E-Cigarettes - How Safe Is the Safer Alternative?
E-cigarettes were invented in China in 2003. Since appearing in the U.S. market three or four years later, sales of e-cigarettes and related supplies have reached $3.5 billion annually. They have been marketed as a safer alternative to tobacco cigarettes. Today, approximately 450 e-cigarette brands and over 7,700 e-cigarette flavors are available on the market. Roughly 8,500 vape shops are selling e-cigarettes, as are other retailers, including: convenience stores, gas stations, pharmacies and drug stores, grocers, bodegas, warehouse stores and supercenters, and liquor stores.
The popularity of vaping has soared with some 10% of American adults now using e-cigarettes, with many of them undoubtedly trying to quit tobacco smoking. According to the Washington Post, it is estimated that over 13% of high school students and nearly 5% of middle school children also use e-cigarettes.
While big tobacco companies - such as Altria Group and Reynolds American - have moved into this space, the vast majority of e-cigarettes sold in the U.S. are still made in China.
There have been several incidents where e-cigarettes have exploded, allegedly burning users. In one case a woman allegedly suffered second degree burns after a Chinese-made e-cigarette exploded. A California jury held the U.S. wholesaler and retailer liable, and awarded the victim $1.9 million in damages.
Vaping liquids may include ingredients that can be harmful. Currently, there are no testing or labeling requirements.
E-cigarettes contain nicotine, an obvious health hazard, albeit at levels lower than tobacco cigarettes. Vaping liquids can be found with no, medium or high levels of nicotine based on the manufacturer's description.
In addition to nicotine, vaping liquids also contain a variety of chemicals and food flavorings. While food flavorings may sound benign, the vast majority have never been tested to determine whether inhalation of these substances could cause harm.
Diacetyl is a case in point. Diacetyl, a chemical butter flavoring, is still used throughout the food and beverage industry and has been for over 60 years. It wasn't until 2005 that the federal government found that inhalation of diacetyl could cripple lung function - an illness called bronchiolitis obliterans. This first came to light in workers at microwave popcorn plants. Victims may need single or double lung transplants. Lawsuits filed by these workers against food flavoring makers and other defendants have resulted in several plaintiffs' verdicts to individual plaintiffs that have run between $2.6 million and $30.4 million.
Previous tests of Chinese-made e-cigarette vaping liquids have found that over 74% contained diacetyl. While the level of diacetyl is significantly lower than that found in many tobacco cigarettes, it is still twice as high as the strict NIOSH-defined safety limit for occupational exposure.
Subsequently, an investigation by the Milwaukee Journal Sentinel into the dangers of diacetyl "found that the testing standards the vaping industry depends upon typically are not sensitive enough to detect potentially dangerous levels of the chemicals." As a result, companies claim their products are free of diacetyl when sometimes they are not.
Other chemicals found in vaping liquids include:
- Aldehydes - Respiratory irritants that may cause airway constriction. California lists acetaldehyde and formaldehyde as carcinogens and reproductive toxins.
- Cadmium - Several regulatory agencies classify cadmium as a carcinogen.
- Isoprene - The CDC classifies isoprene as a respiratory irritant.
- Lead - OSHA says lead is known to cause impaired kidney function, high blood pressure, nervous system and neurobehavioral effects, cognitive dysfunction, and subtle cognitive effects attributed to prenatal exposure.
- Nickel - The Agency for Toxic Substances and Disease Registry lists inhalation of nickel as a cause of chronic bronchitis, reduced lung function, and cancer of the lung and nasal sinus.
- N-Nitrosonornicotine - The National Institute of Health lists as a possible human carcinogen.
- Toluene - OSHA says toluene affects the central nervous system, eyes, skin, respiratory system, liver and kidneys.
In October 2015 the Journal Sentinel exposed two cases of acute lung injuries that were tied to vaping, according to doctors. A 31-year-old woman was diagnosed with a rare form of pneumonia and a 60-year-old man with hypersensitivity pneumonitis.
Recently, three consumers (from NY, CA, and IN) filed a lawsuit against Five Pawns, a manufacturer that distributes vaping liquids throughout the country. The suit alleges that the company knew - and failed to warn consumers - that the vaping liquids contained diacetyl and 2,3-pentandione (a chemically similar diacetyl substitute) even though these chemicals are linked to serious lung disease. The company's attorney has stated that none of the men have claimed any injury.
Whether or not this first lawsuit succeeds or is dismissed, other cases will likely be filed. Keep in mind that with the overwhelming majority of e-cigarettes being made in China, it is unlikely that plaintiffs will be able to sue the manufacturer, leaving only the U.S. distributors and retailers in the liability chain. The number of adults and children using e-cigarettes that contain substances known to be an inhalation risk - such as diacetyl - can make quite the potential plaintiffs' pool. A latency potential seems certain. Given the high percentage of vaping liquids that contain diacetyl or its substitute - as well as the previous verdicts we've seen for injuries caused by diacetyl and the number of potential defendants - e-cigarettes could become a significant emerging issue for the P/C industry.
For more about e-cigarettes and other emerging issues, join me at the NAMIC Commercial Lines Seminar on Thursday, March 3. I am presenting in the morning and again in the afternoon. Many of my Gen Re colleagues will be at the conference to catch up with you on this and other insurance topics.