The American Heart Association released its first policy on e-cigarettes Aug. 24, stating that e-cigarettes threaten to “addict the next generation of smokers.” The AHA said it based its position on the limited scientific research available.

The AHA recently called for further studies and regulation of e-cigarettes, an issue that many e-cigarette companies have faced as organizations like the World Health Organization pressure the Food and Drug Administration to impose regulations. The AHA is the latest major organization to join that list. 

The FDA does not currently regulate e-cigarettes, and scientific research has struggled to keep up with the growth of the e-cigarette industry. Since the first models of e-cigarettes were sold in 2003, the market for them has increased at a rapid pace. According to the AHA, there are currently 465 brands and 7,760 flavors of e-cigarettes available both online and in stores. The AHA’s policy statement projects that by 2017, e-cigarettes are expected to earn nearly $10 billion and could potentially surpass sales for conventional cigarettes. E-cigarette sales currently total about $2 billion, according to the AHA.

Julie Woessner, president of the Consumer Advocates for Smoke-Free Alternatives Association, said that regulation of e-cigarettes could severely damage the market and those financial projections.

“The paperwork alone [for regulation] is going to knock out the vast majority of the products on the market,” Woessner said. “As consumers, we believe diversity in the marketplace is critical.”

E-cigarettes that contain nicotine are considered tobacco products, and the AHA wants to see them regulated so consumers have a better understanding of what is in them. Furthermore, if regulated, e-cigarettes would be limited in the same ways as other tobacco products are in terms of online sales and advertising. E-cigarettes are currently allowed to advertise on television, the radio, print media and online. Conventional cigarettes have not been allowed to produce broadcast ads since 1971. 

Cynthia Hallett, executive director of Americans for Nonsmokers’ Rights, said the regulation battle for e-cigarettes is very similar to the battle conventional cigarettes once faced.

“It’s a serious case of deja- vu,” Hallett said. “In terms of public outcry and outrage, it’s almost the same.”

Perhaps the biggest concern the AHA’s policy statement cites is that e-cigarettes are marketed toward young people. The liquid nicotine used by many e-cigarette companies comes in appealing flavors such as bubble gum and chocolate. Many of the companies also use very colorful packaging. However, Woessner said there is simply no truth to the notion that those flavors are used to entice young people. 

“They are making it up,” Woessner said. “I am 51 years old—you can write that down—and as we speak, I am vaping bubble gum e-liquid. Adults do like flavors.”

The AHA’s policy statement refers to a survey conducted on students grades 6–12 that found that 1.78 million high school and middle school students in the U.S. had tried e-cigarettes by 2012 and 76.3 percent of e-cigarette users said they also smoked conventional cigarettes. Woessner said that the survey results do not have much truth behind them.

“[Those] numbers are meaningless,” Woessner said. “E-cigarettes are not a gateway for cigarette use. There is no credible evidence to support that.”

In April, the FDA proposed banning the sale of e-cigarettes to anyone under the age of 18, subjecting the industry to regulation for the first time. While Woessner may be opposed to this degree of e-cigarette regulation, she said she is in favor of banning the use of e-cigarettes for underage smokers and cannot understand why it has not happened already.

“Ban the sale [of e-cigarettes] to minors and impose draconian punishments for people who sell to minors,” Woessner said.

Julia Kersey, communications director for the AHA’s Chicago division, said the regulation process has already begun.

“Regulation has already happened to some degree at the state and local level,” Kersey said. “As states and localities attempt to address youth marketing, access, taxation and smoke-free air laws, the FDA determines how it will regulate these products.” 

However, the e-cigarette companies are fighting regulation to maintain the freedom to market and sell their products as they see fit, according to Kersey.

“We have seen tremendous push-back from the [e-cigarette] industry at a federal level,” Kersey said. “The industry wants more leeway to manufacture, innovate and market its products without significant regulation and oversight.”