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Robert Hsu
The Casual Observer

Photo: Robert Hsu / The Daily Pennsylvanian

In case you haven’t noticed, there’s a new kid on the block in the smoking world.

She has several nicknames: Blu, Skycig and Elites, to name a few, though her real name is electronic cigarette. She claims to deliver the same pleasure of conventional cigarettes without the harmful tar and carcinogens, which historically have been the most notorious ingredients of cigarettes.

As the number of smokers in the United States has decreased, sales of conventional cigarettes in the nation have been mostly stagnant or dwindling. But now, tobacco companies are turning their attention to the e-cigarette market with new products and acquisitions.

And it’s not just tobacco companies that favor this new product — some public health advocates are just as excited about e-cigarettes as young children are on Christmas morning. Those in favor of promoting e-cigarette use believe that it is better for a smoker to use an e-cigarette rather than a conventional cigarette (otherwise known as harm reduction) and that e-cigarettes have the potential to act as cessation aids. A recently published study in “The Lancet” showed that e-cigarettes had similar cessation rates to currently approved nicotine patches.

Those with more cautious views of e-cigarettes have lingering concerns about the lack of standardized nicotine dosages, product quality and the safety of certain chemicals such as propylene glycol. Currently, the Food and Drug Administration does not endorse e-cigarettes as a safe nicotine delivery method or as a cessation aid.

To declare e-cigarettes a silver bullet to smoking simply because it is the lesser of two evils is to blatantly ignore the lessons we have learned from tobacco control. Research on smoking has shown that visual cues can stimulate cigarette cravings, such as movies with smokers, retail tobacco displays and smoking-related pictures.

Even visual cues in anti-smoking ads have been linked to stimulating cigarette cravings. Given that e-cigarette use is nearly identical to conventional cigarette use, it would not be surprising if the use of e-cigarettes could cue current smokers to smoke more or, even worse, cause smokers who have quit to relapse.

Furthermore, e-cigarettes can be used indoors, which is frequently promoted as an advantage by e-cigarette companies given that many states ban indoor smoking. Existing research on e-cigarette user profiles shows that a large reason people choose to use e-cigarettes is to satisfy nicotine cravings in smoking-restricted areas — not to replace cigarettes entirely.

If this trend continues, does this mean it is okay to renormalize smoking in places like restaurants, schools and even inside of homes until everyone uses e-cigarettes inside and outside one day?

The potential effect of this on vulnerable populations, such as children, is unknown, but it is possible that they could become desensitized to the concept of smoking, whether it is an e-cigarette or conventional cigarette.

Youth are particularly at risk because of sneaky marketing campaigns. The tobacco industry has been wildly successful in targeting youth with rebranded tobacco products, especially those that are smokeless, so it would not be a surprise to see them succeed with e-cigarettes targeted at younger crowds.

As major tobacco companies enter the e-cigarette arena, we can expect an influx of marketing targeted at the younger demographic, such as a plethora of tasty e-cigarette flavors and eye-catching packaging.

Once youth and young adults begin using or experimenting with e-cigarettes, it is possible that they could function as a gateway drug to actual cigarette use, reversing efforts to prevent youth and young adults from smoking.

Clearly, more research is needed on e-cigarettes to determine its impact on smokers and non-smokers. For years, tobacco control advocates have worked to bury smoking through increased regulations on the tobacco industry, increased powers of the federal government to oversee tobacco products and increased policies to reduce public smoking.

Even though e-cigarettes are relatively healthier than are cigarettes, the social and behavioral safety of e-cigarettes is equally as important.

As institutions, companies and states consider smoking bans, it’s easy to brush aside e-cigarettes as harmless. But if we don’t consider e–cigarettes as a potential threat now, years of work to denormalize smoking could be undone.

Robert Hsu, a College and Wharton junior from Novi, Mich. His email address is rohsu@sas.upenn.edu. Follow him @mrroberthsu. “The Casual Observer” appears every other Friday.

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