SmokeFree Wisconsin Misleading Public about Orbs risk

SmokeFree Wisconsin posted a convincing blog post implying to consumers that Camel Orbs carry a high risk of cancer, based on facts culled from a CDC report on smokeless tobacco.

What SmokeFree Wisconsin fails to tell consumers is that report is based on old-fashioned chew and snuff, NOT newer products such as lozenges, strips, sticks and snus.

Stating simply that "smokeless tobacco contains 28 known, cancer-causing toxins," is misleading and a half-truth. The CDC made this declaration about chew and snuff based mostly on a 2007 WHO report, "Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines." The tobacco products they analyzed were not the refined, fine tobacco used in Orbs and other newer smokeless tobacco products. The same levels of nitrosamines (TSNAs) found in those products have not been found in products such as Orbs and snus.

In fact, in June 2010, the Canadian Non-Smokers' Rights Association endorsed tobacco harm reduction, including the use of products such as Orbs, snus and electronic cigarettes. They released NSRA Harm Reduction Policy Analysis June-2010* which showed the true risks of cancer associated with such products were minimal, if not non-existent. Mind you - this is a report by an organization concerned for non-smokers' rights:

The risk of oral cancer varies by type of smokeless tobacco product and is much greater for dry snuff than for moist snuff. The relative risk of oral cancer from use of dry snuff is 5.9 compared to 1.2 from chewing tobacco and 1.0 from moist snuff.37 A meta-analysis in 2007 concluded that the type of smokeless tobacco used in America or Europe “carries at most a minor increased risk of oral cancer.”38 The Royal College of Physicians has concluded that “the risk of oral cancer associated with use of low-TSNA tobacco products such as Swedish snus is small, and possibly non-existent.”39

The report also warns that comparing products such as snus and Orbs with smokeless chew and snuff are misleading:

When considering studies of the health risks of smokeless tobacco, it is important to distinguish between smokeless products such as traditional spit and chew (in Canada the most popular brands are Copenhagen and Skoal) and Swedish-style snus. Most studies of the health risks of smokeless tobacco use do not make the distinction between snus and other forms of smokeless tobacco.

• Oral cancer

– The risk of oral cancer varies according to the type of smokeless tobacco. Two Swedish studies found no elevated risk of oral cancer from snus use, and the findings constituted the grounds for the removal of the oral cancer warning from snus products in Sweden in 2001.50

• Leukoplakia

– There is a very high rate of leukoplakia development from snus use, much higher than with other forms of smokeless tobacco; however, the lesions are mostly due to irritation and only rarely progress to oral cancer.51

• Heart disease

– There are very few studies of the risk of heart disease from use of Swedish snus that also correct for possible confounding variables, including smoking and exposure to second-hand smoke. Of six studies of risks of heart attack risk among long-term Swedish snus users, only one found an increased risk, and five found no increased risk over never tobacco users.52 A meta-analysis in 2009 of eleven studies, eight in Sweden and three in the US, provides consistent evidence of a small increase in risk of fatal heart attack and stroke, with no evidence of a difference in effect of the smokeless products.

The report goes on to discuss lozenges very similar to Orbs:

Small manufacturer Star Scientific has been selling two forms of dissolvable tobacco product for several years—Ariva, targeting cigarette smokers, and Stonewall, aimed at users of smokeless tobacco. Both products come in the form of a small pellet, slightly larger than a Tic Tac mint.59 

Ariva and Stonewall have levels of TSNAs similar to Swedish snus.60

While the pellets may contain higher amounts of nicotine, the average nicotine user tends to "self-regulate" and would simply use less pellets than they would smoke. The craving for nicotine subsides after exposure, so the user would be less likely to use as many Orbs as they would cigarettes. Additionally, the nicotine content in cigarettes varies just as widely and the low nicotine content in NRTs such as nicotine gums, lozenges and patches make them highly ineffective as a substitute for smoking.

Of course, none of these products should be in the hands of children, but claiming that these products are "not a safe alternative to cigarettes" belies the truth that they are a SAFER alternative to smoking and misleads the public into believing that smokers would not have any health benefit by switching. However, even if these smokeless products still have a 1-2% risk of adverse health effects, that still makes them 98-99% less risky than smoking.

As the Canadian report urges:

The public has the right...to accurate information about the relative risks of using tobacco products and to make choices based on the facts. The current warning on smokeless tobacco products, “This product is not a safe alternative to smoking,” is woefully inadequate as it provides no information regarding relative risks.

SmokeFree Wisconsin apparently believes that Wisconsin consumers do not deserve the same right.

If SmokeFree Wisconsin is truly concerned about nicotine products getting into the hands of children, they should also warn parents of another candy-like nicotine product. This product is white (Orbs are brown) and looks EXACTLY like a Tic Tac. They even have those "quitting sucks" commercials with a shark attack and other humorous scenarios that kids think are funny.

Meet the Nicotrette Mini:

Nice "trick" SmokeFree Wisconsin.



*NOTE: The NSRA Harm Reduction Policy Analysis June-2010 also has positive comments on E-cigarettes. I highly recommend reading this report for many facts about tobacco harm reduction.

Memorial Day and the Myth of Nicotine

This holiday weekend I had the opportunity to speak to my husband's aunt regarding electronic cigarettes. She was smoking and showed interest. Ever the e-cig evangelist, I excitedly told her of the advantages of smokefree alternatives.

To my utter dismay, she told me her doctor had given her a prescription for a "low nicotine" or "no nicotine" cigarette, claiming that the nicotine was the dangerous component of smoking. (After an extensive Google search, I couldn't find a "prescription no/low nicotine cigarette," so I've concluded she meant a Nicotrol Inhaler.)

It took me several attempts to get her to understand that nicotine, absent the smoke, is relatively safe. "It's the smoke that contains all of the toxins," I told her. She was shocked, as the vilification of nicotine by the anti-tobacco groups had completely convinced her that nicotine is what killed people.

That led, of course, to a discussion about smoke-free tobacco and another surprise revelation - that smoke-free tobacco is up to 99% safer than smoking cigarettes. The real shock for her was finding out that the risk of mouth and throat cancer was actually up to 50% less than the risk from smoking. As with other typically brainwashed consumers, she believed that smokeless tobacco products actually had a HIGHER risk of mouth/throat cancer. To add to the irony, she had discouraged her occasional-smoker son from using oral tobacco, not because of the perceived health risks, but to prevent damage to his costly dental work. Consequently, he remained an occasional smoker, when simple, good dental hygiene would have reduced his health risks by 99%.

Finally, she told me that she never filled the prescription from her doctor, because insurance didn't cover it and just 30 doses cost $35. So, she continues smoking. After informing her of the truth about the health benefits of smokeless alternatives and electronic cigarettes and especially the low cost, she was quite interested in getting information on how to order.

This whole conversation graphically illustrated the tragic consequences of the lies and myths perpetuated by the groups calling themselves "public health." A 50-something year old woman, who knows that she should quit smoking for her health and well-being, would have been willing to switch to a less hazardous product had she known the facts. "Public health" failed her. Their scare tactics failed to inspire her to quit, their costly "treatments" were out of her financial means and their refusal to endorse reduced harm tobacco products (in a prohibitionist belief that any kind of nicotine use is unacceptable) needlessly exposed her to the most harmful tobacco product available.

It's my hope that groups like CASAA, the Consumer Advocates for Smoke-free Alternatives Association, will be able to fill the huge gap left by the tobacco control and public health groups, by educating committed smokers and giving them the tools and knowledge to make informed decisions about their health and well-being.

If my conversation with my husband's aunt is any indication, the myth of nicotine as the killer in cigarettes continues to be pervasive and persuasive and that is what continues killing people.

The concept of reduced harm tobacco has been around for at least 15 years. In that time, public health and tobacco control have had the opportunity to save many lives. This Memorial Day, I found myself thinking of the 6.6 million smokers who died because of the prohibitionist agenda of "public health."

SmokeFree Wisconsin not about public health

In a recent blog post, I addressed a recent blog post by SmokeFree Wisconsin regarding smokeless tobacco products.

After a few readers questioned the logic of refusing to do "less harm" in promoting the use of smokeless tobacco over smoked tobacco, the author replied,

Our priorities include proving for smoke-free environments, increasing the price of tobacco, and ensuring there is a strong, comprehensive tobacco prevention and control program.

To serve those priorities we partner to collect data, data which indicates that smokeless use is already on the rise in WI. We use data which shows that the burden of tobacco is NOT reduced by the use smokeless products.

We are not exposing smokers to any risks. We pass policies, we don't do treatment.

Smokeless is not less harmful. Period.

So, where is the goal of protecting public health in this statement?

Where is the accountability that in setting policies, they affect public behavior?

Since when did it become "the burden of tobacco" over the burden of smoking and it's affect on public health?

Where is the science that proves that smokeless is not less harmful than smoking? There is plenty of science that proves the greatest exposure to toxins and carcinogens is in the smoke - we see it in the news and in public statements from groups such as the American Lung Association and the American Cancer Society.

If what SmokeFree Wisconsin says is true about smokeless tobacco, wouldn't the opposite also be true? That smoking is no more dangerous than smokeless tobacco? So why the need for indoor smoking bans, if the smoke isn't the real danger?

In its policy to put eradicating any tobacco use as a priority over getting people to quit smoking, SmokeFree Wisconsin completely ignores valid, scientific research and urges people who use tobacco products to continue to use only its most dangerous form - smoking.

Because if smokeless tobacco is no less dangerous, why switch from smoking?

SmokeFree Wisconsin Doesn't Believe in Reducing Harm for Smokers

In a May 6, 2010 blog post, SmokeFree Wisconsin applauded the new, larger warnings on smokeless tobacco products.

That would have been fine and dandy, if not for these comments by the author:

This product is not a safe alternative to cigarettes. This product can cause mouth cancer This product can cause gum disease and tooth loss....

and

The implication here is that you can dance the night away with Snus in your mouth and never have to go out for a cigarette and miss you favorite song.

I couldn't help but comment and surprisingly, my comment was accepted for once:

And WHY that is a bad thing? If they are using snus (which is scientifically shown to be up to 98% less dangerous than smoking tobacco) instead of smoking, wouldn't that be better for the smoker's health? Especially if they would already be smoking?

I understand you want everyone to avoid tobacco products completely, but that isn't going to happen. If offered the choice between deadly tobacco smoke and the far safer smokeless tobacco products, why lie to them and tell them smokeless products are just as bad? All you are doing is (encouraging) the use of a far deadlier product, because people will think they may as well keep smoking.

Granted, we don't want kids to start using tobacco products, but by misrepresenting the comparative safety of smokeless alternatives, you are exposing actual smokers to far greater risks.

The author's reply:

The studies of which you refer are in reference to Swedish Snus, a product which is entirely unlike American made Snus. Moreover public health has a duty and responsibility to "do no harm." The ethics which guide the profession do not promote "doing less harm."
Thanks for your comment.

And my comment back (we'll see if it gets posted):

No offense, Erich, but baloney.

If that were the case, public health wouldn't advise people to use low-fat and sugar-free foods - they'd be telling them not to eat it at all. People would be told not to drive at all, because seatbelts would only "do less harm" and aren't 100% safe.

Reduced harm/risk has been around for years in foods and other public health and safety, why not tobacco?

To tell people to just keep smoking, because smokeless tobacco isn't 100% safe make no sense. I know you want people to quit altogether, but that isn't what is happening with over 20% of the U.S. population who still smoke. By making smokers believe that smokeless alternatives are no safer than smoking, they will just keep smoking, while they could have been breaking their habit of smoking and reducing their health risks.

I'm not talking about encouraging non-smokers to use smokeless tobacco - that'd be irresponsible.

I'm talking about COMMITTED SMOKERS, who are already pumping 4,000 toxic chemicals and 60 carcinogens into their bodies and can't or won't quit. If they won't quit smoking, can you really argue that it isn't the duty of public health officials to alert them to the fact that smokeless products lack up to 98% of those chemicals and carcinogens found in tobacco smoke? (And we know it's the SMOKE, otherwise indoor bans would include smokeless tobacco. Or is this "TobaccoFree Wisconsin" now?)

How is that any different from telling someone to use low-fat products, which aren't as good as abstaining altogether, but at least LESS detrimental to their health?

Not informing smokers that many smokeless tobacco products are up to 98% safer than smoking is like telling a morbidly obese person that they may as well eat Ben and Jerry's, because low-fat yogurt still has "some fat."

I guess it's pretty much self-explanatory. These smokefree "public health" groups are no longer about real public health or even about the "smoke." They are about tobacco abstinence - PERIOD. And it doesn't matter who gets hurt in their rush to force that ideal. How many smokers will die because these groups refused to "do less harm?"

The argument against encouraging committed smokers to switch to reduced harm products, because they can't encourage "doing less harm," holds no water. Seatbelts, helmets, low-fat and reduced calorie foods - are all products meant to do "less harm" to or reduce harm for the user. Doctors regularly prescribe treatments that are risky or dangerous in the hope to save a patient's life. If it were not for the use of deadly chemicals, which make the patient extremely ill and could kill them, many cancer patients would not be survivors today.

So don't try to tell me that public health cannot reconcile itself with "doing less harm."

Are Electronic Cigarettes Safer than Traditional Cigarettes?

by Kristin Noll-Marsh

Recently, there has been media coverage about the safety of electronic cigarettes, which may be confusing and a bit scary. Even groups like the American Lung Association and American Heart Association are attempting to remove them from the market. They claim that there is no "proof" that electronic cigarettes are any safer than traditional cigarettes.

Does this claim make sense? Read more and decide for yourself.

History
Electronic cigarettes were intended to be a less-toxic (or “safer”) option to smoking tobacco cigarettes, but not a treatment for nicotine addiction.

Chinese pharmacist Hon Lik invented the e-cigarette in 2003 with a patented ultrasonic technology. Hon Lik was inspired to invent this smoking alternative, because his father was dying from lung cancer. Since then, most e-cigarette manufacturers use a heating element that vaporizes the nicotine liquid instead.

Read more: http://emerging-business-markets.suite101.com/article.cfm/sources_for_imported_ecigarettes#ixzz0TNTSptUJ

Nicotine
It’s well documented that currently available treatments for smokers, nicotine replacement therapies such as patches and gums, are largely ineffective, with just a 7.2% success rate after 12 months. This is largely due to the fact that smokers aren’t just addicted to the nicotine; they are addicted to the actual habit and ritual of smoking a cigarette. It is a comfort system for them. That is even stronger than nicotine addiction.

However, the greatest danger in cigarette smoking is not the nicotine. Nicotine, while highly addictive, is a stimulant similar to caffeine and non-toxic in low, intermittent doses, which is why it can be used in nicotine replacement therapies. Nicotine, by itself, does NOT cause cancer, but is known to have some minor health effects. Cigarette smoke, on the other hand, contains more than just nicotine. It contains thousands of toxic chemicals and over 60 known carcinogens.

Hon Lik seems to have believed that there could be an option for smokers, to still have the act of smoking, while limiting exposure to the chemicals, toxins and carcinogens found in tobacco smoke. He had to have known that the smoker would still need relief from the nicotine addiction; so to get them to switch to the less toxic electronic cigarettes, he had to include doses of nicotine.

Read more: http://www.drugs.com/sfx/nicotine-side-effects.html

Diethylene glycol
You may have heard that the FDA announced that diethylene glycol, an ingredient in antifreeze, is found in electronic cigarettes. This is a gross exaggeration. The FDA found a non-toxic amount (approx. 1%) of diethylene glycol in just one Smoking Everywhere-brand prefilled cartridge.

Diethylene glycol is a toxic substance used in anti-freeze, but it is not used in the manufacture of electronic cigarette liquid. Because it used in tobacco processing, cheaper, less refined nicotine may become contaminated with traces of diethylene glycol. It is the most likely explanation of how one cartridge may have been contaminated. The other 17 cartridges were not found to have been contaminated with diethylene glycol. Subsequent testing of other electronic cigarettes found no diethylene glycol, so it appears that the one cartridge was an anomoly.

Read more:
http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm
http://en.wikipedia.org/wiki/Diethylene_glycol

Propylene Glycol
Propylene glycol is commonly confused in the media with diethylene glycol as the "toxic chemical found in antifreeze" the FDA found. (Anti-freeze is actually most commonly made with ethylene glycol.) While propylene glycol can be found in some antifreeze, it is actually added to it to make it less toxic to children and animals.

“Antifreeze typically contains ethylene glycol as its active ingredient, but some manufacturers market propylene glycol-based antifreeze, which is less toxic to humans and pets. The acute, or short-term, toxicity of propylene glycol, especially in humans, is substantially lower than that of ethylene glycol. Regardless of which active ingredient the spent antifreeze contains, heavy metals contaminate the antifreeze during service. When contaminated, particularly with lead, used antifreeze can be considered hazardous and should be reused, recycled, or disposed of properly.”

Read more:
http://www.epa.gov/waste/conserve/materials/antifree.htm

Propylene glycol is actually approved for human consumption by the FDA and approved for human inhalation by the EPA. It is a common ingredient in many foods and medicines, such as McCormick (and other brand) imitation food flavoring, toothpaste, cough syrup, hand sanitizer, lotions, cosmetics, asthma inhalers and more.

Read more:
http://www.epa.gov/oppsrrd1/REDs/propylene_glycol_red.pdf
http://en.wikipedia.org/wiki/Propylene_glycol

Tobacco-specific Nitrosamines (TSNAs)
The FDA announced that it's analysis found “carcinogens” in the samples tested. These tobacco-specific nitrosamines are created during the curing and processing of tobacco and would be expected to be found, in trace amounts, in nicotine extracted from processed tobacco. In tobacco smoke, they are found in high concentration and are a leading cause of tobacco-related cancers. These carcinogens were found in just trace amounts in the electronic cigarette liquid and are also found in other tobacco and nicotine products, including nicotine replacement pharmaceuticals such as nicotine patches, gum and inhalers. A study at Oxford concluded that the highest levels of these nitrosamines are found in the reaction of tobacco smoke and minimal in NRTs. Testing of Ruyan electronic cigarettes by Health New Zealand found electronic cigarette TSNAs are comparable to the levels found in the FDA-approved nicotine patch.

Absolute safety does not exist for any drug, but
relative to lethal tobacco smoke emissions, Ruyan
e-cigarette emissions appear to be several
magnitudes safer. E-cigarettes are akin to a
medicinal nicotine inhalator in safety, dose, and
addiction potential. - Dr. Murray Laugesen, Health New Zealand

Read more:
http://en.wikipedia.org/wiki/Tobacco-specific_nitrosamines
http://www.ecassoc.org/downloads/Response-to-the-FDA-Summary.pdf
http://carcin.oxfordjournals.org/cgi/reprint/18/3/587.pdf
http://www.healthnz.co.nz/DublinEcigBenchtopHandout.pdf

Flavoring
Most companies use water-based, food-grade flavorings for their liquids. They make up a very small percentage of the total liquid content. These have been approved by the FDA for ingestion, but the effect of long-term inhalation has not been tested.

Most of the ingredients in electronic cigarette liquid has been tested and approved for long-term exposure in humans, but not when they are all mixed together. There are also no set minimal standards for manufacturing and the FDA has not approved any liquid for sale or use. The FDA wants to classify electronic cigarettes as a drug and drug delivery device for smoking cessation and wants appropriate studies done to show that they are safe. It is unklnown if the FDA will compare the safety of electronic cigarettes to that of smoking tobacco cigarettes long term or to using NRTs short term, to quit smoking.

Injuries and Illness Attributed to Electronic Cigarettes:
Electronic cigarettes have been on the world market for over 5 years and in the U.S. for over 2 years. To date, there have been no public reports or complaints of injury or illness attributed to electronic cigarette use.

Compare that to complaints against the FDA-Approved smoking cessation drug, Chantix. Since it's introduction to the market 4 years ago, there have been numerous complaints of erratic behavior, suicidal impulses, violent behavior and over 50 deaths/suicides reportedly attributed to the drug.

Read More: http://www.fda.gov/drugs/drugsafety/publichealthadvisories/ucm051136
http://www.marketwatch.com/story/pfizer-updates-chantix-label-in-us-to-include-warning
http://en.wikipedia.org/wiki/Varenicline

Traditional Cigarette Toxicity:
Various, peer-reviewed studies show that traditional cigarette smoke contains 4,000 or more chemicals - many of them highly toxic. They also show that approximately 60 of those chemicals are human carcinogens/TNSAs.

Read More: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm198176.htm

The typical electronic cigarette liquid contains water, propylene glycol, glycerin, nicotine & food-grade flavoring, none of which are found in toxic levels nor known carcinogens.

Now you have the facts. You decide, for yourself, if you think electronic cigarettes are safe (or at least safer than tobacco cigarettes) for you.

Why do anti-smoking groups oppose tobacco harm reduction?

An excellent speech by Christopher Snowdon, author of "Velvet Glove, Iron Fist"

Similarly, Americans for Nonsmokers’ Rights - in a press release titled Electronic Cigarettes are NOT a safe alternative! - criticised the e-cigarette specifically because it mimics the act of smoking and because it contains nicotine. Only pharmaceutical nicotine products escape criticism, partly because they are marketed as a medicinal cure for a ‘disease’ and partly because they administer nicotine without providing pleasure. This has led to a somewhat inconsistent view of nicotine, described as being perfectly safe in pharmaceutical products but highly toxic in e-cigarettes, snus and other tobacco products. The EPA describes it as “acutely toxic (Category 1) by all routes of exposure (oral, dermal and inhalation)” while the MHRA says thats “nicotine, while addictive, is actually a very safe drug.”

Read Full Story

Electronic Cigarette Users Fighting Back

Petition Aims to Save Lives

Tobacco smokers aren't known as a politically active group. Even though they make up over 20% of the adult population in the U.S. and make a significant contribution to federal and state revenues, after years of being vilified and desocialized, they've pretty much accepted that the rest of the population won't acknowledge them until they either quit smoking or die.

Their electronic cigarette-using counterparts, however, have no intention of going so quietly into the night. They believe their devices are the antithesis of tobacco cigarettes and are life-savers worthy of a petition against moves by the FDA and numerous anti-smoking groups to remove electronic cigarettes from the market.

Electronic cigarettes have been on the market worldwide for over five years.1 Some models look like a traditional cigarette, but they are actually made from a battery-powered heating element that vaporizes a water-based, flavored nicotine solution into an inhalable mist.2

As of this writing, nearly 600 people had signed and commented on the six-day-old petition posted at EcigsSaveLives.info and they have pledged to withdraw any further financial contributions to organizations, such as the American Lung Association and the American Cancer Society, until those groups reverse their current policies against e-cigarettes.3

The petition, written by the Vapers Coalition4, quoted the named organizations' own statements about the dangers of tobacco smoking and pointed out how, according to published test results, electronic cigarettes are no more of a danger to smokers than FDA-approved smoking cessation products.

As word spreads, the petition numbers are growing and organizers hope to reach at least 10,000 signatures by September 1, 2010. They intend to hand-deliver a hard copy of the petition to each organization and are encouraging petitioners to send their own individually signed hard copy, as well.

Comments on the petition ranged from testimonials of the benefits of electronic cigarettes to angry accusations of financial interests winning out over public health. Many promised to get their friends and families to support boycotting the health organizations and others warned that removing electronic cigarettes from the market would have devastating consequences.

"I am a 1 1/2 year user of PV's (e-cigs) and have been tobacco free for over a year," wrote petitioner Brenda Wood. If a ban were to take effect, I know I would revert to tobacco, as NONE of the NRT's on the market worked for me, and some made me very, very ill."

Mark Watkinson made an appeal on behalf of his father writing, "My father is dying from his habit. If he doesn't switch to an E Cigarette he may be dead in as little as 2-5 years. Please don't ban this life saving device. Nothing can be worse health wise than the legal tobacco cigarette!"

Alluding to federal and state tobacco tax revenues and the multi-billion dollar smoking cessation industry, petitioner George Seder wrote, "Which conflict of interest are you going to side with? Smokers who want to stay healthy or special interests who depend financially on misery and death?"

Electronic cigarette users are adamant that they have finally found a way to painlessly replace tobacco smoking with a product that has been shown, through testing and real-life application, to be multitudes safer than smoking. Unlike tobacco cigarettes, petitioners say electronic cigarettes are worth fighting for.

Sources:

1. A Historical Timeline of Electronic Cigarettes,http://www.casaa.org/resources

2. http://en.wikipedia.org/wiki/Electronic_cigarette

3. http://EcigsSaveLives.info

4. http://VapersCoalition.org

Up in Smoke: How Will Our Tobacco Policies of Today Be Viewed by Future Generations?

In the history of the United States of America there have been more than a few public policies that leave today's generation incredulous.

We look back at the great issues our ancestors faced such as slavery, civil rights, Prohibition, Suffrage, the relocation and assimilation of Native Americans, discrimination, child labor and the wholesale destruction of our natural resources and wonder, "What the heck were they thinking?"

If you looked closely at any situation where a minority group was openly discriminated against and endangered, it usually can be explained with one word - greed. Behind every law or policy, someone stood to gain or lose financially.

Look at today's tobacco policies and cigarette smokers.

Here we have a product that the CDC states "is the single most preventable cause of disease, disability, and death in the United States. Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and another 8.6 million have a serious illness caused by smoking. Despite these risks, approximately 46 million U.S. adults smoke cigarettes." 1

Yet, rather than remove the deadly product, government officials offered regulation. The tobacco industry was banned from advertising in most media outlets, from sponsoring high-profile sports and ordered to redesign packaging with visible health warnings in an attempt to "protect" consumers. Higher and higher taxes were imposed, with the dual intent of making the price of cigarettes less appealing and to finance the health costs associated with smoking. In spite of this, people not only continued to smoke, new smokers continued to start smoking every day.

Anti-tobacco advocates weren't satisfied with the government's efforts, so they formed health organizations intended to educate smokers and support their efforts to quit. This heightened awareness of the health risks (plus the discovery in the 1950's that smoking was linked to lung cancer) prompted an unprecedented number of smokers to try quitting, but the success rates were less than stellar. This stumped the health groups. People knew that smoking was bad for them, why didn't they just quit?

Researchers finally pinpointed nicotine as being the ingredient in cigarettes that made quitting so difficult. Pharmaceutical companies developed "nicotine replacement therapies" designed to temporarily give smokers the nicotine they craved while they attempted to quit. Smokers had to be convinced that nicotine wasn't the dangerous component of smoking - just the addictive one. A new industry was created around smoking cessation, however, the products only worked for a tiny number of smokers. Over 97% of smokers would either bounce back and forth between smoking and the smoking cessation products or simply give up and go back to smoking. Obviously, helping smokers wasn't working, so maybe guilting or punishing them into quitting would.

Along came reports about "second-hand" and "third-hand" smoke. Based on some questionable research, the health advocates announced that smokers were not just hurting themselves, but also hurting those around them - even from simply touching them after smoking. Suddenly, "anti-tobacco" groups became "anti- smoking" prohibitionists, intent on banning any form of smoking or nicotine use and the attempts to help smokers turned into attempts to de-socialize and de-normalize them. Additional taxes on cigarettes were called "sin tax" and smokers were the sinners.

No serious attempts were made to remove the root cause of all of this trouble - cigarettes. The tobacco companies still made their profits, because smokers still had nothing to help them quit successfully. Sure, more token changes were done to make a good showing to their constituents. They banned flavors that no one really bought anyhow while the most profitable flavor - menthol - remained on the market; cartoon characters and other advertising that supposedly influenced children (even though research showed that stress, peer behavior and smoking family members were the largest influence for new smokers) were censored; smoking in public places was banned and any new recreational products containing nicotine were protested and pulled from the market as a "gateway" to smoking. Nicotine, while shown to be relatively harmless absent the tobacco smoke, was simultaneously vilified in the form of any new "reduced harm" smokeless products while being promoted as an "FDA-approved" pharmaceutical treatment.

That's not to say that the earlier, genuine efforts of the government and health organizations didn't have any impact. In the 1950's, more than half of the population in the U.S. smoked cigarettes. 2 As of 2009, that number had been reduced to approximately 21%, but that was an INCREASE from 19.8% in 2007 and it has remained constant since. The CDC placed the blame on state governments putting little or nothing of their $203.5 billion in tobacco-related revenue towards smoking-cessation programs. One has to wonder where all of that money was going instead.3

Of course, by this time there were many more groups making profits from smokers than just Big Tobacco. Federal and state governments now had billions of dollars coming in from the "sin tax." Big Pharma now had a multi-billion dollar per year smoking cessation industry and was donating huge amounts to the anti-smoking groups, who along with the medical community happily peddled their smoking cessation products. Anti-smoking groups, while mostly not for profit, still employed thousands and paid their leaders and lobbyists handsomely. Suddenly, the livelihood of all of these organizations was inextricably tied to tobacco and to smokers continuing to smoke.

So, where did that leave the smokers? Well, they were left with half-hearted attempts to help them quit, costly and ineffective "treatments," life as a social outcast and the privilege paying higher and higher prices to expedite an early death.

Then the electronic cigarette arrived.

Developed by a Chinese inventor in 2003 after his father, a heavy smoker, died of cancer (or so the story goes) the electronic cigarette was already a worldwide, multi-million dollar industry by the time the first shipments hit U.S. shores. While the concept was nothing new, the enterprising Chinese were the first to put it all together in a simple yet brilliant device.

Manufacturers put a small amount of medical-grade nicotine into propylene glycol - which was already recognized as safe by the FDA and the EPA - added appealing flavors and then put the solution in to a cartridge. The user attached the cartridge to a small heating element, which was powered by a cigarette-shaped battery, then inhaled the vapor created by the heated nicotine solution. To complete the illusion, the Chinese cleverly added an LED that lights up when the user inhales from the device. They marketed them to committed smokers - those who had no intention of quitting - as a less hazardous alternative to tobacco cigarettes. Smokers got their (relatively safe) nicotine with the sensations of smoking and without the toxic levels of chemicals and carcinogens found in tobacco smoke.

Seems like win-win, right?

Governments should have been happy that smokers would no longer be overwhelming the health care system. Anti-smoking and healthcare groups should have been happy that smokers would no longer inhaling or exposing bystanders to 4,000 chemicals and 50+ human carcinogens. Big Tobacco should have been happy it could now extract the nicotine from their plants, make their own electronic cigarettes and sell consumers a low-risk, recreational product. Big Pharma had the opportunity to make their own electronic cigarettes, develop a step-down plan and sell consumers a highly effective smoking cessation program.

Smokers would have been happy to satisfy their desire to smoke, without the guilt, cost and health hazards associated with tobacco smoking. Smoking, no longer defined only as burning tobacco leaves, would have been able to step out of the penalty box and back into mainstream society; no longer a public health hazard and as socially acceptable as enjoying a glass of wine or a jolt of espresso. Future generations should have been able to look at their history books and see how humanity made one of the most significant advances for public health in decades.

Instead, history may record that greed once again won out over the public's best interest.

Incredibly, the FDA, numerous state governments and a plethora of health and anti-smoking groups came out in full force AGAINST electronic cigarettes. The results of testing by the FDA and several independent labs, which showed that electronic cigarettes "use the same nicotine, with about the same level of trace contaminants as FDA approved NRT products"4 were twisted or completely ignored. Instead the FDA dramatically announced that the devices "contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze" and left the public to assume that the levels found were dangerous to humans.5

The FDA used the publicity to justify its declaration that electronic cigarettes were "unapproved drug delivery devices" and would be blocked from the market until they were shown to meet stringent smoking cessation standards. Public health organizations, followed by state legislators (with a sharp prod from the former), used the FDA announcement as a spring board and called for the immediate removal of electronic cigarettes from the market until they received FDA approval.

The former smokers who now used electronic cigarettes and the current smokers who found out about the devices via the FDA press statement weren't buying the spin though. The number of smokers switching to electronic cigarettes and then becoming "e-cig evangelists" to other smokers continued to rise.

When angry and confused consumers called and emailed groups like the American Lung Association, providing positive testimony of their experience with electronic cigarettes and demanding to know why the groups opposed a product that could save so many lives, they were met with canned responses such as: "The FDA hasn't approved them as smoking cessation devices." "We don't know what's in them." "They found antifreeze and carcinogens in them." "Quitting is better."

All of these answers completely ignored the fact that there had been no reports of injury or illness attributed to electronic cigarettes since they were introduced 5 years earlier; several tests (including the FDA test) had shown that the health risks of electronic cigarettes were comparable to FDA-approved smoking cessation products and tens of thousands times less hazardous than tobacco cigarettes; that electronic cigarettes were intended to be a safer smoking replacement for committed smokers and not a treatment for nicotine addiction; and that anecdotal reports from users claimed that the product was a successful replacement for tobacco smoking and improving their health, unlike the FDA-approved smoking cessation products.

One's first instinct is to ask. "What were they thinking??" But if history is any indication, that question has already been answered. One just needs to "follow the money."

So, today we sit at crossroads. History is being made in public health. All we can do now is imagine how future generations will look back upon the players in tobacco policies today. Will they see them as innovative and forward-thinking public health advocates who embraced a life-saving device or will they be revealed as self-serving and corrupt special interest groups - willing to sacrifice the lives of their fellow citizens in order to make a few bucks?Only time will tell.

Sources:
1. Centers for Disease Control and Prevention, http://www.cdc.gov/chronicdisease/resources/publications/AAG/osh.htm
2. Smoking Statistics, http://www.smokingstatistics.org/Smoking_Statistics_Since_1950.asp
3. U.S. News and World Report, http://health.usnews.com/health-news/family-health/cancer/articles/2009/11/12/progress-in-stamping-out-smoking-has-stalled.html
4. American Association of Public Health Physicians, http://www.aaphp.org/special/joelstobac/2010/Petition/20100207FDAPetition2.pdf
5. U.S. Food and Drug Administration, http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm173222.htm

8 Biggest Electronic Cigarette Myths

There are many myths and misconceptions about electronic cigarettes. Let's separate fact from fiction.

Myth #1 - Electronic cigarettes are a threat to children/teens.

FALSE.

Where it comes from:
Legislators and anti-smoking groups assume that children will be drawn to the “electronic gadgets,” the fruit/candy flavors and ease of access on the internet & mall kiosks.

Why it’s a wrong:
First, they aren’t easy to purchase on the internet. A credit card or bank account is required. So, unless the child steals a parent’s credit card and then hides the card statement later on, the risk of being discovered is high. The majority of kiosk vendors have already implemented a policy of forbidding sales to minors. The opportunity for minors to purchase electronic cigarettes at those kiosks is no better than purchasing tobacco cigarettes at a gas station – probably less.

Second, the least expensive electronic cigarette starter kits run between $35 - $50 (plus shipping) online and $90 - $150 at mall kiosks. This price point is considerable for the average adult, let alone a child. Children would be more likely to spend that money on music, clothes or video games than an electronic cigarette – especially when they can easily get a $7 pack of cigarettes at the corner store or from friends. Electronic cigarettes also require the additional purchases of accessories and replacement parts. A single battery costs over $10. Heating elements, which require frequent replacement, cost over $8 each.

Third, anecdotal accounts indicate that children/teens view electronic cigarettes as a way for adults to quit smoking. They lack the “danger factor,” which reduces appeal. Additionally, surveys of electronic cigarette owners show that the average consumer is overwhelmingly between 30-50 years old and a smoker(1), indicating that even young adults do not find them particularly appealing.

Myth #2 - Sweet flavors and flashy packaging are intended to specifically attract young people.

FALSE.

Where it comes from:
The assumption by critics that the slick advertisements and fruity flavors only appeal to children and their lack of knowledge of the target consumer and the intended purpose of the product.

Why it’s wrong:
These products are not intended to be a treatment for nicotine addiction. They are intended to be a way for current smokers to “smoke” without the dangerous toxins and carcinogens. Retailers need to differentiate themselves from stop-smoking aids, to convince long-time smokers that the electronic cigarette is just as appealing as the tobacco cigarette they currently use.

Just as with marketing cars, televisions, cell phones, alcohol and other adult products, advertisers attempt to make the devices appeal to adults with a “coolness factor.” Studies show that "smokers are more likely than the general population to be risk-taking, extroverted, defiant, and impulsive"(7) - very similar to teen demographics - so the misconception is understandable, but misguided. Often overlooked by critics in these ads are the claims about the ability to “smoke anywhere” and have a safer/healthier option to smoking – a clear indication that they are targeting current smokers and smokers concerned about their health and not new/young smokers.

Regarding sweet flavors, the tobacco-flavored liquid does not have a pleasant taste for many smokers, as it is difficult to replicate the tobacco smoke taste. Adults, who make up the majority of electronic cigarette consumers, specifically requested alternative flavors that would work well with the liquid base – which were mostly sweeter fruit and candy flavors. About 50% of adult electronic cigarette owners polled (over the age of 26)(1) report that they primarily use these non-tobacco flavors and attribute them with the ability to keep them from returning to tobacco cigarettes. They also testify that the sweeter flavors make tobacco cigarettes taste particularly foul and further reduce their chances of returning to smoking cigarettes.

Myth #3 - Electronic Cigarettes all contain anti-freeze.

FALSE.

Where it comes from:
In 2009, the FDA released a press statement claiming that they tested electronic cigarettes and found diethylene glycol, an ingredient in anti freeze.(2)

Why it’s wrong:
Independent labs extensively tested other electronic cigarettes and found no evidence of diethylene glycol, the toxic component of anti-freeze claimed to have been found in the brands the FDA tested.(3)

To further the confusion, electronic cigarette liquid is made of propylene glycol, an ingredient recognized as safe for human consumption by the FDA. While propylene glycol is sometimes used in anti-freeze, it is an additive intended to make it LESS harmful if accidentally swallowed.

The FDA tested just 18 cartridges, from only two companies. Out of those 18, just one tested positive for “about 1% diethylene glycol.”(4) Because so many other tests failed to find diethylene glycol, many experts conclude that the single sample may have been contaminated in some other way. By no means is it considered a standard ingredient in electronic cigarettes.

If electronic cigarettes did contain anti-freeze, there would be news reports about the thousands of electronic cigarette owners suffering from diethylene glycol poisoning and that is not the case. To date, after five years on the market worldwide, there have been no such reports.

Myth #4 - Electronic cigarettes are just as deadly and carcinogenic as tobacco cigarettes.

FALSE.

Where it comes from:
The FDA stated they found trace amounts of carcinogens in the nicotine cartridges and the media and health organizations used that statement to claim that electronic cigarettes are just as dangerous as tobacco cigarettes.(2)

Why it’s wrong:
The FDA found trace amounts of “tobacco-specific nitrosamines” in the samples they tested, which can cause cancer under certain conditions and in sufficient amounts.(4) The FDA allows certain levels of nitrosamines in consumable products. For example, tests show that other nicotine products, such as nicotine gum and nicotine patches, also contain the same tobacco-specific nitrosamines. The FDA did not release any information on the levels they found, however, the scientific definition of “trace amount” means amounts that are “detectable,” but too small to even accurately measure.

An independent study by Dr. Murray Laugesen showed that, on average, the electronic cigarette contained 8.18ng nitrosamines per 1g of liquid. 8 ng in 1g = eight parts per trillion, an extremely tiny amount. By comparision, nicotine gum tested at 2ng, the nicotine patch tested at 8ng and Marlborough cigarettes tested at a staggering 11,190ng. That translates to electronic cigarettes containing 1,200 times LESS of these cancer-causing nitrosamines than tobacco cigarettes and about the same as the FDA-approved nicotine patch.(3)

Myth #5 - Electronic cigarettes may be more addictive than regular cigarettes.

FALSE.

Where it comes from:
The infamous FDA testing showed that the levels of nicotine found in the cartridges varied from the advertised amount. Also, traces of nicotine were found in cartridges labeled as “no nicotine.” Critics claim that means electronic cigarette users may be inhaling too much nicotine and causing them to become even more addicted.

Why it’s wrong:
Two independent tests, the one by Dr. Laugesen and one by Dr. Thomas Eissenberg at Virginia Commonwealth University(5), showed that electronic cigarette vapor does not deliver nicotine as “efficiently” as tobacco smoke and actually delivers nicotine in lower amounts than tobacco smoke.
Additionally, smokers tend to “self-regulate” their intake, as seen by how many cigarettes a smoker uses in a day. When the need for nicotine is met, the smoker – or in this case, the electronic cigarette user – no longer has a craving and ceases consumption. The fundamental behavior of nicotine addiction just doesn’t support the claims of increasing the addiction in that manner.

Myth #6 – Second-hand “vapor” is a threat to bystanders.

FALSE.

Where it comes from:
Anti-smoking groups claim the toxins and carcinogens in electronic cigarettes (as well as addictive nicotine) can be accidentally inhaled by bystanders, just like second-hand tobacco smoke.

Why it’s wrong:
As shown previously, electronic cigarettes already contain a tiny, barely detectable fraction of the carcinogens found in tobacco cigarettes. They also have been shown not to contain any of the toxins in the amounts found in tobacco cigarettes and that they deliver very little nicotine in the vapor. So, given that the vapor already proves little, if any, danger to the actual user, any danger to bystanders by the exhaled vapor would be negligible.

Additionally, tobacco cigarettes create “side stream smoke,” which is the smoke that comes directly from the end of a lit cigarette and the smoke lingers in the air and travels a fair distance from the smoker.

Electronic cigarette vapor does not behave in the same manner as tobacco smoke. There is no vapor produced from the device, until the user activates it by inhaling, so no “side stream vapor” is created and the vapor dissipates very quickly. In the event that a bystander would pass through the vapor, since it doesn’t contain the irritating toxins of tobacco smoke, it would likely be barely detectable beyond the faint scent of the flavor and only for a fleeting moment.

Myth #7 - Electronic cigarettes are a “gateway” to tobacco smoking.

FALSE.

Where is comes from:
Critics theorize that more non-smokers will be willing to try electronic cigarettes, due to their attractive flavors and attractive styling.

Why it’s wrong:
People start smoking for different reasons. Studies show that children and young adults are more influenced by their peers, parents and stress levels than advertizing or flavors.(6) The most popular tobacco flavors among youth are Camel, Marlborough and Newport – fruit and candy flavors only made up 2% of sales when they were legal – and rarely do people cite the flavor as a reason they started smoking.

Considering that the electronic cigarette is perceived as a health concession for adults, the high start-up costs and the easy accessibility of tobacco cigarettes, electronic cigarettes are unlikely to appeal to new smokers in significant numbers.

Additionally, given the fact that current users claim that electronic cigarettes make tobacco smoke taste considerably foul, in the unlikely event that a new smoker chooses electronic cigarettes over tobacco cigarettes, the chance they will find tobacco smoking appealing is even less.

Taking into account that electronic cigarettes have been shown to be both less toxic and less carcinogenic than tobacco cigarettes, if new smokers actually do choose electronic cigarettes over tobacco cigarettes, it would actually benefit their health and safety and that of those around them.

Myth #8 - If electronic cigarettes were no longer available for smokers, those smokers would simply quit smoking or use traditional stop-smoking aids.

FALSE.

Where it comes from:
Wishful thinking.

Why it's wrong:
According to the 998 poll participants, only 18% responded that they would use traditional NRTs or attempt to quit cold turkey. Nearly 20% said they would switch to other tobacco alternatives, such as snus or snuff; and a whopping 61% indicated they would most likely resume smoking cigarettes.(1)

Sources:
1. Consumer Advocates for Smokefree Alternatives, Electronic Cigarette User Poll, CASAA.org
2. US Food & Drug Administration, FDA and Public Health Experts Warn About Electronic Cigarettes, FDA.gov
3. Health New Zealand, Dr. Murray Laugesen, Safety report on the Ruyan e-cigarette Cartridge and inhaled Aerosol, HealthNZ.co.na
4. US Food & Drug Administration, Final Report on FDA Analyses, FDA.gov
5. Virginia Commonwealth University, Dr. Thomas Eissenberg, Study Reveals a Need to Evaluate and Regulate 'Electronic Cigarettes' "Electronic cigarettes" fail to deliver nicotine , News.vcu.edu
6. Journal of Consulting and Clinical Psychology, Differentiating Stages of Smoking Intensity Among Adolescents: Stage-Specific Psychological and Social Influences, APA.org
7. Dr. Michael Rabinoff, "Ending the Tobacco Holocaust, How Big Tobacco affects our health, pocketbook and political freedom, and what we can do about it." Elite Books, Copyright 2006

CASAA’s mission is to ensure the availability of effective, affordable and reduced harm alternatives to smoking by increasing public awareness and education; to encourage the testing and development of products to achieve acceptable safety standards and reasonable regulation; and to promote the benefits of reduced harm alternatives. CASAA is a volunteer, non-profit consumer organization and receives no compensation from any tobacco, pharmaceutical or electronic cigarette companies.

American Lung Association vs Electronic Cigarettes

Organization's Efforts to Ban Devices Will Do More Harm Than Good

The American Lung Association has come out in full force by sending lobbyists to various state legislators to argue against the electronic cigarette.1 While on the surface this seems like a reasonable effort, a lack of understanding the motivations of the electronic cigarette user has placed the ALA squarely on the wrong side of the fight for public health.

A source at the ALA, an organization which claims to be dedicated to "save lives by improving lung health and preventing lung disease," acknowledged in response to a recent email inquiry that

yes there are fewer chemicals but your body is still being exposed to chemicals that should not be in your system. Nicotine can also cause the body harm, so yes many of the products do contain nicotine, but used correctly a person uses the products to wean down their nicotine level so they can completely get rid of it. Many people are using the e-cigs as an alternative to smoking the regular cigs thinking that it will not harm them and have no intention of quitting, just switching.

So, while the ALA admitted that electronic cigarettes contain fewer chemicals than tobacco cigarettes, they refuse to acknowledge the obvious health benefit that lack of the most toxic chemicals provides to the smokers who switch. Are lives and lung health the real issue here or is nicotine addiction? The ALA must know that numerous studies show that, absent the tobacco smoke, nicotine is relatively harmless and comparable to caffeine. The American Heart Association acknowledges that nicotine is "safe" in other smoke-free forms such as patches or gum.2

Research has also shown that many of the of smokers who successfully quit using nicotine gum never actually "wean down their nicotine level so they can completely get rid of it." The success rate of NRTs (nicotine replacement therapy) has dropped to 7.2%, resulting in chronic use of the products.3 Furthermore, according to a 2004 report, over 36% of gum users continue to use the products as a smoking replacement indefinitely.4 So nicotine itself is not what is killing people. The ALA's insistence on complete nicotine abstinence is admirable yet unrealistic and their claims about the dangers of nicotine, as compared to smoking, are clearly misleading.

The ALA email also acknowledged a fact already known to many e-cigarette insiders - that the majority of smokers who switched to electronic cigarettes had no intention of quitting smoking. So, why remove the only safer option available to those who would otherwise smoke the obviously deadlier tobacco cigarettes?

The only explanation is that the American Lung Association assumes that every smoker and electronic cigarette user wants to quit smoking and uses the devices as an NRT. That is an erroneous and very dangerous assumption.

In surveys of electronic cigarette owners conducted by CASAA (Consumer Advocates for Smoke-free Alternatives Association), respondents overwhelmingly stated that they did not use electronic cigarettes to quit smoking and would go back to smoking if denied access to electronic cigarettes.

An internet questionnaire of a self-selected sample of 783 daily users of electronic cigarettes asked, "Why did you start vaping?" ("Vaping" is a term for the vapor inhaled vs. smoke.) A staggering 92% chose to switch for reasons other than quitting smoking i.e. saving money or reducing the risks associated with smoking. Less than 8% stated they were using e-cigarettes to quit smoking.5

So, the ALA wishes to remove the safer alternative used by several hundred thousand electronic cigarettes users and force them back to smoking tobacco cigarettes, in order to "protect" the less than 8% who would otherwise be using an NRT?

Additionally, the ALA's belief that e-cigarette users will switch to traditional NRTs or quit altogether is disproved in yet another e-cigarette user questionnaire conducted by CASAA. This survey explored the habits and motivations of almost 1,000 electronic cigarette users. The poll indicates that, not only is the typical e-cigarette user a former smoker over the age of 26, but that they have overwhelmingly cut back or quit the use of tobacco cigarettes and have noticed improved health effects - indicating they provide the "improved lung health" the ALA is seeking to promote. Most importantly, the results indisputably contradict the assertion that electronic cigarette users will quit using tobacco should the devices be removed from the market. Over 80% of the respondents indicated they would most likely return to smoking tobacco cigarettes or use another smokeless tobacco alternative, such as snus. Less than 20% stated they would attempt to quit nicotine use altogether. 6

While the nicotine abstinence approach may be the ideal, it simply does not reflect the reality that 80% of smokers do not even wish to quit in the immediate future. Wouldn't it make sense to encourage those smokers to switch to a less harmful alternative in the meantime?

In their single-minded drive to ban e-cigarettes, focusing solely on the small minority of electronic cigarette users who use the devices to quit nicotine, the ALA will do more harm than good to the majority of e-cigarette users who will inevitably return to smoking the more toxic tobacco cigarettes.

The American Lung Association needs to re-read their own mission statement and determine if their opposition to electronic cigarettes would be saving lives - their stated goal - or putting those lives right back into harm's way.

Sources:

1. Michelle Manchir, State Hopes to Snuff Out E-cigarette Sales, ChicagoTribune.com

2. American Heart Association, Nicotine Substitutes/Nicotine Replacement Therapy, AmericanHeart.org

3. Etter JF, Stapleton JA., Nicotine replacement therapy for long-term smoking cessation: a meta-analysis., ncbi.nlm.nih.gov

4. Petra Bartosiewicz., A Quitter's Delima: Hooked on the Cure, NYTimes.com

5. CASAA, Poll of Electronic Cigarette Users: Why Did You Start Vaping?, CASAA.org

6. CASAA, Ecig User Poll Graphic, CASAA.org

Smokefree Wisconsin Continues Endangering Smokers

It seems that Smokefree Wisconsin has finally woken up and realized that electronic cigarettes (personal vaporizers) are not a plot by Big Tobacco to hook kids on nicotine, yet they continue their campaign of lies and misinformation about the devices.

In a post dated 1/20/10, they comment on the recent ruling in the case of Smoking Everywhere vs. FDA:

A statement from the Campaign for Tobacco-Free Kids said, "In ruling today that the U.S. Food and Drug Administration may not regulate electronic cigarettes as drugs or medical devices, U.S. District Judge Richard Leon has ignored decades of precedent and put America's consumers at unnecessary risk."

This statement couldn't be more true. Electronic cigarettes are not being marketed as tobacco products they are being marketed as cessation devices or as some sort of healthier alternative to smoking.

Not only have they done a complete 180 on electronic cigarettes being a Big Tobacco product, now they claim e-cigs are drug devices, make cessation claims and a danger to consumers.

This statement couldn't be any LESS true and puts the health of millions of ex-smokers using the devices at risk.

What is Smokefree Wisconsin's true goal here? To improve the health of Wisconsin residents by getting smokers to quit smoking or to eliminate all forms of nicotine?

If Smokefree Wisconsin truly cared about consumers, ie. smokers, they would worry first about reducing smokers' exposure to the true danger of nicotine addiction - SMOKE - and then worry about nicotine addiction.

Judge Leon ruled that the electronic cigarette companies have absolutely NOT been marketing the product as cessation devices, although many consumers of the product have reported that, while they still consume nicotine, they have ceased smoking tobacco to do so. Leon also rebuked the FDA for it's actions, stating that treating a reduced harm product as a drug product is absurd:

To treat as a drug any tobacco product that merely claims to be a healthier alternative would effectively nullify the provisions relating to modified risk tobacco products, which represent Congress’s implicit acknowledgment that those products were outside of FDA’s jurisdiction prior to the Tobacco Act. Moreover, it would create the absurd result that certain tobacco products-like...electronic cigarettes-would be exposed to the more onerous regulatory burdens for drugs and devices merely because they claim to be healthier alternatives to traditional tobacco products.

Judge Leon also refused to fall for the FDA's and other organizations' claim that electronic cigarettes are a danger to consumers:

Given the particular facts and circumstances of this case, I am not convinced that the threat to the public interest in general or to third parties in particular is as great as FDA suggests. Together, both Smoking Everywhere and NJOY have already sold hundreds of thousands of electronic cigarettes, yet FDA cites no evidence that those electronic cigarettes have endangered anyone. Nor has FDA cited any evidence that electronic cigarettes are any more an immediate threat to public health.

Now, that is a statement that couldn't be more true.

CASAA Applauds Electronic Cigarette Ruling

by Krisitn Noll-Marsh

The Consumer Advocates for Smoke-free Alternatives Association (CASAA) applauded the recent ruling of U.S. District Court Judge Richard Leon in the case of Smoking Everywhere v. Food and Drug Administration (FDA). The group advocates providing consumers with affordable and effective alternatives to tobacco smoking, including electronic cigarettes.

Leon granted the injunction sought by the plaintiffs, Smoking Everywhere and NJOY (d.b.a. Soterra), to release shipments of electronic cigarettes that had been seized by FDA as "unapproved drug-delivery devices." The injunction prohibits FDA from seizing future shipments as well. (1)

"Judge Leon's decision that reduced risk tobacco products, such as electronic cigarettes, are not drug delivery devices and should not be placed under FDA jurisdiction as such is a step in the right direction," stated CASAA president Michal Douglas. "The process of approving new drugs is prohibitive and would leave millions of electronic cigarette users at risk."

E-cigarettes can be used as an alternative to smoking tobacco cigarettes. The devices use a battery and atomizer to vaporize a small amount of liquid in a cartridge that contains propylene glycol--the chemical used to create artificial fog in theatre productions and dance clubs—as well as water, flavoring, and a small amount of nicotine. As many as 80% of regular users of the product are now using it in place of all the tobacco cigarettes they formerly smoked.

"Judge Leon's ruling is a step forward in public health, despite what some anti-smoking organizations may claim. Getting thousands of smokers to stop smoking is a good thing, even if it's with a method that currently only common sense can say is safer," said Dr. Theresa Whitt, CASAA's Medical Director.

Tobacco cigarettes deliver nicotine via the process of combustion, which produces smoke that contains tar, particles of tobacco and paper ash, carbon monoxide, heavy metals, hundreds of carcinogens, and thousands of toxins. "In the absence of quitting," continued Dr. Whitt, "smokers must have alternatives available to them, to reduce their exposure to the dangers of tobacco smoke."

Many organizations have taken a position that smokers must achieve smoking cessation only through complete nicotine abstinence. This position has been characterized as a "quit or die" mentality.

Public health groups such as the American Association of Public Health Physicians (AAPHP) have called for a Tobacco Harm Reduction approach which steers smokers toward less-harmful sources of nicotine such as smokeless tobacco and e-cigarettes, as well as nicotine replacement products in higher more-satisfying dosages. (2)

"When anti-tobacco groups fail to acknowledge the viability of reduced harm alternatives, disregarding the fact that 93% of smokers fail at repeated attempts to quit, they ultimately fail to protect public health," stated Whitt.

"Anti-smoking activists and the FDA should be encouraging smokers to make the switch to reduced harm products such as electronic cigarettes, not making it harder for them."

Sources:
1. Smoking Everywhere vs. FDA, http://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2009cv0771-54, USCourts.gov

2. American Association of Public Health Physicians, http://www.aaphp.org/special/joelstobac/2009/TobaccBill.htm, AAPHP.org