Are E-Cigarettes a Blessing for Smokers, or a Backdoor Move by the Tobacco Industry?

On July 27, Xinhua News reported that several cities in China have successively issued local smoking control legislation. At the same time, e-cigarettes, touted as "smoking cessation devices," have quietly surged in sales and have become fashionable among some youth groups.

Are e-cigarettes a blessing for smokers trying to quit, or a backdoor move by the tobacco industry? Are they classified as food, drugs, tobacco, or electronic products? Who should regulate them? "China Net News" reporters conducted an in-depth investigation into this.

E-cigarettes are "all the rage"

After Beijing implemented the "strictest smoking ban in history," e-cigarettes became popular and sold well. The vast majority of e-cigarette sellers advertise them as "cigarette alternatives" and "helping to quit smoking," claiming they can assist smokers in quitting and that non-smokers can use them harmlessly, asserting that even if they contain nicotine, they are less harmful than traditional cigarettes.

Recently, the International E-Cigarette Franchise, Distribution, and Experience Exhibition was held in Beijing. With over a hundred booths, the venue was "filled with smoke," and staff provided free tastings, attracting franchisees and distributors with cloud-blowing performances. E-cigarette merchants stated that one of their target customer groups is smokers, but not all of them are looking to quit; many are smokers in non-smoking areas who use e-cigarettes to alleviate cravings and discomfort from nicotine withdrawal.

In response to reporters' inquiries about opening franchise specialty stores, exhibitors provided the following answers:

"There is no regulatory authority for selling e-cigarettes; you can franchise for just 10,000 yuan, and there’s no need to worry about business licenses for daily goods or food."

"This is called an 'e-cigarette fog emitter'; it is an electronic product, and the glycerin and propylene glycol in the solution are legal food additives."

"In sales, you need to highlight product features: large vapor, multiple flavors, and no harm of traditional cigarettes, making it easier to sell to non-smoking youth. For smokers, emphasize that e-cigarettes can be used in non-smoking areas, making it convenient when cravings hit."

Investigations revealed that most e-cigarettes do not clearly disclose the ingredients, safe intake levels, or potential harms on their packaging. Some only state "may contain nicotine," with ingredients listed as glycerin and propylene glycol, and some are even "three-no products" (no production license, no quality inspection, no after-sales service). Many e-cigarette devices can adjust from 0 to 150 watts, and the amount of nicotine inhaled in a short time depends on the device's "wattage" control.

Wu Yiqun, deputy director of the New Exploration Health Development Research Center, stated that unlike smoking cessation medications that require "doctor's orders," e-cigarettes are consumer products, and most users' nicotine concentrations and intake amounts are quite arbitrary, but their addictive nature cannot be ignored.

Dr. Gan Quan, director of the International Union Against Tuberculosis and Lung Disease's China office, told reporters: "Internationally, there has been no scientific consensus on the smoking cessation efficacy of e-cigarettes for many years. The adjustable nicotine concentration means that improper use could lead to acute nicotine poisoning."

E-cigarettes target youth

Statistics show that over half of e-cigarette purchasers are aged between 18 and 29. An e-cigarette bar owner said that e-cigarettes can be used in non-smoking areas, so "many fashionable young women are into this." One e-cigarette buyer told reporters: "We are students; we buy them to use in nightclubs." Some e-cigarettes can produce large clouds of vapor, which are visually appealing to youth, allowing users to take deep puffs and exhale large clouds of vapor in public places like pool halls.

"The greatest harm and concern regarding e-cigarettes comes from youth," Dr. Gan said, noting that some e-cigarettes sold near schools are even "three-no products."

The "2014 China Youth Tobacco Survey" indicated that 1.2% of students had used e-cigarettes in the past 30 days, with boys (1.8%) more than girls (0.5%), and rural areas (1.3%) higher than urban areas (1.0%).

According to data provided by Gan, a survey by the U.S. Centers for Disease Control and Prevention at the end of last year showed that the number of e-cigarette users among American youth has surpassed that of traditional smokers for the first time.

Neither tobacco, nor drug, nor food: E-cigarette regulation is a blank

Against the backdrop of a global trend towards smoking control, various signs indicate that in China, e-cigarettes, lacking effective regulation and quality standards, are masquerading as harmless health products, operating in a gray area, and becoming unregulated "addictive" commodities.

Dr. Gan stated that currently, in terms of regulatory scope, e-cigarettes are neither tobacco nor drugs, existing in a regulatory blind spot, leading to inconsistent quality and rapid market expansion and proliferation. He believes that e-cigarettes have more harms than benefits, stating, "If the state classified e-cigarettes as prescription drugs, those wanting to quit smoking could use them under medical guidance, which would be more effective, but for e-cigarette manufacturers and distributors, this would mean a severely limited consumer base and market."

Reporters learned that China has yet to establish standards and processes for the production and safety of e-cigarettes. The product attributes of e-cigarettes are difficult to define, leading to a situation where no department is willing to take on the "hot potato" of regulation.

In March of this year, Mao Qun'an, spokesperson for the National Health and Family Planning Commission, stated in an interview at the 16th "World Conference on Tobacco and Health": "E-cigarettes are a 'double-edged sword'; they can help reduce nicotine dependence during the quitting process, but they may also lead to nicotine abuse. Strict regulation of e-cigarette production and sales is an international trend, while China has almost no regulatory framework in this area, which is concerning and requires urgent action."

Health experts suggest that the ideal scenario for e-cigarettes is that as smoking control measures intensify, more smokers develop a desire to quit, and doctors at smoking cessation clinics assess their quitting potential. If nicotine dependence is severe, doctors should recommend using e-cigarettes in a controlled manner to maintain and gradually reduce nicotine intake. If complete cessation is possible, smoking cessation gums or medications should be recommended to ultimately break free from nicotine addiction.