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Health officials fuming over e-cigarette advertising

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You've come a long way, tobacco cigarettes. But it's time to stand down. You've met your match. The future of nicotine addiction is here. And its name is e-cigs.

Tobacco cigarettes—nostalgically referred to as smokes, squares, butts, or cancer sticks—are going the way of fax machines, pay phones, and AOL.

In 1970, public health advocates pushed former President Richard Nixon to ban cigarette ads on television and radio. They cited higher rates of cancer and heart disease. The last television ad for tobacco cigarettes aired in 1971.

Now in 2014, during the television ratings bonanza called the Super Bowl, over 100 million viewers watched ads for "electronic nicotine-delivery systems" also called e-cigarettes (e-cigs).

"Those who care about public health should be rejoicing that the private sector is…placing anti-smoking advertising on the country's largest stage," said Jeff Stier, Director of the Risk Analysis Division of the National Center for Public Policy Research.

The National Center for Public Policy Research is a conservative think tank.

E-cigs are battery operated nicotine-delivery devices that mimic the look and feel of tobacco cigarettes. They use a heating element that vaporizes a liquid containing nicotine.

Technically, inhaling nicotine vapor isn't smoking. It's "vaping."

E-cigs are the subject of a furious public health debate. Last year, sales of e-cigs in the U.S topped $1.7 billion. Financial analysts predict that sales of e-cigs eventually will surpass tobacco cigarettes.

Opponents of e-cigs claim they're untested, dangerous, unregulated, and may lead young people to try other tobacco products, including conventional cigarettes.

“It is important to keep [e-cigs]…from being sensationalized through the use of celebrity promotion or product placement in movies or other entertainment media," said antitobacco activist Stanton Glantz.

Within days, the U.S. Food and Drug Administration (FDA) is expected to issue new rules about e-cigs. The agency is expected to extend its regulatory oversight of tobacco products to include e-cigs.

"Activist groups…are adamantly opposed to e-cigarettes. They argue that some e-cigarettes look like the real thing. That's nonsense," said Stier. "They have called upon the FDA to ban the NJoy ad and similar ads."

Until the FDA acts, it's the Wild West for e-cigs. Anything goes. Advertising agencies are cashing in, especially in the already fuzzily regulated internet venues such as YouTube.

Today, online ads reach millions of viewers of all ages. They include clever ads for NJoy, Vapor Zone, and blue e-Cig.

One ad aimed at women features Jenny McCarthy, where the former Playboy model, "The View" television host, and anti-vaccine activist promotes blu e-Cigs, a company now owned by tobacco giant Lorillard.

In the ad, McCarthy recites the product's slogan "take back your freedom." The ad is eerily similar to the 1970s Virginia Slims magazine campaign for women called "You've come a long way, baby."

Nonetheless, a growing consensus of experts is heralding e-cigs and vaping as a pathway to "harm reduction."

Harm reduction is the guiding principle behind needle exchange, the provision of sterile syringes for injection-drug users to reduce transmission of illnesses.

According to several articles in the January 23, 2014, issue of The New England Journal of Medicine (NEJM), harm reduction from e-cigs is the preferred choice of evils.

Indisputable evidence shows tobacco cigarettes causes 400,000 deaths annually in the U.S. and over 5 million deaths globally.

Advocates for harm reduction say that "abstinence-only" approaches are merely “moralistic" approaches in disguise, according to one NEJM article. The failure of the 1920s prohibition on alcohol, they say, is a perfect example.

"We may not be able to rid the public sphere of vaping," wrote authors in the second NEJM article, "but given the magnitude of tobacco-related deaths, an unwillingness to consider e-cigarette use until all risks or uncertainties are eliminated strays dangerously close to dogmatism."

Dogmatism, in short, is an aggressive viewpoint without substantial evidence to support that viewpoint.

The authors of the NEJM articles clearly discourage the sale of e-cigs to minors. They also note that the FDA should move swiftly to regulate e-cigs so that their potential harms are better understood—and so that they can contribute to the goal of harm reduction.

"We believe such protections should include a ban on selling all such products to anyone under 21 years of age, given the risks for lifelong nicotine addiction associated with early use," wrote the authors.

"We need to communicate intelligently about harm reduction: not all nicotine-containing products are equal."

While the authors of the NEJM articles remain circumspect, some advocates of e-cigs are more fervent. One peer-reviewed article claims that e-cigs are "one of the greatest public health breakthroughs in human history.”

Smoke or vapor, one thing is clear: Tobacco cigarettes certainly have met their match.

-- Brett Grodeck

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