Business is booming for James Yeager.
He and longtime friend Merek LeGrand opened Aqueous Vapor last summer in Columbia, selling electronic cigarettes and accessories. Less than a year later, they have seven retail stores in Missouri and Kansas and expect to have 20 by year’s end.
But Yeager is more than just an e-cigarette peddler. He’s an evangelist.
After two decades of smoking, he said, the battery-powered devices were the only things that helped him kick his pack-a-day habit.
“I feel better. My cough went away. My clothes don’t stink,” he said. “I became a passionate advocate for e-cigarettes because they helped me.”
Enthusiasts see e-cigarettes as a powerful new technology that could break many smokers from the deadly grip of tobacco. But they face a growing movement to regulate the devices driven by fear that they could just be another path to nicotine addiction.
“We still don’t know that these are safe,” said Stacy Reliford, Missouri government relations director of the American Cancer Society Cancer Action Network. “That’s our greatest concern.”
The rapidly expanding market for e-cigarettes, expected to reach $2 billion this year, has begun to raise concerns about the largely unregulated industry and its potential impact on public health.
Missouri lawmakers entered the fray earlier this year, passing legislation that would prohibit people younger than 18 from purchasing electronic cigarettes. The bill is in the hands of Gov. Jay Nixon, who has not spoken publicly about whether he intends to sign it.
Now health advocacy groups — including the American Cancer Society, American Heart Association, American Lung Association and Tobacco Free Missouri — are urging the governor to veto the proposal. They argue that because the bill classifies e-cigarettes as alternative nicotine and vapor products and doesn’t include them in the state’s definition of tobacco products, the e-cigarette industry will be more difficult to control in the future.
“Our bottom-line concern is that it defines e-cigarettes as something other than a tobacco product,” Reliford said. “The nicotine in an e-cigarette is derived from tobacco.”
E-cigarettes are battery-powered devices that usually resemble traditional cigarettes. They heat a liquid solution, creating vapor that users inhale to get nicotine. Part of their allure is that they give the user the sensation of inhaling smoke without actually producing the smoke of regular cigarettes.
Research studies on the personal and public health effects of the vapor have been inconclusive. That has set off a debate between those who see e-cigarettes as a less-dangerous alternative to smoking, especially for those looking to quit, and those who fear there are still unknown health risks.
The U.S. Food and Drug Administration recently proposed guidelines for regulating e-cigarettes that included a ban on the sale of e-cigarettes to minors and a requirement that e-cigarette companies list ingredients and nicotine strength. But because of the long rule-making process, any federal regulations could still be years away.
Additionally, the agency didn’t immediately place marketing restrictions or a ban on fruit or candy flavors, which are barred for use in regular cigarettes, on e-cigarette makers.
At least 38 states, including Kansas in 2012, have beat the FDA to the punch by prohibiting sales of electronic cigarettes to minors, according to the National Conference of State Legislatures. About a dozen states have enacted some form of ban in public places such as schools and government buildings.
If Nixon signs the pending legislation, Missouri would join those states implementing an age restriction.
“The ramification of a veto is that minors will continue to have access to e-cigarettes,” said state Rep. Caleb Rowden, a Columbia Republican who sponsored the legislation. “That’s the consequence, and that’s the only consequence.”
About 3 percent of U.S. teenagers said they’d used an e-cigarette in the past month, according to a survey done in 2012 and released by the Centers for Disease Control and Prevention. The study also found that middle school students’ use of e-cigarettes had doubled from 2011 to 2012 and that more than 1.78 million U.S. middle and high school students had tried e-cigarettes in 2012.
Of those teenagers who tried e-cigarettes, about 75 percent also smoked a traditional cigarette, raising concerns that e-cigarettes could be an entry point to use of conventional tobacco products.
Yeager points out that his business, like most in Missouri, already refuses to sell its products to anyone under 18. It also doesn’t carry certain flavors that are added to the nicotine solution that could be construed as trying to target minors.
Yet on his company’s website, some of the flavors advertised include vanilla custard, lemon key lime and blueberry cream.
If evidence emerges that e-cigarettes are truly harmful, Rowden said, legislators can always revisit the issue down the road. For now, he said, the focus should be keeping them out of the hands of children.
“The assumption that we can’t change laws in the future is asinine,” he said. “This bill is a compromise. It’s the middle ground. It’s a first step.”
Reliford, however, said health advocacy groups have been down this road before.
“In 1993, Missouri passed a smoke-free air law under the premise that this was a starting point,” she said. “We have never updated that law.”
She said creating a new classification for e-cigarettes, instead of just including them in the state’s definition of tobacco products, opens up the possibility of companies trying to claim they are exempt from any future FDA regulations that come along.
“They’ll be able to tell a court that in these states e-cigarettes are not considered tobacco products, so they shouldn’t be governed in the same way as tobacco products,” she said.
The best way to prevent youth access, she said, is to “raise the price, limit where it can be used and fund programs to prevent them from ever starting.”
The debate over the health risks of e-cigarettes is a “déjà vu situation,” Reliford said. “It’s very similar to the debate over traditional cigarettes decades ago.”
At a recent hearing before a U.S. Senate committee, lawmakers accused e-cigarette manufacturers of following the playbook of tobacco companies by trying to hook young people early to addictive nicotine.
“I think we have seen this movie before,” U.S. Sen. Richard Blumenthal, a Connecticut Democrat, said during the hearing. “It is called big nicotine comes to children near you, and you are using the same kinds of tactics and promotions and ads that were used by big tobacco and proved so effective.”
As the popularity of e-cigarettes has grown, those big tobacco companies have started to get into the game. A subsidiary of Reynolds American, known for Camel cigarettes, was scheduled to start distributing an e-cigarette by the end of this month. A subsidiary of Altria, which produces Marlboro, plans to follow suit later this year.
Lorillard, which sells Newport cigarettes, already owns the nation’s dominant e-cigarette brand, Blu eCigs.
Using an e-cigarette is far less dangerous than using a traditional cigarette, Yeager said. That’s why so many people have turned to e-cigarettes to finally kick the habit.
“If someone isn’t addicted to nicotine, there’s no reason to try e-cigarettes,” he said. “But if you are addicted to nicotine, this is a product that can change your life.”
The legislation passed in both the House and Senate with more than enough votes to override a veto. The governor’s office declined to comment, saying the bill is still being reviewed.