WASHINGTON -- The first look at a major study of how Americans smoke suggests many use combinations of products, and often use electronic cigarettes are part of the mix, reported the Associated Press. The U.S. Food & Drug Administration (FDA) funded the five-year Population Assessment of Tobacco & Health (PATH) study of about 46,000 people, begun in 2011, administered by the National Institutes of Health (NIH).
PATH is expected to provide a wealth of data about smoking behavior that could shape regulations ranging from warning labels and advertising restrictions to new-product approvals.
"Are e-cigarettes a step toward a cigarette smoker getting off of cigarettes? Or are e-cigarettes a crutch so they can get nicotine in places and times when they wouldn't normally be allowed to smoke cigarettes?" asked Dr. Andrew Hyland of the Roswell Park Cancer Institute, the primary investigator for the government study of trends in smoking and tobacco use.
At a meeting of nicotine researchers on February 26, Hyland presented preliminary findings from the first 20,000 people to enroll in the study, a baseline to track how use of tobacco products, or alternatives like tobacco-free e-cigarettes, is evolving.
Twenty-eight percent of adults and nearly 9% of youths reported that they currently use any type of tobacco product, Hyland said.
About 40% of those current tobacco users report using two or more products. And half say battery-powered e-cigarettes are one of the multiple products they use, Hyland found. The most common combination was cigarettes and e-cigarettes.
Policymakers are debating the health effects of vaping as it grows in popularity. Many anti-smoking advocates consider e-cigarettes a safer alternative for smokers who can't or don't want to quit altogether.
But some experts say the PATH study may not be able to capture crucial details about the use of electronic cigarettes, vapor tanks and other devices as tastes and technology are evolving so rapidly.
"While all this data that is being accumulated through the PATH study is great, it is unclear to me how much is going to be useful for setting the policy and regulations of the future," Scott Ballin, a health policy consultant based in Washington, D.C., told Reuters.
No one knows if experimenting with e-cigarettes poses as much risk of hooking someone as experimenting with regular cigarettes, Dr. Wilson Compton, deputy director of NIH's National Institute on Drug Abuse (NIDA), told AP.
Nicotine levels vary widely by type of e-cigarette, from small amounts to nearly as much as a traditional cigarette, he said. Users learn to puff a bit differently as they draw in vapor, and even the voltage in the device's wires may affect nicotine delivery, he said. NIDA plans to fund development of what Compton calls a "standard e-cigarette" that will be a yardstick for comparison with the different e-cigarettes on the market.
It is unclear whether the study will provide enough detail about e-cigarette use to answer public health questions about whether flavors in e-cigarettes attract youngsters to the products. "When you get to e-cigarettes it's really complicated," said Kurt Ribisl, a professor at the University of North Carolina Gillings School of Global Public Health, who also sits on the FDA's Tobacco Products Scientific Advisory Committee (TPSAC). "It’s a vexing and complex issue."
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