Friday, December 2, 2011

Boise gets it but Boston nips it

The Consumer Advocates for Smoke-free Alternatives Association, in conjunction with Jim Longden, the owner of Vapoligy (a Boise e-cigarette store) and several Boise e-cigarette users, successfully campaigned to get truthful and accurate information about e-cigarettes to the Boise City Council members, which resulted in the exclusion of e-cigarettes from ordinances which ban "smoking in bars and private clubs, near bus stops or other transit areas, on outdoor commercial patios accessible to children or on public property, at the Grove Plaza, on 8th Street from Bannock to Main streets, within 20 feet of a City of Boise-owned building and in other public locations" and "within 20 feet of the Boise Greenbelt, except in designated areas within Ann Morrison and Julia Davis parks and the Warm Springs Golf Course."

Mr. Longden was one of several who attended the Boise City Council meeting on Novemeber 1st and his experience supports CASAA's belief that e-cigarette users who show up to these meetings can make a significant impact.

"After the meeting we were able to talk with Councilman Thomson and Adam Park, who is the Communications Director for the Mayor and City Council," said Longden. "They were both very responsive and seemed genuinely interested in seeing an eCigarette perform even to the point where Mr. Park asked me to blow vapor in his face. They both seemed truly amazed at the lack of smell and the vapor dissipating almost instantly."

"This a significant victory. With a population of over 200,000 people, Boise is now the largest city in America to remove e-cigarettes from what was purported to be 'smoking' ban," said CASAA Director Gregory Conley. Other locales that have recently considered, and then rejected, bans on e-cigarette use, include Delaware County, Indiana and Alexandria, Louisiana," said CASAA Director Greg Conley.

Meanwhile, the news isn't as positive for Boston's local vapers. CASAA issued a Call to Action alert September 21st that the Boston Public Health Commission had proposed the Clean Air Works Workplace Smoking and E-Cigarette Use Restrictions Regulation, a prohibition on the use of e-cigarettes in the workplace, which was passed by the Commission on Wednesday. Although many members headed the call, it simply wasn't enough.

"Seeking to close a loophole on unregulated products like electronic cigarettes that deliver nicotine, the Boston Public Health Commission’s Board of Health today approved a proposal to treat e-cigarettes like tobacco products, including requiring retail establishments to obtain a permit to sell them, prohibiting their use in the workplace, and restricting their sale to adults only," the BPHC website stated.

The Commission's statement is confusing, because the public use of many smokeless "tobacco products," such as snus, dissolvables and chew, is not prohibited. Therefore, the inclusion of e-cigarettes in the smoking ban is, in effect, treating e-cigarettes like tobacco cigarettes, not just as a tobacco product.

The prohibition on smoking in the workplace is argued by public health officials as necessary to protect bystanders from the "known hazards" of second-hand smoke. However, there has been no such evidence that vapor exhaled by e-cigarette users poses any risk to bystanders. In fact, researchers and even the FDA have failed to find dangerous levels of any toxins or carcinogens in e-cigarettes tested, so there is no science-based reason to suspect e-cigarettes pose a significant health risk to the user, let alone to bystanders. Absent any scientific evidence of health risks, CASAA suspects e-cigarettes are being treated like tobacco cigarettes by the BPHC based solely on how they may "look" to bystanders.

"E-cigarettes are currently in use by approximately 2.5 million adults to eliminate or significantly reduce their exposure to tobacco smoke and there have been no reports of significant adverse health effects since their introduction to the U.S. over 4 years ago," said Kristin Noll-Marsh, CASAA's vice president. "The ability to use e-cigarettes [where smoking is prohibited] is a powerful incentive to get smokers to consider switching to these reduced harm alternatives. By approving this ordinance, the Boston Health Department is sending the message to smokers that they may as well keep smoking. How is that remotely in the best interest of public health? At least Boise [City Council] got it right."

Monday, November 28, 2011

Chew/snus alternatives free from scrutiny given to e-cigarettes

The FDA has gone after e-cigarettes because it decided that the claims that e-cigarettes were safer than smoking were unproven and that the products were actually unapproved drug delivery systems designed for smoking cessation. Arguments that e-cigarettes are actually safer alternatives to smoking (rather than a treatment) have fallen on deaf ears.

Ironically, another "alternative" to tobacco - tobacco and nicotine-free chew/snus products - have seemingly been free to make similar claims about their products without any clinical trials or FDA scrutiny. Compare the claims made on the web site for a product called "Nip the Grip":
  • Is NiP really safe? Yes. NiP the ENERGY DIP is made with natural sea sponge that is infused with Vitamin B-12, Caffeine, and natural flavorings which are all FDA approved ingredients.
  • NiP is a safe and healthy, natural alternative to smokeless tobacco. It has been specially developed for times of nicotine cravings and your need for increased mental and physical focus.
  • NiP is a unique, safe alternative to smokeless tobacco. NiP is designed to help people break away from the powerful grip of nicotine addiction.
  • Nip is safe, healthy and a great way to cope with the intense physical cravings of nicotine while achieving more ENERGY and enjoying the same oral gratification as a dip of tobacco.
And this is just one product's claims. I found several chew/snus alternatives including Absolut Snus (coffee based), Jake's Mint Chew (mint leaf-based in mint, cinnamon, licorice or cherry flavors), Chattahoochee Herbal Snuff (made with soy and glycerin in wintergreen, cherry, mint, whiskey, tobacco and "spitfire" flavors), and Root 100 (ginseng-based in candy and fruit flavors such as apple, cinnamon, peppermint and tangerine) all making similar claims on their web sites.

So, where is the FDA questioning the safety and efficacy of these products claiming to help you beat your nicotine addiction? Why is it legal for some of them to simply put the standard disclaimer
"These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease," (others don't even bother with the disclaimer) when that is clearly what they state the product is for on their web sites? Where is the demand for clinical trials and peer-reviewed research?

Where are the public health groups questioning the long-term effects of having these products in your mouth? Why are they not objecting to the fact that these products "look like" tobacco products and counter their denormalization campaign against tobacco? Why are the ANTZ not claiming that these fruit and candy flavors are encouraging kids to pretend to chew and that they may be a gateway to using "real" chew? How about the fact that it's sold right along side chewing tobacco in convenience stores?

Now, obviously I don't think any of those things should happen - anymore than they should for e-cigarettes. I don't want to see any alternative taken away from people who want it. It's the double standard that bothers me. 

According to this CNN report on mint snuff, dentists endorse and even hand out the tobacco-free products:

(Note the deceptive and misleading statement made by the reporter at the end. She continues the myth that nicotine and addiction is the greatest health risk by stating, "If you think dipping snuff is better than smoking, you're wrong. Chewing tobacco is highly addictive and exposes the body to levels of nicotine equal to those of cigarettes.")

And there it is: the nicotine. These other products are virtually identical in purpose to e-cigarettes, but they do not contain the nicotine. Which begs another question - then why the objection to nicotine-free e-cigarettes? They just "look like" smoking as these products "look like" chewing tobacco. And what about the addictive qualities of the caffeine in some of these chew replacements?

That is what it really comes down to - the vilification of nicotine and the belief that any "addiction" - no matter how low health risks - is the true evil.
 It's truly not about health - it's about social acceptance. 

Wednesday, November 16, 2011

Fat people - welcome to our world

In a recent Time Magazine online article, "Let’s Stop Being Passive About Fighting Obesity: It's time to embrace the same tactics that worked against smoking," public health writer Shannon Brownlee drew comparisons between smoking and obesity, calling for public health (and the public) to start treating fat people like smokers. I responded in the comments, but felt it was worth posting here, as well:

The author says, "The war on smoking worked because it made smoking shameful and the public health measures needed to fight it permissible."

In fact, the war on smoking was most successful from 1950 (when the link to lung cancer was found) through the 1980's - when public health focused on education and information, not the "shaming" of smokers. The smoking rate dropped dramatically from 44% to 26% (from 1950 to 1990.) The greatest advances in the mid to late 1980's - nicotine gum approved by the FDA, first city bans smoking in restaurants in 1987, nicotine compared to heroin (without any actual studies to support it), had very little impact in the following decade. The research on second-hand smoke came out in the 1990's, which was gleefully used to change a war against the negative health effects of smoking (to HELP smokers improve their health) into a war AGAINST smokers. The smoking rate at that time was 25%. Since the war on smoking turned from education and encouragement to a war on smokers and making smoking "shameful," the smoking rate has decreased only 5% in those 20 years (1990 to present) and has even ticked back up from 19% to 20% in the past couple of years.

The war on smoking worked for 40 years because it focused on education, developing tools for smokers to quit (finding them safer alternatives) and helping get smokers access to those tools. It relied on sound science and a true dedication to improving public health by empowering people - not controlling human behavior.

Since the late 1980's, public health has turned from trying to help smokers to battling "Big Evil Tobacco" - regardless of the health effects. The discovery that nicotine is addictive turned nicotine and addiction into the evil of smoking, rather than the health effects of inhaling toxic smoke. The science shows that not all tobacco use is equally hazardous - modern smokeless tobacco and e-cigarettes have been shown to be 99% safer than smoking, but since the anti-tobacco groups want everyone to quit, they feel justified in letting smokers think they may as well smoke, so they don't just switch to safer options. The insistence on absolute abstinence from all nicotine use, even if it has extremely low health risks, angering smokers and tobacco users by treating them as less than human, applying punitive charges, taxes and policies to smokers - all while isolating them and ostracizing them - has created a backlash.

Additionally, using junk science to justify these actions (claiming taxes, graphic labels, bans and nicotine products work, when real scientific research proves they don't or claiming smokeless products like snus, dissolvable tobacco or e-cigarettes are just as dangerous as smoking when they are 99% less of a health risk) has created distrust and animosity of public health groups. Not to mention revelations that tobacco taxes - having been raised over 2,000% in some places since 1990, because proponents claimed for every 10% taxes were raised overall smoking rates would fall 4% (yet the smoking rate has only fallen 5% overall in the same time period) - are being relied upon to balance state budgets and pay tobacco control executive salaries, which seems to be a huge conflict of interest in actually wanting to END smoking.

Is this really the model you want to apply to fighting obesity?

Monday, October 10, 2011

The E-cigarette bans

If YOU don't speak up for vapers, who will?? First they'll stick us back outside, then they'll charge us high taxes, limit our flavors, devices and strengths, stop online may as well still be smoking.

If you don't think these bans will affect you - THINK AGAIN! Don't think someone else will step up for you - you cannot afford to not be involved. Participate and/or donate, but join CASAA today!

Monday, September 12, 2011

Medsafe in New Zealand apparently banned cigarettes

According to a recent news story by 3 News in New Zealand, "Medsafe has ruled that nicotine for inhalation is a medicine and insists that more research needs to be done before they can be sold in New Zealand." Based on this criteria, cigarettes - which deliver nicotine (along with 4,000+ other chemicals) for inhalation - are a medicine and are banned for sale.

Curiously, this is not actually the case. While cigarettes, which deliver nicotine for inhalation and are clearly hazardous to public health, remain legal to sell, e-cigarettes containing just nicotine and no toxic levels of any chemicals are banned for sale there.

"It's a start but there's a way to go before, really, there's going to be enough information for us to know about how safe these products are and how effective they are," said Dr. Stewart Jessamine about e-cigarettes.

Dr. Stewart seems to have forgotten that smoking "is the leading cause of preventable death in New Zealand, accounting for around 4300 to 4600 deaths per year." These 4600 smokers obviously could not or would not quit using Medsafe-approved "nicotine medicine" products and will continue to smoke, so why is Medsafe not fast-tracking the research and approval of a product which contains just 3 low-risk main ingredients: nicotine, propylene glycol and food flavoring? A product which has been on the market - world-wide - for several years without any reported serious adverse affects or deaths? How "safe and effective" do they need to be proven to try to prevent those 4300 to 4600 annual smoking-related deaths? How long is "a way to go" to get the information they need? One year? Two years? Or rather just 4600 more deaths? Just 9200 more deaths?

The good news from the article is the study being done by Dr. Chris Bullen at Auckland University, which will hopefully contribute to the reversal of not only Medsafe's e-cigarette policy, but other irresponsible e-cigarette sale bans currently in place around the world.

“We are going to recruit 650 people in New Zealand for this trial, so we think at the end of this study, the evidence will suggest one way or the other, do they help people quit smoking,” said Bullen.

The news piece also included little-publicized information about New Zealand anti-smoking campaigner Dr. Murray Laugesen, who has completed his own tests on e-cigarettes and is convinced that they cause less harm than traditional cigarettes.

"All around the emmissions score for e-cigarettes is about less than 1% of what it is ordinary cigarette," Laugesen said.

Hundreds of thousands of e-cigarette users are reporting success switching from using hazardous traditional cigarettes to e-cigarettes without serious adverse events. Even if they only worked for half of New Zealand's smokers or had only 50% of the health risks of smoking, that could mean 2300 prevented smoking-related deaths a year or more. E-cigarettes can't possibly be any less effective than Chantix (Champix,) with a failure rate of 86% after 12 months nor more dangerous, with hundreds of Chantix-related suicides, murders and heart attacks reported; in the nearly identical time period e-cigarettes have also been on the market with no reports of serious adverse events. In spite of the increasingly obvious unknowns of Chantix, Medsafe continues to endorse its use, while banning another product which has shown no evidence of safety issues.

Luckily, in the U.S., the FDA was stopped short (by court order) of being able to follow in Medsafe's footsteps and treat e-cigarettes as a nicotine medicine, rather than what they really are - a much, much safer alternative to smoking for people who cannot or will not quit using "nicotine as medicine." As a result (and in spite of numerous ANTZ and FDA scare tactics) hundreds of thousands of U.S. smokers have access to a much safer product and are now smoke-free. CASAA is working to keep it that way.

Tuesday, August 23, 2011

Safe sex vs. Safe tobacco

In the 1980's, public health groups began campaigning for "safe" sex. These campaigns promoted the use of condoms to reduce exposure to HIV and AIDS and continue to be used today to promote reduced exposure to other dangerous and debilitating sexually transmitted diseases (STD).

Rarely are the public health benefits of reducing health risks via "safe" sex questioned, even though "safe" sex is a misnomer. A 2001 NIH panel of experts examined dozens of studies and found that proper and consistent condom use reduced the incidence of STDs by 18% to 92%, depending upon the disease in question. At best case, that still leaves an 8% health risk for "safe" sex practices. For the human papilloma virus (HPV) - which has been linked to cervical cancer, the fifth most deadly cancer in the world for women - the harm reduction is even less. 

In reality, condoms contribute to "safer" sex, but do not cause sex to be 100% safe. This does not stop public health groups from promoting "safe" sex to the public and the majority of us agree that it's better to be safer, even if it's not 100% safe. Millions are still spent promoting safe sex practices, even though STDs rarely result in death. In fact, it's reported that 80% of those infected with STDs are asymptomatic and not even aware that they are infected. The CDC reports that around 18,000 people with AIDS and approximately 4,000 women with cervical cancer die annually.

On the other hand, the CDC and other health groups report that "tobacco use" (or more specifically, smoking) causes 440,000 deaths annually in the U.S. (including the highly debated second hand smoke deaths.)  Compared to smoking deaths, mouth cancer, the main health warning for smokeless tobacco use, contributes to only 8,000 deaths annually. However, according to the National Cancer Institute, researchers have been unable to determine how many of those deaths are actually caused by smokeless tobacco use. Based on one 1981 study of female chew users in the southern U.S., the NCI reports that "users of smokeless tobacco are at four times the risk of developing oral cancer than non-users." More recent research shows that smoking actually causes twice the risk of oral cancers (compared to smokeless) and factors such as alcohol abuse and dual use of smoking and smokeless seem to have reduced the link to oral cancer caused by smokeless use alone even further. In fact, the scientific research overwhelmingly shows evidence that smokeless tobacco carries very little to no health risks, at or less than 1% compared to never-users.

In spite of knowledge of this widely known research and the ready acceptance of harm reduction practices for less lethal STDs, public health officials refuse to acknowledge the obvious potential health benefits of promoting harm reduction in the form of smokeless tobacco products. In fact, they go out of their way to convince the public (and smokers) that smokeless products are just as deadly as smoking. While condoms, with a contribution of lowering health risks 18% - 92%, are required by the FDA to inform the public that condoms reduce the risk of STDs, smokeless tobacco products are required to display health warnings such as "This product is not a safe alternative to smoking," or "This product causes oral cancer." Rather than informing smokers that switching to smokeless tobacco would reduce their health risks by 99% or greater, the FDA actually prohibits smokeless tobacco companies from informing the public and forces them to misrepresent the comparative risks, causing the 440,000 people who die from smoking annually to believe that they may as well keep smoking.

Additionally, public health groups continue to lobby legislators to limit or outright ban and/or apply unwarranted "sin taxes" to smokeless products such as snus, lozenges, sticks and strips, claiming "no safe tobacco use" and over unfounded concerns that children and smokers will flock to these less deadly products rather than eschew tobacco products altogether. The concern about youth use is particularly comical, considering that banning these smokeless products would leave no competition for cigarettes, leading curious and reckless youths to smoking tobacco instead of using smokeless and increasing their health risks by 99%. Taxing these products to make them just as expensive as cigarettes also removes further incentive for current smokers - who have no intention of quitting tobacco - to switch to smokeless alternatives.

This insane double standard of approving and encouraging harm reduction for less lethal practices and denying them for tobacco must end. The "abstinence only" approach has resulted in smoking quit rates stagnating at 20% and public health efforts to stop smokeless use as an alternative could result in that percentage increasing again as smokeless products are made less available and more expensive for smokers who have already switched. Not only must the "quit or die" approach be rethought, but public health must stop misleading the public about the health risks and start encouraging inveterate smokers to switch. If they can call an 8% health risk "safe" when it comes to sex, then a less than 1% health risk from smokeless tobacco IS a "safe alternative to smoking." The great dream (lie) of total tobacco abstinence must end. Based on the scientific evidence, the time for tobacco harm reduction must be allowed its turn.

Concerned groups such as the Consumer Advocates for Smoke-free Alternatives Association (CASAA) and are working to promote "safer" tobacco use. For more information on Tobacco Harm Reduction please visit

Monday, August 15, 2011

American Lung Association continues to misrepresent smokeless risks

The ALA posted an article titled "Is There an Easy Way to Quit?" on it's web site today, which is filled with typically deceptive ANTZ tactics.

Making statements such as  smokeless tobacco has "28 cancer-causing agents" and "increases the risk of developing cancer" and that e-cigarettes contain "cancer-causing agents and toxic chemicals" found in anti-freeze is not only leaving out key information, it relies upon questionable "science" and sensationalism to deceive the reader.
Smokeless Tobacco
Smokeless tobacco includes chewing tobacco, snuff, snus and some other new products. Some people think that using smokeless tobacco is a safe alternative to smoking but that’s not the case. Smokeless tobacco has 28 cancer-causing agents and it increases the risk of developing cancer in the mouth, gums, and pancreas. The amount of nicotine that is absorbed from smokeless tobacco is 3 to 4 times the amount delivered by a cigarette.

The key information left out here is that many products we consume contain "cancer-causing agents." The question is, "How much?" Hot dogs can contain "cancer-causing agents." Whole milk can contain "cancer causing agents." Potato chips and french fries can contain "cancer-causing agents."

Yet we consider these foods to be "safe," because although the "agents" are present, the risk of actually getting cancer from them is extremely low.

While there is a "risk" of developing cancer in the mouth and gums from some smokeless tobacco, the risk is extremely small - somewhere between 0% to 4% - and smokeless snus studies have not shown any increased risk of oral or other cancers. The very few studies linking smokeless tobacco to a very low risk of pancreatic cancer have contradicted themselves, so the link remains inconclusive as to whether or not there is an actual risk at all.

Yet the ALA reports these as established facts and make it sound as though the health risks are great.

Once again the ALA has ignored scientific evidence and used inflammatory language to make something sound worse than it is by reporting the statement made by the FDA rather than the scientific evidence from the actual FDA testing.
There is no scientific evidence establishing the safety of e-cigarettes. The FDA has found that these products contain cancer-causing agents and toxic chemicals, including the ingredients found in anti-freeze. While some distributors directly or indirectly market e-cigarettes for smoking cessation, there is no scientific evidence that demonstrates these products are safe or effective at helping smokers quit.

By this time, anyone who has bothered to read the actual FDA test results knows the truth vs. the spin put out by the FDA. The "cancer-causing agents" discovered in the e-cigarette cartridges tested were found in only one out of the 18 tested, were not found in the actual vapor that is inhaled and were at levels so low they were comparable to the levels of "cancer-causing agents" found in the FDA-approved nicotine patch.

Yet the ALA reports this as though e-cigarettes have been proven to cause cancer and hides the fact that the same levels of "cancer-causing agents" are found in the nicotine patch - which they endorse.

The inflammatory language used to describe the non-toxic amount of diethylene glycol detected (again in just one cartridge and not in the vapor) as "ingredients found in anti-freeze" is pure sensationalism. Diethylene glycol is also found in other FDA-approved products at non-toxic levels. Because the amount found in the one e-cigarette cartridge is so small and not in the actual vapor to which the user is exposed, the user would have to drink the contents of a few thousand cartridges per day in order to reach toxic levels.

Yet the ALA reports the presence of "ingredients found in anti-freeze" as though e-cigarettes have been shown to be just as poisonous as anti-freeze.

So let's see why using the products and methods endorsed by the ALA isn’t a good way to quit:
Nicotine Replacement Products (NRT)
NRTs includes nicotine gum, nicotine patches, nicotine lozenges and nicotine inhalers. Some people think that using NRT is a safe alternative to smoking but that’s not the case. NRT has cancer-causing agents and it increases the risk of developing oral cancer. The amount of nicotine that is absorbed from NRT is much lower than the amount delivered by a cigarette, which may contribute to a failure rate as high as 95%, greatly increasing the risk of relapse to deadly smoking. Nicotine is highly addictive and because these nicotine products are available over the counter to both adults and youth, they are easily abused, contributing to sustained addiction rather than cessation.

Chantix (Varenicline)
There is no scientific evidence establishing the long-term safety or effectiveness of varenicline. The FDA did not review varenicline for the usual 10 month period and it had not been tested in those under 18 years; those with mental illness or pregnant women and therefore is not recommended for use by these groups. The FDA has received reports of "suicidal acts and ideation, psychosis, and hostility or aggression, including homicidal ideation, were the most prominent psychiatric side effects. Multiple reports suggested that varenicline may be related to the loss of glycemic control and new onset of diabetes, heart rhythm disturbances, skin reactions, vision disturbances, seizures, abnormal muscle spasms and other movement disorders."

While some claim varenicline is "safe and effective," only 4.3% more smokers had still quit after one year compared with placebo and over 200 deaths have been linked to varenicline since its release to the public. France's government health insurance no longer subsidizes varenicline prescriptions due to questions about its safety. Canada and Australia have received more than 1,800 reports of adverse events related to varenicline as of May 2010. The number of adverse events associated with varenicline outnumber any other medication monitored by ISMP and more than twice as many deaths have been linked to varenicline than with any other medication currently on the U.S. market.

Really, American Lung Association? Compare all of that to zero reports of serious adverse events linked to e-cigarette use since they were introduced to Europe in 2004 and the U.S. in 2006.

The ALA claims that "Becoming smokefree is anything but simple, yet some folks will try almost anything that promises to a quicker, easier way to quit smoking. You can’t wave a magic wand and suddenly be done with the process of quitting." Yet millions of smokers world-wide, most of whom have tried and failed with the ALA's "safe and effective" methods, are calling e-cigarettes a "miracle" and the "easiest" method they've ever used to remain smoke-free. Sweden, where smokeless snus use is most common, boasts the lowest smoking rates in the E.U. without increased adverse health effects vs. never-smokers.

Any "fact" can be spun to appear to support an agenda. The difference is whether or not the "facts" are based on scientific evidence or if they are based upon junk science and made to sound reliable. Can you tell the difference?

Tuesday, May 3, 2011

So e-cigarettes are a “tobacco product.” Now what?

Be sure to tune in to the CASAA discussion on this topic Thursday, May 5th at 7:00PM EST/8:00pm CST on VP-Live's BlogTalk radio show:

On April 25, 2011 the FDA announced its decision to forego petitioning for Supreme Court review of the legal victory won last December by a major electronic cigarette distributor. (See, )

"The FDA's decision to regulate electronic cigarettes under the Tobacco Act is a great victory for public health," stated Dr. Theresa Whitt, M.D., CASAA Medical Director.

While it is obvious that CASAA* sees this as a victory for vapers everywhere, it is understandable that many folks not as closely associated with the legal case view the announcement with some reservation and concern.

“Concerns for taxation and specific restrictions are my cautions. I guess by putting e-fluid under the Tobacco Act, it gives FDA power it previously didn't have and unless another source of nicotine comes cost effectively available, we are under the FDA thumb, which is horrifying,” wrote one CASAA member. “I'm not letting my guard down even if CASAA claims a success.”

It is a common theme on e-cigarette discussion boards. Yet many of the concerns are based on misunderstandings of the PACT Act, the FSPATC Act, the Tobacco Act, Chapter IX and the FDA’s existing regulatory power over nicotine products. Members mainly worry about the future of e-cigarettes regarding increased taxes and costs, the ability to purchase over the internet, excessive regulatory standards imposed on vendors, indoor use bans and reduction in effectiveness through reduced nicotine strengths and flavor restrictions.

The first thing to remember is that CASAA views this success as winning a major battle, but is well aware that there are many more battles ahead before we can claim to have won the war. All of the issues mentioned previously are concerns, but they are not as imminent nor as black and white as it may seem at first blush. In order to have a clear view of these issues, one must read the aforementioned legislation to understand how they currently relate to e-cigarettes. CASAA’s Legal Director Yolanda Villa and CASAA Advisor Bill Godshall of Smokefree Pennsylvania have reviewed this legislation extensively as related to e-cigarettes.

As Director Villa recently wrote, “First the FDA has to propose its new regulations over e-cigarettes, then there is a public comment period and only after the whole administrative process is undertaken do the regulations become officially in effect. This can take up to two years, during which time we must all be vigilant and active in the battle to ensure that any actually official regulations are reasonable and science-based. And we must start to prepare, now, whatever evidence will be needed in that battle, starting with a very careful reading of the full [FDA] announcement and then paying equally close attention to other "guidance" documents the FDA issues as it proceeds."

"Yes, we have a lot of other battles to wage, but this concession to the court ruling in favor of Njoy is still a huge win for now!"

"And this does not mean automatic PACT Act inclusion [excluding internet/mail sales.] That would only happen with an amendment of the PACT Act itself. Nor does it mean an automatic flavor ban as that specifically only applies to cigarettes. All future regulation of e-cigs remains to be proposed, warred over - and that can include further litigation, even, if the proposals are unnecessarily harsh or rigid - and then ultimately enacted,“ said Villa.

“If e-cigarette sales/consumption continues to double, triple, quadruple in the next year, as I suspect it will, we'll have even more folks to advocate against unwarranted regulations, against state/local sales ban proposals and against state/local usage restrictions,” wrote Bill Godshall.

On the subject of tobacco taxes, CASAA Vice President Elaine Keller reminded members that tobacco taxes are set not by FDA classification but by the individual states. Tobacco tax rates, specifically “sin taxes” applied to combustible tobacco products to discourage smoking, should be directly related to perceived harm.

“One of the ways that we as consumers can help to keep the taxes down is to learn all we can about the concept of Tobacco Harm Reduction -- how switching to less harmful alternative sources of nicotine reduces health risks -- and then educate our legislators on these concepts. Whenever a state starts making noises about taxing smokeless products as highly as cigarettes, we need to be ready to make a lot of phone calls and send a lot of letters,” wrote Keller.

Regarding indoor use bans Keller reminded, “The issue regarding clean indoor air laws is not how a product is categorized. Snuff and chaw are tobacco products but are not covered in smoking bans. The issue is smoke and if someone tries to turn the issue into "The FDA says they're tobacco products" it will be our job to jump all over their case about it.”

As far as this being a "new" power for the FDA, the FDA actually has had the power to regulate tobacco products since the FSPTCA was passed and it has always regulated non-tobacco nicotine and smoking cessation treatment products. There was never a question about the FDA having power to regulate e-cigarettes in the U.S. So, it wasn't a "win" in any way on Monday for the FDA to be able to regulate e-cigarettes, because they always had that ability. That "win" occurred a long time ago in a completely different battle. This fight was about how they would be allowed to regulate e-cigarettes - as a drug or as tobacco. They wanted to regulate as a drug, we wanted to be a tobacco. The courts ruled in "our" favor; the FDA finally admitted defeat on Monday and that is 100% a win for e-cigs.

The point is that the PACT Act, flavor bans (per the FSPTCA), indoor use bans and tobacco taxation are specific laws which name and affect specific tobacco products – specifically combustible tobacco products. So not even all existing tobacco products are included in those laws, especially not e-cigarettes and it can take years to get them included. In the meantime, the vaping community will continue to grow in both numbers and influence, CASAA, harm reduction advocates and other vapers will have the opportunity to testify on behalf of e-cigarette regulation and safety and harm reduction studies can be completed. E-cigarettes will have science, truth and fact on their side.

Mr. Godshall summed it up quite succinctly. “If everyone who has negatively speculated about the future of e-cigarettes joined forces with CASAA, NVC, Smokefree Pennsylvania and tobacco harm reduction advocates, to hold the FDA accountable for promulgating sound regulations; to oppose e-cigarette taxes; to oppose e-cigarette sales and usage bans and to educate the public, we'll continue winning most - and maybe all - battles and e-cigarette sales will continue to skyrocket, which will give us even more clout in the public policy process,” he said.

*The opinions expressed here are the views of the writer and those quoted and do not necessarily reflect the views and opinions of CASAA.

Saturday, February 12, 2011

E-cigarette Research: Looking for love in all the wrong places?

Two recent blog posts by Carl Philips brought to me the realization that reduced-harm researchers may be looking at e-cigarette research all wrong. His first post regarding a recent study by Dr. Michael Siegel got me thinking and the second one critiquing the study actually inspired me to comment.

It seems that even well-meaning researchers don't quite "get" e-cigarettes or their users and that is hampering their efforts to analyze them and their effectiveness.

As I mentioned in my comment on the blog post, e-cigarette users posting on forums (who have successfully switched and are fans) were not necessarily looking to "quit smoking," yet they seem to be the most successful at doing just that. Researchers, however, seem to focus their efforts on smokers who are unfamiliar with e-cigarettes and are looking for a smoking/nicotine cessation alternative rather than a smoking alternative. It seems that after so many years of researching nicotine cessation products that it is difficult even for reduced harm supporters to think outside of the box when it comes to researching a product as unique as electronic cigarettes.

In researching nicotine cessation products, one would obviously want to avoid surveys of "avid fans" of a particular product, as their opinion would be biased due to their satisfaction. Those subjects would also be in a particular segment of the population that was already in the mindset of wanting to quit anything to do with smoking and not indicative of the average smoker. Based upon my observations of the "avid fans" of e-cigarettes, this is not usually the case. Most e-cigarette users posting on forums comment that they specifically were NOT trying to quit. While they may have attempted to quit using traditional NRTs in the past, the most common reasons listed for trying e-cigarettes include saving money, protesting taxes, bypassing indoor use bans and the ability to "smoke" without the same health risks. Many e-cigarette users claim that they "accidentally" quit smoking. No one starts using NRTs without the intention to quit smoking!

Most research that I have seen to date has used test subjects who were looking to quit smoking and/or were previously unfamiliar with e-cigarettes. They were given or questioned about inferior products and had little to no instruction on technique. It's no wonder that they (and researchers) were underwhelmed with the results. Conversely, e-cigarette users who have successfully switched are not your average consumer. They typically purchased "mall brands" (basic and often over-priced e-cigarettes typically found in mall kiosks or through online advertisers), saw the potential and then went online to not only discover better products, but also learned techniques for using and maintaining the devices. In doing so, they have become knowledgeable and biased - precisely the "educated" consumers which researchers would normally avoid. Yet educated consumers are the key to the e-cigarette's success.

Researchers looking to determine the efficacy and safety of e-cigarettes need to take a step back and rethink their modus operandi. Traditional NRTs have an obvious purpose for consumers - to wean smokers from nicotine in order to help them quit smoking. The purpose of e-cigarettes for each individual smoker is less clear - those who try them aren't necessarily looking to quit. So, simply testing them in the same way and with the same pool of subjects as you would traditional NRTs is looking for the answer to the wrong question. Instead of asking, "Is this product a safer and effective smoking cessation product?" they need to ask, "Is this product proving to be a safer and effective smoking alternative?"

Therefore, the best course would be to first study those who have embraced the products, not those who have never used the product or are really looking for an NRT. Look at e-cigarettes not as if they could be successful NRT products but at how they are already being successfully utilized as smoking alternatives. Researchers must to tap into the established e-cigarette community to understand why they are being chosen, how they are successfully being used as reduced harm alternatives and to determine if there have been any adverse health effects with their sustained use. This large pool of subjects can show how e-cigarettes are already being used safely and effectively both to the general public and to the smokers who most need reduced harm alternatives. If researchers look in the right place and ask the right questions, they will find the love.

Friday, February 11, 2011

A Look at the Family Smoking Prevention and Tobacco Control Act

The FSPTCA seems to directly contradict its purpose to improve the health of smokers. Not only does it perpetuate the myth that ALL tobacco is equally dangerous, it pushes the idea of dependency itself being inherently dangerous, whether or not the addictive chemical is actually a serious health risk.

Direct quotes from the FSPTCA:
A consensus exists within the scientific and medical communities that tobacco products are inherently dangerous and cause cancer, heart disease, and other serious adverse health effects.

Note that it says "tobacco products" and not "smoking," even though smokeless tobacco carries very little risk of cancer, heart disease and other SERIOUS health effects.
Nicotine is an addictive drug. 

Yes, but it does not carry high health risks by itself. The word "addictive" is used in this sentence to say "bad" or "dangerous."
Tobacco use is the foremost preventable cause of premature death in America. It causes over 400,000 deaths in the United States each year, and approximately 8,600,000 Americans have chronic illnesses related to smoking.

Not including deaths questionably attributed to second-hand smoke, about 16.5% of all annual adult deaths in the U.S. are smokers/ex-smokers who died from smoking-related diseases (393,600 smoker deaths to 2,383,724 total U.S. adult deaths in 2007.) I cannot find data on smokers who died from non-smoking related diseases or natural causes. However, it's interesting to note that while 80-90% of lung cancer patients are smokers, only 10% of smokers actually get lung cancer. The 8,600,000 illnesses equals about 18.2% of smokers having a chronic illness related to smoking, which means 81.8% of smokers do not have smoking-related chronic diseases.

Not sure where I'm going with that one but it is interesting seeing it from a different persepective.

But it's important to note that they don't give actual statistics for smokeless tobacco and nicotine products. They are saying "tobacco" and then only give stats and health effects for "smoking," which intentionally leaves the reader thinking all tobacco use causes the same illnesses and diseases as smoking.
Tobacco dependence is a chronic disease, one that typically requires repeated interventions to achieve long-term or permanent abstinence.

Tobacco dependence ITSELF is a chronic disease?

Definition of disease: "a disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity, or unfavorable environmental factors; illness; sickness; ailment."

Hmmm...didn't realize tobacco grew in my body.

SMOKING can CAUSE disease, but tobacco dependence is not a disease in and of itself. Dependence upon something not normally needed to keep the body healthy/alive would be a DISORDER: "a disturbance in physical or mental health or functions; malady or dysfunction."

Diabetics are dependent upon insulin, but insulin dependence is NOT a disease.

Exposure to radiation can cause disease, but taking risk and working at a job that exposes one to radioactive material is not a disease.

There may be underlying conditions which cause people to be more likely to become dependent upon nicotine/tobacco, but the dependency is not a disease. I suppose the same argument could be made for any chemical dependency.
Because the only known safe alternative to smoking is cessation, interventions should target all smokers to help them quit completely.

This sentence is nonsensical and redundant unless you deduct from it that "quit completely" means no tobacco or nicotine use, because isn't the definition of cessation "quit completely?" What this sentence really should say is "Because the only known safe alternative to smoking is to not smoke (cessation), interventions should target all smokers (not "tobacco users") to help them quit smoking completely. "


But what they are really saying is that they see no evidence that a smoker who switches to a smokeless alternative will reduce their health risks enough to justify encouraging them to switch and only complete abstinence from tobacco and nicotine is acceptable for them. It doesn't matter that repeated attempts at abstinence means repeated exposure to smoking, while the 1-2% risk from smokeless at least keeps them from smoking.

Well.....DUH again.

Again, they are expecting something to be 100% SAFE for treating tobacco dependence, when other disorders or diseases are usually treated with drugs that are SAFER. No medical treatment can be considered 100% SAFE, because they ALL have risk. This also lumps nicotine use in with smoking. Smokers aren't considered to have "quit completely" unless they quit any form of nicotine.
It is essential that the Food and Drug Administration review products sold or distributed for use to reduce risks or exposures associated with tobacco products and that it be empowered to review any advertising and labeling for such products. It is also essential that manufacturers, prior to marketing such products, be required to demonstrate that such products will meet a series of rigorous criteria, and will benefit the health of the population as a whole, taking into account both users of tobacco products and persons who do not currently use tobacco products.

Reduced harm products are seen as a possible threat - a ruse or fraud by tobacco companies. The criteria that it be considered safe for current non-smokers too makes it nearly impossible to get accepted. How can any tobacco product or even nicotine be considered acceptable for non-smokers to start using, even if it reduced risks to smokers by 99%?
Unless tobacco products that purport to reduce the risks to the public of tobacco use actually reduce such risks, those products can cause substantial harm to the public health to the extent that the individuals, who would otherwise not consume tobacco products or would consume such products less, use tobacco products purporting to reduce risk.

So, the product not only has to reduce risk for smokers, but has to ensure that people who would otherwise avoid nicotine products because of the perceived danger won't start using them because they now perceive them to be low-risk.

This is the theory that the non-tobacco users who will start using low-risk tobacco products will so outnumber the smokers who switch that MORE people have health risks. It completely ignores the level of risks and probability. Here is what it would take for that to happen:

1000 non-users start using 1% risk products = 10 people get sick

10 current users switch to 1% risk products = 9 people get healthier

So, in the above scenario, more people who otherwise wouldn't use tobacco products got sick than people who switched from smoking got better, resulting in an increase in health risks.

The problem is, there is no evidence or even reason to believe that so many non-users will suddenly use and so few users will fail to switch even when given the truth about reduced harm alternatives. But there is no way for a company to guarantee (however unlikely) that non-users won't be at greater risk to the point where it offsets the health benefits of users switching. It's an impossible criteria for approval.

One good thing in the Act which I think was completely unintended:
in order to ensure that consumers are better informed, to require tobacco product manufacturers to disclose research which has not previously been made available, as well as research generated in the future, relating to the health and dependency effects or safety of tobacco products; if the tobacco companies have research which supports the fact that smokeless tobacco is in fact safer than smoking, they can now not only say that but are REQUIRED to inform people? Awesome!


Wednesday, February 9, 2011

Tobacco Prohibition and a Law of Physics

If tobacco prohibitionists get their way, will it really be a 'win' for public health?

It's pretty obvious that the "anti-smoking" movement, based on the principle that smoking is the "leading cause of preventable deaths" in the world, has changed course. No longer is it only about the health risks of smoking. Unable (and often unwilling) to get smoking products banned in the U.S., these groups now target smokeless tobacco products; making unsubstantiated claims that these products somehow lead to smoking and must be banned to protect public health. They completely ignore, hide and even discourage the substantial research and science that contradicts their claims.

And they don't stop there.

After "wins" of banning rarely sold "flavored" cigarettes and insisting that smokeless products, such as snus and chew,  display technically true (yet intentionally misleading) labels which declare that the much safer products are "not a safe alternative to smoking," they have set their sights on nearly harmless nicotine products such as tobacco lozenges and e-cigarettes. They are now somehow convinced that people accustomed to the pleasant taste and low health risks of these nicotine products will suddenly and inexplicably stop using their safer, pleasant-tasting product and switch to the harsh smoke, foul taste and increased health risks of cigarette smoking. Apparently any nicotine product, unless it is made by a pharmaceutical company and designed to get the user to wean off of nicotine, is now taboo. Anti-smoking for health reasons has now become anti-smokeless nicotine for no valid reason at all.

So, what if they get their way? What if tomorrow all tobacco and non-pharmaceutical nicotine products were removed from the market? Would this be the great victory for public health that the health groups claim it will be?

Well, let's look first at why people smoke. Most people will point to the obvious - that people are addicted to the nicotine. So why did they try smoking in the first place? Peer pressure? Parental example? Rebellion? Stress? Those could all be reasons to start. But while millions of people try smoking for various reasons, only a small percentage of them keep smoking. So, why don't they just stop like the others? If it was just that "nicotine is as addictive as heroin" as claimed, why do the vast majority of people who try smoking not become addicted? The most logical answer is that there is something about smoking, tobacco and nicotine that goes beyond the addictive nature of nicotine itself, a theory which is most simply supported by the fact that most nicotine-only products fail to actually keep smokers from smoking.

If it was just the need for nicotine, a piece of nicotine gum would be 100% effective as a tobacco replacement, yet the success rate actually hovers around 7%. Many smokers reportedly miss the mechanics themselves - the taste, the feel, the ritual and the social aspect of smoking. However e-cigarettes, which not only contain nicotine but also mimic the habits and ritual associated with smoking, reportedly still seem to be "missing something" for about 25% of users. Additionally, smokers who have been nicotine and cigarette-free for several years have been known to relapse under certain stressors or triggers - which strongly indicates that smoking is linked just as much to the smoker's mental health and less to simple chemical addiction and habit as thought.

Whether it's chemical or psychological, smokers seem to be predispositioned to smoking for various reasons. In spite of the negative health risks posed by smoking, tobacco and nicotine products seem to provide many benefits similar to various medications. Tobacco or smoking may be a stimulant for some and have a calming, stress-reducing effect on others. Some find it improves cognitive abilities or lessens attention deficit disorders. Others find it keeps them from other oral fixations such as over-eating or compulsive nail biting. The presence of nicotine and other monoamine oxidase inhibitors (MAOIs), which act as anti-depressants, in cigarette smoke suggests that those suffering from mild depression often find relief from tobacco use. Research also shows that an inordinate number of those with schizophrenia or other mental health issues are smokers and may be somehow "self-medicating."

My experience within the e-cigarette community has shown me just how different smokers (and their reasons for smoking) really are. It's reflected in the choices smokers make when actually given a choice with e-cigarettes. Suddenly they can choose the nicotine level, no nicotine, flavors, styles, sizes and the vapor production to best fit their needs. While some e-cigarette users pick up a basic e-cigarette and never have the desire to smoke again, others can't give up tobacco altogether, no matter how high the nicotine content. They seem to need something else found in tobacco other than the smoking habit or nicotine, such as the other tobacco alkaloids or MAOIs. Many in this category find that using a smokeless tobacco such as snus, along with e-cigarettes, can satisfactorily replace smoking. On the other hand, some e-cigarette users just need a higher nicotine content, while others need no nicotine at all - just the look, taste and feel of smoking.

So, smoking seems to be helping people with a great variety of mental health issues and addictive behaviors and the sense of satisfaction is determined by different factors for each individual. The drawback is that this "cure all" comes in such a deadly delivery system. The question is that in trying to keep people from harming themselves with the delivery system, by targeting even low-risk products - such as smokeless tobacco and e-cigarettes - simply because they contain nicotine, will the goal of improving public health really be achieved? What will the people who rely on smoking turn to instead? Will those with oral fixations turn to food and become obese and face other health risks? Will those looking for relief from depression or other mental health issues, smokers who may currently avoid recreational drugs such as marijuana, cocaine, heroin, prescription drugs and even alcohol, turn to even more dangerous behaviors and/or addictions? Will all of these smokers just quit tobacco and nicotine use and somehow be magically cured of all of the underlying issues that caused them to continue smoke in the first place? Is it really reasonable to expect them to stop something that works for them and simply substitute a pharmaceutical drug in its place? Are pharmaceutical drugs really free from risks and side effects themselves? Are those dependent upon tobacco-specific chemicals any more "weak" or "immoral" than those dependent upon pharmaceutical chemicals to get through their day?

The solution to the health issues related to smoking is not to remove access to nicotine and tobacco and hope all of the reasons why smokers smoked go away too. The solution is to develop and make accessible the safer products which can address the real needs of smokers, without passing moral judgment on the product or the user. Smokeless tobacco and e-cigarettes already address many of those issues with very low health risks. The majority of scientific research does not support the claims that their use will lead to smoking, so other than the irrational vilification of tobacco and nicotine and the moral judgment of the user, there is no valid reason to call for their removal.

The likelihood of cigarettes being banned for sale (and without a black market created) is slim to none. Therefore, those affected by the removal of safer tobacco and long-term nicotine products are not only current smokers, but those who for whatever reason may choose to try smoking and find themselves dependent in the future. So long as tobacco cigarettes remain available and so long as there are people who find the benefits outweigh the risks, removing safer options merely increases the health risks for those who may have otherwise sought them out. Smokers and “would-have-been” smokers deprived of all sources of tobacco or nicotine, including low risk products, will likely seek out an alternative for relief that may even more dangerous and detrimental than smoking itself.

Basic physics - for every action there is always an equal and opposite reaction. Considering the likely reaction of a ban on all tobacco and nicotine products, can prohibitionists really forsee that it will result in a "win" for public health?

Saturday, January 29, 2011

Discovery News: How safe are e-cigarettes?

Discovery News recently published an online article regarding e-cigarettes.

Amongst other things, e-cigarette opponents continue make the claims that while they somehow know nothing about what is in e-cigarettes, in spite of 16 different reports available to them, e-cigarettes are probably more dangerous than tobacco cigarettes and are a threat to our youth. In case you don't buy their claim about safety, they argue that being addicted to anything is the problem, regardless of whether or not the product actually has been shown to have little or no health risks.

Prue Talbot is being sneaky by accusing all of those available e-cigarette studies as being suspect because they are paid for by companies. She's banking on the fact that most Americans don't realize that all of the tests and studies submitted to the FDA for approval are also paid for by the companies. That is the only way to get them tested. Who else is going to pay for them?

New York Assemblywoman Linda Rosenthal has ignored the plethora of reports emailed, faxed and mailed to her and continues to claim that e-cigarettes "are a mystery," and yet, claims that e-cigarettes contain chemicals which are more dangerous than those found in tobacco cigarettes. If they are a mystery, how does she know there are dangerous chemicals? She insists if she could quit that anyone could quit, completely ignoring the multitude of correspondence from e-cigarette users that they couldn't quit using any other method or don't wish to give up nicotine and shouldn't have to. Rosenthal snidely remarks, "If people want the easy way to just get addicted to another nicotine delivery system, I hope soon they'll have to look elsewhere." Given that e-cigarette users have told her that they have tried everything else, she seems unmoved by the fact that it leaves tobacco cigarettes as their only option.

Dr. Siegel's e-cigarette research paper clearly shows that there is nothing in e-cigarettes to make them even remotely as dangerous as tobacco cigarettes. The 4 ingredients in e-cigarettes - nicotine, propylene glycol, glycerine and artificial flavoring - are already found in tobacco cigarettes, yet e-cigarettes lack the toxic chemicals and high levels of carcinogens found in tobacco cigarettes. It's like claiming non-alcoholic beer "may" be as intoxicating (and therefore equally or more dangerous) as real beer because they both have bubbles, malt and barley. There is simply no logic to the argument.

The FDA study Talbot and Rosenthal cite found that one cartridge of eighteen was contaminated with a non-toxic amount of diethylene glycol and that the levels of carcinogens were as low as the nicotine patch. Diethylene glycol has not been found in any e-cigarettes since. If anything, the FDA test proved that there were no toxic amounts of any chemicals and extremely low carcinogens. Yet they disingenuously claim that there is a great danger to the public. If the carcinogens and non-toxic chemicals found in e-cigarettes are a danger, why are they still selling the patch?

Additionally, the double-speak of e-cigarette opponents is painfully obvious. They claim tasty flavors are a scheme to attract youth to e-cigarettes, yet ignore the fact that pharmaceutical nicotine gum and lozenges come in Cinnamon Surge, Fruit Chill, Fresh Mint, Cherry and Cappuccino flavors. Additionally, youth smoking is on the rise even though flavored cigarettes have been banned since 2006. Youth aren't anymore attracted to "safer" e-cigarettes than they are to tasty pharmaceutical gums and lozenges. Surveys of thousands of e-cigarette users found that the vast majority are former smokers between 35 and 65 years old. There is absolutely no evidence that young adults, and therefore copy cat teens, are even interested in the start-up costs and maintenance involved with e-cigarettes. It's much easier, cheaper and more "cool" to buy a pack of cigarettes.

Prue Talbot's study found leaky cartridges and inaccurate labeling. Ironically, she didn't bother to test e-cigarettes to find out what was actually in them. If quality control is an issue, then address those companies which get a failing mark, but don't throw the baby out with the bath water. The FDA has the power to regulate quality and safer designs by classifying e-cigarettes as tobacco products rather than continuing its quixotic charge to classify them as nicotine addiction treatments. This would also automatically ban sales to minors.

These simply aren't a treatment for nicotine addiction. The vast majority use them as an alternative source of nicotine that still gives them the smoking experience without the high health risks. There is nothing else on the market that can simultaneously provide relief for nicotine addiction, greatly reduce health risks and simulate smoking. If they didn't have e-cigarettes, most users would still be using tobacco cigarettes - not gums and patches. E-cigarettes are not an alternative for gums and patches, they are an alternative for tobacco cigarettes. These folks don't want to quit nicotine, they just want to quit smoking. Once people like Linda Rosenthal, Prue Talbot and their supporters get that through their thick skulls, they'll understand why their crusade is fundamentally wrong.

Let's remember that the anti-tobacco movement started because of the high health hazards linked to smoking, not the extremely low health risks of smokeless nicotine addiction. E-cigarette users may remain addicted to nicotine, but the only reason they would ever return to smoking is if these "well-meaning" anti-smoking zealots ban e-cigarettes and leave tobacco cigarettes as their only option.

Join and fight this insanity!

Sunday, January 23, 2011

New York at it again - your state could be next!

The New York State Assembly Health Committee is meeting this coming Tuesday to discuss Bill AO1468.

This bill would not only ban the sale of electronic cigarettes to minors, but proposes to ban sales of any products which contain nicotine that are "not defined by law as a tobacco product or approved by the United States food and drug administration for sale as a tobacco use cessation or harm reduction product." This of course has the intended effect of banning e-cigarettes, because although the U.S. Appellate Court has supported Federal Judge Richard Leon's opinion that e-cigarettes should be regulated by the FDA as a tobacco product, the  FDA still refuses to do so. Because consumers are replacing tobacco cigarettes with e-cigarettes and feel that they have "quit smoking," the FDA's stance is that makes them a drug delivery device, even though the majority users have not quit nicotine at all - just smoking. Last I knew, nicotine addiction was considered the disease, not how you got your nicotine. Quitting smoking and quitting nicotine are two very different issues.

The justification for this proposed change in the New York law is
Recent advertisements have touted "e-cigarettes" as a healthier alternative to traditional tobacco consumption and as a tobacco cessation product. These electronic cigarettes are battery-operated devices that vaporize cartridges filled with nicotine, flavor and other chemicals that the user inhales. Advertisements for these products omit any mention of FDA testing that found users inhale carcinogens and toxic chemicals such as diethylene glycol, an ingredient found in antifreeze.

Given the unregulated nature of this product, there is no way of knowing the amount of nicotine in each cigarette, the amount that is delivered with each inhalation, or the contents of the vapor created in the process. "E-cigarettes" are often marketed and sold to young people and are readily available online and in shopping malls. They are produced in different flavors, such as chocolate and mint, in order to increase their appeal to all segments of the population. These products also lack any health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes. These devices are often made overseas in countries with less stringent standards for product quality than exist in the United States.

First, let's look at the claim that e-cigarette companies fail to advertise the FDA testing. The FDA tested just two brands of electronic cigarettes. Why would other companies have to claim that the FDA testing had any relevance to their product, as their product wasn't tested by the FDA? The diethylene glycol was found in just one of the 18 tested cartridges and has not been found in any other independent tests of ANY e-cigarette brands. Additionally, neither the FDA nor any other lab has found toxic levels of ANY chemical in e-cigarettes. Expecting companies to tell consumers that there are "toxic chemicals" and "diethylene glycol" in their products is like expecting the makers of Skippy peanut butter to tell consumers there is salmonella in their product because another brand of peanut butter was once contaminated with salmonella.

Claiming that users inhale carcinogens is nothing but hypocritical spin. Are pharmaceutical companies required to warn nicotine patch users that they are "absorbing carcinogens?" The FDA tests showed that the extremely low level of carcinogens (tobacco-specific nitrosamines) found in their e-cigarette samples were nearly identical to the levels found in the FDA-approved nicotine patch. So, if those extremely low levels are of concern in e-cigarettes, they should also be of concern for nicotine patch users. In reality, if e-cigarette companies were actually allowed to report what the FDA really found, rather than the spin the FDA presented to the public, they would be able to show that the FDA tests actually showed e-cigarettes to be non-toxic and no more carcinogenic than the nicotine patch. Somehow, I don't think that's what those proposing this bull - er - bill have in mind.

This bill also pulls out the tried-and-true "save the children" tactics. These are completely unsubstantiated claims that these products appeal to and are targeted at youth. They completely ignore surveys of thousands of e-cigarette users which show the average user to be closer to 40 than 14 and offer absolutely no examples of actual sales to minors. The claim that chocolate and mint flavors are intended to "appeal to all segments of the population" (read "kids") is really saying nothing. What product doesn't try to appeal to as many consumers as possible? Additionally, nicotine gums and lozenges come in Cherry, Cappuccino, Fresh Mint, Fruit Chill and Cinnamon Surge. The Nicorette site says their products have "been developed with palatable flavors" and "sweetened with sorbitol," (another trusted product.) One can only surmise this is to make their products more appealing to all segments of the population, as well, yet no one accuses Glaxo SmithKline of marketing to youth.

The bill sponsors want e-cigarettes to come with warnings, but as of yet, there have been no serious adverse effects reported linked to e-cigarette use. The irony being, of course, that tobacco cigarettes do come with warnings and have been linked to serious health risks, yet remain perfectly legal. If New York legislators get their way they will have successfully banned a low-carcinogen, non-toxic product - one which also has been reported by thousands of users to have provided improved health benefits - and protected the market share of tobacco cigarettes.

Finally, if the FDA would have given up this quixotic charge to classify e-cigarettes as a drug delivery device (rather than an alternative tobacco product) months ago, they could already have e-cigarettes subject to the same regulations as other tobacco products - complete with warning labels and banning sales to minors. It's the FDA's own obsessive behavior, unable to move on even after losing on appeal, which has kept e-cigarettes completely unregulated!

Your tax dollars in action.
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