Tuesday, September 8, 2009

Negative Reactions Mystify Electronic Cigarette Owners

By Kristin Noll-Marsh

The booth at the Wisconsin State Fair Expo was black with big, gold lettering exclaiming, "Electronic Cigarettes - The Smoking Alternative!" Initially, I found the concept of electronic smoking laughable, as would most tobacco users. However, after dragging my husband over to the booth for a look, it only took us a moment to realize that this was a truly revolutionary invention. Surprisingly, the price was reasonable, too!

The vendor made it clear that it was not intended as a smoking cessation device, only a much safer and cheaper way to smoke. To date, there is no scientific proof that they are safer, but it didn't take a degree in rocket science to see that the absence of smoke, tar and a few thousand other ingredients - including the 60-70 known carcinogens and poisons found in tobacco - made the flavored nicotine liquid seem tame by comparison. Moreover, the ability to reduce the nicotine levels from high, medium and low to liquid containing no nicotine whatsoever was an appealing way to wean off nicotine altogether.

Of course, as soon as I got our new devices home, I had to log online to see what I could find out about them.

The first thing I found was a wide range of different devices and liquids available and not all devices are created equal.

Additionally, I found that a whole subculture has quickly built up around the new phenomenon of "vaping," the term coined by electronic cigarette owners to differentiate it from tobacco smoking. The electronic cigarette is known as a personal vaporizer, as it produces a fine mist or vapor, similar to the steam from a cup of hot coffee. Tobacco cigarettes are amusingly called "analogs." Personal vaporizer owners who have quit using tobacco cigarettes proudly consider themselves non-smokers.

"I feel free of cigarettes for the first time in my life," said James Solie, of Hudson, WI. Solie said his life has changed in so many ways since he has quit smoking. "I used to go to bed at night and could smell the smoke on myself, and it wasn't good. I don't miss that. I just feel better in every way imaginable. I breathe better, don't have that nasty congestion in the morning. My throat feels better. My sense of smell, thus taste, is much better." Solie added that his wife is happy that he has quit smoking, as well.

The fact that personal vaporizer owners are no longer smoking is difficult for non-smokers and smoke-free advocates to understand, because vapor looks similar in appearance to smoke. Thus many advocates welcomed recent news of the FDA's proposed ban on certain electronic cigarettes, due to safety concerns, and proposed bans on their use in public spaces in municipalities in New York, Connecticut and Oregon. Vaporizer owners fear the public has been falsely led to believe that personal vaporizers aren't any different than tobacco cigarettes.

"Because vaping looks like smoking people immediately associate the two and come to a bad conclusion," said Scott Brower, of Santa Clarita, CA. Brower said he was an occasional pipe and cigar tobacco smoker, but now enjoys only nicotine-free electronic pipes and cigars. "They need to be educated to understand the fundamental differences."

On the FDA report, Brower said, "The announcement was rushed and omitted critical details. What should have been a scientific process and conclusion felt more political and reactionary. While I applaud their recognition of vaping and the need for testing, I also have to admonish their lack of care and due process. The FDA serves a critical role and I want them to take a very hard look at vaping. However, they must follow the scientific method to the letter if they are to fulfill their purpose.
Given the potential significance of this to real tobacco users, and their fair and accurate treatment of this is literally life and death for millions."

Brower's response was typical of many vaporizer owners - one of shock and disbelief at the knee-jerk public and governmental reaction. It is hard for them to see the logic in allowing the sale and use of tobacco cigarettes, which are proven to contain dozens of poisons and carcinogens and create second-hand smoke while attempting to ban the vaporizers, which were found, in the FDA's own research, to possibly only contain trace amounts of adverse ingredients. As Brower pointed out, those results were based on incomplete data collected from only a few samples - out of hundreds of different liquids and cartridges available on the market.

Dr. Michael Siegel is a professor at Boston University School of Public Health and a physician who specialized in preventive medicine and public health. On his blog, The Rest of the Story: Tobacco News Analysis and Commentary, he commented, "With the FDA now approving the sale and marketing of conventional cigarettes, it is absurd to think that the Agency would spend so much of its energy on an attempt to remove this much safer alternative from the market, while ignoring the very real threat posed by the cigarettes being smoked by 45 million Americans."

"While further testing of electronic cigarettes is certainly warranted, and while restrictions on the sales of these products to minors and the types of marketing claims that can be made are reasonable," Dr. Siegel stated, "it would be criminal to take these products off the market. Smokers who have found these products to be a life-saver, allowing them to stay off regular cigarettes, should be permitted to have the choice of continuing to use the product while more definitive studies are conducted."

Other physicians seem to agree with his conclusions.

Just a few days before she started using a personal vaporizer, Julie Williams of Manchester, TN had a blood pressure reading of 230/110 and her heart rate was elevated. "I was on medication but it wasn't working," she recalled. "Within a week of vaping and only smoking 2-3 cigarettes a day, all my numbers went down to normal ones. My primary care doctor and cardiologist both attribute the change to me stopping smoking and vaping [instead.] Both doctors are telling other patients about e-cigs." She said she has now quit smoking tobacco cigarettes altogether. "Both my primary care physician and my cardiologist are behind me 100% in my vaping. I even vape in the exam rooms while we discuss my ongoing treatments."

Williams' doctors don't seem too concerned about alleged "second-hand vapor" either, unlike a few legislators and anti-smoking groups across the country, such as Suffolk County, NY, which, sponsored by Majority Leader Jon Cooper (D-Lloyd Neck), bans e-cigarette use in public spaces.

"There is no substantial evidence that these devices do any harm to the user or bystanders around the user," argued Spike Babaian, of Long Island, NY, in a recent press release. "Despite the plethora of evidence provided to the Suffolk County legislature, that shows evidence that these devices are no more harmful than consuming a hot dog, they have determined that the "stress, fear and confusion," which the public could potentially feel due to the presence of the fog, was sufficient reason to force vapers to follow the Suffolk County smoking ordinance and utilize these devices only in areas where smoking is allowed."

"This restriction would push thousands of non-smoking Suffolk County residents who utilize nicotine vaporizers into smoking areas where they would be exposed to the second hand smoke and toxic chemicals that they quit smoking to avoid," continued Babian. "This is a clear violation of the civil rights of non-smokers who wish to avoid the toxic chemicals given off by cigarette smoke. This law was passed based on public fear, rather than fact, and the total disregard for the safety of these former smokers is an unjustifiable disgrace. Suffolk County’s Health and Human Services Committee, which is supposed to protect the health of Suffolk County residents, has put "psychological discomfort" of the minority ahead of physical health and that is an unforgivable offense."

Aside from putting electronic cigarette owners back into the toxic cloud produced by tobacco smoke, personal vaporizer owners point out that their vapor doesn’t contain the amounts of lethal toxins nor does it behave in the same manner as cigarette smoke. The vapor isn't created unless actively in use, unlike the smoke that continuously comes from a lit cigarette and it doesn't appear to travel more than a couple of feet from the user. It also tends to dissipate more quickly than smoke, making it fairly undetectable and unobtrusive for those nearby, so presenting the two as the same thing is misleading.

In addition to the "second-hand vapor," legislators and anti-smoking groups such as ASH, the national anti-smoking group Action on Smoking and Health, argue that the electronic cigarettes are being marketed to appeal to children, specifically through fruit and candy-like flavors. Such claims leave a bad taste in vapers mouths.

"I didn't know that once I grew up I had to stop liking things that taste good," said a confused Julie Williams. "You can get the [nicotine] gum in a number of flavors and they are out in the open for any kid to grab. What is a kid going to choose to buy...an e-cig that they have to save up to buy online ($50 and up for a starter kit) or a pack of cigarettes they can get anywhere for $5.00?"

Ed Corcoran, of Lowell, MA, was equally shocked by the allegations. "I think that's ludicrous," he said. "Many alcohol products have sweet, fruity flavors. No one accuses those manufacturers of marketing their products to children based on that criteria. Just because something is meant for adults only, that doesn't mean it has to taste bad."

Others counter that many children get access to cigarettes because of the low cost or sneaking cigarettes from a parent – something which is almost impossible to do unnoticed with a personal vaporizer. And even if a child decided to spend over $100 on equipment and liquid refills and lie about their age to obtain it, what reason would they have to order a fruity flavor filled with nicotine? Nicotine produces no pleasant "rush" or "high" for a non-smoker and the liquids are available nicotine-free, with the same taste. The accusation holds no credibility and defies logic.

Many proponents of personal vaporizers have begun to suspect that the bad press is being manufactured and research results are being misrepresented purely for financial gain. Simple research online reveals that their claim can easily be substantiated.

ASH, one of the loudest opponents to electronic cigarettes and often a source of exaggerated or false propaganda, reportedly receives huge contributions from Pfizer Inc., the maker of numerous nicotine replacement drugs designed to assist smokers with quitting cigarettes. One of their products is Chantix, already known by the FDA to have been related to 78 deaths, 28 of which were suicides. Yet, the FDA has not banned that particular smoking cessation product and is going after electronic cigarettes, which have thus far not had any reported adverse effects or related deaths.

"If e-cigarettes really take off, they represent a huge threat to the profits of pharmaceutical companies, and in turn, they represent a threat to future funding of ASH," explained Dr. Siegel on his blog. "This conflict of interest is significant, but ASH has failed to disclose it in any of its statements about the dangers of electronic cigarettes. Each of the other anti-smoking groups which have warned the public about the dangers of e-cigarettes is also heavily funded by Big Pharma. Is this merely a coincidence? I think not."

While reputable electronic cigarette manufacturers and resellers do not advertise their product as a smoking cessation device, it is hard to ignore the anecdotal evidence that they end up being just that for many tobacco smokers who switch exclusively to personal vaporizers. It is common knowledge that most FDA-approved medical alternatives, such as nicotine gum and patches, are dismal failures, with some studies showing less than a 6.75% success rate after six months.

"The drugs are approved because they've shown in FDA studies that they're better than placebo," said Dr. Edward Levin, a psychopharmacological researcher at Duke University Medical Center in Raleigh, N.C., in a recent CNN article. "But being better than placebo doesn't take a whole lot, so there really is room for improvement." A University of Wisconsin study showed that the most successful drug, Chantix, only had a 44% success rate during 12 weeks of use. That success dropped to one in four in the weeks after the treatment was stopped.

In contrast, a survey of personal vaporizer owners at an electronic cigarette support site shows that 79% of respondents indicated that they have successfully quit smoking tobacco cigarettes. Some continue to use nicotine doses, others have reduced or eliminated the nicotine altogether. They feel that the gradual reduction of nicotine intake, with a familiar and comforting delivery system, allows them to immediately remove the known dangers of cigarette smoke while weaning off the nicotine.

Some may even continue to use the devices purely for recreational use, even with the nicotine. They see no difference in enjoying their nicotine alternative like others who enjoy recreational use of alcohol, caffine or chocolate. Personal vaporizers give them a way to do this without affecting those around them, as cigarette smoke did. Nicotine is a legal substance and adults should be allowed to enjoy it responsibly, they argue.

Dawn Brain, of Smith Mountain Lake, VA, did not start using personal vaporizers to quit smoking, she only wanted a lower cost alternative.

"I didn't start using them for health reasons," Brain said. "I decided to try [personal vaporizers] because I was tired of the cost of cigarettes going up. When the price of the brand I was smoking went from $23 to $35 in one week I was fed up. If I had not had PVs to turn to I would have kept smoking and just grumbled about the fact that my cost went up by 50% over night, but this time I had an option and I jumped on it.

"Added to the cost benefit," Brain continued, "I liked the fact that my house and clothes would no longer smell like cigarettes and I wouldn't be putting 35 cigarette butts into the landfill daily. I no longer have to worry about my cats knocking over my ashtray and having to clean up ashes and butts."

"It never occurred to me that I would feel so much better, be able to breathe deeply for the first time in 23 years, and be able to taste things that had lost much of their flavor from my smoking."

Electronic cigarettes may save many lives, providing the FDA doesn’t make them illegal. Responsible vaporizer owners are mystified about the reactions to the revolutionary device, and hope that as the public becomes more knowledgeable, they will be more positively received.

Thanks to a chance encounter at the expo that day, my husband and I are now ex-smokers. Like thousands of other personal vaporizer owners, who are now smoke free, I wonder how can that be considered a bad thing?

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Dr. Michael Siegel, My Op-Ed in Hartford Courant Calls for a Scientific, Not an Ideological or Political Response to the Electronic Cigarette Issue, The Rest of the Story: Tobacco News Analysis and Commentary

Dr. Michael Siegel, Action on Smoking and Health Warns Public of the Dangers of "Secondhand Electronic Cigarette Smoke", The Rest of the Story: Tobacco News Analysis and Commentary
U.S. Food & Drug Administration, Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted By FDA , FDA.gov

Suffolk County Legislature, Resolution No. 717: A local law banning the sale of e-cigarettes to persons under the age of 19, legis.suffolkcountyny.gov

Spike Babaian, Suffolk County, New York says Former Smokers are still "Smoking", PRLog.org
Aaron Smith, Antismoking drugs go up in smoke, CNNMoney.com

E-cigarette-forum.com Poll, E-Cig Success Rate?, e-cigarette-forum.com

National Cancer Institute, Cigarette Smoking and Cancer: Questions and Answers, Cancer.gov

John R. Polito , Chantix blamed for 3,063 serious injuries and 78 deaths, WhyQuit.com

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Kristin Noll-Marsh is a real estate consultant, blogger, freelance writer and now an ex-smoker in Antigo, WI.
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