My take

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I put up this site to give you the news on e-cigarettes because of things like this – U.S. Food and Drug Administration (FDA) Acting Commissioner Dr. Stephen Ostroff announced the agency’s intention to proceed “full steam ahead” on regulations intended to (reduce e-cigarette use).

Oh my god, why would anyone want to stop e-cigarettes use.

Do they want people to keep smoking ?

I just post the news I find, good or bad.

You have to check out this person’s Comments about e-cigarettes.

Quote :This idea that it renormalizes smoking is absolute bullshit. There is no evidence so far that it is a gateway into smoking for young people.”

EDITORIAL: E-cigs aren’t the real thing

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Electronic cigarettes are not tobacco products. While there is mixed evidence as to the short- and long-term health effects of e-cigarette use and exposure to vapors emitted by the devices, the devices do not contain tobacco.

Yet earlier this month, the California Senate voted 25-12 to expand existing definitions of “tobacco product” to include e-cigarette devices, with a mixed input from Inland legislators.

The proposal is Senate Bill 140, by state Sen. Mark Leno, D-San Francisco. It would treat e-cigarettes the same as actual cigarettes.

Thus, e-cigarette use would be prohibited in the same places tobacco cigarettes are.

The devices in question may or may not contain nicotine and additives for flavor or aroma, and existing law prohibits the sale of the devices to people under the age of 18.

The need for this bill is thus difficult to see, unless we are to believe e-cigarettes are ushering in an unseen health crisis.

One of the most prominent voices in support of treating e-cigs as tobacco products has been Sen. Jeff Stone, R-Murrieta, the only Republican to support the bill.

“It’s my belief and the belief of many professionals that this is nothing more than a gateway, ultimately, to getting people addicted to traditional tobacco,” said Mr. Stone on the Senate floor, elaborating on the negative health effects of tobacco and the many preventable deaths attributable to smoking.

Given the minimal empirical basis for that remark, invoking a gateway theory is a peculiar one.

On the contrary, tobacco smokers often will turn to e-cigarettes as a smoking-cessation tool, as shown by two studies released in April by King’s College London’s Institute of Psychiatry, Psychology and Neuroscience.

Further, the effort to make up for the lack of evidence of serious negative health risks associated with e-cigarette use by invoking the dangers of tobacco requires a tremendous array of assumptions.

It assumes that not only are e-cigarettes a gateway to tobacco, but the state of California must restrict where people can use the devices in order to prevent people from smoking and dying from tobacco.

By making it difficult to use e-cigarettes, nothing is accomplished but inconveniencing those who might be interested in using the devices as a means of quitting smoking.

While restricting e-cigarettes further is probably unnecessary, at the very least the decision should be left to local communities, which may be able to more thoughtfully consider the issue than state lawmakers can.

Are E-Cigarettes Bad for Your Health?

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Ever since their introduction into the market, electronic cigarettes, or e-cigarettes, have raised a lot of questions from the health community. They have been both credited as a potential tool against smoking and deemed a gateway for those to begin smoking again. Either way they are looked at, the main question is to whether or not they are harmful to the health of those who use them.

Since their introduction, there has been a noticeable decline in the sale of traditional cigarettes. This is perhaps true due to those who want an alternative to the addictive and potentially deadly cigarette.

HOW DO THEY ACTUALLY WORK?

Electronic cigarettes use battery powered heating elements to vaporize a solution of either vegetable glycerin or propylene glycol with nicotine and added flavors.
Electronic cigarettes’ introduction into the world of smoking has been marketed as a healthier alternative to smoking actual cigarettes.

THERE’S A LOT TO CHOOSE FROM, complicating matters

There are currently about 500 different brands of electronic cigarettes offered in over 7,000 flavors. These different brands offer flavors often involving mixtures of nicotine, carcinogens and other toxins, just like the real cigarette.

So, can that really mean that vaporized tobacco is that much better for your health than actual cigarettes? According to the recent reports that have been released, the answer is likely a negative one. A lot of research has recently been done to see the effects of these electronic cigarettes.

ITS HARD TO DETERMINE ACTUAL RISKS BECAUSE OF number of BRANDS AND FLAVORS

The sheer number and variety of different brands and flavors being offered has made it difficult for researchers to make a clear assessment of this technology’s health impacts.
There aren’t any studies showing the long term effects of electronic cigarette smoking, but it is known that the overall effect on the body is negative. The lack of studies showing the long term effects has the health community at odds with each other. Some of the other studies that have been done have been compromised by conflicts of interest. Either way, the State of California issued a warning against e-cigarettes back in January, stating that they are harmful and can easily lead to nicotine poisoning. Especially strong was the state’s warning against leaving E-cigarettes within the reach of children.

Consumers unclear about risks or benefits of e-cigarettes

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While some smokers consider electronic cigarettes a potential aid in quitting, some people who have already quit see them as a temptation to resume a habit they fought hard to ditch, a small study suggests.

Researchers in Scotland interviewed 64 smokers and found little consensus about the potential benefits and harms of e-cigarettes, which may reflect division in the medical community on the appropriateness of promoting e-cigarettes as a safer alternative to the real thing, the authors note in the journal Tobacco Control.

“Because e-cigarettes are relatively new products we are only beginning to learn about the health risks,” senior study author Amanda Amos, a researcher at the Center for Population Health Sciences at the University of Edinburgh Medical School, said by email.

E-cigarettes are designed to mimic the real thing, with a glowing tip that emits a cloud of vapor. There’s a battery and heating element inside as well as a cartridge that holds nicotine and other liquids or flavorings.

Because part of what makes cigarettes harmful is the tobacco smoke, it’s possible that e-cigarettes might be safer because they don’t actually burn tobacco. Even so, the nicotine inside e-cigarettes is still addictive.

Amos and colleagues conducted 12 focus groups and 11 individual interviews with current smokers and people who had quit smoking within the past year.

Most participants viewed smoking as a form of addiction and believed willpower played a strong role in quitting. Almost all of them had tried e-cigarettes at least once.

They generally viewed e-cigarettes as distinct from other nicotine replacement products like patches or gum that are designed to help people quit. Because general practitioners give nicotine alternatives to smokers trying to quit, the study participants tended to think of these as medical products.

With e-cigarettes, however, people were less clear about what their intended purpose or correct use might be, though they were seen as less directly tied to smoking cessation than patches or gum.

Some people saw e-cigarettes as a more satisfying replacement to smoking, while others viewed them as less desirable or even as a threat to smoking cessation.

“This paper shows that the public’s view of e-cigarettes is far from being clear, with a great deal of ambiguity around the product and its intended use,” Dr. Ricardo Polosa, a professor of internal medicine at the University of Catania in Italy.

“Really, it’s not complicated at all,” Polosa, who wasn’t involved in the study, said by email. “E-cigs are a much safer alternative to smoking and are intended for smokers who are unable to quit using other methods.”

While the study is too small to draw many conclusions about public perception of e-cigarettes, it highlights widespread confusion among consumers that has been observed in many countries, said Dr. Konstantinos Farsalinos, a researcher at Onassis Cardiac Surgery Center in Athens.

“Unfortunately, the end result is that smokers are discouraged from using e-cigarettes as an alternative to smoking,” Farsalinos, who wasn’t involved in the study, said by email. “For those smokers who cannot switch with, or do not want to use the pharmaceutical medications, e-cigarettes can really be life-saving.”

SOURCE: bit.ly/1eMb7bO Tobacco Control, online June 8, 2015.

House Bill Aims for Less E-Cigarette Regulation

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House Republicans are pushing to ease proposed government regulations for companies that sell e-cigarettes and other new tobacco products, a move that Democrats charge could lead to unsafe products on the market.

A spending bill approved by a House subcommittee Thursday would prevent the Food and Drug Administration from requiring pre-market reviews of e-cigarettes that already are on the market.

As part of a broader rule regulating e-cigarettes for the first time, the agency has proposed that e-cigarette brands marketed since February 2007 undergo those pre-market reviews retroactively once the final rule is approved. Companies would have to submit the applications within two years of the final rule, and then the FDA would ensure that the product is “appropriate for the protection of the public health.” If not, the agency could take it off the market.

In addition to e-cigarettes, the FDA rules and the House legislation would apply to other unregulated tobacco products such as cigars, hookahs, nicotine gels, waterpipe tobacco and dissolvable tobacco products. The FDA already regulates cigarettes, smokeless tobacco and roll-your-own tobacco products.

Republicans said the pre-market review would be a lengthy and expensive process that could drive companies out of business. Alabama Republican Rep. Robert Aderholt, who sponsored the bill, said the provision is just a technical change that would keep the newer products under FDA oversight but allow them to be regulated in the same way as older tobacco products. The legislation would not affect the FDA’s proposal to ban the sales of the products to minors and would still allow certain product standards.

Public health groups said the legislation would hamper the FDA’s ability to prevent tobacco companies from marketing the new products to kids, and Democrats said before the panel’s vote that the change would reduce regulation on the industry at the same time that e-cigarette use is skyrocketing.

The bill “is nothing short of a giveaway to the tobacco industry,” said New York Rep. Nita Lowey, the top Democrat on the Appropriations Committee.

FDA’s proposed rules, expected to be finalized in the coming months, are aimed at eventually taming the fast-growing e-cigarette industry.

E-cigarettes are plastic or metal tubes, usually the size of a cigarette, that heat a liquid nicotine solution instead of burning tobacco. That creates vapor the user inhales.

The nicotine-infused vapor of e-cigarettes looks like smoke but doesn’t contain all of the chemicals, tar or odor of regular cigarettes. Some smokers use e-cigarettes as a way to quit smoking tobacco, or to cut down. However, there’s not much scientific evidence showing e-cigarettes help smokers quit or smoke less, and it’s unclear how safe they are.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, said the House language could keep products on the market that appear to be targeted to children, like cigars and e-cigarettes in a variety of candy and fruit flavors.

Gregory Conley, president of the American Vaping Association, said the FDA regulations could hurt small businesses.

“This proposal does not remove the FDA’s ability to regulate vapor products,” Conley said. “The FDA will still have the full authority to make science-based regulatory decisions on the manufacturing, marketing and sale of these products.”

The FDA would not comment on the legislation, but FDA spokesman Michael Felberbaum said the rules are important consumer protections.

“When finalized, the rule will represent a significant first step in the agency’s ability to effectively regulate tobacco products and, as we learn more about these products, the agency will have additional opportunities over the long term to make a positive difference in the public health burden of tobacco use in this country,” Felberbaum said.

E-cig regulations hurt addicts, medical basis lacking

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In the Pacific Northwest, public officials’ good intentions leave little empathy for citizens trying to kick the harmfully addictive and costly habit of smoking.

Last week, Oregon Gov. Kate Brown signed a new statewide law that regulates e-cigarettes just like regular cigarettes. A bi-partisan bill in this year’s Washington Legislature proposed a 95 percent tax on vaping products. The bill would also ban minors from vaping, forbid flavored vaping fluids, and ban Internet sales of vaping products.

Southwest Washington’s Clark County recently joined a handful of other Washington counties in regulating e-cigarettes just like tobacco cigarettes. King, Pierce, and Grant Counties preceded Clark County in these regulations. Just across the Columbia River from Clark County, densely populated Multnomah County, whose county seat is in Portland, Oregon, passed a similar law in March.

The basis of all of these new regulations is the concern that not enough is known about the potential health risks related to “vaping” e-cigarettes. Washington and Oregon officials have said that without proof that e-cigs have absolutely no adverse effects, they must be treated exactly the same as dangerous tobacco cigarettes.

But could this high level of caution actually be creating a worse situation, by restricting the use of a potentially useful gateway for tobacco smoking cessation? Could these new laws actually maintain the status quo for first-hand and second-hand smoke exposure, by treating e-cigs the same as tobacco cigarettes?

Tobacco smoking has long been recognized as one of the strongest addictions. Pediatric specialist and author Armin Brott states, “Research indicates that nicotine addiction is one of the most difficult to break. Like other addictions, it works in a fiendishly clever way to keep the smoker smoking, signaling the “reward” circuits of the brain to release dopamine, which produces feelings of pleasure.”

E-cigarettes remain a practical option for low-income smokers who are trying to quit smoking, or at least manage their addiction in a low-cost manner. A University of Washington Public School of Health white paper, “E-cigarettes: Evidence and policy options for Washington State,” found that the average daily e-cigarette user spends about $33 per month compared to $150-200 spent by a pack-a-day conventional cigarette smoker.

In his March 31, 2015 State Budget Solutions Policy Analysis “E-Cigarettes Poised to Save Medicaid Billions,” J. Scott Moody states “Numerous scientific studies show that e-cigs not only reduce the harm from smoking, but can also be a part of the successful path to smoking cessation.”

Moody points out that the term “e-cig” is misleading because there is no tobacco in an e-cig, unlike a regular cigarette. The vapor is inhaled like cigarette smoke, but it lacks the carcinogens found in tobacco smoke.

Nicotine replacement therapy such as gum or patches lacks the physical routine that smokers also find hard to break. E-cigs provide that routine, without the smoke and additional carcinogens.

Tobacco smokers switching to e-cigs will directly lower health care costs caused by their smoking. According to Moody, these benefits will greatly impact the Medicaid system where cigarette smoking is twice that of the general public (51 percent versus 21 percent, respectively).

The U.S. Medicaid system includes 36 million smokers out of a total Medicaid enrollment of over 68 million. The high costs of treating tobacco- related reduces available care and resources for children, the elderly, and other truly needy Medicaid recipients.

Moody further estimates that the potential savings of replacing tobacco smoking with e-cigs could have been up to $48 billion in Fiscal Year 2012. This savings is 87 percent higher than all state cigarette tax collections and tobacco settlement collections ($24.4 billion) collected in that same year.

These benefits may not continue if barriers such as new taxes and increased regulations dampen cigarette smokers desire to switch to e-cigs, and experts say these barriers are unwarranted.

A comprehensive 2014 study led by University of California’s Neal Benowitz, MD found says the evidence for such regulations falls short:

Regulating EC (e-cigs) as strictly as cigarettes, or even more strictly as some regulators propose, is not warranted on current evidence. Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to EC as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use.

New regulations for public use of e-cigs are primarily based on the fear that second-hand exposure to the vapors could create a significant health concern to others. Yet a separate 2014 study by Drexel University’s Igor Burstyn, PhD states:

Current state of knowledge about chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces . . . Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.

Another area of cost savings from low-income citizens switching from tobacco smoking to e-cigs is reduced smoke and fire dangers in subsidized and public housing. Smoking is these buildings increases health care costs from exposure to second-hand smoke, increased building renovation costs, and increases fires caused by smoking.

Nicotine is a dangerous, addictive drug, and there is no completely harmless way to use it. E-cigs have the potential to help many citizens quit smoking tobacco, greatly reduce the resulting health care costs on both Medicaid and for exposure to first-hand and second-hand smoke.

FDA Going ‘Full Speed Ahead’ on E-Cig Regulations

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U.S. Food and Drug Administration (FDA) Acting Commissioner Dr. Stephen Ostroff announced the agency’s intention to proceed “full steam ahead” on regulations intended to reduce e-cigarette use.

Ostroff says FDA intends to enact a “deeming rule” expanding the agency’s regulation of tobacco products to include e-cigarettes, which do not contain tobacco.

California Polytechnic State University professor of economics Michael L. Marlow says this is a bad idea because e-cigarettes are a useful tool for reducing health damage and helping smokers kick the habit.

‘Doesn’t Make Much Sense’

“If e-cigarettes help smokers reduce consumption of more harmful tobacco or maybe even allow them to quit cigarettes, even if e-cigarettes themselves are somewhat harmful, it still would be an overall reduction of harm,” Marlow said. “If you just ignore that theory, and the FDA certainly has, an economist would say it [still] doesn’t make much sense.”

Marlow says e-cigarettes are a positively disruptive invention some special-interest groups want to suppress.

“In fact, e-cigarettes have become the greatest source of ‘creative destruction’ that we’ve seen against the tobacco industry,” Marlow said. “But unfortunately, maybe it’s also a source of creative destruction for those who make a living out of tobacco control.”

Growing Evidence

Marlow says studies show e-cigarettes help people quit smoking, a stated goal of policymakers and public health organizations.

“Evidence is growing that these e-cigarettes are extremely useful,” Marlow said. “The Tobacco Control Journal recently published a paper that said that the various nicotine replacement therapies that had been approved by the FDA work no better than going cold turkey.”

Keeping Alternatives off Market

Dr. Gilbert Ross, the medical and executive director of the American Council on Science and Health, says the government crackdown on e-cigarettes is hampering efforts to reduce smoking.

“The real story is the bias against harm reduction products at the FDA and other public health agencies,” Ross said.

Ross says some opposition to harm-reduction products is financially motivated.

“Some of the groups advocating for this anti-science, anti-public-health charade … are influenced by undisclosed but generous financial support from the pharmaceutical industry, which is devoted to keeping effective competition to its poorly performing nicotine replacement therapy patches, gums, and drugs off the market,” said Ross.

‘A Sad State of Affairs’

Ross says e-cigarettes decrease the difficulty of quitting and provide less harmful alternatives to tobacco use.

“This is a sad state of affairs, especially for America’s 42 million adult smokers and the frightful toll of 480,000 dead each year thanks to the difficulty of quitting,” Ross said. “Clearly, e-cigs or vapor products would provide a much less harmful alternative to smoking and will be able to help many smokers quit who otherwise would not be able to.”

Ross says government health officials should encourage the use of these less-harmful alternatives, instead of reducing their availability.

“I don’t know why the FDA and the [Centers for Disease Control and Prevention] want to regulate e-cigarettes as if they were tobacco and regulate them right off the market, but that seems to be their plan,” Ross said. “It’s like going through the looking glass. Here we have a potential remedy to one of the biggest public health threats in the Western world, and they want to regulate it so no one can use it.”

Is Vaping E-Liquid Really Safer Than Smoking Tobacco?

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The question in the title above is one that has been asked many times by many smokers or, more poignantly, an ex-smoker or someone who is in the process of giving up tobacco.

While people now know full well that smoking tobacco is harmful to their health, many are suspicious about vaping e-juice (also known as e-liquid and vape-juice) as no long-term research is available yet as to how it affects health.

There is much controversy about the benefits of e-cigs, particularly over the degree of toxicity of e-cigs as compared to tobacco. The problem with traditional cigarettes is the chemicals added by the tobacco companies to increase the addictive properties.

The liquid used in e-cigs has very little in the way of additives to the the pure nicotine. Most e-cigarettes comprise of four basic ingredients: propylene glycol, vegetable glycerol, nicotine, and flavorings.

Here is a quick breakdown of those four ingredients.

Propylene Glycol (PG) is the carrier for the nicotine and flavorings, which produces the vapor. The U.S. Food and Drug Administration (FDA) has declared that propylene glycol is “metabolized by animals and can be used as a carbohydrate source and there is no evidence in the available information on propylene glycol that demonstrates a hazard to the public when they are used at levels that are now current or that might reasonably be expected in future.”

Vegetable Glycerol (VG) is the alternative carrier, which is usually combined with PG. It is a plant-based carbohydrate and produces a vapor upon exhaling. Studies have demonstrated that it is non-carcinogenic. Both PG and VG are widely used in many industries, and the FDA has designated both PG and VG as “Generally Recognized as Safe” for oral or dermal use.

Nicotine is an alkaloid which is found in tobacco plants and all the nicotine in electronic cigarettes is extracted from these plants. While nicotine does have addictive properties, it also has a stimulant effect on the brain by activating receptors and releasing chemicals.

Flavorings can supplement or even replace nicotine altogether in e-cigarettes. They range from basic flavors, like menthol, to exotic versions of fruits, like mango or papaya, or alcohol flavors, like Pina Colada.

While it remains to be seen what the long-term effects of vaping are, there is little question that it is a far better alternative to smoking tobacco, a fact that is hard to dispute.

Link

Many E-Cig Users Think The Devices Are Better Than Cigarettes, But Are They?

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By Dennis Thompson
HealthDay Reporter

E-cigarette users are much more hopeful that the devices will help them quit smoking than the general public is, including people who just smoke traditional tobacco cigarettes, according to a new French survey.

“Vapers” (people who use e-cigarettes) also are much less concerned about how possible toxins in e-cigarette vapors might affect them and those around them, said lead study author Dr. Sebastien Couraud, a doctor of respiratory medicine and thoracic oncology at Lyon Sud Hospital and Lyon University Cancer Institute in France.

“E-cigarette users appear to have a different view of reality, compared with everyone else,” Couraud said. “Their reality is elsewhere.”

Couraud presented his findings Monday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. Findings presented at meetings are generally viewed as preliminary until they’ve been published in a peer-reviewed journal.

Electronic cigarettes are battery-operated products designed to create an aerosol that delivers nicotine, flavor and other chemicals when inhaled by the user.

Couraud said that the public opinion his team captured appears to mirror ongoing expert debate over whether e-cigarettes can actually help people quit smoking and whether e-cigarette vapors might contain toxic chemicals.

About 69 percent of e-cigarette users believe the devices can help a person quit tobacco smoking, compared with just 31 percent of the general population, researchers found.

Many e-cigarette users genuinely appear to want to quit smoking tobacco, Couraud said. They are more likely to be worried about dying from lung cancer than people who only smoke tobacco, he suggested. E-cigarette users are also more likely to think that using e-cigs will reduce their risk of lung cancer death, the survey revealed.

The findings from this survey highlight why regulation of e-cigarettes from the U.S. Food and Drug Administration is needed as soon as possible, said ASCO spokesperson Dr. Jyoti Patel, an associate professor of hematology and oncology at Northwestern University Feinberg School of Medicine in Chicago.

“For people who are addicted to nicotine, e-cigarettes don’t help,” said Patel. “They are still addicted, and they use a lot. It’s not a bridge to abstinence. It’s a way for them to stay addicted in a restaurant or an airplane, where they are unable to smoke.”

And, indeed, users of e-cigarettes tend to be much more dependent on nicotine than traditional cigarette smokers, based on a standard test of nicotine addiction, Couraud said. About 58 percent of e-cigarette users registered as very or highly addicted, compared with 46 percent of people who only smoked tobacco.

In January, ASCO issued a call for regulation of e-cigarettes and other electronic nicotine delivery systems, in conjunction with the American Association for Cancer Research, Patel noted.

For the study, Couraud and his colleagues surveyed nearly 1,500 residents of France. Ninety-three (6 percent) of those surveyed were e-cigarette users, and 74 of them also still smoked tobacco cigarettes, according to the survey.

About 33 percent of e-cigarette users in the survey believed that the devices are effective in reducing deaths from lung cancer, compared with 18 percent of smokers and 12 percent of the general population.

E-cigarette users also parted ways with popular opinion over whether they should worry about toxins in the vapor they inhale.

About 68 percent of current e-cigarette users in the study said that e-cig vapors are less harmful than cigarette smoke for the user, and 87 percent said the vapors pose less of a threat to those around them than secondhand cigarette smoke would.

By comparison, around 40 percent of the general French public felt that e-cigarette vapor is less harmful than cigarette smoke for the user, and about 55 percent were less concerned about e-cig vapors than cigarette smoke.

“Probably they aren’t completely wrong, because we know that e-cigarettes are less toxic than traditional cigarettes,” Couraud said. “But there still is some toxicity, and they have a low awareness of that.”

Couraud and Patel both said that American opinions of e-cigarettes likely are similar to those found in this French survey.

Dr. Gregory Masters said he completely understands conflicted public opinion over e-cigarettes.

“I do have safety concerns for e-cigarettes because nicotine is bad for you, and we don’t know all of the risks with e-cigarettes,” said Masters, an oncologist at the Helen F. Graham Cancer Center in Newark, Del.

“But I struggle when I get asked by patients, should I use e-cigarettes? I don’t want to condone e-cigarettes as a healthy alternative, but could it be a less dangerous alternative? It could be,” he added.

According to the U.S. Food and Drug Administration, e-cigarettes haven’t been fully studied, so consumers don’t know:

the potential risks posed by the devices,
how much nicotine or other potentially harmful chemicals are being inhaled,
whether there are any benefits to be gained from the products.
More information

For more on e-cigarettes, visit the U.S. Food and Drug Administration.

Pacific Northwest e-cig regulations hurt addicts, medical basis lacking

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By Melissa Genson | Watchdog Arena

In the Pacific Northwest, public officials’ good intentions leave little empathy for citizens trying to kick the harmfully addictive and costly habit of smoking.

Last week, Oregon Gov. Kate Brown signed a new statewide law that regulates e-cigarettes just like regular cigarettes. A bi-partisan bill in this year’s Washington Legislature proposed a 95 percent tax on vaping products. The bill would also ban minors from vaping, forbid flavored vaping fluids, and ban Internet sales of vaping products.

Southwest Washington’s Clark County recently joined a handful of other Washington counties in regulating e-cigarettes just like tobacco cigarettes. King, Pierce, and Grant Counties preceded Clark County in these regulations. Just across the Columbia River from Clark County, densely populated Multnomah County, whose county seat is in Portland, Oregon, passed a similar law in March.

The basis of all of these new regulations is the concern that not enough is known about the potential health risks related to “vaping” e-cigarettes. Washington and Oregon officials have said that without proof that e-cigs have absolutely no adverse effects, they must be treated exactly the same as dangerous tobacco cigarettes.

But could this high level of caution actually be creating a worse situation, by restricting the use of a potentially useful gateway for tobacco smoking cessation? Could these new laws actually maintain the status quo for first-hand and second-hand smoke exposure, by treating e-cigs the same as tobacco cigarettes?

Tobacco smoking has long been recognized as one of the strongest addictions. Pediatric specialist and author Armin Brott states, “Research indicates that nicotine addiction is one of the most difficult to break. Like other addictions, it works in a fiendishly clever way to keep the smoker smoking, signaling the “reward” circuits of the brain to release dopamine, which produces feelings of pleasure.”

E-cigarettes remain a practical option for low-income smokers who are trying to quit smoking, or at least manage their addiction in a low-cost manner. A University of Washington Public School of Health white paper, “E-cigarettes: Evidence and policy options for Washington State,” found that the average daily e-cigarette user spends about $33 per month compared to $150-200 spent by a pack-a-day conventional cigarette smoker.

In his March 31, 2015 State Budget Solutions Policy Analysis “E-Cigarettes Poised to Save Medicaid Billions,” J. Scott Moody states “Numerous scientific studies show that e-cigs not only reduce the harm from smoking, but can also be a part of the successful path to smoking cessation.”

Moody points out that the term “e-cig” is misleading because there is no tobacco in an e-cig, unlike a regular cigarette. The vapor is inhaled like cigarette smoke, but it lacks the carcinogens found in tobacco smoke.

Nicotine replacement therapy such as gum or patches lacks the physical routine that smokers also find hard to break. E-cigs provide that routine, without the smoke and additional carcinogens.

Tobacco smokers switching to e-cigs will directly lower health care costs caused by their smoking. According to Moody, these benefits will greatly impact the Medicaid system where cigarette smoking is twice that of the general public (51 percent versus 21 percent, respectively).

The U.S. Medicaid system includes 36 million smokers out of a total Medicaid enrollment of over 68 million. The high costs of treating tobacco- related reduces available care and resources for children, the elderly, and other truly needy Medicaid recipients.

Moody further estimates that the potential savings of replacing tobacco smoking with e-cigs could have been up to $48 billion in Fiscal Year 2012. This savings is 87 percent higher than all state cigarette tax collections and tobacco settlement collections ($24.4 billion) collected in that same year.

These benefits may not continue if barriers such as new taxes and increased regulations dampen cigarette smokers desire to switch to e-cigs, and experts say these barriers are unwarranted.

A comprehensive 2014 study led by University of California’s Neal Benowitz, MD found says the evidence for such regulations falls short:

Regulating EC (e-cigs) as strictly as cigarettes, or even more strictly as some regulators propose, is not warranted on current evidence. Health professionals may consider advising smokers unable or unwilling to quit through other routes to switch to EC as a safer alternative to smoking and a possible pathway to complete cessation of nicotine use.

New regulations for public use of e-cigs are primarily based on the fear that second-hand exposure to the vapors could create a significant health concern to others. Yet a separate 2014 study by Drexel University’s Igor Burstyn, PhD states:

Current state of knowledge about chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces . . . Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern.

Another area of cost savings from low-income citizens switching from tobacco smoking to e-cigs is reduced smoke and fire dangers in subsidized and public housing. Smoking is these buildings increases health care costs from exposure to second-hand smoke, increased building renovation costs, and increases fires caused by smoking.

Nicotine is a dangerous, addictive drug, and there is no completely harmless way to use it. E-cigs have the potential to help many citizens quit smoking tobacco, greatly reduce the resulting health care costs on both Medicaid and for exposure to first-hand and second-hand smoke.