Long-awaited federal rules announced Thursday that will ban e-cigarette sales to minors and require safety reviews for vaping products were greeted with outrage from the industry and applause from many, but not all, health advocates.
The controversial regulations could have a particular impact in Pennsylvania, the only state besides Michigan with no age limit for e-cigarette sales.
The Keystone State "should be dramatically affected for the better by the new federal law," said Cliff Douglas, vice president for tobacco control with the American Cancer Society.
The Pennsylvania Medical Society - which has pushed to extend all tobacco safeguards, including age restrictions, to e-cigarettes - applauded the U.S. Food and Drug Administration action as a "step in the right direction to protect the health of our country's citizens."
"Vaping activists often portray e-cigarettes as less harmful than their tobacco cousins, using this as an excuse not to regulate," said society president Scott Shapiro, a physician in Montgomery County.
Those in the vaping industry - as well as some tobacco control advocates - argue that the devices are a helpful smoking-cessation tool. They say they fear the new regulations will hurt public health in the long term by keeping some smokers hooked. At the same time, they say the rules could kill most vaping businesses by requiring them to submit to FDA safety reviews that could cost $1 million per vaping product.
Thousands of small companies, many of them mom and pop shops, make and sell such products.
"This is not regulation. It is prohibition that will cost lives, kill jobs, and further entrench America's largest cigarette companies," said Gregory Conley of Medford, president of the American Vaping Association, a nonprofit advocacy group funded by the vaping industry.
Conley predicted that Americans will buy vape juice, oils, and devices from overseas if the new rules cripple the U.S. industry. "For the first time in American history, consumers will have to go to the black market to purchase a far less hazardous alternative to a completely legal product - deadly cigarettes," he said.
Brian Santangelo, owner of three Liberty Vapor stores in the Pennsylvania suburbs of Lansdale, Phoenixville, and West Chester, said he does not sell to minors, even though the state has no age restriction.
A former chain smoker, Santangelo said he tried to kick the habit with nicotine gum and $800 worth of hypnotism sessions. Four years ago, an "entry level e-cigarette" enabled him to break his cigarette addiction.
"We're fighting the fight to get people off nicotine," he said.
Bill Godshall, executive director of Smokefree Pennsylvania, a former three-pack-a-day smoker who once worked for the American Cancer Society, also says e-cigs are "harm-reducing."
"I'm not saying [e-cigs] are safe, but they're safer. They reduce risk. It's about harm reduction; you're not inhaling smoke. There is no carbon monoxide, and there is no tar. They're not going to give you cancer."
The rules issued by the FDA, which come five years after the agency first announced its regulatory intent, would also extend long-standing restrictions on traditional cigarettes to a host of other products, including hookahs, pipe tobacco, cigars, and nicotine gels. However, the rules do not address e-cigarette flavorings or marketing, which public health advocates say are especially aimed at youngsters.
E-cigarettes, invented in China and introduced to the United States in 2007, are battery-powered devices that convert liquid nicotine into a inhalable vapor. While they don't have many of the toxic chemicals that are in tobacco smoke, e-cigarettes have not been extensively studied, and there is no scientific consensus on potential benefits or harms from vaping.
Federal data show e-cigarettes have caught on among teenagers, raising concern that vaping may be a gateway to smoking. More than 15 percent of high school students reported recently using e-cigarettes, up more than 900 percent over the last five years. High school boys are also fans of small cigars, smoking them at the same rates as regular cigarettes.
"Millions of kids are being introduced to nicotine every year, a new generation hooked on a highly addictive chemical," Health and Human Services Secretary Sylvia Burell said. "We cannot let the enormous progress we've made toward a tobacco-free generation be undermined by products that impact our health and economy."
Public health groups have opposed legislation in some states to ban e-cigarette sales to minors. That is because the laws did not extend all tobacco control provisions - including smoke-free areas and taxation - to e-cigarettes.
In Michigan, for example, the American Cancer Society and other groups persuaded the governor to veto an e-cigarette age-restriction bill because it did not go far enough. In his veto letter to lawmakers, Gov. Rich Snyder wrote that creating a new class of vapor products rather than defining e-cigarettes as tobacco would "unnecessarily sow confusion" and "send a mixed health message to the public on a topic that is already complex and confusing."
In Pennsylvania, a bill that would add "nicotine-delivery products" to the law that bans tobacco sales to minors passed the House; a Senate version is in the judiciary committee.
Philadelphia, in contrast, has prohibited the sales of e-cigarettes to minors, and banned vaping in workplaces, restaurants, and other public spaces since 2014. New Jersey restricts e-cigarette sales to those 19 and older.
"The situation in Pennsylvania is similar to Michigan," said Douglas at the American Cancer Society. "The tobacco industry lobby is good at creating legislation that in part will do something the public health community is looking for, but includes poisonous provisions. . . . E-cigarettes are enormously complicated."
Staff writer Sam Wood contributed to this article, which also contains information from the Associated Press.