Public health officials in cities and towns north of Boston are pushing for tough restrictions on the sale and use of electronic cigarettes, as new studies show the high-tech tobacco substitutes are becoming increasingly popular among youth.
In Marblehead, the town’s Board of Health has proposed a raft of new regulations that would outlaw the sale of e-cigarettes to children under 18 and prohibit their use in bars, restaurants, and public buildings, among other restrictions.
If approved by the board later this month, Marblehead would join dozens of other communities — including Burlington, Gloucester, Peabody, Salem, Reading, Rockport, Winchester, and Woburn — that in the past year have passed stringent regulations on e-cigarettes and other so-called nicotine delivery products, such as wafers, candy, and inhalers.
“Our biggest concern is that we don’t know anything yet about the health affects of e-cigarettes,” said Andrew Petty, the town’s director of public health.
He said board members are equally worried e-cigarettes might act as a steppingstone to getting teens hooked on regular cigarettes. They want to keep them out of the hands of teens until there is more research on the effects from nicotine or other potentially harmful chemicals that are inhaled during e-cigarette use.
“With e-cigarettes, you’re getting a much higher concentration of nicotine than with a regular cigarette, which is a major concern for us,” Petty said.
E-cigarettes are battery-powered devices that look like cigarettes but do not burn tobacco. Instead, they provide users with vaporized puffs containing doses of nicotine, sometimes with flavorings such as mint, fruit, or chocolate. A starter kit with two e-cigarettes and a few nicotine cartridges can cost from $20 to $200.
Although supporters say e-cigarettes are a less dangerous alternative to traditional cigarettes, health officials said they worry the devices could spur teen cigarette use, possibly undermining decades of work to reduce smoking rates.
The Federal Drug Administration is expected to release new guidelines for the sale and distribution of e-cigarettes this fall and is also considering whether to ban online sales of e-cigarettes due to potential health risks. About 250 brands are on the market with no federal restrictions.
On its website, the FDA points out that the public health effects of e-cigarettes have not been studied enough for regulators to determine if they are safe.
State Attorney General Martha Coakley recently joined 40 other state attorneys generals in urging the FDA to draft federal regulations for e-cigarettes.
To date, at least 86 towns and cities in Massachusetts have approved restrictions on the use and sale of e-cigarettes, according to the state Department of Public Health’s tobacco control program. Many communities decided to extend the smoke-free workplace law, which bans smoking in enclosed workplaces as well as restaurants and nightclubs. Dozens of others are drafting regulations.
“We wanted to send a message that if folks want to use these products in their homes they have every right to do so, but we don’t want them in public places,” said Richard Haggerty, a Woburn alderman at large whose proposal to ban e-cigarettes was approved by the City Council on Oct. 1. “We’ve had a lot of complaints about people using them in public places, including libraries.”
Meanwhile, the industry has been spending lavishly on advertising to glamorize e-cigarettes, using celebrities like Steven Dorff and Jenny McCarthy to market them as healthy alternatives to tobacco smoke in TV advertisements.
“They are flooding the market,” said Joyce Redford, executive director of the North Shore and Cape Ann Tobacco and Alcohol Policy Program, a state-funded group that advises towns and cities on regulations. “We have seen a huge proliferation of marketing and advertising that clearly targets young people.”
Redford said communities also have the option of an outright ban on the sale of e-cigarettes — which she argues would have legal grounds — but they run the risk of prompting a costly legal challenge from the manufacturers.
“There’s not many communities that are able to take on such a challenge, but we would support them if they did,” Redford said. “By restricting it, we’re not doing anything that isn’t required for cigarette smoking, which is to go outside.”
Studies show that e-cigarette usage is increasing among teens as quickly as with adults, Redford said, which has health officials “very concerned.”
Ten percent of high school students say they tried e-cigarettes last year, up from 4.7 percent in 2011, according to a National Youth Tobacco Survey released last month by the US Centers for Disease Control and Prevention. Usage also doubled among middle school students, the study found, while similar spikes in teen use were found in a previous study by the Florida Youth Tobacco Survey.
“The increased use of e-cigarettes by teens is deeply troubling,” CDC director Thomas Frieden said in a statement. “Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.”
In Massachusetts, more than 9,000 people die every year from smoking-related diseases and annual health care costs associated with treating tobacco-related illnesses in the state have risen to an estimated $3.9 billion, the CDC says.
Under Marblehead’s proposed regulations, which will be discussed at a public hearing Tuesday, businesses would be required to place advertising alongside e-cigarette displays directing customers to visit the state’s Make Smoking History antismoking website for information on nicotine addiction. Businesses that violate the rules face fines ranging from $100 to $350 for repeat offenses.
Sean Johnson, a clerk at the “Smoke to Live” kiosk at the Northshore Mall in Peabody, said he thinks concerns about e-cigarettes are being overblown. He started using e-cigarettes nearly three years ago and said they helped him kick a two-pack-per-day habit.
“Honestly, they changed my life,” the 24-year-old said. “I don’t have any of the health problems I used to with cigarettes, the shortness of breath, coughing.”
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