Senators and state attorneys general are clamoring for the Food and Drug Administration to quickly restrict the sale of electronic cigarettes, but the past president of the American Lung Association, Charles Connor, says e-cigarettes may be "the breakthrough product" that stomps out carcinogen-packed conventional cigarettes.
Connor, president and CEO of the lung association from 2008 to 2012, joined the Electronic Cigarette Industry Group (ECIG) on Thursday as a paid consultant. He will serve as a conduit between public health experts, regulators and the booming industry, which will have an estimated $1.7 billion in U.S. sales this year.
"I tried all my life to get my mother off smoking, without success," Connor told U.S. News. "I just buried her in December due to the failure of her lungs, undoubtedly due to cigarettes. I am deeply committed to eliminating tobacco cigarettes from the American scene."
With millions of adults switching over in part or entirely from conventional to e-cigarettes, Connor says the battery-powered vapor-producers may be "the breakthrough product that gives the smoker an alternative." Cigarette smoking, the leading cause of preventable death in the U.S., could be drastically curtailed by the devices, he said.
"The smoking rate did go down a lot, but it has plateaued around 20 percent, so that's been a great frustration to public health organizations," Connor said. "Might not these be the things that get America off cigarettes?"
The hiring of a high-profile health advocate came less than a week after 37 state attorneys general and several U.S. senators asked the Food and Drug Administration to apply restrictions on conventional cigarettes in the 2009 Tobacco Control Act to e-cigarettes, a move that could ban popular flavor options and restrict advertising.
Some e-cigarette customers fear FDA regulations – expected to be proposed in October – may squeeze smaller online-based companies out of the marketplace, forcing them purchase inferior products sold by large companies, including traditional tobacco companies scrambling to enter the e-cigarette market.
Connor says he supports "intelligent regulation" by the FDA, but not knee-jerk dictates.
"I have a general view that science should triumph over opinion" he said. "Wouldn't it be nice if we could all agree on what science is required, what additional research on what questions are needed? I anticipate we could be on the same page about those questions."
E-cigarettes, he said, are "[not] necessarily health products, but they are sure a lot safer than a tobacco cigarette and even opponents say that. ... If FDA's overall job is to regulate the tobacco industry with a view toward reducing its consumption and reducing the number of deaths, I think they need to take into consideration the role electronic cigarettes might play in doing that."
Connor's primary role, ECIG President Eric Criss said, will be to "build bridges with the public health community [to start] a real dialog about what their concerns are."
Connor does worry that large conventional cigarette companies jumping into the e-cigarette market may "present optics problems" for the industry and "perhaps harden the opposition." In addition to hundreds of small- and mid-sized companies, all three of the major U.S. cigarette companies are now in the e-cigarette game. Lorillard, which produces Newport and Maverick cigarettes, purchased the e-cigarette Blu brand last year. Philip Morris USA's parent company introduced its own e-cigarette brand in August, following Reynolds American's June debut of its own e-cig.
As the debate over regulating e-cigarettes heats up, leaders on both sides of the debate are beginning to emerge.
Skeptics of the e-cigarette industry include U.S. Sens. Richard Blumenthal, D-Conn., and Sherrod Brown, D-Ohio. They allege flavor options are intended to create new addicts for the conventional cigarette industry. State Attorneys General Mike DeWine, R-Ohio, and Martha Coakley, D-Mass., are leaders of this push, too. They sent a letter to the FDA Sept. 24 calling for a flavor ban and recruited 35 other state attorneys general and three territorial attorneys general to sign on.
The budding e-cigarette industry has its own champions. In addition to ECIG and Connor, the Consumer Advocates for Smoke-free Alternatives Association organizes thousands of avid fans to advocate for the products and the Smoke Free Alternatives Trade Association, another e-cigarette industry group, is conducting a "fly in" to meet with congressmen on Oct. 3-4 in Washington, D.C. Criss, the ECIG leader, said he communicates on a regular basis with SFATA leaders.
Scientific analysis of e-cigarettes may tilt the debate. Studies on the devices are beginning to sprout up, and so far the results have been largely positive for e-cigarettes.
E-cigarette liquid is typically, although not always, laced with nicotine. The e-liquid is mainly comprised of vegetable glycerin – which studies found may reduce the incidence of tumors in mice – and propylene glycol, which a 2001 Environmental Protection Agency review found was not carcinogenic.
An analysis released in August by Drexel University researcher Igor Burstyn said the chemical composition of various e-cigarette liquids pose a negligible risk to second-hand smokers. Further, Burstyn wrote, "[t]here are no known toxicological synergies among compounds in the aerosol, and mixture of the contaminants does not pose a risk to health."
And a study published in March by the journal Tobacco Control looked at 12 brands of e-cigarettes and found they had far fewer toxins than conventional cigarettes. Large-scale, comprehensive studies on long-term health outcomes, however, haven't been performed yet.