American Heart Association calls for tougher restrictions on e-cigarettes

Electronic cigarettes should be subject to the same laws that apply to tobacco products, and the federal government should ban the marketing and sale of e-cigarettes to young people, a new American Heart Association policy statement says.

The group also called for thorough and continuous research on e-cigarette use, marketing and long-term health effects.

"Over the last 50 years, 20 million Americans died because of tobacco. We are fiercely committed to preventing the tobacco industry from addicting another generation of smokers," Nancy Brown, CEO of the American Heart Association (AHA), said in an association news release.

"Recent studies raise concerns that e-cigarettes may be a gateway to traditional tobacco products for the nation's youth, and could renormalize smoking in our society," Brown said. "These disturbing developments have helped convince the association that e-cigarettes need to be strongly regulated, thoroughly researched and closely monitored."

The recommendations were published Aug. 25 in the AHA journal Circulation.

"E-cigarettes have caused a major shift in the tobacco-control landscape," statement author Aruni Bhatnagar, chair of cardiovascular medicine at the University of Louisville, said in the news release.

"It's critical that we rigorously examine the long-term impact of this new technology on public health, cardiovascular disease and stroke, and pay careful attention to the effect of e-cigarettes on adolescents," he urged.

The AHA noted that a recent study found that youth exposure to e-cigarette advertising rose 250 percent from 2011 to 2013, and now reaches roughly 24 million young people.

The U.S. Food and Drug Administration needs to immediately implement promised measures to regulate the marketing and sales of e-cigarettes, the AHA said.

"In the years since the FDA first announced it would assert its authority over e-cigarettes, the market for these products has grown dramatically," Brown said. "We fear that any additional delay of these new regulations will have real, continuing public health consequences. Hence, we urge the agency to release the tobacco deeming rule by the end of this year."

The AHA also wants states to include e-cigarettes in smoke-free laws, but only if changes to include the devices won't weaken existing laws.

While some research suggests that the use of e-cigarettes to help smokers quit may be as or more effective than nicotine patches, there is no evidence to show that e-cigarettes are an effective first-line smoking cessation treatment, the statement said.

Proven methods of helping smokers quit should be tried first. But if they fail, doctors should not discourage the use of e-cigarettes by patients who want to use the devices to try to quit smoking, the AHA said.

"Nicotine is a dangerous and highly addictive chemical no matter what form it takes -- conventional cigarettes or some other tobacco product," AHA President Dr. Elliott Antman said in the news release.

"Every life that has been lost to tobacco addiction could have been prevented," Antman said. "We must protect future generations from any potential smokescreens in the tobacco product landscape that will cause us to lose precious ground in the fight to make our nation 100 percent tobacco-free."