But You're Still Addicted...

Vapers are often told, "Sure, you quit smoking, but you're still addicted." What does that even mean?

I consume around 12 mg to 18 mg of nicotine per day as a vaper. Vapers may consume anywhere from 0 mg to 200 mg per day. If I don't use my vapor device for a while, I sometimes feel a bit anxious and maybe feel a little crabby. Nicotine is not a carcinogen, but some studies say nicotine could raise the risk of cardiovascular disease.

Lining up for a fix of their socially acceptable.
 mood-altering, psychoactive drug.

But compare that to caffeine. The average daily caffeine consumption (from all sources) by US adults is, on average, 178 mg per day. (If you include children under 18, the mean only goes down to 165 mg per day, so kids are consuming a significant amount of caffeine, as well.) Some age groups consume 300 mg to 400 mg per day. Many health experts say that the safe level is around 300 mg per day. People who eliminate caffeine from their diet can experience "withdrawal" symptoms such as headaches, anxiety, nausea and restlessness, in many ways similar to the effects of nicotine "withdrawal." Some studies have also linked caffeine to cardiovascular disease.

Both caffeine and nicotine use are linked to improvements in mental alertness and concentration, but nicotine is curiously known to also help with relaxation. Both chemicals have been linked to possibly helping in some way with brain diseases like Parkinson's, Alzheimer's and MS. Nicotine has additionally been linked to aiding patients with ulcerative colitis.

Both caffeine and nicotine occur naturally. Caffeine in coffee, tea and cocoa; and nicotine in eggplant, green peppers, tomatoes, other vegetables and the tobacco plant. (Notice which chemical is present in nutritious, fresh, whole foods and which must be heavily processed for human consumption?) Both chemicals are stimulants. Both are a mood-altering, psychoactive drug. Both chemicals are natural insecticides. Both chemicals are toxins and can kill you if you consume too much.

One clear difference between nicotine and caffeine is that the effects of nicotine wear off far faster than the effects of caffeine, so nicotine consumers take in more or less the same in milligrams, but do it more frequently. Because of that, a caffeine consumer can drink a big cup of coffee and be good for a few hours, whereas a vaper may seem to have their device glued in their hand. That gives the false impression that nicotine consumers are "more dependent" than caffeine consumers. (Of course, many caffeine users are never far from their morning cup off coffee then switching to their afternoon energy drink or caffeinated soda, but no one really notices that.)

So, does it really make sense that vapers are treated as "addicts" and nicotine use is warned against, while caffeine consumers are treated as "normal" and caffeine use is practically worshipped?

Vapers aren't smoking. They are just nicotine consumers and, as I've just shown, that's not much different from being a caffeine consumer. Unless you never consume caffeine and also see caffeine consumers as "addicts," maybe consider checking your judgemental opinion of "vapers are still addicts" at the door?

Why I oppose vapor bans (and why you should, too.)

Next week, vapers in Madison, Wisconsin will be fighting a proposed amendment to that city's smoking ordinance, which adds the use of vapor products to the definition of "smoking." This will ban the use of all vapor products anywhere smoking is prohibited.

On the surface, this may not seem like a big deal to most vapor consumers. Most experienced vapers either don't find it necessary to vape where smoking is prohibited or can easily vape discreetly enough to go unnoticed. However, the reason I oppose these bans has nothing to do with any desire to vape in an Applebee's or at a Home Depot. My concern is the unintended consequences of such bans to overall public health.

CASAA is truly grassroots, not a 'front group'

I recently came across a blog post about e-cigarettes that had this in the comments:

What strikes me about CASAA is that the board is stacked with power players: lawyers, smokeless tobacco lobbyists and web marketing experts. Not a random assortment of Americans, but exactly what a company would seek out as a PR front.

Once I stopped laughing at "stacked with power players" and picked myself up off the floor, I wanted to set the record straight.

CASAA, The Consumer Advocates for Smoke-free Alternatives Association, was formed in 2009 on an online e-cigarette enthusiast forum. Here is a thread discussing the creation of the organization, before it even had a name: ECO - Organization Charter: Administration and here you can see a lot of the democratic process that went into the name and organization. Clearly, CASAA was not formed by e-cigarette or tobacco companies as a "PR front."

On Coffee and (e)Cigarettes

I believe that there are benefits to smoke-free nicotine use for a lot of people and nicotine itself isn't any more "addictive" than caffeine. That shocks a lot of people to hear, because it goes against everything we've been taught over the past few decades. However, a lot of more recent research backs me up in this. (See http://nicotinepolicy.net/karl-fagerstrom/520-dependence-on-tobacco-and-nicotine) Of course, if you would tell people to not start using caffeinated products, then the same advice would obviously apply to smoke-free nicotine products. But if you have no objection to people using caffeinated products, that pretty much makes any arguments against smoke-free nicotine products moot.

Are nicotine e-cigarettes a tobacco product?

I frequently see vapers arguing that e-cigarettes are not a "tobacco product," because they do not actually contain tobacco. They argue that nicotine e-cigarettes are not the same as tobacco or smoking cessation products and should have a classification all of their own.

However, nicotine isn't regulated in the U.S. by what form it takes, but instead by "intended use."

If the nicotine is contained in a product with an "intended use" as a smoking cessation or other treatment, it is then regulated as a "drug" and must go through clinical trials, studies, etc., and the product must meet strict manufacturing protocols before release to the public. If the nicotine is contained in a product with an intended use of "recreational" (ie. intended for human consumption but not as a treatment of any kind) it is regulated as a tobacco product. (A third classification is a pesticide, but that form of nicotine is not allowed for human consumption.)

Please. Just smoke already and quit lying.

Guns & Roses guitarist, DJ Ashba, reported to his fans on webstagram that the e-cigarette he bought at a Polish mall, which he reports he used for 9 months, contained "antifreeze which kills people;" and that his doctors told him to start smoking again, because "the nicotine intake that was going into [his] body" from the smoke-free e-cigarettes "was equivalent to smoking 33 packs of cigarettes a day."

Is distrusting the MHRA's regulation of e-cigarettes "conspiracy theories?"

Recently on a forum for e-cigarette enthusiasts, a commenter said he "saw no harm" in the move to regulate electronic cigarettes as medicine in the U.K., if what the MHRA was saying about just wanting to have e-cigarette companies "apply for licensing and to make sure the nic juices deliver consistent amounts of nicotine as advertised" was true. Apparently expecting doubt from other commenters that the MHRA was being forthright, the commenter said, "Conspiracy theorists have at it."

How is it a conspiracy theory, I asked? These people have 30 years of lying to the public about tobacco, nicotine and low risk alternatives as evidence they have no interest in telling the truth.

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 for...an 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.

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.

e-Cigarettes
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?

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.

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?

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 CASAA.org and fight this insanity!

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.