Are e-cigarettes an example of the "cobra effect?"
Electronic cigarettes were developed and marketed as a safer, healthier alternative to traditional tobacco cigarettes. The growing popularity of e-cigarettes, however, has raised fears among some health professionals that the attempted solution may worsen the problem - a classic definition of the "cobra effect."
An e-cigarette is a battery-powered device that produces an odorless vapor, not smoke, but still delivers nicotine, the addictive substance in cigarettes.
A recent survey by the federal Centers for Disease Control (CDC) found teen smoking of tobacco cigarettes has dropped from 13 percent to 9.2 percent.
But, the number of high school students who tried e-cigarettes tripled in one year - to more than 13 percent.
These see-saw findings have heartened some anti-smoking advocates, including Legacy President Robin Koval, who described the decline in traditional cigarette smoking as "very dramatic and very encouraging."
Her euphoria, however, is not universal. CDC Director Tom Frieden called the findings "alarming." He fears increased use of e-cigarettes creates its own problems.
Some researchers contend nicotine is harmful for the developing brain. And Friedman considers e-cigarettes - sometimes marketed with flavors and/or as hookahs or water pipes - as another way of introducing young people to nicotine.
E-cigarettes have been marketed as a step-down method for cigarette smokers to quit entirely. Some health care professionals worry they will do just the opposite - hook kids on nicotine and, eventually, tobacco products.
At this juncture, no one seems to know the answer, including the federal Food and Drug Administration, which is expected to decide by June on what regulations, if any, will apply to e-cigarettes.
Koval said: "Is this a gateway in? Or a pathway out: We don't know."
Adds Kenneth Warner, a University of Michigan public health professor: "Is it a fad, or will it stick around and come back to haunt us? We really don't know the implications of this in the long run."
E-cigarettes may have eliminated tobacco smoke, but may perpetuate, or even increase, nicotine addiction. Like the origin of the "cobra effect," potentially poisonous outcomes are in the balance.
EDITOR'S NOTE: The "cobra effect" refers to an episode during British colonial rule in India when a bounty was offered for every dead cobra. The initial result diminished the population of venomous snakes. Entrepreneurs, however, began raising cobras for the bounty. When the government learned of the practice, it eliminated the bounty. The worthless snakes were released, resulting in a net increase in the population of the deadly cobras.