SmokeFree Wisconsin Misleading Public about Orbs risk

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

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

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

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

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

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

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

• Oral cancer

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

• Leukoplakia

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

• Heart disease

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

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

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

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

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

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

As the Canadian report urges:

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

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

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

Meet the Nicotrette Mini:

Nice "trick" SmokeFree Wisconsin.



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

Memorial Day and the Myth of Nicotine

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

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

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

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

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

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

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

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

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

SmokeFree Wisconsin not about public health

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

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

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

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

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

Smokeless is not less harmful. Period.

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

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

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

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

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

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

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

SmokeFree Wisconsin Doesn't Believe in Reducing Harm for Smokers

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

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

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

and

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

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

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

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

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

The author's reply:

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

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

No offense, Erich, but baloney.

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

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

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

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

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

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

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

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

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

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

Are Electronic Cigarettes Safer than Traditional Cigarettes?

by Kristin Noll-Marsh

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Why do anti-smoking groups oppose tobacco harm reduction?

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

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

Read Full Story

Electronic Cigarette Users Fighting Back

Petition Aims to Save Lives

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

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

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

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

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

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

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

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

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

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

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

Sources:

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

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

3. http://EcigsSaveLives.info

4. http://VapersCoalition.org