E-cigs get latitude on ads - which troubles some

The commercial shows a leggy, high-heeled blonde blowing Flavor Vapes e-cigarette vapor into a baby carriage as the words SAVE HUMANITY materialize in the mist. The punch line appears in her next exhalation: START VAPING.

It's an audacious sales pitch. It's also a dig at cigarettes, for which advertising has been steadily crushed, if not snuffed, in this country to further the public-health goal of reducing tobacco-related disease and death.

Over the last 60 years, cigarette companies have been forced to stop making health claims and add health warnings. Stop radio and TV commercials, celebrity endorsements, event sponsorships, movie product placements. Stop using billboards, cute cartoon mascots, and reassuring words like light and mild.

These rules don't apply - at least, not yet - to electronic cigarettes, the battery-powered gizmos that convert liquid nicotine into a vapor inhaled by the "vaper."

Whether e-cigs are a public health bane, boon, or some of both is an evolving debate, with federal regulators proposing restrictions that could take years to put into effect.

Meanwhile, e-cigs are being marketed using all of the old forbidden tactics, plus Internet-age innovations ranging from blogs and tweets to YouTube and Vimeo videos.

"Not only have e-cigarettes recapitulated virtually every advertising method used by conventional cigarettes, they've invented some new ones," said Robert Jackler, an expert on tobacco advertising at the Stanford University School of Medicine. "And they do stuff that cigarettes never dared, like naming a product 'Lung Buddy.' "

Ray Story, head of the Tobacco Vapor Electronic Cigarettes Association, countered, "The ban on cigarette ads came because they were not honest about the long-term effects of tobacco use. E-cigarettes have no history of harm. The advertising is not the problem. We're losing four million people annually, directly related to tobacco smoking. That's why vaping would change humanity. That's why we feel we can support ads like" the Flavor Vapes commercial.

In 2007 - about the time e-cigs arrived in the United States from China, where the devices were invented - Jackler, a head and neck surgeon at Stanford, and his wife, Laurie, an artist, founded the Stanford Research into the Impact of Tobacco Advertising. It has amassed a searchable online archive of 26,000 ads, including 8,000 for e-cigarettes (see http://tobacco.stanford.edu).

Drawing on that archive, Jackler and Stanford developmental psychologist Bonnie Halpern-Felsher led a discussion of e-cig advertising at a nicotine and tobacco research conference last month in Philadelphia.

One particularly pithy pitch, a Regal e-cig ad seen on TV and in magazines, got lots of reaction. Set in a restaurant, it portrayed a father - e-cig in one hand and a beer in the other - toasting his son's sippy cup. The tagline: "Find Out How James Can Smoke Anywhere."

The ad, viewers at the session agreed, distilled crucial e-cig inducements: safer than tobacco-burning cigarettes, no second-hand smoke, no guilt, no shame, no banishment.

They also agreed it was misleading.

Bans on public vaping have been passed in at least 26 states (New Jersey's is especially comprehensive; Pennsylvania has not acted) and many municipalities, including Philadelphia.

E-cigs are so new the safety of long-term use is unclear.

However, even detractors concede e-cigs are likely safer than conventional cigarettes because they don't have many of the toxic chemicals, such as carbon monoxide and tar, that are in tobacco smoke. Still, critics worry that e-cigs might lead people who have never smoked - particularly children - to move on to the tobacco-burning kind.

Proponents say e-cigs, now a $2 billion market, can help smokers cut down or quit. The evidence so far is conflicting, and e-cigarettes are not approved for smoking cessation.

You wouldn't know that from the marketing. Brand names include Pure, Nicocure, and Quitters. Ads proclaim "Stop smoking today," "Don't quit cold turkey." Some feature supposed doctors or scientists endorsing an e-cig brand - reminiscent of ads from the first half of the 20th century showing trustworthy physicians hawking cigarettes and cigars. (L&M was "Just what the doctor ordered.")

More worrisome to public-health experts, e-cigs are increasingly popular with youths. The U.S. Centers for Disease Control and Prevention reported that 10 percent of teens used e-cigs in 2012, more than double the rate just a year earlier.

E-cigarette industry groups support banning sales to minors, and many jurisdictions, including New Jersey and Philadelphia, already have done so.

But that has not stopped sales to youths.

Indeed, 94 percent of minors in a supervised study were able to buy e-cigs online, easily bypassing age-verification features on vendors' websites, researchers reported last week in JAMA Pediatrics.

E-cigs appeal to youngsters on many levels, and psychologist Halpern-Felsher believes the marketing exploits that.

An ad for the top-selling Blu brand, for example, has an elderly woman making an obscene gesture with her finger under the caption "Dear Smoking Ban." Another brand, Freedom Smokeless, refers to itself as "the socially acceptable smoking alternative."

Said Halpern-Felsher: "Take back your freedom. It's OK to rebel. It's your decision, your right. This is a perfect message to adolescents."

Cigarette ads were always big on images of unpolluted, outdoorsy lifestyles - beaches, mountain streams, Marlboro men on horses. E-cigs add a 21st-century twist with brands like Green Smoke, Eco-Cigs, Green Nicotine, Green Vapors, Enviro, and White Cloud.

"To celebrate Earth Day, the White Cloud crew made planters from glass bottles!" says a Facebook post by young-looking people holding colorful creations.

Many e-cigs have adjustable nicotine strengths. But no matter the level, the chemical is still addictive. And even e-cigs with no-nicotine options offer something that critics say is intended to hook kids: flavorings.

In tobacco products, flavors other than menthol are prohibited because of their appeal to youngsters. Vapers, in contrast, can buy liquid that tastes like Gummi Bears, Snickers, bubble gum, cotton candy, banana splits, butterscotch, kiddie cereals, root beer, pepperoni, and much more.

"These flavors," Stanford's Jackler said, "are not aimed at the adult palate."

E-cig companies contend that's not true.

Sweet flavors "are not made to appeal to children or underage people at all," asserts an Eversmoke e-cig Web page. "You'd be surprised how many elderly people . . . love the different flavors they have at their choosing."

The Stanford ad archive shows other ways the e-cig industry is wooing vapers, often through the Internet, including event sponsorship, free samples, Super Bowl commercials, online games, cartoons, consumer testimonials, and vaping videos of everything from a postcoital puff to TV stars shilling for e-cigs in the Emmy Awards gift lounge.

As someone who researches adolescent thinking and perceptions, Halpern-Felsher worries that decades of tobacco control efforts are being undone by e-cigs.

"My big fear," she said, "is that it's changing the social norms and getting young people who would never have smoked cigarettes to become addicted and turn into the next generation of smokers."

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