Excellent Electric Cigarette Information!

For the past half century, the American Association of Public Health Physicians (AAPHP) has served as the national voice of physician directors of state and local health departments and other like-minded physicians. We have long been involved with tobacco control, with the singular goal of doing everything in our power to reduce tobacco related illness and death.

As you assume leadership of the new FDA Center for Tobacco Products, we urge you to consider the actions FDA can take, within the powers granted by this new legislation, to rapidly and substantially reduce tobacco related illness and death in current adult smokers.

Unfortunately, FDA has not gotten off to a good start. FDA condemnation of electronic cigarettes, in its July 22 press conference, and FDA insistence that electronic cigarettes should be regulated as a drug/device combination rather than as a tobacco product makes no sense from a public health perspective. It flies in the face of FDA laboratory findings on other products already approved by FDA. If one looks at electronic cigarettes as a sentinel for all tobacco products less hazardous than conventional cigarettes – the outlook for FDA action reducing tobacco-related illness and death among current adult smokers is dismal.

With this in mind, we respectfully request your consideration of the following actions:

1. We urge FDA to make public the laboratory data behind the July 22 condemnation of electronic cigarettes, along with comparable data on pharmaceutical nicotine products and conventional cigarettes. Then, on the basis of these data, either fully justify or retract the July 22 condemnation of electronic cigarettes.

2. We urge FDA to reclassify electronic cigarettes from a drug/device combination to a tobacco product. This will enable FDA to immediately regulate manufacturing and impose marketing restrictions during this initial period of FDA Tobacco Center development. This reclassification will eliminate pressure on the several hundred thousand current American users of electronic cigarettes to switch back to the much more hazardous conventional cigarettes.

This year, about 400,000 American adult cigarette smokers will die of a tobacco-related illness. Their second hand smoke will kill about 48,000 non-smokers. About 700 more will die in residential fires. Despite progress on other measures of tobacco use, per CDC estimates, this death count continues to inch up from year to year. In contrast, even though smokeless tobacco products represent about 20% of nicotine intake in the United States, the number of deaths per year from these products is too small for reliable estimates from the CDC.

Our (AAPHP) best estimate is that smokeless tobacco products currently cause about 700 cancer deaths per year in the United States. This is less than 1% of the more than 110,000 deaths that would occur each year if smokeless products carried the same mortality as conventional cigarettes.

This last week, Boffetta and Straif published a paper alleging evidence of an increased risk of fatal heart disease and stroke among smokeless tobacco users. This is a study sure to be referenced by those seeking evidence of the harmfulness of smokeless tobacco products. Unfortunately, this study suffers from major technical and ethical flaws, including failure to note in the abstract that they found no increased risk of non-fatal heart attack or stroke. Even worse, of the many studies reviewed, only two showed evidence of even a slight increase in risk of death – and these were the ones selected for the conclusion and abstract. That having been said, their allegations of a 13% increase in risk of fatal heart attack and 40% increase in risk of fatal stroke pale in comparison with the 180% to 300% increases in risk for men and women 35-64 years of age posed by smoking conventional cigarettes.

Contrary to prevailing conventional wisdom, virtually all the heart and lung disease from conventional cigarettes, and an estimated 98% of the cancer mortality, are due to direct inhalation of fresh products of combustion deep into the lung. Our best estimate (based on the work of Pankow et al and others) is that only about 2% of the cancer mortality from cigarettes is from the named carcinogens commonly found in tobacco products. Smokeless tobacco products carry little or no risk of heart disease and no risk of lung disease. They do not kill innocent bystanders and they do not burn down houses. The risk of cancer of any kind from smokeless products ranges from a high of about 5% of the risk of cancer posed by conventional cigarettes to a low well under 1% of the risk of cancer posed by conventional cigarettes. While definitive studies have not been done, we have reason to believe that tobacco products, such as electronic cigarettes, consisting of nicotine extracted from tobacco with only trace amounts of other chemical substances, should carry even less risk.

Most of the discussion to date around the new FDA/Tobacco bill has focused on reducing initiation of nicotine use by children and teens. The only discussion of current smokers has been limited to encouraging use of pharmaceutical products to aid cessation. This has been touted as doubling quit rates – but without mentioning that this doubling is from about 3% to about 5% per year. In other words, this option fails 95% of smokers willing to try it, even under study conditions with optimal counseling.

It should be possible to save the lives of 4 million or more of the 8 million adult American smokers who will otherwise die of a cigarette-related illness over the next twenty years. This could be done by making smokers aware of selected smokeless tobacco products (including but not limited to snus and electronic cigarettes) that promise to reduce the risk of tobacco-related illness by 99% or better for smokers who are unwilling or unable to quit. Rather than discouraging nicotine cessation, however, such an approach, even with no medical intervention, would be expected to triple the rate at which current smokers eventually discontinue their nicotine use.

Those writing the new FDA legislation endorsed a harm reduction component to current tobacco control programming, but in a most peculiar way. The law encourages cigarette manufacturers to develop “reduced exposure“ products and market them with no scientific proof that such reductions in exposure will reduce risk. The law then requires presumably new “scientific evidence” for smokeless products, already known to be of substantially lower risk. This makes no sense. The law encourages a harm reduction component to current tobacco control programming that might reduce tobacco-related cancer mortality by one or two percent; while actively discouraging switching to lower risk tobacco products that promise to lower total tobacco-related illness and death by 99% or better.

The secret to success, as we see it, will be to add an effective harm reduction component to current tobacco control programming while using the tools made available by this new law to prevent this new harm reduction
initiative from increasing the numbers of children and teens who initiate tobacco use.

Reconsidering the FDA stance on electronic cigarettes would be the most logical first step.

We look forward to working with FDA to use the powers granted by this new legislation to rapidly and substantially reduce tobacco-related illness and death, among both current and potential future tobacco users.

References:
The data on smoking attributable deaths on page 2 of this letter are from the Centers for Disease Control MMWR report of November 14, 2008. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a3.htm

The estimate that 20% of current nicotine consumption in the United States is from smokeless tobacco was generated by Mr. William Godshall, based on the formula utilized by Fagerstrom et al, when estimating 2002 nicotine consumption by type of tobacco product in multiple countries.

The discussion on risk of heart disease and stroke from smokeless tobacco products is from Paolo Boffetta and Kurt Straif : Use of smokeless tobacco and risk of myocardial infarction and stroke: systematic review with meta-analysis. Published August 18, 2009. BMJ 2009; 339: b3060 [Abstract] [Full text]

The data on relative risk of fatal heart attack and stroke from smoking, in men and women 35-64 years of age, are data from the American Cancer Society as quoted in “Changes in cigarette-related disease risks and their implication for prevention and control.” Smoking and Tobacco Control Monograph 8. Bethesda, MD: US Department of Health and Human Services,
Public Health Service, National Institutes of Health, National Cancer Institute 1997;305-382. NIH Publication no. 97-1213.

The other references to the scientific literature that back-up the points made in this letter can be found on the Tobacco Issues page at the http://www.aaphp.org web site. There is an October 2008 “Resolution and White Paper on Tobacco Harm Reduction.” This paper, on pages 6 and 13, includes then-current CDC and AAPHP mortality projections. “The Myth of the Safe Cigarette,” is based on the paper by Pankow et al (http://cebp.aacrjournals.org/cgi/reprint/16/3/584 ) and others. It makes the case that conventional cigarettes cannot be made measurably safer. The exchange of correspondence with Zhu et al, from a paper published earlier this year, deals with the difference in quit rates, comparing conventional cigarettes to smokeless tobacco products.

Click Here For The Lowest Prices In The World For Electric Cigarettes!

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Yours,
Joel L. Nitzkin, MD, MPH, DPA
Chair, AAPHP Tobacco Control Task Force
jln@jln-md.com
504 899 7893
Kevin Sherin, MD, MPH, FACPM, FAAFP
President, American Association of Public Health Physicians
ksherin@yahoo.com

I get a lot of emails asking me about which brands and styles of electric cigarettes are compatible. Can you use a battery from brand “A” on a cartomizer or atomizer of brand “B”? In this article I will try to outline some of the brands that I know to be compatible. Please feel free to post a comment if I have missed anything or mistaken anything.

The E-9 Style or Two Piece Designs

The E-9 style is one of the most popular styles because of it’s ease of use and two piece design. Unlike the three piece ecigarettes that have a separate atomizer, the E-9 style has the atomizer built in to the disposable cartridge. The “E” stands for “electric” and the “9″ refers to the 9mm thread pattern. I would recomend this style to anyone who is new to the world of ecigarettes.

E-9 Brands That Are Compatible With Each other

Some companies that provide the E-9 style are:

Green Smoke – They sell exclusively the E-9 style and they do it right. In my opinion this is the best company out there. The product is top quality, the customer service is un-beatable and the free shipping is super fast.

Smoke 51 – They sell two different styles, one of them is the E-9 style. They call it the Duo because of the two piece design.

E-Cig Brand – They offer many different styles, One of them is the E-9 style. This company probably has the least expensive ecigarettes but you can only order them directly from china. They also offer a simple starter kit for $19.95 if you are curious about ecigs and want to try them out without spending a lot to begin with. This kit comes with 1 rechargable battery and two cartomizers. You can buy a charger later if you enjoy the ecig.

Zero Tar – They offer a few different styles of ecig, one of them is an E-9 style that they call the E-Vaporizer Kit

E-Smoke Brand Sensation Ecig –  E-Smoke brand sells two different styles of electric cigarettes, one of them is an E-9 9mm style ecig that they call the Sensation. This is fully compatible with all of the above ecig brands and the shipping and customer service is top-notch! I can recommend buying from E-Smoke.net

That pretty much covers what I know of about the E-9 style and which companies provide them.

The E-8 or  8mm Style

The E-8 style electric cigarette is nearly identical to the E-9 model ecigarette except it has a smaller thread pattern and a slightly smaller, lighter weight battery.

Here are a couple of different brands of E-8 8mm style electric cigarettes that I can highly recommend:

Premium Electric Cigarettes -  The Premium Electric cigarette is one of the highest quality electric cigarettes on the market, we only endorse the highest quality ecigs. They sell an awesome 8mm E-8 style ecig and all of the coolest accessories that go with ecigs, including a portable charging case, a really neat portable pocket sized starter kit, the coolest unique battery colors, They also sell Electronic Cigars.

E-Cig Brand E-8 Style Electric Cigarette -  E-Cig Brand is the original designer and developer of the ecigarettes with the cartomizer technology. Their E-8 Model is nearly identical to the E-9 Style Electric Cigarette.  E-Cig Brand is the only company in the world that will let you choose the battery color, cartridge color, battery tip color and also the battery light color. They also feature the lowest prices in the world by far and the shipping is surprisingly fast from China, Every time I have ordered it has come in only 5 days.

The Trio or Three Piece Designs

The three piece design is the second most popular design. The difference from the two piece design is that they have a separate atomizer, unlike the duo design which has the atomizer built into the nicotime cartridge.

Trio Brands That Are Compatible With Each other

These are some of the three piece designs that I know of that will work with each other:

The Blu Ecigarette -  This ecigarette is one of the highest quality on the market and a good starter for someone new to ecigs. The starter kit includes a charging case that is exclusive to the Blu Ecigarette and that no other company offers anything quite like it. The case will ensure that you always have a fully charged battery.

Smoke 51 Trio -  The Smoke 51 Trio is another high quality three piece ecigarette. the starter kit comes with everything you need to start vaping and even includes one extra nicotine cartridge.

The Luci Ecig -  Yet another high quality three piece electric cigarette. They offer four different versions of their starter kit, each with different amenities.

The Instead eCig -  Instead is one of the only companies that sell their kits with e-liquid so that you can refill the cartridges. Most of the other companies just want you to buy the pre-filled cartridges.

The Dragonfly ecig -  This one is not fully compatible with the above brands but I decided to include it because the battery has the same thread pattern. The cartridges slips into the atomizer rather than onto the atomizer. but you can use the battery with any of the above models.

Please feel free to download this article as a PDF and share it on your website or blog. The only condition is you MUST NOT change anything, all of the links need to remain in-tact.  You must first register to download:

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ECD: Given what we know about the ingredients and carcinogens contained within the electronic cigarette, is there reason to believe it could be a safer alternative to regular cigarettes?

Carl Phillips: I think that’s quite an understatement. I think there’s absolutely no doubt that it is a safer alternative to regular cigarettes. Now safe, that’s a word that implies there is absolutely no health risk from something, and that doesn’t really apply to anything. But our estimate is that it is probably in the order of 99 percent less harmful than smoking, I think there’s little doubt that it’s down in the neighborhood.

ECD: Professor Michael Siegel suggested that if we banned electronic cigarettes based on the carcinogens found in the FDA study we would have to ban peanut butter. Is that something you would agree with?

Carl Phillips: At least! We’d have to ban half the foods that are available. I mean, the FDA study really didn’t find any cancer risk. That study was basically pure propaganda.

ECD: Is there any danger of passive smoking with electronic cigarettes?

Carl Phillips: Probably not. As far as we know, the vapour, the propylene glycol vapour, has no human health risks at low concentrations, so it’s possible that there’s some miniscule risk, far too small for us to have ever noticed it or measured it. The amount of nicotine that escapes out into the air is also quite trivial and nicotine itself has such a low risk profile… so again it is never proper science to say that there is absolutely no risk from something, just as it is not proper science to say simply that there is a risk from something without trying to quantify it. But I guess there is no serious risk from second hand vapour as I guess it would have to be called.

ECD: In your opinion, could the electronic cigarette aid smoking cessation or be of use as a tobacco harm reduction product?

Carl Phillips: Yes, not only could it but it clearly is already being used for exactly that. Self reports suggest that thousands, tens of thousands of smokers have quit smoking by switching to the electronic cigarette which is the perfect proof that it does work as a smoking cessation aid and a tobacco harm reduction tool.

ECD: Electronic Cigarettes have been in use for several years now, and there are a few organisations which are concerned about them. What side effects have been found so far?

Carl Phillips: As far as I know there hasn’t been any discoveries of acute side effects, which of course is good news. There is no reason to expect any but you never know quite what is going to happen with a new exposure. You can have reports that start to trickle in of a case here or there of something very strange happening. I’m not aware of any such thing.

We of course know that long term use of nicotine poses a small, a very small but non-zero risk of some cardiovascular diseases so I suppose you could call that a side effect which is predictable for the long run, but that’s a total risk which is down in the range of drinking coffee, nothing remotely similar to the risk from smoking cigarettes.

ECD: What’s your biggest concern with regards to the electronic cigarette?

Carl Phillips: Well, we don’t know too much about the manufacturing process and there’s not enough quality control, or at least there is not enough guarantee of quality control in the process.

Now, this of course varies from manufacturer to manufacturer, but with reasonably free entry that just about anybody with an appropriate factory in China can start manufacturing these and start putting them out under some brand name there is worry about contamination. I mean this is not a plastic toy or something like that, which alone generates a lot of worry about Chinese manufacturers.

This is something that is delivering chemicals into the body in a way which is definitely going to be absorbed so it doesn’t take much of a production mishap to create something that is very harmful. And I really fear that it is going to happen one of these days if we don’t get some effective regulation and it is going to give the entire product line a bad name which of course would be inappropriate but quite understandable.

ECD: Following on from those concerns about the quality of production, let’s talk about the FDA. The FDA carried out tests on electronic cigarettes in which they found diethylene glycol in one “Smoking Everywhere” e-cigarette and traces of tobacco specific nitrosamines in both Smoking Everywhere and NJOY electronic cigarettes. So what are the significance of those findings?

Carl Phillips: There’s no significance of those findings whatsoever from a scientific or health standpoint. From a political standpoint the fact that they did that was quite significant.

So on the first point the fact that there are any detectable levels of any small molecules that that can be found in the tobacco plant in the e-cigarettes is not surprising at all. The nicotine comes from tobacco and our ability to detect a few stray molecules of contamination means that basically any molecule that is small enough to be a contaminant that is found in the tobacco plant will also be found in e-cigarettes. It’ll also be found in nicoderm, nicorette, any product that contains nicotine that has been extracted from a tobacco plant. So that’s completely meaningless – the quantities of the nitrosamines in the electronic cigarette were so many orders of magnitude smaller than those, say, in smokeless tobacco, which has been shown to not cause a measurable risk of cancer, so we know that that doesn’t matter.

Now, there is some more significance in finding contamination in the carrier chemicals, not that there was enough in this particular case that it was going to be harmful but because there is not supposed to be anything other than the propylene glycol and the water there, it does mean that there is a manufacturing problem – a manufacturing problem under some circumstances could be quite a bad thing. Now what really is the biggest problem is the politics that this reflects.This shows up in all sorts of harm reduction type situations and the basic rule of thumb is, if you ban something or if you’re trying to ban something, declare war on it, then you can’t regulate it, you can’t make it safer. So if you have a war on injection drug use and you simply want to forbid it and don’t want to admit it is happening in any way, you will prevent needle exchanges from happening which would save a lot of lives.

If you want to have a war on prostitution and just absolutely forbid it and pretend it doesn’t exist then it is impossible to impose rules that force prostitutes to get health exams and so forth.

Similarly if the FDA is intent on declaring war on electronic cigarettes and simply forcing them from the market then they are going to be abdicating their responsibility to make sure that the electronic cigarettes are what they are supposed to be and keep them safe and that goes back to this quality control problem. The FDA would really be the perfect entity to help impose some quality control on ecig manufacture even though they are manufactured in a different country but it looks pretty bad in terms of the possibility of them doing that.

ECD: What health benefits, if any, might smokers find if they smoked electronic cigarettes, or changed to electronic cigarettes?

Carl Phillips: The health benefits of switching are almost exactly the same as the health benefits of quitting, and this applies to electronic cigarettes, smokeless tobacco and pharmaceutical nicotine. If a smoker can manage to switch from smoking to one of those other products the benefits are approximately the same as quitting – they lower their cancer risk, they lower their cardiovascular disease risk, they get rid of acute symptoms of lung and airway problems, a risk that comes from smoking for pulmonary diseases and so forth. Switching is so close as good as quitting that from a health point of view there is no point in worrying about the difference.

Read more: http://www.ecigarettedirect.co.uk/carl.html#ixzz0bbBhvjSi

By John E. Calfee

June 2, 2009, 11:01 am

Both the New York Times and the Wall Street Journal carried front-page stories today (in the Journal, atop the Marketplace section rather than p. A1) on “e-cigarettes,” something most of us never heard of until the past few weeks or not until today. Most e-cigarettes come from China. They have been around for a couple of years but only recently reached the $100 million mark in annual sales. In a sense, e-cigarettes are the latest chapter in the continuing debate over smokeless tobacco, which deliver nicotine from tobacco but eliminate the smoke, which is the source of practically all the harms from cigarette smoking. E-cigarettes are the ultimate smokeless product because they don’t actually involve tobacco at all. They typically contain nicotine, water, some flavorings and scents, and propylene glycol (which the Times explains is common in hand sanitizers)—plus a battery and a miniature atomizer so that when the user takes a puff, he or she receives a nicotine-laced flavored mist.

The leading public health antismoking organizations like the American Cancer Society, American Heart Association, and the Campaign for Tobacco-Free Kids (supported by litigation-induced taxes on smokers) are furious about these unregulated products. They want proof of safety and efficacy, and they want the Food and Drug Administration to force e-cigarettes off the market. That is exactly what the FDA is prepared to do, on the grounds that e-cigarettes are obviously designed to help smokers quit, which is a recognized medical use and therefore renders these products subject to FDA rules about the testing and approval of new drugs.

It is hard to believe that e-cigarettes pose even a tiny percentage of the risks of smoking. Remember, there is no smoke, and the dangers of nicotine itself resemble those of caffeine. The antismoking groups are intent upon perpetuating their reckless gamble that smokers can be induced to quit and that in the meantime, virtually harmless substitutes should be kept off the market unless they go through rigorous FDA testing with all its expense and narrow focus on how products are used.

All of which leads to the totally weird observation that e-cigarettes would be free of all this controversy if only they were more dangerous (by putting real smoke in the lungs, for example) and if they didn’t seem to help people quit smoking cigarettes. In today’s strange public health regulatory environment, cigarettes are OK and smokeless substitutes are not.

And now, what about FDA regulation of tobacco products? Well, that’s another story for another time (really soon).

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OVERLAND PARK, Kan. — As more cities ban smoking in restaurants and bars, there is a newer product to the United States that makers claim you can still smoke indoors. It’s under fire from cities across the country, the Food and Drug Administration and a metro parent.

If you’ve been to the mall lately, you may have seen a kiosk selling electronic cigarettes. We’ve found the kiosks at Independence Center and Oak Park mall.

If you walk past the kiosk at Oak Park, a salesperson will ask if you smoke.

At Smoke51 we were shown a product that closely resembled a real cigarette. It comes with a battery and filter and even comes in flavors.

“There’s a heating element that steams water, nicotine, and flavor so you’re going to see me blow out smoke but it’s actually steam or water vapor,” the salesman said.

There are many questions about how this product is marketed.

The Electronic Cigarette Association (ECA) tells its members they can’t make health claims, cannot sell to minors, and they should not make cessation claims.

“We do not market it as a smoking cessation device or healthy alternative. We market it as an alternative to smoking tobacco that kills 500,000 people a year,” President Matt Salmon said.

Despite ECA goals, we were clearly told it’s a healthy alternative at Independence Center and Oak Park Mall kiosks by companies that are not part of the ECA membership.

At Smoke51, the owner calls it a “healthy alternative.”

His salesman says, “It’s not harmful to you.”

The salesman went on to say, “You’re getting a cigarette with all the pros and not the cons. It saves your life and it saves your health.”

In Independence Center, the flavors were pushed to a minor we sent to the kiosk.

“Most girls really like it again my wife absolutely loves the blueberry. It gives you Vitamin D and it gives you the exact same thing you get out of a regular cigarette the only difference it’s not killing you,” the salesman said at Smoking Everywhere.

Kids Think They’re Cool

E-cigarettes are available in a variety of flavors and have different levels of nicotine.

Since they don’t contain tobacco, it’s not illegal to sell them to a minor. However, most company websites and kiosks won’t sell to someone under age 18. Online, you’re not even allowed on some Web sites unless you certify you’re over 18.

It’s still a concern to parents who thought their teens were safe at the mall.

John Wickwire says his 17-year-old son came home from the mall and talked all about electronic cigarettes. John says his son was with a group of teens who were all under age 18 except for one.

“He came home all excited, and I was like, freaked, and I think he was surprised by how I reacted.

“He’s excited and saying, ‘Oh, yeah, there’s this new thing. It’s so cool. They have these flavors,’ and I’m like, ‘What is it?’

“And then he said, ‘Oh, it’s this new kind of cigarette’.

“And I’m like, ‘No, I don’t want you doing cigarettes’,” Wickwire said.

Wickwire thinks there’s a better place for this product than the mall.

“It’s nicotine. It’s addictive. It should be in a drugstore,” Wickwire said.

He says he complained to management at Independence Center. Then he called for action.

Undercover: Easy Access for Kids

We launched an investigation, sending our intern into the mall with a minor whose parents gave us permission. They were armed with a hidden camera.

At the kiosk in Independence Center, our minor wasn’t allowed to try the e-cigarrette.

“I would let you, I don’t have a problem with it, but they would get mad at us. I’m a new employee and got four kids I have to try to support,” the salesman at Smoking Everywhere told our minor.

Wickwire is pleased our minor wasn’t offered a smoke, and hopes his complaining helped bring about that change.

Independence Center would not comment on our story. We also called the corporate Smoking Everywhere office, and have not heard back from the company.

Wickwire was also concerned that the e-cigarettes kiosk at Independence Center was located near teen stores like a skate shop, but he says it has since been moved.

At Oak Park Mall, Smoke51 has also been moved. It was on the lower level of the mall to start. The owner says it was near a carousel where moms and their children would play, so it’s been moved to the food court.

Rafael Orlan owns the Smoke51 kiosk, and says he doesn’t even want kids hanging around his kiosk.

“We have signs must be 18 to buy or try it,” says Orlan.

However, when our minor and intern went to his kiosk, they were offered an e-cigarette with no nicotine.

Our intern asked, “So what’s the point of that?”

The salesman answered, “An oral fixation. It just feels like a cigarette if you want to try the zero one I’ll let you try it.”

A few seconds later, our minor was puffing away on a product that looked like a cigarette but supposedly has no nicotine.

We showed the video to Orlan.

“He made a mistake. A horrible mistake. He did give her zero nicotine which, I guess he made a judgment call, but it was the wrong call for me,” Orlan said.

Orlan says he trains he employees to ask for ID.

“Of course they’ll take notice of this because he will get fired,” Orlan said.

While what happened is not illegal, Orlan says he doesn’t want his product marketed to people who don’t smoke and the $180 price point is one way he tries to make it unattractive to children.

The Food and Drug Administration (FDA) is also concerned about the product being targeted to teens.

It currently bans flavored cigarettes fearing they target children, but flavored e-cigarettes are allowed.

In July, the FDA did put out a warning about e-cigarettes.

“These products are marketed and sold to young people and are readily available online and in shopping malls. In addition, these products do not contain any health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes. They are also available in different flavors, such as chocolate and mint, which may appeal to young people,” the FDA says.

The FDA’s Division of Pharmaceutical Analysis analyzed a sample of cartridges from Njoy and Smoking Everywhere.

The FDA says one sample detected diethylene glycol, which the FDA says is a chemical used in antifreeze, and is toxic to humans.

The FDA says other samples revealed carcinogens.

While it did the testing, the FDA calls it a preliminary analysis and adds that you should not draw conclusions about what is or is not in these products because it can vary.

The FDA says it tested some cartridges that were labeled as having no nicotine, yet the FDA says it found low levels of nicotine in all except one cartridge. The FDA says it also found that the nicotine levels vary.

FDA Blocks Some E-Cigarette Imports

Shipments of e-cigarettes have even been detained at the border.

The FDA is concerned because these devices have not been submitted for approval or evaluation by the FDA, and they have only limited testing to determine product safety.

The FDA believes e-cigarettes meet the definition of a drug-device under the Federal Food, Drug, and Cosmetic Act. There is even a federal case pending over the FDA’s jurisdiction over this product.

For the FDA to approve the product, the company would need to submit data showing that the product is safe and effective.

Florida-based Smoking Everywhere, Inc. is asking for a preliminary injunction against the FDA so the company can import electronic cigarettes and its accessories. One-hundred percent of its e-cigarette supply is imported, and the FDA has refused some e-cigarette shipments, and added the product to an “Import Alert” list.

The company believes it was not notified correctly of this alert, and questions the FDA’s ability to regulate electronic cigarettes.

The lawsuit from Smoking Everywhere, Inc., says, “By including electronic cigarettes on the FDA’s import alert, several shipments of SE’s products have been wrongfully refused entry into the United States.”

Effective Alternative to Tobacco Smoking

The Electronic Cigarette Association questions the timing of the FDA’s testing.

“If they truly believe that the public is out there being harmed, isn’t one day too long to sit on a study like that? Whey did they not release it for three months? That’s their own factual information,” Salmon said.

Salmon doesn’t smoke, but believes you have the right to smoke and believes there should be an alternative available. He’s seen the devastating effects of smoking on family members.

As an Arizona congressman, Salmon pushed through one of the first public smoking bans. He wants the industry to sell a safe product, and applauds increased regulation as long as it’s within reason.

Since the ECA tells its members to not make health claims, he doesn’t believe FDA testing is necessary to continue sales.

“It would probably take three to eight years to accomplish that, and up to $1.5-billion to do that kind of testing. This is a small industry. We are not big pharmaceutical companies. We are tyring to offer an alternative,” Salmon said.

As for the concerns raised by Wickwire, Salmon shares his belief that e-cigarettes should be pulled from malls.

“I don’t think there’s enough safeguards in kiosks in malls to keep them out of the hands of children,” Salmon said.

He even agrees with banning the flavors if that will protect more children.

Some States have Banned or Restricted E-Cigarettes

John Wickwire is surprised safety discussions didn’t happen before the product was put in malls. He’d like to see e-cigarettes moved to drugstores.

“I thought we had a lot more safeguards,” Wickwire said.

We called the Jackson and Johnson County health departments, and they weren’t aware of the kiosks.

In Oregon, the attorney general filed a lawsuit against Smoking Everywhere, alleging the company made false claims about it’s electronic cigarette.

“It’s my duty to protect the public from products that are falsely advertised as safe,” Attorney General John Kroger said in August.

Oregon sued the company for rejecting a settlement similar to one it reached with other retailers and distributors. The deal keeps them from selling the battery-operated device until they meet state and federal standards.

In California, Governor Arnold Schwarzenegger vetoed a bill to ban e-cigarettes.

“While I support restricting access of electronic cigarettes to children under the age of 18, I cannot sign a measure that also declares them a federally regulated drug when the matter is currently being decided through pending litigation,” Schwarzenegger wrote to the California Senate.

In August, Suffolk County New York passed a bill that means e-cigarettes will face the same restrictions as traditional cigarettes. You can’t sell cigarettes to anyone under age 19 and you can’t use them in public places where traditional smoking is banned. “We here in Suffolk County can be proud that we didn’t sit on our hands and wait for Washington to act,” said Majority Leader John Cooper in August.

The e-cigarettes are also banned in some countries across the world.

However, the local Smoke51 owner, points to research from New Zealand to declare the safety of the product.

As the debate heats up concerning the use of electronic cigarettes, Electronic
Cigarette Association (ECA) President Matt Salmon today encouraged those
involved in this discussion to carefully and honestly study how these devices
work and recognize that the more than one million adult committed smokers, who
use electronic cigarettes, are seeking an alternative to combustible cigarettes
that contain a multitude of toxic, harmful chemicals.

The debate on these devices has intensified in recent months as events have
fueled and focused attention on electronic cigarettes, including a front-page
story last week and a follow-up editorial in yesterday`s edition of USA Today
and stories or editorials in other major newspapers such as the New York Times
and Los Angeles Times. Governor Schwarzenegger`s veto of a bill that would have
denied California citizens the right to purchase electronic cigarettes and a
warning by the Food and Drug Administration (FDA) based on a flawed, narrow
study have also contributed to the growing debate.

“Unfortunately, many of the arguments we`ve seen recently against electronic
cigarettes have been driven by fear of the unknown, insufficient evidence,
political agendas, and ignorance about our members` products,” said Salmon. “As
in the case of California Governor Schwarzenegger, we`ve found that reasonable
people, when willing to honestly and intellectually evaluate the information
about electronic cigarettes, find that these products provide smokers a viable
alternative to combustible tobacco cigarettes.”

Some legislators have taken a stance against electronic cigarettes as a result
of an FDA study that Salmon says was extremely narrow in scope and failed to
follow established scientific protocols. The Electronic Cigarette Association
has called on the FDA to take a more scientific approach and to work with ECA
members before making any hasty decision to ban electronic cigarettes
altogether. Such a ban would leave smokers without an alternative to combustible
cigarettes, whose toxic substances and life-threatening health effects are
clearly documented and which the FDA has no intention of banning.

“We understand that to protect the public, some form of regulation may be
necessary, and we welcome that. Our goal, nevertheless, is to ensure committed
adult smokers the freedom of a clear, better alternative and to prohibit sales
to minors,” said Salmon.

About the Electronic Cigarette Association

The ECA (www.ecassoc.org) is an association of private sector companies engaged
in electronic cigarette technologies. Its mission is to provide the tools and
information necessary for policy-makers, opinion leaders, media, and private
sector companies worldwide to make informed decisions about the management and
use of electronic cigarette technologies. The association institutes and
promotes industry-wide standards and a code of conduct, works to maintain sound
professional practices, educates the public and policy-makers on the industry`s
activities and potential, and works to ensure the ethical use of electronic
cigarette technologies.

Electronic cigarettes are opening a new front in the tobacco wars as state and local lawmakers try to restrict the product, which may allow users to circumvent smoking bans.

The battery-powered device is made up of a cartridge containing nicotine, flavoring and chemicals. It turns nicotine, which is addictive, into a vapor that is inhaled. Users say they’re “vaping,” not smoking.

E-cigarettes are used by at least a half-million Americans, says Matt Salmon, head of the Electronic Cigarette Association.

“People who smoke ought to have better alternatives, because some can’t quit,” he says. His father, a longtime smoker, died last week of cancer and emphysema.

Public health officials question the safety of e-cigarettes. The Food and Drug Administration, which regulates tobacco and nicotine replacement devices, says the e-cigarettes it tested had carcinogens. E-cigarette distributors have filed a lawsuit challenging the FDA’s authority.

“It’s a new frontier. We don’t know what the dangers are,” says John Banzhaf of Action on Smoking and Health, an anti-smoking group.

“We’re actively investigating these companies and their products,” says Connecticut Attorney General Richard Blumenthal. Other actions:

• California passed a ban on e-cigarette sales, but Republican Gov. Arnold Schwarzenegger vetoed it this month.

• Oregon Attorney General John Kroger, a Democrat, reached a settlement in August with retailers and distributors not to sell them.

• New Hampshire state Rep. Rich DiPentima, a Democrat, is crafting a bill to ban sales to minors.

• New Jersey state Assemblywoman Connie Wagner, a Democrat, plans a bill to subject e-cigarettes to the same restrictions as cigarettes.

• In Paramus, N.J., the health department’s board plans to propose an ordinance today banning e-cigarettes where smoking is not allowed.

• In August, Suffolk County, N.Y., restricted e-cigarettes in public places and banned sales to minors.

To Julie Woessner, 46, a former smoker in Wildwood, Mo., they are “almost a miracle,” allowing her to kick her two-packs-a-day cigarette habit.

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Industry hails veto of anti-smoking alternative bill as victory for consumers, common sense

Washington, D.C. – October 12, 2009 | Matt Salmon, president of the Electronic Cigarette Association (ECA), today praised California Governor Schwarzenegger’s wise decision to veto Senate Bill 400, which would have banned electronic cigarette sales in the state, protecting adult consumers’ access to these alternative smoking devices.

“This is not just a victory for consumers and common sense but is smart public policy as well,” said Salmon. “Rejecting this bill is the right step and should serve as a model for other states to follow.”

In his veto message, Governor Schwarzenegger reiterated the stance of the ECA that strongly supports restricting access of electronic cigarettes to children under the age of 18. “We agree with the original intent of SB 400 to ban sales to those under the legal smoking age. And we support that on a national level as well,” added Salmon.

The Governor affirmed that this restriction should not apply to adult consumers: “If adults want to purchase and consume these products with an understanding of the associated health risks, they should be able to do so unless and until federal law changes the legal status of these tobacco products.”

The ECA actively communicated to the Governor its members’ concerns about the bill and the fact that banning these electronic cigarettes would disenfranchise thousands of California adult smokers who have difficulty quitting but want an alternative to combustible cigarettes without the host of carcinogens and harmful chemicals. Salmon credited this legislative victory to the efforts of thousands of consumers and ECA members who appealed directly to Governor Schwarzenegger to protect their rights.

“While we know that combustible tobacco smoking kills over 400,000 Americans annually, and the percentage of smokers that quit every year is dismally low, we ought to be looking for more alternatives to traditional combustible tobacco products,” said Salmon.

Electronic cigarette kits usually include the electronic cigarette, a replaceable cartridge pack (that may or may not contain nicotine), rechargeable lithium batteries, and a charger. There is some variation between different companies in what is included in their starter kit, but all components are listed on their Web sites. While ECA members do not market these devices as a healthy alternative or smoking cessation device, it is clear that they do not contain the harmful tars and hundreds of carcinogens that consumers get from combustible tobacco products.

“We look forward to working with all government agencies, including the FDA, to ensure that consumers who want an alternative to combustible tobacco products have access to e-cigarettes that contain fewer harmful substances and produce no secondhand smoke,” concluded Salmon.

THE City Council this week voted 46-1 to ban many flavorings in a variety of tobacco products, and Mayor Bloomberg is likely to sign it into law. Speaker Christine Quinn justified it as an effort to protect children — but the main effect will be to make it harder for adult smokers to quit.

The ban also covers many flavors of snus — a smokeless, and thus far less harmful, tobacco.

Snus is a pouch of tobacco that goes between cheek and gum, delivering the nicotine that smokers crave without the harmful chemicals that come from burning and inhaling tobacco. The risk of oral cancer from smokeless tobacco is low — far lower than the oral cancer risk from smoking cigarettes.

And switching from cigarettes to snus eliminates the risk of heart disease, lung cancer and the other systemic diseases related to smoking — not to mention secondhand smoke.

Still, Council Health Committee Chairman Joel Rivera lauded the bill: “This legislation is a major step forward in protecting kids and deterring them from starting a lethal habit.”

But sales of all tobacco products to minors are already illegal. The city should enforce the law on the books rather than stymie adults’ switch to a less harmful product.

Ironically, the city ban exempts flavored hookah tobacco and menthol — both of which are popular among younger tobacco users and which, unlike the banned flavored snus, have no redeeming public-health value. They certainly don’t help people quit cigarettes.

New York City is not alone in banning the wrong products. Connecticut Attorney General Richard Blumenthal recently called for a ban on e-cigarettes.

E-cigarettes are devices that supply users with vaporized nicotine and look like cigarettes. They contain no tobacco and are noncombustible, eliminating almost all smoking risks. They could be a lifesaver; the only reason to crack down is the ideology of the public-health movement, which has decided that anything that has tobacco in it, or even looks like a cigarette, must be illegal, even for sale to adult smokers trying to stop smoking.

The pollyannas behind this approach believe that no level of risk is acceptable. Elizabeth Kilgore, acting assistant commissioner of tobacco control at the NYC Department of Health, says smokers who have tried to quit but failed should just keep on trying again and again rather than try snus or e-cigarettes.

It is a quit-or-die dogma that evades logic.

The federal government is getting into the act as well. The Food and Drug Administration, now tasked with regulating tobacco, in July warned about tiny levels of carcinogens in e-cigarettes, telling smokers to stay away — in effect telling them to stick with deadly cigarettes.

These government actions will do nothing to protect kids. The only effect is to promote the most dangerous form of tobacco use, smoking cigarettes.

If the advocates get their way, the only thing addicted smokers will be able to buy are mostly ineffective nicotine gums and patches — and, of course, cigarettes.

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Julie Woessner puffs on an electronic cigarette and feels a vapor full of nicotine wafting deep into her lungs.

Woessner and thousands around the country are passionate in their belief that the battery-powered sticks that deliver nicotine without burning have been lifesavers.

“If I hadn’t have had it, I’d still be smoking,’ said Woessner, 46, a homemaker living in Wildwood.

People like Woessner call themselves “vapers” because they “vape” or inhale vapor that includes nicotine from e-cigarettes. They

worry the government may try to take away something they see as a lifesaver.

“If that happens, I will be smoking again, and that makes me sick,” said Woessner. She first used the device in January and immediately stopped smoking.

A federal Food and Drug Administration spokeswoman said the FDA has not moved to ban e-cigarettes, which heat a liquid and nicotine to a vapor so people can puff them.

FDA spokeswoman Siobhan DeLancey contends her agency wants to regulate electronic cigarette so it can be sure that the people who use them are getting a reliable dose of nicotine, and that there are no far-reaching health effects from long-term use.

“There are no long-term studies on the health effects of just nicotine, minus the tobacco component. We know what smoking tobacco does to the body over the long term,” DeLancey said. “What we want to see are well-designed clinical studies. Personal reports are not enough,” DeLancy said.

The FDA maintains e-cigarettes contain carcinogens and toxic chemicals like diethylene glycol, an ingredient in industrial antifreeze.

But backers of e-cigarettes contend what is produced is much safer than cigarettes.

The Electronic Cigarette Association doesn’t claim e-cigarettes are smoke cessation devices and it isn’t making health claims.

The trade association made up of about 20 companies was formed this year.

Matt Salmon, the group’s president estimates revenues this year at $100 million, way above last year.

There are hundreds of thousands of users, he said.

“They’re very, very passionate,” Salmon said.

Salmon said that while the government continues to allow a known killer like combustible cigarettes, it should allow an alternative like e-cigarettes. “The FDA doesn’t seem to have a clear agenda,” Salmon said. “If it’s totally about public health, why not ban tobacco?”

Patricia Clewell, 49, a mosaic artist living in Webster Groves, is asking similar questions. She started smoking at 15 and was averaging a pack a day when she started vaping in March. She immediately stopped smoking.

“If you’re going to smoke anyway, whatever you can do to minimize your tobacco use is a good thing,” she said.

Clewell doesn’t consider vaping the same thing as smoking.

“You’re not lighting anything. There’s no combustion. It’s the combustion that kills you, not nicotine,” Clewell said.

What makes the electronic cigarettes more effective than things like the nicotine patch is that people use the hands to bring something to the month, Clewell said.

Clewell’s husband, David Clewell, 54, a professor who directs the creative writing program at Webster University, went from two packs a day to four to six cigarettes a day when he started vaping.

“I feel much better. I’ve got more breath,” David Clewell said. “I really like the fact that my clothes, my skin, my hands are not wreaking of cigarettes.”

The Clewells say they wonder what the government is up to. So does Woessner, who met Patricia Clewell through groups that used e-cigarettes.

Woessner said an initial device with supplies costs $75 to $100 and that supplies can cost $40 to $50 a month. A pack of cigarettes might cost $4.50.

One starter kit advertised on the Internet included a pack, two batteries, an atomizer, a charger and 25 cartridges equal to 150 cigarettes. It sold for $59.95. Five additional cartridges equaling 30 cigarettes sold for $5.

Woessner expects to vape for years to come, but at a level with very little nicotine.

“This is something the government should be pushing for, a clean way of allowing people to smoke,” Woessner said.

Delancey disagreed.

“I feel their pain,” she said. “We don’t know if this is any better for them.”