April 24. 2014 8:56PM

NH health experts say FDA proposed rules on e-cigarettes only a first step

New Hampshire Union Leader

Kate McNally, who counsels people on quitting smoking, said the U.S. Food and Drug Administration’s move to regulate e-cigarettes is “a very limited first step” and more research is needed to see whether electronic cigarettes are harmful.

“I would like to see regulations on marketing of the products and get it off of TV and get it off of the radio and start to regulate the advertising of the product the same way we regulate the advertising of other tobacco,” said McNally, who also is co-chair of the tobacco work group of the New Hampshire Comprehensive Cancer Collaboration, which was formed to work on eliminating cancer.

The FDA’s proposed rules, released Thursday, would require health warnings, ban free samples and restrict e-cigarette sales to adults.

New Hampshire already has a law banning e-cigarette sales to those under 18, said McNally, who is a tobacco cessation counselor at Cheshire Medical Center at Dartmouth-Hitchcock Keene.

“A lot of people are trying (e-cigarettes). Most people who come to see me said they tried it and didn’t like it because they say it causes people to feel jittery,” McNally said. “Another person said it felt like they were breathing underwater. They really didn’t like the vapor part and went back to tobacco.”

E-cigarettes are devices that create an inhalable nicotine vapor by heating a liquid nicotine solution, according to a briefing paper put out by the cancer collaboration. Like smoke, the vapor is white, but doesn’t contain the tar. Chemicals in the tar are known to cause several different kinds of cancer, according to the paper.

More study, McNally said, is needed to assess the chemicals used in the e-cigarettes.

McNally said the FDA also didn’t propose curbing the flavoring of the liquid nicotene for e-cigarettes, including a bubble gum variety that might appeal to young people.

Norris Cotton Cancer Center Dr. James D. Sargent, an internationally recognized expert who regularly publishes research on the effects of media exposure on childhood smoking behaviors and comments on the influence of media on adolescent smoking, said the effects of the FDA decision will mean “little at first.”

Sargent said in an e-mail that a “big question” is how people use the e-cigarettes.

“If kids start using them then move on to cigarettes, they could actually increase adolescent smoking,” Sargent said. “If adults who would have quit smoking prolong their use of cigarettes through use of e-cigarettes (when they can’t smoke) that would also be a sign that e-cigarettes aren’t helping much.”

He said people wanting to quit tobacco smoking should try a nicotene patch or gum first.

If they choose to use e-cigarettes, they should “completely stop using cigarettes,” said Sargent, who co-wrote the issues brief. “Using both will expose you to the known harms of cigarettes and the unknown harms of e-cigarettes.”

The brief said more time is needed.

“The bottom line is that we do not know a lot about the safety of these products,” it said. “As was the case for cigarettes, it will likely take many years for the risks and harms to be understood. Since these products are attracting a great deal of attention now, short-term research should be available in the next several years, but long-term health risks will not be known for many years.”