E-cigarettes Are Being Marketed as “Vitamin Delivery” Devices

Scientists continue to debate the relative risks and benefits of e-cigarettes relative to combustible tobacco.¹ However, several e-cigarette companies are advertising their products as “vitamin delivery devices” and “weight management aids” for appetite reduction. During our ongoing research on tobacco-related marketing, we have observed several e-cigarette companies making unsubstantiated claims that their products provide health benefits including an improved immune system, better sleep, and increased energy.

Table 1 contains a list of some of some of the claims being made by brands such as VitaCig, VitaminVape, Vapor4life, VitaStik, and NutroVape. For example, VitaCig, on its company’s Web site, claims that its products contain herbal supplements associated with appetite suppression, including hoodia and konjac root; however, there is no scientific evidence to conclude that inhaling these supplements is safe or that it results in appetite suppression. Vapes intermixes ads for “fruity e-juices” containing up to 24 milligrams of nicotine with ads for e-cigarette kits with vitamins, which could lead people to associate vaping with keeping a healthy lifestyle.

TABLE 1—

Claims Made by E-cigarette Marketers on English Language Web Sites Between June and October 2018

Company Name (Web site)	Ingredient Profile	Product(s) Advertised	Product Claim(s)
VitaCig (https://vitaciggroup.com)	Nicotine-free	Vitamin and essential oil inhalation, aromatherapy devices	“Contain several key vitamins”; ingredients include “Vitamin A, Vitamin B12, Vitamin C, Vitamin E, Coenzyme Q10, and Menthol”; “may be absorbed via the mucous membrane of the oral cavity.”
Vapes (https://www.vapes.com)	Both nicotine and nonnicotine products	Peach berry e-liquid	“Boost your mood with Vitamin B12 infused into fresh picked Red Top peaches muddled with ever-bearing strawberries. This Vita Vape e-liquid has been reinvented and repurposed to deliver a dose of vitamin B12 instead of nicotine.”
		E-cigarette kits	“The Fit Kit by SMOK is the new black. In the sport of vaping, there is no off-season. Utilize this vape in your daily routine to stay Fit!”
Davinci (https://www.davincivaporizer.com)	Nicotine-free, cannabis	Vaporizers	“The aromatherapy herbs we offer are known to have benefits that help treat certain ailments—also they are really good for you. Did you know that Chamomile helps boost the immune system? Or that Wild Lettuce relieves headache?”
VitaStik (https://www.vitastik.com)	Nicotine-free	Vita Stick Wellness Tonic Ginger Honey Lemon Vitamin Inhaler	“Inhale Healing Edible Organic Waters.”
		VitaStik Beauty, Youth Edition, Minty Watermelon Collagen Inhaler	“No Chemicals, No Calories, No Sugars, Vegan, Gluten Free, and Kosher.”
NutroVape (https://nutrovape.com)	Nicotine-free, some products include caffeine	NutroVape Sleep,	“A blend of melatonin, l-theanine, natural passionflower, and natural chamomile that helps you sleep like a freaking baby through the whole night—with no morning hangover. Take three to five inhalations before bedtime and don’t operate heavy machinery after using NutroVape Sleep.”
		NutroVape Diet	“Our natural blend of Hoodia Gordonii, Garcinia Cambogia, Green Tea Extract, and L-Theanine suppresses your appetite and reduces cravings for sugars and carbs. Just take 5 inhalations with a glass of water 15 minutes before a meal and don’t exceed 20 inhalations in a single hour.”
VitaminVape (https://vitaminvape.co)	Nicotine-free	Nutritional supplement inhaler	“Going to get B12 shots can cost hundreds of dollars, not to mention the pain and inconvenience. Each vaporizer contains 14 times the amount of B12 you'd find in a shot.”
Vapor4life (https://www.vapor4life.com)	Nicotine	Orange juice e-cigarette cartridges	“This citrus vape flavor will fill your mouth with the zest of freshly squeezed OJ.”
VapeFully (https://vapefully.com)	Nicotine-free, cannabis-based	Vaporizers	“Why smoke herbs and inhale harmful substances if you can evaporate the active ingredients and inhale the vapor in a way that's completely safe for your health?”
			“Certified materials that do not off-gas even when exposed to high temperatures, therefore pose no danger to your health. In our store you'll find only safe and trusted vaporizers.”
			“The Raw hemp drops also include the most highly recommended 1:3 ratio of Omega 3s and 6s, as well as free radical-fighting Vitamin E and co-factors and co-nutrients.”

Furthermore, companies are promoting e-cigarettes along with vitamins and herbal supplements in the absence of scientific evidence that inhaling these substances confers health benefits. Davinci, a vaporizer manufacturer, states on its Web site that vaping of herbs such as chamomile may have salubrious effects akin to drinking chamomile tea; however, future research is required to establish whether inhaling chamomile confers the same effects as drinking it.

VitaminVape, VapeFully, VitaStik, and NutroVape sell devices that resemble e-cigarettes but claim that they are nicotine-free and that they deliver vitamins and nutrients. NutroVape claims that its devices deliver “nutritional supplements,” and VitaminVape directly implies that the effects of inhaling B₁₂ are similar to the effects of a B₁₂ injection. Consumers may see these health claims and assume that e-cigarettes, including those containing nicotine, are health enhancing. No known research has demonstrated that e-cigarettes have health benefits relative to not inhaling any substances.

VapeFully claims that one of its products contains blends with lavender, suggesting it can have “healing effects.” Davinci’s Web site advertises a lavender product, stating that it is intended for migraine relief, pain, insomnia, anxiety, depression, relaxation, and sexual energy despite evidence contradicting such conclusions about lavender.² A recent study noted that 23 unique patents have been filed introducing e-cigarette delivery of weight-loss constituents,³ and therefore this area of research deserves investigation.

It is currently unclear whether inhaled vitamins or supplements are equivalent to those that are ingested. If they are prescribed to treat medical conditions (e.g., migraines) and weight loss, they are considered a medicine rather than a food. Per the Food and Drug Administration (FDA), the standard of proof is different because drugs must first prove safety, whereas foods and dietary supplements are “considered safe until proven unsafe” (http://bit.ly/2SiHBOz). Alternatively, if these products are meant to be dietary supplements, the FDA has the power to take regulatory action after they enter the marketplace; thus, because such products do involve an unreasonable risk of illness or injury, the FDA should intervene. Any product containing e-liquid or enabling vitamin inhalation should be evaluated by the FDA.

The 2009 Tobacco Control Act requires the FDA to consider the health impact of regulatory actions on nonusers of tobacco and gives it the authority to regulate false and misleading statements used to advertise these products.¹ By associating their products with vitamins and healthy foods, nicotine and nonnicotine vaping companies could be confusing consumers. Moreover, the health claims related to these products have not been validated scientifically, and there are untested substances in e-liquids that could be associated with acute or chronic toxicities. Recent evidence supports these concerns: e-liquid fruit flavors of almost every kind contain diacetyl, which has been linked to bronchiolitis obliterans (i.e., “popcorn lung,” an irreversible respiratory disease that obstructs the smallest airways of the lungs and was initially discovered among popcorn factory workers), and even diacetyl-free e-liquids contain other hazardous chemicals.⁴ There is evidence that strawberry-flavored e-liquids are particularly cytotoxic⁵ and that administration of vitamins via inhalation could cause pulmonary damage.⁶

Marketing vaping products as healthy vapor–vitamin inhalation products represents a potentially new phase in misleading e-cigarette advertising. In the past, e-cigarette companies claimed that their products were less harmful than cigarettes or even completely harmless, but now some marketers are positioning their products as health promoting on the basis of unsubstantiated claims.

Section 5 of the Federal Trade Commission Act prohibits unfair and deceptive acts or practices and prohibits false food advertisements. Several countries restrict false claims about the functional benefits of foods, including “claims that describe the effect that a substance has on the structure or function of the body.”⁷ E-cigarettes and vaping devices purportedly used for healthy lifestyle goals should not be permitted under the current regulations because there is no evidence to date that vitamin delivery through e-cigarettes confers health benefits. E-cigarette and vaping marketers are using their Web sites to claim that vitamin vaping can help mitigate weight gain, but such claims seem premature given that there could be detrimental effects, particularly from long-term use. Advertising regulations—and strict enforcement of these regulations—are needed to prevent e-cigarette companies from making false and misleading health claims about the functional benefits of their products.