NEW YORK A small US study raises new questions about whether using electronic cigarettes will lead people to quit smoking, adding to the debate over how tightly the products should be regulated.

The study, which looked at the habits of 88 smokers who also used e cigarettes, was published as a research letter in the journal JAMA Internal Medicine on Monday. It found that smokers who also used e cigarettes were no more likely to quit smoking after a year, compared to smokers who didn&#39 t use the devices.

Outside experts say the small number of respondents, and a lack of data on whether they intentionally used e cigarettes to help them quit smoking, mean the findings from the Center for Tobacco Control Research and Education at the University of California, San Francisco can&#39 t take the place of much more rigorous study on the subject.

E cigarettes were first introduced in China in 2004 and have since grown into a $2 billion industry. The battery powered devices let users inhale nicotine infused vapors, which don&#39 t contain the harmful tar and carbon monoxide in tobacco.

At issue is how strictly U.S. health regulators should control the products. Advocates say e cigarettes can help smokers quit. Public health experts fear they can serve as a gateway to smoking for the uninitiated, particularly teenagers. Leading U.S. brands include blu byLorillard Inc and products from privately held NJOY and Logic Technology.

A previous report from the UK found that people who use e cigarettes primarily want to replace traditional cigarettes (see Reuters Health story here ).

“We did not find a relationship between using an e cigarette and reducing cigarette consumption,” Rachel Grana, the lead researcher on the new study, told Reuters Health.

Grana and colleagues at the University of California, San Francisco analyzed 2011 survey data collected from 949 smokers. Of those, 88 reported using e cigarettes.

When the researchers looked at those smokers&#39 responses a year later, they found that the people who reported using e cigarettes in the 2011 survey were no more likely to quit smoking than the people who didn&#39 t use e cigarettes.

For those who were still smoking in 2012, using e cigarettes also didn&#39 t appear to change how many traditional cigarettes people smoked per day.

The researchers note that the small number of participants who reported using e cigarettes may have limited their ability to detect a link between quitting smoking and using the device.

Dr. Michael Siegel, who was not involved with the new research, told Reuters Health that the new study had several design flaws, including that the researchers did not know why some of the participants tried e cigarettes or how long they had used them. Siegel is an expert on community health at Boston University School of Public Health and has studied e cigarette research.

By comparing people who smoked regular cigarettes and those who smoked e cigarettes, the researchers are assuming “that the groups are exactly equivalent in terms of their motivations and their levels of addiction to cigarettes,” Siegel said. “You can&#39 t make those assumptions. You&#39 re not dealing with comparable groups.”

In an emailed statement, Grana and fellow researchers acknowledged that they did not have information on the participants&#39 motivations to use e cigarettes, but said their analysis took into account other factors known to be linked to quitting smoking, such as their stated intention to quit and how many cigarettes they already smoked each day.

“These factors may also reflect motivations to use e cigarettes, as e cigarettes are frequently marketed and perceived as cessation aids,” they wrote. “While these factors predicted quitting as expected, we found that e cigarette use did not predict quitting.

Siegel also pointed out that only about eight percent of the people surveyed said they had any intention to quit smoking within the next month. He hopes people will reserve judgment on e cigarettes until randomized controlled studies considered the “gold standard” of medical research are published.

“We need solid data that&#39 s based on solid science before we make decisions,” he said. “I hope no one would take this research letter and make any conclusion based on it.” Reuters

Growing use of e-cigarettes draws attention of entrepreneurs, lawmakers –

Annapolis businessman David Purdy started smoking when he was 15. He tried nicotine patches to kick the addiction. Later, he tried Nicorette gum. Neither worked.

Then a neighbor, also a heavy smoker, introduced him to an e cigarette, a battery operated device that mimics smoking a traditional cigarette. Unlike a tobacco cigarette, it emits vapor, not smoke. Purdy, then 47, gave it a try.

“Within a month, I started feeling the health benefits of it,” Purdy said. “I started tasting food again much better, started breathing much better. I could feel my body responding to not smoking anymore.”

Purdy eventually quit smoking and began researching the possibility of opening his own e cigarette store, saying, “I saw the industry taking off.”

His store, 2 Vapes, is located in the Cape St. Claire shopping center. The storefront is about the size of a large living room, with three main display cases. Star Wars figurines and other small toys decorate the countertops.

“Here I am, and I’m doing quite well,” said Purdy, now 50.

Purdy is among business people and customers latching onto the interest in e cigarettes, devices that contain a liquid solution, usually a mix of nicotine, flavoring and propylene glycol and vegetable glycerin. The device heats up the solution to emit vapor that users inhale.

The rise of e cigarette stores, both online and brick and mortar shops, is increasing in Maryland and beyond. Yet as the popularity rises, so do concerns.

There are decades of research concluding tobacco smoke from traditional cigarettes is harmful. Many say that it’s just too early to tell if that’s the case with e cigarettes.

The FDA does not regulate e cigarettes, so it’s up to states and local governments to establish regulations. Chicago, Boston, New York, Washington and, most recently, Los Angeles, ban the use of e cigarettes in restaurants, bars, nightclubs and other public spaces. In Los Angeles, the use of e cigarettes in “vapor lounges” is permitted.

In Maryland, Hartford and Anne Arundel counties have some restrictions on the use of e cigarettes in public. Airlines prohibit e cigarette use, as well do MARC trains. It became illegal for minors to buy e cigarettes in Maryland in 2012.

Maryland lawmakers during the 2014 General Assembly session have been weighing a measure that would prohibit the use of e cigarettes wherever traditional cigarettes are banned. A bill sponsored by Del. Aruna Miller, a Montgomery County Democrat, sought to place e cigarettes under the definition of “smoking” in the Maryland Clean Indoor Air Act of 2007, which bans smoking in virtually all indoor workplaces.

The bill received an unfavorable report from the House Economic Matters Committee last week and is now considered a long shot to advance during the session.

There is no conclusive evidence that vapor produced from e cigarettes is harmful. A 2012 study published in the science journal Inhalation Toxicology compared the effects of e cigarette vapor and cigarette smoke on indoor air quality. The study concluded that electronic cigarettes produce very small exposures relative to tobacco cigarettes. The study also indicated that there is no apparent risk to human health from e cigarette emissions based on the compounds analyzed.

But supporters of a ban say they’d prefer to be on the safe side. E cigarette use more than doubled among U.S. middle and high school students from 2011 to 2012, according to data published by the CDC, and Miller said she believes they could be “a gateway product to a lifelong addiction to nicotine.”

Others note that e cigarettes and e cigarette liquids are unregulated by the FDA or any other governmental organization.

“There is a lack of standards and quality control,” said Susan Glover, a smoking cessation counselor, during a recent Annapolis hearing. Glover said the amount of nicotine on e cigarette fluid labels could be inaccurate, and there could be contaminants in containers.

The federal Food and Drug Administration does not endorse the use of e cigarettes as a smoking cessation device, but some e cigarette users said that it’s the only method that’s helped them quit smoking.

Industry advocates note that e cigarette users can control the amount of nicotine in the fluid of their e cigarettes some don’t use nicotine at all. They note the user can start off with a higher amount of nicotine and gradually reduce the amount.

Bans such as the one Miller proposed would prohibit the use of e cigarettes even inside e cigarette stores.

“Customers can come in and try different flavors,” said Purdy, making reference to a row of small vials of e cigarette flavorings on a counter in his store. “What are they going to do if they can’t test out a product in an e cigarette store?”

Some e cigarette users said it’s reasonable to ban e cigarette use from some public places, such as restaurants. They say they try to be mindful of where they use e cigarettes.

“It really depends on the setting,” said Dorrien Bell, who uses e cigarettes socially that do not contain nicotine. “I don’t think people should blow lots of fumes” inside a restaurant.

Bell, 36, said he didn’t use tobacco products before using e cigarettes, but even without nicotine, he said he’d never blow fumes around his 8 year old son, or even teenagers.

“I regard it as an adult activity,” he said.