(Repeats with no changes to text)
By Jilian Mincer
NEW YORK Jan 29 When Marty Weinstein decided to
quit smoking, he took a friend's advice and tried electronic
cigarettes rather than government-approved nicotine replacement
Weinstein, 58, has gone from a pack a day nine months ago to
the equivalent in nicotine of four or five cigarettes. The
e-cigs have a familiar look and feel, and quench his desire to
hold on to a cigarette and puff.
"I fully understand I'm still addicted to nicotine," said
Weinstein, a Connecticut taxi driver who had smoked for more
than 20 years. "But I'm now so much healthier."
E-cigarettes, metal tubes that heat liquids typically laced
with nicotine and deliver vapor when sucked, are transforming
the market for smoking cessation products and slowing the $2.4
billion in global sales of long-standing aids such as nicotine
patches and gums. But their impact on health remains unclear,
experts say, raising difficult questions for regulators who are
starting to impose limits on e-cigarette use.
E-cigarette makers in the United States are barred from
explicitly marketing the products as smoking cessation devices,
but have found ways to appeal legally to smokers who are
thinking of quitting.
"You never say 'quit' because it's not approved by the FDA
as a smoking cessation device," said Jose Castro, the chief
executive of A1 Vapors in Miami, referring to the U.S. Food and
A1 Vapors runs an ad on its website urging customers to
"kiss tobacco goodbye" and give themselves the "gift of your
life. literally", adding a disclaimer that e-cigs are not a
smoking cessation product.
E-cigarettes, or e-cigs, have only come into widespread use
in the past few years, but have already made inroads into
traditional quitting therapies.
About a third of British smokers trying to quit were using
e-cigarettes, according to a University College London survey in
January of 1,800 people, including 450 smokers.
E-cigs are used by almost twice as many people as
government-approved nicotine gums, lozenges and patches,
according to the survey. That was a reversal from 2011, when
only about 5 percent of people were using e-cigarettes and more
than 30 percent used over-the-counter products.
Similar data is not yet publicly available for the United
Worldwide sales of all nicotine replacement therapies grew
just 1.2 percent last year, to almost $2.4 billion, according to
data from commercial researcher Euromonitor. U.S. sales, at $900
million, grew 0.2 percent, and are expected by Euromonitor to
drop this year by that amount.
Big tobacco companies like Altria, Lorillard
and Reynolds American have rushed into the e-cig market.
The entire U.S. market for "vapor devices" such as e-cigs grew
in 2014 by 40-50 percent to $2.5 billion to $3 billion,
Euromonitor said. The global market is worth $5 billion.
RULES ON E-CIGS TIGHTENING
Mark Strobel, a consumer health analyst at Euromonitor, said
e-cigarettes have slowed nicotine replacement therapy sales,
along with relatively high prices and a shrinking population of
smokers, especially in the United States.
"For some consumers it has been a direct substitution."
GlaxoSmithKline (GSK) and Johnson & Johnson
don't break out the data on their smoking cessation products,
which are relatively small parts of their sales, but the
companies have noted the change.
"It's definitely taken a bit of our market, no question at
all - but there's a lot of competition in that space," GSK chief
executive Andrew Witty told Reuters in an interview this month.
GSK's nicotine replacement therapies and smoking cessation
products include the brands Nicorette, NicoDermCQ and the
There is little long-term safety data on e-cigarettes,
although some healthcare professionals say they may be better
for consumers than tobacco cigarettes because they have no
carbon monoxide and fewer cancer-causing chemicals.
A growing number of states, cities and countries - including
Israel and Australia - are considering or have approved
legislation to ban or limit the devices or the liquids, which
come in exotic flavors from bacon to bubble gum.
California's top public health official on Wednesday slammed
e-cigs as addictive, saying they were leading to nicotine
poisoning among children and threatened to unravel the state's
decades-long effort to reduce tobacco use.
Earlier this week, California introduced a bill that would
ban the devices in public places, and New York Gov. Andrew Cuomo
proposed a similar ban earlier this month.
Last year, the World Health Organization recommended that
smokers should be encouraged to try already approved treatments
rather than e-cigarettes. The FDA last April proposed rules for
electronic cigarettes that would, among other things, ban sales
to those under 18, but not restrict flavored products, online
sales or advertising.
MAKING SMOKING COOL AGAIN?
Many health experts worry that e-cigarettes will become
established as smoking cessation aids before enough research is
done to determine their health impact. Another concern is that
they may stop people from quitting tobacco completely and deter
people from trying potentially more effective methods.
Dr. Albert Rizzo, senior medical advisor for the American
Lung Association, said that when patients ask about the
products, he tells them it's good that they are trying to quit
but: "We don't know enough to recommend them."
Some healthcare professionals said that even if they are not
opposed to e-cigarettes, they are concerned about their
marketing, especially to young people.
The Federal Trade Commission declined to comment on specific
e-cig ads but said "advertising must be truthful, non-deceptive
and supported by competent and reliable scientific evidence."
E-cigs risk bringing the "cool" back to smoking, reversing
the progress over decades in which smoking has become less
socially acceptable, said Dr. Robert K. Jackler, a professor at
Stanford University School of Medicine.
"A lot of us are very concerned about the renormalization
phenomenon," he said. "These glamorize smoking behavior."
Still, some doctors point to the low efficacy of traditional
ways to quit smoking.
"They have better results than placebos, but their rates of
success are quite low," said Dr. Michael Siegel, a professor at
the Boston University School of Public Health, who said
e-cigarettes are an alternative, especially for people who have
tried the conventional therapies and failed.
(Additional reporting by Kate C. Kelland and Ben Hirschler in
London; editing by Peter Henderson and Stuart Grudgings)