The Tennessee Department of Health is issuing a public health advisory on electronic cigarettes and other electronic nicotine delivery systems. The advisory urges caution for consumers using or considering the use of electronic nicotine delivery systems, including electronic cigarettes and other electronic emissions-producing products. It also addresses concerns about secondhand exposures.
The advisory contains the following information users and potential users should consider:
- There is inadequate scientific information about the effects of using current electronic nicotine delivery systems to assure the public about the impact to safety and health. Coupled with the absence of state or federal regulation of manufacture, this information should prompt consumers to be cautious about using the devices as well as exposure to secondhand emissions.
- Nicotine is a highly addictive chemical which can be toxic. It can affect the nervous and circulatory systems in both people and pets. Studies show most people who smoke want to quit, but are unable to end their nicotine addiction.
- The manufacturing of electronic nicotine delivery systems is currently not regulated by any state or federal agency. Consequently, consumers are cautioned they may be exposed to varying levels of nicotine or other chemicals and contaminants in these products.
- Emissions from electronic nicotine delivery products are not only water vapor. They can contain nicotine and other chemicals such as formaldehyde, propylene glycol, acetaldehyde, acrolein and tobacco-specific nitrosamines.
- Electronic cigarettes and similar electronic nicotine delivery devices have not been adequately tested as tobacco cessation devices. Until Food and Drug Administration approval is given, TDH recommends FDA-approved nicotine replacement therapy products, which contain controlled doses of nicotine, for those wanting to use them for tobacco cessation efforts.
- Parents should not allow children to play with electronic cigarettes or similar devices. They contain batteries and liquid chemicals which, if swallowed, could cause serious health complications.
- Parents should be aware electronic cigarettes and similar electronic nicotine delivery devices are available in a variety of flavors that may be attractive to children, such as bubble gum, strawberry, chocolate, mint and others. TDH reminds parents and retailers that it is illegal to sell or distribute any electronic cigarette to another person who has not yet attained 18 years of age or to purchase an electronic cigarette on behalf of such person less than 18 years of age. (TCA 39-17-1504)
- Best current evidence is that most adolescents who use electronic cigarettes also smoke traditional cigarettes. Because many adults are also dual users (conventional and electronic cigarettes) there are significant unknowns about the cumulative health impact on individuals of any age using multiple nicotine delivery products.
- Pregnant women should avoid using these devices and children should not be exposed to them. The nicotine can impact fetal development, affecting the brain, nerves and circulatory systems. Pregnant women should know exposure to nicotine, in conventional or electronic cigarettes, may:
- cause a miscarriage.
- cause low birth weight, creating significant health challenges for their babies.
- affect the unborn baby’s blood flow, heart rate and breathing.
- contribute to sudden infant death syndrome.
More research is needed on the overall impact of e-cigarettes and similar electronic nicotine delivery products on cancer, heart disease and other long-term health issues in primary users and in those exposed to secondhand emissions. Until additional research is done, the Tennessee Department of Health encourages all users of any electronic nicotine delivery system to avoid exposing others to secondhand emissions and cautions potential users to have conversations with their personal clinician about the impact to their individual health from inhaling emissions.
State of TN Health Department