Wellness: Blowing Electric Smoke

Would children be protected by a ban on local sales of electronic cigarettes, or is it an affront to civil liberties?

Comments (13)
Thursday, September 02, 2010
From www.eciggreenvapor.com
One of many e-cig kits available online

Thanks to technology, kids today can do almost anything—virtually, that is. Once they sign into cyberspace, the rules and boundaries of the real world blur as quickly as a screen saver. Mom always said don't play ball in the house—unless they're playing simulated baseball on the Nintendo Wii console. Children should never handle firearms—unless they're fending off an invading alien coalition in the Halo videogame series. Now some fear a new electronic gadget threatens to undermine the cautionary messages about adolescent smoking.

Electronic cigarettes, commonly known as e-cigs, were first developed in 2004, but have only recently garnered the American public's attention since companies began touting these smoking substitutes in shopping malls, on television, and on line. Resembling a cigarette in its shape and size, the e-cig is supposed to recreate the sensual experience of puffing on a cigarette, but without the smoke and tobacco. To achieve the sedative effect, most e-cigs contain a capsule of nicotine-laden liquid that vaporizes when heated, to be inhaled by the user. Though e-cigs aren't widely available for purchase in the Pioneer Valley, Internet vendors are offering these devices in every color, flavor, and size imaginable to anyone, anywhere, at any age.

The lack of regulation on both the manufacturing and sale of these products has stirred the suspicions of public health officials. Even the FDA seems stymied by this strain of cigarette, as it has yet to deliver any conclusive results regarding the content of the nicotine solution and the potential health hazards it presents.

Rather than waiting for a verdict from the federal authorities, some local boards of health have chosen to "exercise precaution," drafting ordinances to regulate the purchase and public use of e-cigs. Failure to do so, according to Northampton Department of Health Director Ben Wood, would signal that the organization has reneged in the mission against smoking: "We would be undermining our cigarette laws. In effect, we would be reversing social and cultural norms." He fears the youth would be most vulnerable to the shift in the tobacco trend—that they would be swept away on the wave of e-cig excitement.

Making e-cigs inaccessible under law and invisible in public, Wood hopes, will prevent minors from tinkering with the gizmos. To that end, the Northampton Department of Health has drawn up a series of proscriptions banning the sale of e-cigs to minors and forbidding the use of e-cigs indoors in public spaces. Northampton is not alone. Holyoke, South Hadley and other cities in Western Massachusetts have enacted similar legislation.

The ordinances have e-cig supporters fuming. Though there have been no scientific studies confirming its effectiveness as a smoking cessation method, recovered smokers swear the e-cig has helped wean them off of their dangerous habit. To e-cig advocates, the laws represent a systematic stigmatization of the device. They fear that its illicit status will dissuade potential beneficiaries of the e-cig from trying it.

Joining personally invested opponents are people with libertarian leanings who have denounced the ordinances as an example of government intrusion. They interpret the Department's preemptive approach as an uninformed regulation and an unwarranted encroachment on civil liberties.

The Board of Health's concerns aren't entirely unsubstantiated; in a laboratory analysis the FDA found trace amounts of carcinogens and toxins like diethylene glycol, a chemical found in antifreeze. The FDA has yet to determine if these particulates pose health risks or if they're really negligible in such small doses. But in this current climate of uncertainty, critics contend, lawmakers shouldn't be passing any definitive legislation.

Purported to be cheaper than the classic cigarette in the long run, e-cigs are still an investment. The starter kits range from $50 to $200, and the refill cartridges, marketed as the equivalent of 20 cigarettes, start at $10. In the Valley e-cig vendors are few and far between, so the bulk of the transactions are electronic, via phone or internet. Given the high cost and the fact that orders require a credit card, it's not easy for children to acquire an e-cig, but parents and city officials remain on high alert, concerned that e-cigs could gradually infiltrate the mainstream if legal defenses against them aren't secure.

Wood insists that the real impetus of the laws stems from the Board's concern about protecting minors from a potentially addictive, harmful substance. Plastered with colorful packaging and offered in fun flavors like Coca-Cola and chocolate, e-cigs are tricked out with a marketing strategy that could leave an impression on children. And as obesity has superseded smoking as the prevention priority in schools, the thrust of the anti-tobacco movement has waned. Smoking rates are still declining, but the trend has stagnated.

As tobacco use remains an important public health concern, however, officials want to douse any flicker of cigarette enthusiasm before it spreads to a younger demographic. In Northampton, both e-cig advocates and adversaries will have to hold their breath until fall, when the Board of Health finalizes its decision.

Comments (13)
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"Trace amounts" means that the amount of diethylene glycol was so minute, they couldn't tell exactly how much was present. Even then, the FDA permits up to .2% DEG in all products that also contain propylene glycol. That a single sample of a single brand of the FDA toxicology examination indicates that the FDA needed to examine more samples of that brand before coming to its "OH GOD, THE SKY IS FALLING!" conclusion. Further toxicology testing of that brand turned up 0 DEG, ultimately indicating that it may have been a contaminated sample.

The amount of tobacco-specific nitrosamines present were equal to or less than the amount found in FDA-approved NRTs. This far and away not considered carcinogenic, as demonstrated by the FDA studying and approving the aforementioned products.

As for the flavors, FDA-approved NRTs also come in fun-sounding flavors like cherry, orange, and mint. Where are your pitchforks now?

Posted by Diana on 8.31.10 at 15:49

Fact checking when writing a story is important. It is what makes one a reporter instead of a fantasy novelist.

"Though there have been no scientific studies confirming its effectiveness as a smoking cessation method, recovered smokers swear the e-cig has helped wean them off of their dangerous habit."

Really? No studies confirm effectiveness for smoking cessation?

http://www.healthnz.co.nz/2010%20Bullen%20ECig.pdf

http://www.vapersclub.com/Eissenberg2ndstudy.pdf

Are those studies?

Yup.. they are! National Vapers Club provided those studies to Ben Wood at the Northampton public hearing on this proposed legislation.It is a shame he did not mention that to the reporter. Just makes her look silly now.. doesn't it?

Posted by Spike Babaian on 8.31.10 at 18:16

Health directors should know how to read. Wood, apparently, doesn't. Fire him.

Posted by Treece on 8.31.10 at 18:31

I heard that the diethylene glycol contamination was a one-off, and was due to a cheap chinese manufacturer cutting corners.

The e-liquid I use is made in the USA and is fantastic.

Obviously minors shouldnt be taking up puffing on e-cigs. But this kind of "bad press" tends to generate stigma about the product in general, when in fact these products should be credited for the great help they are providing to smokers who otherwise couldnt have broguth themselves to give up.

I use the Green Smoke (pictured in the article) and can vouch for it. They are one of the few good e-cig company and provide a lot of info about e-cigs in general on their website - http://greensmoke.com/vaporpromo

Posted by John S on 8.31.10 at 22:12

diethylene glycol is a liquid at these temperatures and would not produce particulates.

Posted by tiedyeguy on 9.2.10 at 7:26

The people in my "circle" who have tried these, have quit at a rate of 100%.

We have all tried the FDA approved methods, with a success rate of 0%.

After 1 year we are all still at 100%.

As far as the "bad" stuff they found. It was such a small sample they cannot even quantify it. If you pour anti-freeze into your car, you are exposed to 1000 years worth of using electronic ciggies.

The Government wants people to keep using real cigarettes, or pad the pockets of the FDA by purchasing crap that is proven not to work. If a doctor said your surgery had a 7.% chance of working for 6 months, would you do it? Heck no.

As far as the flavors go, I'm 44 and have never lost the taste for good things. The lozenges and gum that is ineffective is also marketed in fun flavors.

Kids can only use these if their parents allow them to. Its pretty much the same as alcohol. If the parent is a looser who refuses to take care of their children, what the heck are the kids still doing in that home! A parent who allows a kids to use any cigarette and alcohol needs to be locked up!

Posted by Dana on 9.3.10 at 20:30

How about citing your sources? I'd like to know where you are getting your information from. The base ingredient in electronic cigarette liquid is propelene glycol and it is used in many medications where the ingredient is not water soluable, the other common base is vegetable glycerin. Regardless of this, in comparison to traditional cigarettes they are much less harmful. Personally I feel that these people who want to ban them just don't want to see people enjoying themselves. Please don't get me wrong however, I do agree that there are some public places where I think it is rude to use an electronic cigarette such as restaurants, people want to enjoy their meals and since not everyone understands the e-cigarette it would cause too much of a disruption for everyone. But in outdoor cafes, bars, and when I decide to take a puff while I'm shopping, I feel like people should just leave e-cigarette users alone. There is no smoke to bother anyone in regards to their health because they are not in contact with second hand smoke or carbon monoxide. As for the marketing to children, I think you need to investigate the practices of the vendors individually just like with tobacco sales. I have my own small e-cigarette business and I would never sell to anyone under 18, and in my experience my customer base is people who already smoke and are looking for an alternative because they want to continue smoking with less harm to themselves, I never market them as a cessation device and my customer base is aged 23-65 I've never had an 18 year old even remotely interested, the few who were interested preferred traditional cigarettes. And as for the flavors that you feel entice children, I don't even advertise flavors like cherry or chocolate, I offer them to customers I already have. I stick to advertising tobacco-like flavors only. I really hope that you put some more thought into this before condemning the e-cigarette. From what I'm seeing right now, for such a liberal and progressive community all I am seeing is ignorance and pretentiousness. e-cigarettes are a green product, all of the components can be cleaned and recycled, the vapor doesn't linger or stick to clothing and it doesn't have an unpleasant smell so what's the big deal?

Posted by Vapour Cat on 9.4.10 at 7:08

I read with dismay your article on electronic cigarettes. Let me make a few points.

“The lack of regulation on both the manufacturing and sale of these products has stirred the suspicions of public health officials. Even the FDA seems stymied by this strain of cigarette, as it has yet to deliver any conclusive results regarding the content of the nicotine solution and the potential health hazards it presents.”

The FDA has the ability to regulate both the sale and the manufacture of these products, they have just elected not to do so under the tobacco act. This is an important point. They are spending tax payer money to try to prove that they are a drug and drug delivery device. They are trying to turn a commercial product into a nicotine replacement therapy which it isn’t. Yes, many people, including myself, have used personal vaporizers (PV for short as in electronic cigarette) to stop smoking without the need to stop using nicotine. There’s no need to unless you’re going to argue that no drugs should be sold as consumer products. In that case, I suppose, the Pharmaceutical industry would surely welcome the opportunity to start selling CRT drugs (caffeine replacement therapy). The physiological effects of nicotine and caffeine are very similar.

The term “strain of cigarette” is so, so misleading. The PV is not a cigarette at all, other than the name. There is no smoke, period. The reason that cigarettes have the great majority of health risks is the smoke. Without it, the risks reduces by 98-99% by most estimate
s.

“Rather than waiting for a verdict from the federal authorities, some local boards of health have chosen to "exercise precaution," drafting ordinances to regulate the purchase and public use of e-cigs. Failure to do so, according to Northampton Department of Health Director Ben Wood, would signal that the organization has reneged in the mission against smoking: "We would be undermining our cigarette laws. In effect, we would be reversing social and cultural norms." He fears the youth would be most vulnerable to the shift in the tobacco trend—that they would be swept away on the wave of e-cig excitement.”

This attitude is directly out of the ?non-profit?”health” association playbook. Many years ago I respected the work of organizations such as the ALA, ACS, AHA and such. Unfortunately, at one point, it has become a matter of keeping the cash cow working for them rather than the health of the citizenry. At one time the devil was smoking, now it’s tobacco and nicotine. They forget, conveniently, where this war started. Why? Their main receivables come from both tobacco and Big Pharma. If smoking disappeared, much of their income would also. Money is laundered to them via the tobacco MSA agreement, through state governments and into their coffers. Contributions come from Big Pharma, the suppliers of NRT products. No need for NRT, no need for Pharma to donate, pretty straight forward.,

Do a little research. Look at North Dakota who back in 2003 was proposing a total smoking ban in the state. One week the Finance Committee of the state voted overwhelmingly to pass the legislation. One week later when the vote was put to the House, the legislation was voted down. Six of the nine members of the Finance Committee who voted for the ban changed their votes one week later. Why? According to Rep. Wes Belter, chairman of the Finance and Taxation Committee, committee members were frustrated with the testimony from anti-tobacco groups that testified against the tobacco ban, including the North Dakota Medical Association, American Heart Association, American Cancer Society, American Lung Association, North Dakota Public Health Association and North Dakota Nurses Association.

http://www.freerepublic.com/focus/news/827172/posts

Using minors as an excuse is a smokescreen. Cigarettes are easy. You buy a pack you get a match or lighter and you’re good to go. In the case of PVs, they are expensive, they are inconvenient with charging batteries and maintenance and they are un-cool.

Even getting young adults to buy into PVs is difficult. I’ve personally introduced a couple dozen twenty something smokers into trying them and not one has totally quit smoking. Many just give up due to the lack of dedication that it takes to taking care of the equipment.





“The Board of Health's concerns aren't entirely unsubstantiated; in a laboratory analysis the FDA found trace amounts of carcinogens and toxins like diethylene glycol, a chemical found in antifreeze. The FDA has yet to determine if these particulates pose health risks or if they're really negligible in such small doses. But in this current climate of uncertainty, critics contend, lawmakers shouldn't be passing any definitive legislation.”

This is part of the FDA smokescreen. They had a dog and pony show that was well publicized. However, if you read the actual report, you get a much better picture. The carcinogens found in PV liquid are at the same levels found in NRT products. The diethylene glycol was found in one of the almost 20 cartridges and at a safe level according to their own standards. It also was only found in the liquid, not in the vapor. They also brought up flavors and the supposed marketing to children. There again, nicotine gums and lozenges also come in the same type of flavors. There presentation was clearly disinformation to influence the public against the two companies that brought suit against them.

“Wood insists that the real impetus of the laws stems from the Board's concern about protecting minors from a potentially addictive, harmful substance. Plastered with colorful packaging and offered in fun flavors like Coca-Cola and chocolate, e-cigs are tricked out with a marketing strategy that could leave an impression on children. And as obesity has superseded smoking as the prevention priority in schools, the thrust of the anti-tobacco movement has waned. Smoking rates are still declining, but the trend has stagnated.”

Wood only insists this because that was what he was told by the ?non-profit?”health” associations. It’s in their playbook. Rather than running around, spending their money on attacking a product that will indeed help both smokers that are looking for a safer alternative to combustible tobacco and non-smokers who do not like the smell of smoke, they should be running education programs for the underage youth that they say they are trying to protect.

As long as there are cigarettes, there will be youth smoking them. That’s a fact. The harder you make it to get them, the more they will work to get them. Just look at the illicit drug market, they have no problem getting whatever they want. I personally believe most long term smokers are stronger advocates for not smoking than the ?non-profit?”health” organizations.

There are benefits to using both nicotine and tobacco for a part of the population. There are also much safer alternatives than smoking available. If the government and the ?non-profit?”health” organizations want to truly and dramatically reduce the harm associated with smoking, they will establish an honest continuum of risk and sell that to the public rather than this abolitionist approach that they refuse give up.

Posted by Jim Rothenberger on 9.5.10 at 12:49

The Consumer Advocates for Smoker-free Alternatives Association (CASAA) works to ensure the availability of reduced harm alternatives to smoking and to provide smokers and non-smokers alike with truthful information about such alternatives. The FDA is not providing truthful information.

Eight nanograms of Tobacco-Specific Nitrosamines (TSNAs) in a day's supply of e-cigarette liquid is no more likely to cause cancer than the 8 nanograms of TSNAs in an FDA-approved nicotine patch. Those 8 nanograms, whether from e-cigarettes or from a nicotine patch, are a lot less likely to trigger cancer than the 126,000 nanograms in a pack of Marlboros. Likewise, the quantity of DEG detected in one cartridge was at far below toxic levels. The FDA's press release was a classic study in propaganda techniques.

Those propaganda techniques continue to be employed in the press releases and policy statements issued by the organizations that claim to be concerned about lung health, cardiovascular health, and cancer. Their claim that there have been no scientific studies confirming the effectiveness of e-cigarettes as a smoking cessation method is belied by population studies of e-cigarettes users published in peer-reviewed publications.

J.F. Etter's survey of e-cigarette consumers from three European countries showed that 63% had recently quit smoking. His article was published in BMC Public Health BMC Public Health 2010, 10:231. http://www.biomedcentral.com/1471-2458/10/231

“Electronic cigarettes (e-cigarettes) as potential tobacco harm reduction products: Results of an online survey of e-cigarette users,” by Heavner, et al was published as Chapter 19 of the Tobacco Harm Reduction Yearbook 2010. (available at http://tobaccoharmreduction.org). This study showed that consumers reported using electronic cigarettes as a complete (79%) or partial (17%) replacement for, rather than in addition to (4%), cigarettes.

Both surveys show that over 90% of users report that their general health has improved. Users most often report improved breathing and reduction or elimination of wheezing and coughing.

All of the respondents in these surveys were cigarette smokers when they began using an e-cigarette. The overwhelming majority (91%) had made previous attempts to stop smoking, with 63% having tried four or more times, and 21% having tried more than 10 times. Methods employed included medicinal nicotine products such as the patch, gum, lozenges, and prescription inhalers; prescription smoking-cessation drugs Zyban and Chantix, hypnosis, support groups, and more – to no avail.

Hundreds of former smokers who at one time thought there was no hope they could ever quit have written to the American Lung Association (ALA), American Heart Association (AHA), and American Cancer Society (ACS) to share their stories of failed attempts using the recommended smoking cessation methods and success with the electronic cigarette. The answers they have received are form letters telling them that electronic cigarettes don’t work and that they should stick with the “safe and effective” recommended methods.

When used as directed to wean down and off nicotine, the FDA-approved nicotine products have a success rate of 7% at 6 months, 5% at one year, and a dismal 2% at 20 months. Both Zyban and Chantix have slightly better success rates, but have generated hundreds of reports of serious adverse events. However, in the 6 years that electronic cigarettes have been in use world-wide, there have been zero reports of seriious adverse events.

So why are the FDA, ALA, AHA, and ACS telling people who have already quit smoking to stop using the tool that finally worked for them and to switch back to tools that didn’t work before? Why should they switch to tools with documented success rates less than 1/10th that of the electronic cigarette or switch to strong medications that have a risky safety profile?

Posted by Elaine Keller on 9.5.10 at 22:16

I have used a personal vaporizor (aka electronic cigarette) for the past nine months, and it has enabled me to quit smoking entirely. Prior to this I had tried the patch and the pill and several other methods and nothing worked for me. I no longer cough all the time, I don't smell like smoke, I have increased energy and ability to exercise, I don't wheeze, and I fully expect that I will live longer than I otherwise would have. I want to share these health benefits with others, so it makes me sad when I see well-meaning legislators act without enough information in ways that may prevent smokers from getting the help they need.

On a separate note, one thing I don't think gets enough attention about the FDA study is that all the liquid they tested was tobacco flavored; it seems obvious to me that tobacco-flavored liquid would have some tobacco chemicals in it including nitrosamines and DEG. What would be more interesting to me would be a study on other flavors such as vanilla or my favorite pecan pie... despite the fact that the FDA found only trace amounts of these chemicals in the tobacco flavored liquids, I would suspect they would find even less in a non-tobacco flavored liquid. Possibly zero.

Posted by Chris Odhner on 9.7.10 at 16:36

Same addiction, different delivery sysytem. Cigarette manufacturers add amonia to their products to make smokers absorb nicotine faster into their bloodstream. Maybe smoking E-ciggs which use flavored nicotine liquids helps people stop smoking tobacco, but those people are still addicted to nicotine. Lastly, do we want our children to have more exposure to nicotine? Judging by the difficulty that many people have in quitting, it seems nicotine is a hard chemical habit to kick.

Posted by ozzyjacob on 9.13.10 at 6:10

The Government wants people to keep using real cigarettes, or pad the pockets of the FDA by purchasing crap that is proven not to work. If a doctor said your surgery had a 7.% chance of working for 6 months, would you do it?

Posted by h33t dvdrip on 12.9.10 at 6:17

Everything that I've seen about e cigs are good. I've even been thinking of getting my uncle one of those e cig starter kits. I've had friends get off of smoking thanks to the e cigs.

Posted by Raphael Costello on 9.6.11 at 10:33
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