Well, it’s official: CVS has stopped selling cigarettes and other tobacco products.
The sales ban will cost the multi-billion dollar pharmacy chain about $2 billion a year in profits. But the hope is that the move will provide a more consistent health promotion message to consumers (it has changed its corporate name to CVS Health) and lead to new business (for example, through visits to its in-store health clinics).
But will this move have any effect on smoking in the population? It’s difficult to say at this point.
The impact of the ban on overall tobacco sales nationwide will probably be negligible. Only a very small percentage of consumers buy their tobacco at pharmacies and there are plenty of retail options available beyond the local pharmacy.
CVS is also banning the sale of electronic or e-cigarettes. Advocates from this industry are predictably agitated: “It’s smoking that causes all the health problems, not the smokeless alternatives.” Others argue that e-cigarettes and other smokeless alternatives are effective aids for those wishing to quit-smoking.
Users and non-users of electronic cigarettes (e-cigarettes) have many legitimate questions about these nicotine-delivery devices. E-cigarettes represent a nearly $2-billion-a-year industry, and one that’s growing exponentially. The number of young people trying e-cigarettes doubled from 2011 to 2012, according to the Centers for Disease Control. So it is natural that so many people are interested in the health consequences of using e-cigarettes.
Research from the Department of Health Behavior at Roswell Park Cancer Institute has documented the impact of first-, second- and third-hand exposure to e-cigarette vapors. Our most recent research, done in collaboration with scientists from the Medical University of Silesia in Poland, offers insight into the user’s exposure to carcinogenic carbonyls.
The e-liquids used in e-cigarettes are primarily composed of glycerin and propylene glycol. We set out to find out what chemicals are generated during use of e-cigarettes, particularly at variable voltages. Some devices allow the user to adjust the voltage to increase vapor production and nicotine delivery.
We found that when e-cigarettes were operated at lower voltages, the vapors that were generated contained only traces of some toxic chemicals. These chemicals included the carbonyls formaldehyde, acetaldehyde, and acetone. However, when the voltage was increased, the levels of these toxicants also significantly increased.
The novel finding of our study is that the higher the voltage, the higher the levels of carbonyls. Increasing battery output voltage leads to higher temperature of the heating element inside the e-cigarette. Increasing the voltage from 3.2 to 4.8 volts resulted in increases of anywhere from 4 times to more than 200 times the exposure to formaldehyde, acetaldehyde and acetone. The levels of formaldehyde in vapors from high-voltage devices were similar to those found in tobacco smoke.
One thing that is known about electronic cigarettes: they’ve become a serious business in the United States.
Although e-cigarettes represent only a tiny percentage of the U.S. tobacco market, the industry is growing.
The number of people currently “vaping” has increased substantially over the last few years, with sales of nearly $2 billion in 2013.
Some analysts predict that this could grow to $10 billion by 2017 and eventually overtake sales of conventional cigarettes. It’s worth noting that the industry is maturing without much in the way of oversight or regulation.
We also know how e-cigarettes work—mechanically speaking. Using a battery-powered heating element, they convert liquid nicotine (sometimes flavored with food additives) into a vapor that users then inhale or “vape.”
This unique system delivers nicotine without the cancer-causing and other harmful elements associated with burning tobacco.
Unfortunately, that’s where a lot of the certainty ends. Currently, evidence for the safety, harmfulness, utility, and addictiveness of e-cigarettes is lacking.
The questions that research needs to answer, however, are clear as day—particularly since business is booming.
Are E-Cigarettes Bad for You?
Some of the food additives that flavor e-cigarette vapor may be dangerous when inhaled; the long-term health effects of inhaling the vapor are unknown. And of course, e-cigarettes still deliver nicotine, the main addictive ingredient in cigarettes and other tobacco products.
Nicotine from e-cigarettes could have detrimental effects on cardiovascular health and may impair breathing among those with already compromised lung functioning.