Electronic Cigarette: The Electronic Cigarettes Battle Continues

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Research & Commentary…

The SWOF Campaign – Smoke without fire.
A crowdfunded documentary project that will tell the truth about electronic cigarettes. Vapers around the world are facing bans – and they need to know why.
https://twitter.com/SWOFcampaign

E-cigarettes are not a ‘gateway,’ they help smokers quit
August 22, 2014
By Gregory Conley
If there was a device that helped smokers quit the habit — saving lives, reducing the leading cause of preventable disease in the United States and making life better for everyone — you would think public health officials would enthusiastically endorse it.
There is such a device: the e-cigarette. And, indeed, some public health officials are embracing it. But far too many are spreading false statements about e-cigarettes, blunting the products’ ability to help smokers quit smoking.
Here are the facts: E-cigarettes are non-combustible, non-tobacco devices that use a battery to heat a liquid nicotine solution, thereby creating an inhalable vapor. The activity is called “vaping.”
Unlike cigarette smoke, which contains more than 4,000 chemicals and 70 known carcinogens, e-cigarette vapor is far more comparable to the FDA-approved Nicotrol Nicotine Inhaler, which contains only trace levels of toxicants and chemicals.
More to the point, e-cigarettes help smokers quit smoking. They are the opposite of a “gateway” to smoking, even though some public health officials spread this myth.
Thomas Frieden, director of the Centers for Disease Control & Prevention, has said that “many kids are starting out with e-cigarettes and then going on to smoke conventional cigarettes.”
That is simply not true.
Dr. Ted Wagener at the University of Oklahoma Health Sciences Center recently studied college smokers. Out of 1,300 smoking students he surveyed, Wagener found one — one! — who had started nicotine use with e-cigarettes.
In a study of 26,566 European smokers, Dr. Constantine Vardavas of the Harvard School of Public Health found that just 1 percent of nonsmokers had tried vaping.
The majority of e-cigarette users surveyed were in fact heavy smokers who had tried to quit.
A recent study in the United Kingdom sponsored by Action on Smoking and Health, the country’s largest anti-smoking charity, found that 700,000 ex-smokers used e-cigarettes.
Even though they are relatively new to the market, e-cigarettes have already shown the ability to help smokers quit — and research suggests e-cigarettes may in fact be the best means for helping smokers kick the habit.
A study in England published in the medical journal Addiction earlier this year surveyed 6,000 smokers who tried to quit.
Among the respondents who had used e-cigarettes in their most recent quit attempt, 20 percent had successfully broken their tobacco habit. In contrast, less success was found with those who quit without help (15 percent) and those who used nicotine-replacement therapy such as gum or a patch (10 percent).
Looked at this way, e-cigarettes are in fact a gateway — a gateway to leaving smoking.
Finally, from a business point of view, the independent e-cigarette industry — those businesses not affiliated with Big Tobacco — have no incentive to use e-cigarettes to drive their customers toward cigarettes. Our product helps people quit smoking, and we like it that way.
E-cigarettes are a disruptive technology that have enjoyed incredibly fast consumer uptake. Because of their newness and innovative nature, however, such technologies are often the victim of misinformation.
The stated goal of public health officials is to reduce the number of smoking-related diseases and deaths. E-cigarettes can do that.
We urge public health officials and policymakers to study the facts and research about e-cigarettes before making false statements about a device that helps accomplish the objective they want most.
Gregory Conley is president of the American Vaping Association, based in Hoboken, N.J.

Popularity of e-cigs expected to surpass that of traditional cigarettes
MAY 25, 2014
BY WINSTON-SALEM JOURNAL
WINSTON-SALEM, N.C. — Electronic and vapor cigarette products take up – for now – two small display spaces when compared with racks of traditional cigarettes sold at Blue Ridge Tobacco and Candle Outlet, according to the Winston-Salem Journal.
But operators of the store on Cloverdale Avenue are convinced, by measuring growing consumer demand and traffic flow, that the reverse could be true by the end of the decade – if not sooner.
One accommodation toward that reality, according to store manager Nancy Hardy, is that the store chain has created a separate accounting ring-up for e-cigs and for vapor products.
Electronic cigarettes, or e-cigs, are battery-powered devices that heat a liquid nicotine solution in a disposable, closed cartridge and create a vapor that is inhaled.
Vapor products can feature a liquid capsule that is inserted into an open-fill cartridge. Vapors, at least for now, offer consumers a wider variety of flavor options.
“We’re gaining more sales and more profit from these products every day,” Hardy said as she takes turn smoking examples of disposable and rechargeable e-cig cartridges and vaporizers.
“There is the challenge of getting smokers to go beyond trying to sticking with it, but more seem to feel healthier from using these products,” Hardy said. After pausing for a few seconds, she added, “Not that we’re advertising that benefit by any means.”
The cost of a rechargeable e-cig cartridge and vaporizer can range from $30 to $70, while the nicotine liquids tend to range from $6 to $8.50. It’s hard to estimate a price equivalence to a pack of cigarettes because it depends largely how hard a user draws the nicotine liquid per puff.
Hardy said e-cigs seem to appeal to traditional cigarette smokers who want a product that tastes like a regular or menthol cigarette – even though Lorillard Inc.’s blu eCigs subsidiary offers vanilla, cherry crush, java jolt, pina colada and peach schnapps.
R.J. Reynolds Vapor Co. is sticking with tobacco and menthol flavoring, said Susan Cameron, chief executive and president of parent company Reynolds American Inc.
“Those individuals just want a taste and a feel that is as close to a traditional cigarette as they can get,” Hardy said.
When it comes to the vaporizers, Blue Ridge sells a small sample of what has proven to be a Wild Wild West of flavored nicotine liquids.
For example, the store sells 27 flavors from Ecto, which makes domestically nicotine liquids that range in potency from 24, 18, 12 and 6 milligrams of nicotine to no milligrams.
Anti-tobacco advocates and some Democratic congressional leaders have decried nicotine liquids with flavoring that resembles gummy bears, bubble gum, fruits, candies and mixed alcoholic drinks. They say those flavors encourage consumption from teen consumers – part of their push to get the Food and Drug Administration to act quicker on setting regulations.
Hardy said Ecto recently renamed some of their flavors, possibly to avoid trademark infringement issues, from Snickers to chocolate bar and from Sweetish fish to sweet fishies.
The store also sells Pfoom products, which is testing a device that vaporizes real tobacco in a tiny pod.
Frank Armstrong, the store’s owner, said he carries nicotine liquid for suppliers in which he is comfortable with the ingredients.
Hardy said that even thought the FDA in the very early stages of reviewing e-cigs and vapor products for potential safety issues, consumers already are asking what in their inventory is FDA approved.
They also ask about when the products will be taxed by the state. If the state Senate approves the House omnibus tax bill, a tax of 5 cents a milliliter will be applied to the nicotine liquid mixture. If the bill is signed into law, and Gov. Pat McCrory said Friday that he would do that, the excise tax would go into effect Feb. 1.
By comparison, a pack of traditional cigarettes has an excise tax of 45 cents a pack, one of the lowest in the country.
The potential that e-cigs and vapors have reducing harm from tobacco products had Jennifer Barker trying different models at the store.
A smoker for 19 years, typically the Camel Menthol style, Barker said she has been smoking an e-cig for about two months. Her favorite is mixing the chocolate bar and menthol flavors.
She said she has cut down from 20 cigarette sticks a day to two to three while also smoking the e-cig.
“I’ve tried the nicotine replacement therapy, the prescription medicine, the patch, and nothing has worked,” Barker said.
“From what I’m sensing so far, I think not only will I be able to cut down on my nicotine consumption, but end it and eventually quit cigarettes altogether.
“Smoking has been a crutch and the vaporizer is now a crutch. It’s just been hard, but I hope to have a handle on quitting now.”

Banning E-Cigarette Marketing to Kids
March 13, 2014
S. 2047 Protecting Children From Electronic Cigarette Advertising Act of 2014
The Essentials
1. As e-cigarettes become more popular, the federal government is looking for ways to regulate their use, especially among teens. A March study in the journal JAMA Pediatrics reported that 3.3 percent of 6th to 12th graders said they’d tried e-cigarettes in 2011. In 2012 the number more than doubled, to 6.8 percent. Using data from the Centers for Disease Control and Prevention, the study found kids who tried e-cigarettes were more likely to try real cigarettes than those who hadn’t.
2. On Feb. 26, Senator Barbara Boxer introduced the Protecting Children From Electronic Cigarette Advertising Act of 2014, the first of what is likely to be many bills meant to control the sale of the product. The legislation seeks to make it illegal for companies to aim e-cigarettes at minors. It directs the Federal Trade Commission to define what constitutes marketing to kids and gives it authority to work with state attorneys general to enforce banned practices with fines.
3. The bill’s sponsors say it’s obvious companies are targeting teens with ads and with e-cigarettes that come in bright colors and candy flavors. But it’s not clear that Congress can dictate what colors a product can come in, how it tastes, or which ads are acceptable—particularly for those e-cigarettes that contain no nicotine. In 2012 a federal court knocked down a ban on colorful billboards and print ads for conventional cigarettes as being “vastly overbroad.”

Blowing smoke over e-cig ad
February 3, 2014
By Jeff Stier & Gregory Conley
One of Sunday’s most controversial Super Bowl ads came with the message “Friends don’t let friends smoke.” Bizarrely, it’s organized anti-smokers in the public-health establishment who want the commercial banned.
The line comes in an ad for the NJOY King, an electronic cigarette produced by Scottsdale, Ariz.-based NJOY. The commercial shows people helping each other in situations like moving a couch up a flight of stairs or helping a friend in a bar fight. Then one man starts to light up a cigarette, only for his friend to offer him an NJOY King.
For most people, the message is clear: If someone close to you smokes cigarettes, try recommending they switch to a smoke-free alternative.
Those who care about public health should be rejoicing that the private sector is not only placing anti-smoking ads on the country’s largest stage, but that the ad actually offers smokers an appealing alternative to smoking.
Many smokers complain that nicotine gum and patches, which are promoted by government-funded anti-smoking campaigns, aren’t satisfying; e-cigs give those trying to quit an experience closer to smoking. Many ex-smokers who’d failed to quit smoking with the government-endorsed solutions are now succeeding with e-cigarettes.
Yet the response from many of America’s most prominent anti-smoking groups is a call for a ban on all TV and radio advertising of e-cigs. Last year’s NJOY Super Bowl ad made activists furious. That ad, which also ran in select markets, focused on distinguishing between smoking and vaping (for the vapor emitted from e-cigs). Yet Bill Pfeifer, president and CEO of the American Lung Association’s Southwest chapter, fumed that the NJOY ads were “slick misinformation” that should be banned by the Food and Drug Administration, and that both CBS and the NFL should have benched the ads.
Why would the American Lung Association, whose purpose is to reduce lung disease, oppose letting smokers learn about smoke-free e-cigarettes, which even opponents acknowledge are dramatically less harmful than smoking? Because, they argue, some e-cigs look like the real thing.
No, really. E-cigarette opponents say the products should be demonized because they look like cigarettes, or as the World Health Organization claims, they “normalize” smoking.
That’s nonsense.
That some e-cigs look, feel and taste somewhat like cigarettes is actually what makes them so appealing to people trying to quit smoking. Yet if it were up to activist groups, alternatives to cigarette smoking would be entirely unappealing — and therefore ineffective.
As Clive Bates, the former head of Action on Smoking and Health, the largest anti-smoking group in the United Kingdom, recently stated at an e-cig investors conference held in New York City, “If you’ve got a very, very low risk product that no one wants to use, you don’t get much harm reduction.”
Instead, Bates encourages a pragmatic view of harm reduction that recognizes that so long as a product is far less hazardous than smoking, it should be free to compete with deadly combustible tobacco cigarettes.
And public-health advocates should favor giving them competitive edges over cigarettes, such as the opportunity to advertise to adults on TV.
Jeff Stier is a senior fellow at the National Center for Public Policy Research in Washington, DC, and heads its Risk Analysis Division. Gregory Conley is a Heartland Institute research fellow.

New concern about e-cigarettes: They’re making smoking ‘normal’ again
January 24, 2014
By Michael Hiltzik
E-cigarettes, those battery-powered nicotine vapor delivery systems that are infiltrating the airwaves, schoolyards, and public spaces, are threatening to undo a decades-long campaign to stigmatize smoking.
That’s according to an article in the latest New England Journal of Medicine. Anti-smoking activists, the article reports, fear that e-cigs will lead to the “renormalization” of smoking. Their concern is that the rise of e-cigs will interfere with the tobacco “endgame”–the global elimination of all tobacco use by returning the habit of smoking from the social margins to which it has been relegated.
Since the health effects of e-cigs haven’t yet been fully studied, moreover, the return of public puffing, even of a non-tobacco product, is dangerous.
E-cigs use a battery-powered heater to vaporize liquid synthetic nicotine, along with a substance that replicates the look and feel of cigarette smoke for the user to inhale and expel. Traditional tobacco companies such as Lorillard and Altria have jumped into the market with widely-advertised brands such as blu and MarkTen.
Since most e-cigs are based on nicotine, a highly addictive substance, the anti-smoking community sees e-cigs as tools for tobacco companies to replace one habit-forming product on the decline for another one on the rise.
E-cigarettes, the NEJM observes, “are challenging a barrier to television promotion erected more than 40 years ago.” Media figures like Jenny McCarthy (whose baleful effect on public health through her anti-vaccination campaign we’ve touched on here) and Stephen Dorff are hawking e-cigs in ads, sometimes positioning them as tools to circumvent freedom-killing laws barring tobacco smoking in public places.
Flavored varieties, including bubble gum-like flavors, with raises concerns that the tobacco industry is once again trying to hook children and adolescents on an addictive product. indeed, the Centers for Disease Control reports that use is growing sharply among middle- and high-school students, albeit from a small base.
The battle over public e-smoking is just being joined. The Los Angeles City Council late last year placed e-cigs in the same product category as conventional cigarettes, banning their sale from street kiosks, ice cream trucks and self-service displays, and requiring retailers to obtain a license before selling the products. Bans or other restrictions are under consideration in other cities across the nation. Of all UC campuses, e-cigs are allowed only at UC Irvine. Pressure is on the Food and Drug Administration to regulate e-cigs as it does tobacco.
Not all smoking opponents think the goal of eradicating e-cigs is a good thing. According to the NEJM, some studies indicate that e-cigs are being used mostly as smoking cessation aids. Other activists say that the goal of totally eliminating anything resembling smoking will work against the more important, and more achievable, goal of reducing risk by discouraging smoking. They point to the history of alcohol and narcotics prohibition as a warning that total eradication is almost impossible and efforts to accomplish it often backfire.
What’s more important, the NEJM concludes, is for the FDA to get its arms around the phenomeon and subject it, without delay, to regulation.

Senators want awards show to be free of e-cigarettes
JANUARY 14, 2014
BY SEAN LENGELL
Following Sunday’s primetime broadcast of the Golden Globes that featured images of celebrities smoking electronic cigarettes, a group of Democratic senators are pressing for future broadcasts of the awards show to be smoke — and vapor — free.
Sens. Dick Durbin of Illinois, Richard Blumenthal of Connecticut, Sherrod Brown of Ohio and Edward Markey of Massachusetts on Tuesday pressed Golden Globes’ broadcaster NBC Universal and the show’s sponsor, the Hollywood Foreign Press Association, to promise that future broadcasts refrain from showing the so-called e-cigarettes and, by doing so, avoid the “glamorization of smoking and protect the health of young fans.”
“Throughout the country and the world, people tune in to watch fashionable actors on the red carpet, enjoy the show, and root for their favorite films and actors,” said the senators’ statement. “Unfortunately, this year, many young viewers saw notable displays of e-cigarette use throughout the awards show, including the opening monologue and repeated shots of celebrities smoking e-cigarettes.”
E-cigarettes use a heater that vaporizes a mixture typically composed of liquid nicotine, propylene glycol and other chemicals. Since they don’t burn tobacco, the Food and Drug Administration doesn’t regulate them in the same way as traditional smokes.
Most researchers say e-cigarettes are safer than traditional cigarettes because tobacco isn’t ingested into the lungs and they don’t produce second-hand smoke, although few studies have been conducted on their long-term health risks.
But critics, who have accused the industry of heavily marketing their products to children and teens, worry the devices can serve as a gateway to traditional cigarettes for users.
“In light of studies showing that exposure to on-screen smoking is a major contributor to smoking initiation among youth, we are troubled that these [Golden Globe] images glamorize smoking and serve as celebrity endorsements that could encourage young fans to begin smoking traditional cigarettes or e-cigarettes,” the senators said.
The electronic cigarette industry is booming, with sales doubling annually since 2008 and 2013 revenue expected to reach at least $1.5 billion.
Federal law prohibits the sale of tobacco cigarettes to anyone under 18, but there is no such restriction for e-cigarettes. And with no advertising restrictions and the products coming in an array of flavors such as bubble gum, strawberry and chocolate, critics say the devices increasingly are becoming popular with teens and children.
The FDA, concerned that children and teens have easy access to the battery-powered inhalers, is considering strict new rules that would treat the nicotine inhalers in much the same way as traditional cigarettes.
Responding to the growing popularity of e-cigarettes among young people, last month the four senators and Democratic Sens. Barbara Boxer of California and Tom Harkin of Iowa called on the Federal Trade Commission to investigate the marketing practices of electronic cigarettes.
And in September, Durbin, Blumenthal, Brown, Markey, and eight other members of Congress called on nine e-cigarette makers to provide additional information regarding the sale, distribution, labeling, and marketing of their products to children and teens.
Holy smokes! Leonardo DiCaprio and Julia Louis-Dreyfus puff away INSIDE the Golden Globes… but they keep it legal with electronic cigarettes
13 January 2014
Stars tend to believe they are above the law.
And at first glance, it looked as if Leonardo DiCaprio and Julia Louis-Dreyfus were brazenly flouting California’s two decade-long smoking ban at Sunday night’s Golden Globes ceremony.
But upon closer inspection, the stars were in fact puffing legally on electronic cigarettes during the awards show at the Beverly Hilton Hotel in Los Angeles.
Leonardo, 39, who has been pictured puffing on the relatively safe alternative in the past, was seen taking a long drag of an e-cigarette while seated at the awards show.
While it looked like a normal cigarette, the tell-tale glowing end gave the game away.
Leonardo was no doubt smoking to calm his nerves before he won Best Actor in the musical or comedy category.?
Julia, meanwhile, smoked the battery-powered device as part of a skit during the ceremony.
The 53-year-old was seen wearing black cat-eye shades as she casually blew the steam out her mouth, while Reese Witherspoon giggled alongside her.
The actress, who was up for two nominations in TV and film, was called out by hosts Amy Poehler and Tina Fey for being ‘too cool’ to sit with the other television actors now that she was nominated for her role in film Enough Said.
Julia – who is the daughter of multi-billionaire Gerard Louis-Dreyfus – then played along, adopting the haughty persona.
After she lost in the film category, she was then seen biting into a large hotdog after Amy and Tina joked that the star had ‘slithered back to the TV section.’
But perhaps not surprisingly, one star who opted for the real deal was Courtney Love.
To be fair, the 49-year-old didn’t smoke at the ceremony, but outside the Sunset Tower Hotel during one of the many after parties.
The Hole singer was seen leaning over to grab a light from man, before inhaling while chatting animatedly with friends.
In 1995, California was the first state to ban smoking in most indoor spaces.
E-cigarettes have grown in popularity, but concerns have arisen as to how safe the devices really are.
In 2009, the Centers For Disease Control And Prevention did a study of two well-known brands and found they contained potentially dangerous chemicals, according to CBS.

More evidence e-cigs may help in quitting tobacco
Nov 7, 2013
By Kathryn Doyle
(Reuters Health) – Electronic cigarette users followed over a year reduced or quit using tobacco cigarettes in large numbers and were less prone to resume smoking, at least in the short term.
Experts continue to debate whether or not “e-cigs” are smoking-cessation tools or just leisure products. The electronic vaporizers use cartridges of liquid nicotine to deliver a flavored nicotine-laced vapor without the byproducts of burning tobacco in traditional cigarettes.
“Our results may not be generalizable to all vapers,” Jean-Francois Etter said, using the slang for vaporizer users. “We had a majority of ex-smokers at baseline whereas in the general population, most vapers are current smokers,” he told Reuters Health.
Etter led the study at the Institute of Social and Preventive Medicine at the University of Geneva in Switzerland. The results were published in Addictive Behaviors.
A few small studies have found that e-cigarettes seemed to help smokers quit using tobacco or at least to smoke fewer traditional cigarettes. But there have been no long-term studies of how people actually use e-cigarettes, so experts are still unsure.
The researchers posted a questionnaire on a French stop-smoking website and asked sites selling e-cigs to link to the questionnaire. Most “vapers” buy their e-cigs online.
The e-cig users recruited answered a baseline questionnaire, another one a month later and a third one year later. Questions covered e-cigarette use, tobacco use and the date of quitting tobacco, if one applied.
Of more than 1000 original recruits, 367 responded to all three surveys.
For those who had quit smoking already and were using e-cigarettes instead, six percent had relapsed to tobacco after one month. That number was stable after one year.
Of those who were smoking and using e-cigarettes when the study began, 22 percent had quit smoking tobacco after a month and 46 percent had quit after a year. That group averaged 11.3 tobacco cigarettes daily at the beginning of the study and six cigarettes per day after one month.
This was just an exploratory study and will need confirmation from follow-up studies, Etter said.
“This suggests that e-cigs may help them quit, but our results need to be interpreted with caution, because of the dropout rate at follow-up and the fact that our sample is not representative of all vapers,” he said.
In the short-term, e-cigs appear not to carry any health risks of their own, he said. But researchers still don’t know the long-term health effects of inhaling the common solvent glycol and food flavoring over many years.
E-cigarettes don’t need to be 100 percent safe, he said, they only need to be significantly safer than tobacco cigarettes because they are primarily used by cigarette smokers. Of the three studies that have investigated e-cig users, none of the daily vapers were non-smokers.
Even though the evidence is still thin, Etter believes smokers should use e-cigarettes as quit-smoking aids, and doctors should recommend them. But the products should not be treated as medical devices or drugs, even though they may have therapeutic benefit for patients, he said.
“Internet surveys are more likely to attract people who had a positive experience with e-cigarettes,” professor Peter Hajek said. “The study is nevertheless innovative in that it did not just ask for a one-off information as a number of previous studies did, but it followed the e-cigarette users up to see what happens to their e-cig use and to their smoking one year later,” he said.
Hajek is director of the Tobacco Dependence Research Unit at Barts and The London School of Medicine and Dentistry in London, UK. He was not involved in this study.
The new study adds to the evidence that e-cigarettes can help smokers quit or cut down, he said.
“There are two products competing for smokers’ business,” Hajek said. “One kills half the users, the other one is at least an order of magnitude safer,” he said. “It makes little sense to try to cripple the safer one so the deadly one maintains the market monopoly.”

E-Cigarettes: The Vapor This Time?
A Live Webcast Panel
October 3, 2013
UCSF Health Sciences West 301
Expert researchers will present the state of the science on electronic cigarettes. A question and answer discussion period will follow presentations.
Jean-Francois Etter, PhD, University of Geneva, Switzerland
Monique Williams, ABD, University of California Riverside
Natalie Walker, PhD, University of Auckland, New Zealand
Prudence Talbot, PhD, University of California Riverside
Discussant: Stanton Glantz, PhD, University of California San Francisco
Moderator: Phillip Gardiner, Dr. P.H., TRDRP
Host: Tobacco Related Disease Research Program (TRDRP), University of California Office of the President
(This is the link to the event page)
http://www.trdrp.org/event-link.php
(Watch)
http://www.youtube.com/watch?v=-yyy2vSbzEY

View the Recording of Speaker Presentations and the Question and Answer session below:
Introduction by Phil Gardiner: Electronic Cigarettes: The Vapor This Time?
http://lecture.ucsf.edu/ETS/Play/8c3a1b0bc89b4fff896ee6e25d36bd961d
Monique Williams: E-Cigarette Liquids and Vapors: Is it Harmless Water Vapor?
http://lecture.ucsf.edu/ETS/Play/005db638e1024d74ad1b4ab0adfca5dd1d
Prudence Talbot: Electronic Cigarettes: How Will They Impact Human Health?
http://lecture.ucsf.edu/ETS/Play/b14229722f8941f68d4ac621c36fd93e1d
Natalie Walker: E-Cigarettes: A 21st Century Cessation Device?; A Review of the Literature
http://lecture.ucsf.edu/ETS/Play/65add3d0fc944486acca56d0964d7b3c1d
Jean-Fran?ois Etter: The Profile of Vapers and How E-Cigarettes Should be Regulated
http://lecture.ucsf.edu/ETS/Play/f8e41c8c0f1048fbb43c89953dc286721d
Stanton Glantz (Discussant): E-Cigarettes: Where are We; Where Should We Go?
and Question and Answer session https://vimeo.com/76543477


Non-Combustible Cigarettes – “Vaping”
Alternative Method of Nicotine Delivery
Document Date ?19800313 (March 13, 1980)
Presentation by Dr. Norman L. Jacobson of San Antonio to a meeting of the American College of Chest Physicians at Houston on 4-8th November, 1979.
http://legacy.library.ucsf.edu/tid/lsl80a99
http://legacy.library.ucsf.edu/tid/lsl80a99/pdf


E-Cigarettes: Electronic, but Maybe Not Online
August 22,2013
By Stephen Drill
The Food and Drug Administration is considering a ban on online sales of electronic cigarettes, as part of a package of regulations the agency is readying for the increasingly popular devices, people familiar with the matter said.
The FDA, which warned in 2009 that e-cigarettes could pose health risks, has been meeting with e-cigarette makers this week to hear their views on its proposed regulations for the industry. The agency is expected to formally unveil its proposals in October, after several delays.
The “listening sessions” at FDA headquarter in Silver Spring, Md., north of Washington, are part of a series of meetings slated for coming weeks. At least 20 FDA staffers have attended the gatherings, the people familiar with the matter said, as the agency prepares its proposals for public comment.
As part of that effort, the FDA has been weighing an online-sales ban to keep e-cigarettes out of the hands of minors and looking at whether the minimum legal age for buying them should be 18 or 19, the people said. They said the agency is also reviewing television, radio and print advertising standards for the products. Overseeing the project is Mitch Zeller, who became director of the FDA’s Center for Tobacco Products in March.
E-cigarettes aren’t yet regulated by the agency, which is poring over scientific research about the devices as it fine-tunes its proposed rules. FDA spokeswoman Jennifer Haliski confirmed the rules were being developed but declined to comment on whether the agency had a deadline for putting them out for comment.
“Further research is needed to assess the potential public-health benefits and risks of electronic cigarettes and other novel tobacco products,” she said.
Analysts estimate e-cigarette sales in the U.S. will reach $1 billion this year. Bonnie Herzog, with Wells Fargo Securities, predicts sales could hit $10 billion in five years as smokers switch from tobacco to battery-operated nicotine-vaporizing technology.
An estimated 45 million Americans smoke. In 2011 they bought a total of 293 billion cigarettes, according to the U.S. Centers for Disease Control and Prevention.
E-cigarettes pose a competitive threat to traditional tobacco companies-so much so that some of those companies are buying into the industry. In April 2012, Lorillard Inc. (LO), the third-largest tobacco manufacturer in the U.S., paid $135 million for Blu Ecigs, based in Charlotte, N.C. In June, Silicon Valley entrepreneur Sean Parker was part of a $75 million investment in leading brand NJOY, based in Scottsdale, Ariz.
The investments carry plenty of regulatory risk. New York’s city council is considering three bills backed by the city’s Health Department that would ban flavored tobacco. The ban would cover many e-cigarettes. The bills also would raise the city’s legal age for buying tobacco and e-cigarettes to 21 from 18.
Elliot Maisel, chairman, chief executive and major shareholder of e-cigarette maker Fin Branding Group, said he isn’t afraid of regulation. The Atlanta-based company started up in 2011 and released its popular Fin brand in 2012. The company, whose products are sold in more than 40,000 outlets nationwide, expects sales to hit $60 million this year.
“If they shut me down tomorrow, would I lose money? Yes. But, do I think that’s going to happen? No, because of the demand for these products,” Mr. Maisel said.


More thoughts on harm reduction or why if you keep smoking cigarettes its not the end of the world
August 19, 2013?
by Paul Bergen
Chris Snowden had a good post the other day regarding concerns about the aged drinking too much.? Not only were the statistics suspect but the conclusion that such drinking would have long term health effects was laughable.? Its no different that worrying about any drug use which has minimal immediate consequences, smoking included, past a certain age.
As he puts it: “If, God forbid, I live to ninety and some pipsqueak of a health researcher tells me to cut down on my drinking, I shall poke them in the eye with my walking stick. The biggest risk factor for virtually all diseases is age. For those who are elderly, every other risk factor fades into insignificance (which, perhaps, is why Leonard Cohen plans to start smoking when he’s 80). It is no wonder that they “do not care” about the trivial health risks of drinking a bottle of wine a day. Rather it is a wonder that they don’t drink more”.
Naturally those of us promoting harm reduction argue for users to substitute reasonable alternatives for harmful enough behaviors however this should not be construed as an actual argument against those behaviors. As human beings we have the right to pursue peace of mind as long as it does not infringe on the well being of others.? And that well being of others does not encompass infringing on their right to be prohibitionist assholes.
I am currently reading a remarkable novel by Eugen Ruge (In Times of Fading Light), a family saga placed in what used to be the DDR before and after the fall of the wall.? What strikes me as I read this, and other books like it, is how free of state interference our lives are (essentially when the state marginalizes most of the population), and also how few real difficulties we have in our everyday lives.? I speak, of course, as a mainstream citizen (this generalization does not hold for the marginalized many in our midst).
And I wonder if it is this lack of having to deal with very serious issues that leads to forming campaigns like the drug wars, the anti-smoking wars and such. And of course like all things Western this globalized and started using up funding that should have gone to alleviating things like diarrhea and poverty.
Even in our affluent sphere, we can end up desiring respite from everyday life.? I won’t even say need because want should be a sufficient defense for engaging in an activity that makes life a little better and harms no one else.
One of the principles of harm reduction is that we should have access to healthier alternatives to behaviors that have higher associated costs (methadone for heroin users, ecigs for smokers, seat belts for drivers, helmets for cyclists) but another is that movement to the safer alternative should be a product of exercising free will and not being coerced.
Harm reduced alternatives are not morally superior. They are simply alternatives to adopt if you prefer their balance of benefits and costs to the original.? Not only are you in most cases the one best suited to know which behavior suits you better but In the larger scheme of things, whichever one you choose is nobody’s business but your own.
The Candi Staton song Sure as Sin (not about drugs but about an affair) says it very well: “Ain’t nobody’s business how we carry on….Cause 100 years from now we’ll all be dead and gone. They say I’m not a good woman. That I’m no good for you , Cause I just live it like I feel it. And there ain’t nothing else I can do, cause somebody put an urge inside me to satisfy your kind of man. Just as sure as sin. They call us lowdown and dirty. They even talk behind our backs, but the people are living a lie, just a pot calling the kettle black. But we ain’t gonna worry no we ain’t gonna pretend. Because we were made to be together just as sure as sin”.
We’re all going to die someday and you are not going to get brownie points for not having had that smoke or drink. Its all about choice and for some the correct and best and most pleasurable choice is to abstain but for many that is not true and in death whether you were a user or nonuser of whatever will be irrelevant.


Old tobacco playbook gets new use by e-cigarettes
Enid News & Eagle – August 3, 2013 Michael Felberbaum, Associated Press
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Also: NewsOK – August 3 2013; Houston Chronicle Aug 3, 2013

“So far, there’s not much scientific evidence showing e-cigarettes help smokers quit or smoke less…”
See Dr. Siegels Blog:

And the study article:

And what have the FDA, CDC, anti-smoking groups and pharmaceutical funded philanthropic organizations done to encourage better solutions than their ineffective NRT products?
Nothing.
Consumer oriented e-ciggies threatens market share of both the traditional tobacco and pharmaceutical companies. It also reduces (Oklahoma) state revenue from punitive taxes and the MSA. The Tobacco Control playbook has never been about health. It’s all about money.


Everything Not Forbidden Is Compulsory
August 3, 2013
The past few days have seen a few developments on the medicines regulations front, ranging from the release by the MHRA of new guidelines concerning the procedure and requirements for acquiring Marketing Authorisation for e-cig related substances and associated devices, to the full text of the advice from Sir Francis Jacobs QC to ECITA. We’ve also seen the UK release of the Vype cigalike by British American Tobacco.
In putting this post together, I am mindful of the comments and contributions of others and will seek not to tread on ground pretroddened, except where I can’t really help it. So if you think there are gaps in what I’m covering, that’ll be why.
Read More.

Anti-Smoking Researcher Misleads Public with Invalid Comparison of E-Cigs and Nicotine Inhaler: Correct Analysis Shows that Nicotine Inhalers Have Higher Amounts of Six Carcinogens
July 25, 2013
By Dr. Michael Siegel
On his tobacco blog last week, Dr. Stan Glantz argued that nicotine inhalers are safer than electronic cigarettes as a harm reduction product based on a comparison he made between the amounts of several carcinogens in e-cigarette cartridges and nicotine inhaler cartridges. Actually, the comparison was between levels of these chemicals in the vapor produced from these cartridges. The data were taken from a paper by Goniewicz et al. that reported levels of various constituents of e-cigarette vapor and used a nicotine inhaler as a reference product.
Read More.


Regulator to act on e-cigarettes
July 24, 2013
THE FOOD and Drug Administration (FDA) will resolve in a month whether to regulate or ban electronic cigarettes (e-cigarettes) after medical groups raised health concerns on its use.
Dr. Kenneth Y. Hartigan-Go, director-general of the FDA, said inputs presented in a public hearing yesterday as well as position papers of various stakeholders on e-cigarettes will be considered in the decision.
“The regulators will study these and come back to you in a period of one month’s time with a clear position of what we need to do as far as this item is concerned,” Mr. Go said.
In April 2013, the FDA issued an advisory that it has “not registered any electronic cigarette product and will not register them as health products.” The FDA also said in the advisory that e-cigarettes violate Republic Act (RA) 9211 or the Tobacco Regulation Act of 2003 since it promotes smoking among children and the youth.
In yesterday’s hearing, medical experts pointed out that there are no “middle ground” when it comes to health — the e-cigarette is either fit or unsafe for consumption.
Dr. Maricar Limpin of the Framework Convention on Tobacco Control Alliance, Philippines said there are no available data as yet that e-cigarettes will prevent people from consuming the regular tobacco product.
“I think we need to do some researches on that aspect,” Ms. Limpin said. She added there is limited data on the “safety and efficacy as alternative to reduce the harmful effects of tobacco”.
Dino Abulencia, a chemical engineer, said during the public consultation that during his “initial runs” of five brands of nicotine juice, the vapors produced dietyhlene glycol which is supposedly not fit for human consumption since it is used as an “anti-freeze” compound.
For his part, Dr. Anthony C. Leachon, an internist-cardiologist and consultant of the Department of Health on noncommunicable diseases, said e-cigarettes started as early as 1963 when Herbert A. Gilbert patented a device described as “a smokeless non-tobacco cigarette” that replaced the burning tobacco rolled on a paper.
The e-cigarette device was first introduced to the Chinese domestic market “as an aid for smoking cessation and replacement.” The first international patent was recorded in 2007.
E-cigarette users, on the other hand, said the device helped them quit smoking. For one, Joshua Alexander Espino said he is “one of the few success stories” where the use of e-cigarettes ended his dependency on nicotine.
Gilbert L. Mendoza of Philippine E-Cigarette Industry Association said e-cigarette is “significantly less harmful” than tobacco based on experiences of users.
The public hearing stemmed from medical groups raising health issues on the use of e-cigarette. The World Health Organization, for their part, does not consider it as a means for smokers who are attempting to quit. — M. F. E. Flores

Research & Commentary: The Emergence of E-Cigarettes
June 26, 2013
Matthew Glans
Electronic cigarettes, or “e-cigarettes,” have quickly become one of the most popular nicotine replacement products. The Wall Street Journal reports sales of e-cigarettes doubled in the United States over the past five years, moving from $250 million to $500 million in total sales. Some industry experts predict sales of e-cigarettes could reach $1 billion this year, doubling sales from 2012.
Read more.

Looking at the helpfulness of e-cigarettes
July 1, 2013
By JUNIOUS SMITH III Kinston Free Press
KINSTON — In the fight for better health, electronic cigarettes — or “e-cigarettes” — have been looked at as the new alternative method to people who have been trying to quit smoking. The product has been gaining popularity for its ability to emulate the taste and feel of the original cigarette without the harmful chemicals.
E-cigarettes have been sold in tobacco stores, gas stations and retail stores across the nation since 2009. With increased laws on smoking because of the harmful toxins that provide secondhand smoke and the smell of the carcinogens, e-cigarettes can be used in order to get the nicotine fix without bothering nonsmokers.
E-cigarettes can be “smoked” just like regular cigarettes, but without the use of lighters or flicking ashes. Instead, the e-cigarette is like an electronic inhaler, releasing a vapor into the air in contrast to the smoke from standard cigarettes.
Some e-cigarettes taste just like original tobacco or menthols, but there are alternative flavors that can be found. Blu — one of the most popular brands of e-cigarettes — gives smokers a variety of flavors such as cherry, vanilla and pina colada, amongst others. Also, people have the option of buying disposables — which can last about as long as a pack of cigarettes — or rechargeable e-cigarettes which can last for months.
When inhaled, a light comes on and the nicotine is released. When the light fades away or won’t come on, the e-cigarette needs to be recharged or discarded.
Like patches or gum, nicotine is entered into the bloodstream, but in an article in The Huffington Post on Monday, Dr. Lynn Kozlowski said e-cigarettes are more likely to get a smoker to quit altogether.
“An ineffective cigarette substitute could fool an addicted smoker for a few hours or a few days, but not for weeks or a few months,” Kozlowski said. “After many months, it will be rare to see a placebo effect satisfying an addicted smoker. Will they work for every smoker? Probably not. Can they work for many smokers? Probably.”
Linda Walston — store manager of Tobacco Road Outlet on Herritage Street — has sold quite a few e-cigarettes in her establishment and has utilized it herself with positive reviews.
“If you’re trying to quit or just looking for something to use when you don’t have a cigarette at the time, it works,” Walston said. “When I’m with my grandbabies, I don’t smoke around them so the e-cigarette is a good substitute.”
With the increase in health, additional places to smoke and the flavors provided, Walston had a prediction about the future of e-cigarettes.
“The electronic cigarettes have really taken off,” Walston said. “There might be only e-cigarettes in 10 years.”


FDA: Second-hand smoke from e-cigarettes may be harmful to your health
June 27, 2013
E-cigarettes, the seemingly innocent alternative to the real thing, may not be that harmless after all, the Food and Drug Administration said as it issued an advisory identifying the “volatile” substances in the device and its emitted smoke.
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“Electronic cigarettes are not emission-free.? E-cigarettes contain volatile organic substances, including propylene glycol, flavors and nicotine, and are emitted as mist or aerosol into indoor air,” it said in FDA Advisory No. 2013-015 dated June 26, which was posted on the FDA website Thursday night.
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“If several people are using e-cigarettes in a room at the same time, considerable indoor air pollution will accumulate and may result to harmful second-hand exposure,” it added.
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FDA cited studies showing these “ultrafine liquid particles” measuring less than 2.5 micrometer in diameter may penetrate deeply into the lungs.
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Also, the FDA said such ultrafine particles could be inhaled by non-users especially when used indoors.
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“Second-hand exposure to e-cigarette emission which may lead to adverse health effects cannot be excluded,” it said.
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The FDA also cited a German publication on electronic cigarettes showing:
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•?besides glycol, the main ingredient, nicotine, flavors, tobacco-specific nitrosamines, volatile organic compounds, acetone, form aldehyde, acetaldehyde, benzo(a)pyrene as well as silicate and various metal particles are present
•?the particle size is between 100 and 600 nanometers, which is comparable to the particle size found in tobacco smoke of conventional cigarettes.
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“The levels of most harmful substances are lower in the e-cigarettes than in conventional cigarette smoke, but they do accumulate in indoor air,” it added.
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Also, FDA said the study showed four metals – sodium, iron, aluminum, and nickel – were at higher levels than with those known in cigarette smoke.
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Five other metals – copper, magnesium, lead, chromium, and manganese – were present in the same amount, while potassium and zinc were present at lower levels.
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“Nickel and chromium are carcinogenic and lead is suspected to be carcinogenic,” it noted.
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Because of this, the FDA reiterated its appeal to the public, especially the youth, “NOT to start smoking at all and to stop using cigarettes, cigars, or e-cigarettes.”
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It reminded local government units to enforce the Consumer Act of the Philippines, by “strengthening their ordinances against smoking in public places and on second-hand exposure to harmful substances.”? — ELR, GMA News


CDC Study Shows that Electronic Cigarette Use is Growing Among Smokers and Helping Some Smokers Quit, But Without any Increasing Appeal to Nonsmokers
March 04, 2013
By Dr. Michael Siegel
According to a national survey conducted by the Centers for Disease Control and Prevention (CDC), there was a tremendous increase in electronic cigarette use among smokers from 2010 to 2011 along with a large increase in the proportion of former smokers who reported having used electronic cigarettes, but without any increase in use by never smokers, suggesting that these products show promise as part of a national strategy for smoking cessation and reduction.
The study reported that ever use of electronic cigarettes among smokers increased from 9.8% in 2010 to 21.2% in 2011. Ever use of electronic cigarettes among former smokers increased from 2.5% to 7.4%. Ever use among never smokers remained steady at 1.3%.
In a press release accompanying the article, CDC Director Tom Frieden, MD, MPH, stated: “E-cigarette use is growing rapidly. There is still a lot we don’t know about these products, including whether they will decrease or increase use of traditional cigarettes.”
Also in the press release, director of the Office on Smoking and Health at CDC – Dr. Tim McAfee – stated: “If large numbers of adult smokers become users of both traditional cigarettes and e-cigarettes — rather than using e-cigarettes to quit cigarettes completely — the net public health effect could be quite negative.”
The Rest of the Story…
Despite the CDC’s concerns about the use of electronic cigarettes among youth to cigarette smoking initiation, there is no evidence that such a phenomenon is occurring. This study shows that despite the tremendous growth in awareness, publicity, and marketing of electronic cigarettes, there has been no recent increase in the ever use of these products among adult nonsmokers.
The study also demonstrates a tremendous increase in ever use of electronic cigarettes among smokers. Furthermore, it demonstrates that a large proportion of former smokers have used electronic cigarettes. This doesn’t prove that they used the electronic cigarettes successfully to achieve cessation, but it is consistent with this hypothesis.
Combined, these results add further support to the evidence that electronic cigarettes are a promising strategy to enhance smoking cessation and smoking reduction.
Interestingly, despite what these results actually suggest, the CDC is presenting them in a most negative light. The CDC director emphasizes that we don’t know whether the use of electronic cigarettes will increase or decrease the use of traditional cigarettes. However, there are only two ways electronic cigarettes could increase the use of traditional cigarettes: (1) if smokers who would otherwise have quit switch to electronic cigarette and tobacco cigarette dual use; or (2) if nonsmokers begin using electronic cigarettes and then initiate cigarette smoking.
There is absolutely no evidence that #2 is occurring. Electronic cigarettes are not popular among youth nonsmokers and in prior surveys, it has been difficult to identify even a single youth nonsmoker who uses electronic cigarettes.
There is also no evidence that #1 is occurring. Most electronic cigarette users are attracted to these products because they want to cut down or quit smoking but have failed to do so using other available smoking cessation products, like drugs. It is unlikely that these smokers would have quit smoking completely had it not been for electronic cigarettes.
The director of the Office on Smoking and Health is incorrect in stating that: “If large numbers of adult smokers become users of both traditional cigarettes and e-cigarettes — rather than using e-cigarettes to quit cigarettes completely — the net public health effect could be quite negative.”
Actually, the net public health effect could only be negative if large numbers of adult smokers who would otherwise have quit smoking completely become dual users of traditional cigarettes and e-cigarettes. If large numbers of adult smokers who would not have quit smoking completely reduce their cigarette consumption by substituting electronic cigarettes for some of their tobacco cigarettes, then the net effect on public health will be massively positive, as there would be a substantial decline in cigarette consumption.


The Anti-Tobacco Activist’s Foundation is a Lie
19 January 2013
The Anti-Tobacco Activists Know that their Ulterior Motives are Flawed, and so they take advantage of a Complex Debate
Prof Stan Glantz and several of his colleagues submitted a public comment to the FDA docket regarding a “Report to Congress on Innovative Products and Treatments for Tobacco Dependence”. Glantz and his colleagues made note of the fact that electronic cigarettes were successfully ruled by The US Courts in 2010 to be excluded from FDA regulations, and regulated as “tobacco products” specifically because electronic cigarettes were not being marketed with therapeutic claims.
Read more.

Research & Commentary: Electronic Cigarettes

August 16, 2012
Matthew Glans

Nearly 50 million U.S. adults—more than a fifth of the total adult population—smoke cigarettes. After vigorous public health efforts including taxes, education, and outright bans on smoking, the percentage of Americans who smoke has fallen by almost half in the past four decades.

In recent years, however, the number of Americans quitting cigarettes has begun to level off. No particular therapy is more than about 8 percent effective in causing smoking cessation. Consequently, some doctors and scientists suggest a “harm reduction” strategy in which smokers give up cigarettes but continue using tobacco or nicotine in different forms such as “e-cigarettes” and smokeless tobacco.

Electronic cigarettes, or “e-cigarettes,” have quickly become one of the most popular nicotine replacement products and a key building block in harm reduction strategies. According to the Wall Street Journal sales of e-cigarettes have doubled in the United States over the last five years, moving from $250 to $500 million in total sales. An e-cigarette vaporizes a solution of either propylene glycol or glycerin with a weak concentration of nicotine; this simulates the act of smoking and gives smokers their nicotine fix while eliminating the harmful compounds found in tobacco smoke.

Despite these benefits, some public health crusaders argue e-cigarettes should be banned. In the past year at least six states have proposed legislation to prohibit the sale of e-cigarettes to minors, and four states would add e-cigarettes to products covered under smoking bans. These critics and the U.S. Food and Drug Administration claim chemicals found in e-cigarette vapor could cause health problems. They also argue the main focus of tobacco policy should be the end of all nicotine use, regardless of source.

Supporters of the freedom to use e-cigarettes argue the devices are a viable nicotine replacement therapy. E-cigarettes mimic many of the physiological and psychological triggers of smoking without transmitting the toxins present in tobacco smoke. E-cigarette advocates also note the FDA’s acceptance of similar nicotine replacement products at similar concentrations and point to the flawed methodology of studies showing dangers from e-cigarettes. The American Association of Public Health Physicians has concluded e-cigarettes might “save the lives of 4 million of the 8 million current adult American smokers.”

The following articles examine electronic cigarettes and tobacco harm reduction from multiple perspectives.
Read more!

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