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Smokers are on board with e-cigarette regulations, Rutgers finds

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With the Food and Drug Administration planning to issue a final ruling on whether to regulate electronic cigarettes, a new study by the Rutgers Cancer Institute of New Jersey and Rutgers School of Public Health finds most smokers are unaware that e-cigarettes aren't currently regulated by the FDA, and would support e-cigarette rules.

A proposal by the FDA last April would require e-cigarette makers to register their products with the FDA, make an application to market the devices, use a nicotine addiction warning label and create a minimum purchase age, along with other requirements. The FDA said it expects to publish a final rule in June.

The new Rutgers study of smokers’ attitudes toward e-cigarette policy by Olivia A. Wackowski, assistant professor of health education and behavioral science in the Center for Tobacco Studies at the School of Public Health, and Cristine Delnevo, co-leader of the Cancer Institute’s Cancer Prevention and Control Program, appears in the current online edition of the journal Tobacco Control.

The authors used data from an online survey of current smokers conducted in April 2014, just prior to the announcement of the FDA’s proposed rule. Nearly half (46 percent) of these participants were also current e-cigarette users. Former e-cigarette users made up 62 percent of the overall tobacco smoking group and were defined as those who had tried the devices but had not used them in the past 30 days.

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Overall, researchers found that, while 90 percent of respondents were aware of e-cigarettes, nearly two-thirds (62.5 percent) did not know the devices are unregulated. A majority (83.5 percent) of all respondents also agreed that e-cigarettes should be FDA regulated. This number included 77.9 percent of current e-cigarette users. Nearly 87 percent of all respondents and 78 percent of e-cigarette users agreed that e-cigarettes should carry warning labels about potential risks, and a majority of respondents also agreed the devices should have the same legal age of sale as other tobacco products (87.7 percent of all respondents; 91.8 percent of current e-cigarette users).

Wackowski, the study’s lead author, said: “One finding of note in this work is that nearly two-thirds of respondents did not realize e-cigarettes are not regulated under any government agency — possibly leading to a false sense of security about the safety of the devices. But when respondents were prompted, a vast majority of them believed they should be regulated by the FDA for both quality and safety. As the FDA prepares to issue a final rule regarding e-cigarette regulation, it is important to have such data.”

The study was supported in part by the New Jersey Health Foundation, the FDA Center for Tobacco Products and the National Cancer Institute, which is part of the National Institutes of Health.

New Jersey in 2010 banned the use of e-cigarettes in public places and workplaces and banned e-cigarette sales to people under age 19. State Department of Health spokeswoman Donna Leusner said this was the first state law of its kind in the nation, and took effect March 13, 2010.

New Jersey's e-cigarette regulations are an amendment to the 2006 New Jersey Smoke-Free Air Act, which requires smoke-free environments in essentially all indoor workplaces and places open to the public, except gaming areas in casinos.

The study found more than half of respondents (55.5 percent) supported advertising restrictions for the devices. 

“Exposure to tobacco advertising is a risk factor for youth tobacco use and, while cigarette marketing is considerably restricted in the U.S., e-cigarette companies have no such restrictions,” said Delnevo, study co-author and professor and chair of health education and behavioral science at the Rutgers School of Public Health. “Youth e-cigarette experimentation is rising, and so it is encouraging that there is support to restrict e-cigarette advertising.”

Wackowski said: “It was also interesting to find in this study that, even though smokers largely believe e-cigarettes are less harmful than tobacco cigarettes, almost 90 percent nevertheless agreed that e-cigarettes should carry warning labels, something they are not required to do at the moment.”

Wackowski is now embarking on a new research project to develop and pilot test a series of warnings that may be appropriate for e-cigarettes. That research is being funded by the FDA’s Center for Tobacco Products.

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