The time to regulate e-cigarettes is now

Swift regulation by the FDA will help preserve America's hard-won anti-smoking victory and help ensure that parts of the US economy do not, once again, become dependent on nicotine.

Opinion

The hard-won public health triumph over the cigarette may be under threat from a new player on the scene: the electronic cigarette, a battery-powered vaporizing device that simulates tobacco smoking, supplying nicotine and often flavor, but without tobacco.

For most of the 20th century, Big Tobacco companies argued that the hardworking tobacco farmer was the ultimate victim in any attempt to regulate their industry. It’s a familiar argument – that industry regulation just hurts the little guy.

Today e-cigarettes are largely produced in China. No US farmers or factory workers have livelihoods that depend on e-cigs. But if the e-cig industry continues unregulated, it may get a bigger foothold in the US economy, and public health may again become beholden to a small handful of heartstring-pulling stakeholders who speak on behalf of an even smaller number of corporate executives.

The political history of tobacco farming furnishes a cautionary tale. Since the surgeon general first linked cigarette smoking to lung cancer in 1964, farmers – and their representatives – have been mainstays in the opposition to tax increases, marketing restrictions, and other antismoking legislation.

At one 1969 congressional hearing on cigarette labeling, a Kentucky representative argued that farmers, the “thousands of decent, law-abiding people” should not be “sacrificed on a statistical altar erected by many who are antismoking zealots.”

Farmers also testified frequently at congressional hearings, providing a living illustration of their congressmen’s overheated rhetoric. For whatever health benefit would be rendered by more stringent warning labels, tobacco growers were made earthy ambassadors of the tangible social costs of regulation – or, in the words of the farmer who spoke that day, “the economic devastation which would come to tobacco growers if tobacco is sentenced and executed.”

It is true: Many US tobacco-growing regions have never fully recovered from the antismoking measures that have served to safeguard public health. Fortunately, no such dilemma faces those who want tighter oversight of e-cigarettes. Today, that means any oversight at all, as the devices are not currently governed by federal law, though New York City and a few other states and cities have placed e-cigs under their smoking bans.

E-cigs are much less pernicious than a tobacco cigarette and may even have a public health benefit if they can help smokers quit. But because of the regulatory vacuum, the public doesn’t know, exactly, what’s in e-cigs, neither do we know much about how people use them.

If e-cigarettes can be cessation devices, as many hope, then they should be regulated like the patch or nicotine gum. But other data raise the possibility that in fact, e-cigs could be “activation devices,” particularly for young people; or equally problematic, that they actually weaken smokers’ ability and resolve to quit smoking. If that’s the case, there should be common-sense restrictions on flavor additives or advertising.

Such regulations have obvious benefits: They would help consumers make more informed choices, reduce youth consumption, and help preserve the public’s antismoking victory.

And, for now, the economic costs are minimal. No state economy is today dependent on the production of e-cigarettes. This may not be the case forever, though. As electronic cigarettes grow in popularity, more Americans may find themselves invested in those little glowing cylinders.

Right now, electronic cigarettes don’t have much of a place in our narrative about America: Thomas Jefferson never grew an e-cigarette, the noble yeoman farmer never once hauled his harvest of e-cigs to market, and whole regions have not grown on the proceeds of their sale.

But the hardworking laborer is still a potent political cover. When New York Mayor Michael Bloomberg banned the sale of sugary drinks, it was the small business owners – minority owners of bodegas – that became the emblem of the perils of regulatory overreach. And earlier this year, when President Obama proposed a tax hike of 94 cents on cigarettes (to no avail), the tobacco farmer reappeared as a sympathetic proxy for the rest of the industry. Senator Kay Hagan, a Democrat from North Carolina, argued that the “tobacco tax would hurt farmers and the economy in North Carolina.”

Yesterday’s tobacco farmer might be tomorrow’s hardworking “e-cigarette entrepreneur.” Swift regulation by the Food and Drug Administration can help ensure that parts of the US economy do not, once again, become dependent on nicotine.

Sarah Milov is a visiting scholar at Harvard’s Center for History and Economics and will be an assistant professor of history at the University of Virginia beginning August 2014. She is writing a book on tobacco and politics.