides young people to use nicotine products. As llona Jaspers, also at the University of North Carolina at Chapel Hill, pointed out, e-cigarettes have only been popular for about ten years-it is too early to assert the long-term health risks to users. Jaspers studies how inhaled chemicals and particles affect human health, and is far from believing that scientists are fully aware of the dangers of e-cigarettes.

"It has taken several decades for epidemiologists to discover that regular inhalation of the smoke produced by burning plant material tobacco can cause lung cancer. Why is the scientific community so quickly assuming that e-cigarettes will not have hidden dangers that may take years to manifest? "Jaspers wrote.

She pointed out that there are hundreds of cases of lung injury related to e-cigarettes recorded at home, and these major health problems occur much faster than smoking-related diseases. In short, she believes that the comparison with ordinary smoking fails to grasp the key point: smoking e-cigarettes itself has health risks.

So to supervise

Compared with ordinary old cigarettes, whether they are suitable for the relatively new e-cigarette industry is part of the reason why it took so long for the FDA to start regulating e-cigarette products.

Michael P. Eriksen of Georgia State University explained in a 2016 article that the federal government is making slow progress in regulating e-cigarettes because the court ruled that e-cigarettes are tobacco products, not Drug device combination, which will require FDA supervision. Erickson pointed out that when President Barack Obama's Family Smoking Prevention and Tobacco Control Act allowed the FDA to regulate some tobacco products, but did not explicitly include e-cigarettes, things became more chaotic.

Therefore, the e-cigarette industry is basically unconstrained for a period of time. This situation changed in August 2016, when the FDA's Tobacco Products Center was granted the right to supervise all electronic nicotine delivery systems, including e-cigarettes. This move led to the announcement this week that three e-cigarette products have become the No. One is authorized to sell in the United States.

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