WHAT WE KNOWE-Cigarettes:

What are e-cigarettes?• E-cigarettes are battery-operated devices that produce

an inhaled aerosol.1

• E-cigarette design varies, and sometimes resembles conventional cigarettes.

• E-cigarettes are defined as tobacco products by the FDA and Minnesota law.

Are e-cigarettes safe to use?• E-cigarettes are not regulated by the FDA. There is no way

for users to know what types or concentrations of chemicals or how much nicotine they are inhaling.2,3

• E-cigarette aerosol has lower levels of toxins than conventional cigarette smoke, but studies show it contains nicotine, heavy metals, formaldehyde and other carcinogens. 4,5,6

• Nicotine is the highly addictive chemical found in tobacco.• No amount of nicotine is safe for youth. Nicotine exposure

during adolescence is harmful to brain development.7,8

• E-cigarettes’ long-term impacts on the health of users and bystanders is unknown.

Who is using e-cigarettes?• 5.9 percent of Minnesota adults used e-cigarettes at

least once in the past 30 days.9

• 17.8 percent of Minnesota adults have tried an e-cigarette at least once.9

• Most e-cigarette users also use cigarettes. 65.8 percent of Minnesota adults who used e-cigarettes in the past 30 days are current smokers.9

• More young Minnesotans are using e-cigarettes. 28.4 percent of Minnesota high-school students have tried e-cigarettes.10

• 12.9 percent of high-school students and 12.8 of young adults (18-24-year-olds) used them in the past 30 days. 10,9

• Most students who used e-cigarettes in the past 30 days (60.1 percent) also used conventional tobacco products.10

Can e-cigarettes help people quit smoking?• There is no conclusive scientific evidence that e-cigarettes

are effective in helping people stop smoking.11

• A scientific review raised concerns that dual use of e-cigarettes and conventional cigarettes may make quitting more difficult.11

• People looking to quit should use FDA-approved smoking cessation aids proven to be safe and effective, such as nicotine gum, lozenges and patches.

• Free quitting help is available to all Minnesotans through QUITPLAN® Services (1-888-354-PLAN/www.quitplan.com).

Why should communities care about e-cigarettes?• Tobacco companies like Philip Morris and R.J. Reynolds

have e-cigarette product lines, which are not regulated like conventional cigarettes and e-liquid.

• E-cigarettes and e-liquid are sold in flavors like gummy bear, cotton candy and many others, and flavored tobacco products appeal to children and teens.12,13

• E-cigarette use by Minnesota youth and adults has significantly increased in recent years.10,9

• Youth exposure to e-cigarette advertising increased 250 percent from 2011 to 2013.14

• A scientific review found that e-cigarette emissions can be a source of indoor air pollution and concluded that they should be included in smoke-free policies.11

• Some e-cigarette ads encourage smokers to use them in places they cannot smoke.15,16

• Research shows e-cigarette poisonings have dramatically increased in Minnesota and nationwide.17,18

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How does Minnesota law treat e-cigarettes?19

• E-cigarettes containing nicotine are taxed as tobacco products and it is illegal to sell e-cigarettes to minors. Retailers must keep them behind the counter or in a locked case and obtain a tobacco license. Child-resistant packaging is required on all e-cigarette liquids, and kiosk sales are prohibited.

• E-cigarette use is still allowed in stores, bars and restaurants, but not in:• Public schools;• Hospitals, clinics and

doctors’ offices;• Most government-operated

buildings, including correctional facilities;

• Any facility owned by the U of M or MNSCU, including dorms; and

• Foster homes and licensed daycare facilities, including home daycares during hours of operation.

Many Minnesota communities have gone further.• Eighteen cities and eight counties have added e-cigarettes to

tobacco ordinances, including Minneapolis, Duluth, Mankato and Moorhead, and Hennepin, St. Louis and Olmsted counties.

• A number of cities and counties also prohibit e-cigarette sampling in stores.

• Target Field, Target Center and the Minnesota Zoo prohibit e-cigarette use.

Communities can regulate e-cigarettes

79 percent of Minnesotans support restricting e-cigarette use where

smoking is prohibited.20

Businesses can:• Prohibit the use of e-cigarettes on their property.

Cities and counties can:• Adopt or update policies to prohibit e-cigarette use.• Restrict sales of flavored e-cigarettes.• Prohibit e-cigarette sampling in stores.

Minnesota can:• Update state law to prohibit e-cigarette use

in all workplaces.• Restrict sales of flavored e-cigarettes.• Prohibit e-cigarette sampling in stores.• Require manufacturers to disclose e-cigarette

ingredients.

1 U.S. Food and Drug Administration. What are e-cigarettes? http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm.

2 U.S. Food and Drug Administration. Memo re evaluation of e-cigarettes. http://www.fda.gov/downloads/drugs/scienceresearch/ucm173250.pdf.

3 Goniewicz ML, et al. Nicotine levels in electronic cigarette refill solutions: A comparative analysis of products from the US, Korea and Poland. Int J Drug Policy. 2015.

4 Goniewicz ML, et al. Levels of selected carcinogens and toxicants in vapor from electronic cigarettes. Tob Control. 2013.

5 Williams M, et al. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLOS ONE. 2013.

6 Callahan-Lyon P. Electronic cigarettes: Human health effects. Tob Control. 2014.

7 Goriounova N, Mansvelder H. Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. Cold Spring Harb Perspect Med. 2012.

8 Benowitz N. Nicotine: Addiction, effects on the adolescent brain and electronic cigarettes. http://www.iom.edu/~/media/79C64AF3B65448ECBECE08FDFDDFC83E.ashx.

9 ClearWay MinnesotaSM and Minnesota Department of Health. Tobacco Use in Minnesota: 2014 Update. 2015.

10 Minnesota Department of Health. Teens and Tobacco in Minnesota, 2014 Update. 2014.

11 Grana R, et al. E-cigarettes: A scientific review. Circulation. 2014.

12 U.S. Surgeon General. Preventing Tobacco Use Among Youth and Young Adults. 2012.

13 King BA, et al. Intentions to smoke cigarettes among never-smoking U.S. middle and high-school electronic cigarette users, National Youth Tobacco Survey, 2011-2013. Nicotine Tob Res. 2014.

14 Duke J, et al. Exposure to electronic cigarette television advertisements among youth and young adults. Pediatrics. 2014.

15 Stanford School of Medicine. Stanford research into the impact of tobacco advertising. http://tobacco.stanford.edu/tobacco_main/images_ecigs.php?token2=fm_ecigs_st380.php&token1=fm_ecigs_img17000.php&theme_file=fm_ecigs_mt025.php&theme_name=Freedom&subtheme_name=Break%20the%20Rules.

16 FIN Electronic Cigarettes. Experience. http://www.fincigs.com/blog/e-cigarette-experience/.

17 Minnesota Department of Health. Toxic Exposures for E-Cigarettes and Tobacco Products. 2014.

18 U.S. Centers for Disease Control and Prevention. Notes from the field: Calls to poison centers for exposures to electronic cigarettes. MMWR. 2014.

19 Minnesota Department of Health. Electronic cigarettes and the Minnesota Clean Indoor Air Act. http://www.health.state.mn.us/divs/eh/indoorair/mciaa/ftb/docs/ecig.pdf.

20 Blue Cross and Blue Shield of Minnesota. Minnesota Public Opinion Survey by the Morris Leatherman Company. 2014.