Prof. Carl V. Phillips, just published in Harm Reduction Journal, shows that for most smokers, immediately switching to a low-risk alternative will lower their risk of dying from their habit more than quitting eventually, even if they use the smoke-free product for the rest of their lives.
November 2, 2009 — Switching to low-risk nicotine products, like smokeless tobacco, electronic cigarettes, and pharmaceutical nicotine, offers smokers a chance to almost completely eliminate their health risks. While these alternative products still pose some very small health risk, a new study at the University of Alberta School of Public Health in Canada shows that in most cases switching is better for reducing lifetime risk than trying to quit. The study by Prof. Carl V. Phillips, just published in Harm Reduction Journal, shows that for most smokers, immediately switching to a low-risk alternative will lower their risk of dying from their habit more than quitting eventually, even if they use the smoke-free product for the rest of their lives.
For the average smoker, the study finds, smoking for just one more month poses a greater health risk than a lifetime of using one of the increasingly popular low risk products like snuff, snus, the new electronic imitation cigarettes, nicotine lozenges, or some other non-combustion alternative. Switching products is a strategy known as “tobacco harm reduction.” “It has long been known that while no nicotine product is completely harmless, harm reduction products pose only about 1% the risk from smoking,” says Dr. Phillips, “and this difference is so great that for the average smoker, using a smokeless product for the rest of his life poses about the same risk as 30 days of continuing to smoke.” What this means is that most smokers, even those who plan to quit soon, will not quit before damaging their health far more than using low-risk products for a lifetime. Moreover, for some older smokers, smoking for a day or two more poses a greater risk than using a low-risk product for the rest of their life. Since switching products is often much more appealing to smokers than quitting nicotine entirely, this option is more practical than quitting and leaves the former smoker happier and less likely to relapse. Those who switch can still choose to quit entirely later, lowering their risk further still.
Dr. Phillips and his public health research group publish the website www.TobaccoHarmReduction.org, and have worked for years to educate smokers about the advantages of low-risk alternatives. The new study, which also looks at some of the history and politics of tobacco harm reduction, suggests that efforts to promote abstinence as the only healthy choice may be killing thousands of smokers per month. Discouraging switching causes the deaths of far more smokers than could ever die from using low-risk nicotine products for their entire lives.
This study comes on the heels of a major study by Peter Lee, published in another BioMed Central journal, BMC Medicine, that showed that the cancer risk from smokeless tobacco is so small it cannot even be reliably measured. Given the ample evidence about the risks of different products, “there is no scientific basis for denying the benefits of tobacco harm reduction” says Phillips, “and it is time that we offer smokers honest public health interventions rather than the moralizing and deadly ‘abstinence-only’ approach.” The abstinence-only approach leaves many ex-smokers miserable and leaves millions of others no choice but to keep smoking. Some activists object to alternative products because they let smokers stay addicted to nicotine or allow companies to profit from selling the products. But, asks Phillips, “is addiction to a low-risk habit — not much different from drinking coffee — really such a problem, or is the profitability of some companies so terrible that it outweighs the millions of lives that could be saved by harm reduction?”
Contact: Dr. Carl V. Phillips, Associate Professor, University of Alberta School of Public Health: cvphilo(at)gmail(dot)com; +1 651-503-6746.
Professor Phillips is an epidemiologist and health policy researcher, journal editor, popular educator, and consultant. He and his work group are leading advocates of tobacco harm reduction, and he advises and works with many other organizations who are trying to promote it, some of which are companies that hope to profit from selling low-risk nicotine products. The www.TobaccoHarmReduction.org research group at the University of Alberta School of Public Health is partially supported by an unrestricted (completely hands-off) grant from U.S. Smokeless Tobacco Company. No funder, company, or other organization played any role in initiating, designing, or conducting this research.
http://www.tobaccoharmreduction.org/papers/press.htm
]]>August 23, 2009
Connecticut Attorney General Richard Blumenthal recently announced plans to seek a ban on the sale of electronic cigarettes in the state. This ill-advised decision follows a federal Food and Drug Administration report that put a scare into electronic cigarette users across the country, telling them that these battery-powered devices — which deliver nicotine without burning tobacco like conventional cigarettes — are dangerous because they contain carcinogens.
The agency also reported that of 18 cartridges tested, one contained diethylene glycol, an ingredient in antifreeze. The FDA threatened to remove electronic cigarettes from the market and to take enforcement action — including potential criminal sanctions — against product distributors.
Backed by the finding that e-cigarettes contain carcinogens and diethylene glycol, a number of anti-smoking groups and several other states in addition to Connecticut have jumped on the bandwagon, considering or enacting legislation to remove these “harmful” devices from the market.
However, the FDA failed to mention in its press conference that the levels of tobacco-specific nitrosamines (the carcinogens) detected in electronic cigarettes were extremely low, below the level allowed in nicotine replacement products, such as nicotine patches, inhalers and gum. The agency is not threatening to take nicotine patches or gum off the market, although they too contain detectable levels of carcinogens.
The nicotine in electronic cigarettes and FDA-approved nicotine replacement products is derived from tobacco, which makes traces of some tobacco carcinogens essentially inevitable.
The level of the same tobacco-specific nitrosamines in conventional cigarettes is at least 300 to 1,400 times higher than what has been detected in electronic cigarette cartridges. In other words, you would have to smoke as many as 1,400 electronic cigarettes to be potentially exposed to the same amount of these carcinogens as smoking one conventional cigarette.
In fact, the FDA failed to perform the laboratory test of most importance: a comparison of the presence of, and concentrations of, toxins and carcinogens in electronic cigarettes and conventional ones. Scientific studies have demonstrated that conventional cigarettes contain 57 identified carcinogens, while electronic cigarettes have not been found to contain any carcinogens at higher than trace levels.
The bottom line is this: Conventional cigarettes have been thoroughly tested. They are known to contain at least 10,000 chemicals, including about 57 carcinogens. Electronic cigarettes deliver nicotine without these 10,000 chemicals and 57 carcinogens. It doesn’t take a rocket toxicologist to figure out that electronic cigarettes are a much, much safer alternative to conventional ones.
Unfortunately, what the FDA and the anti-smoking groups are essentially telling smokers is that they would rather have them continue to smoke the most toxic cigarettes — the conventional ones — rather than switch to a product that is likely orders of magnitude safer.
The question the FDA and the anti-smoking groups are asking is: “Are electronic cigarettes safe?” That is not the right question. The right question is: “Are electronic cigarettes much safer than conventional ones?” The FDA and anti-smoking groups are comparing electronic cigarettes to a solution of spring-fresh Maine mountain stream water. What they need to compare electronic cigarettes to is a Marlboro cigarette.
This doesn’t mean that there aren’t problems with e-cigarettes that need to be addressed. This doesn’t mean e-cigarette manufacturers shouldn’t be asked to make certain changes, such as instituting tighter quality control procedures and making sure the propylene glycol is devoid of diethylene glycol. This doesn’t mean that there shouldn’t be restrictions on the sale of these devices to minors.
But it does mean that it is lunacy to ban the product, especially given that the very same FDA is now approving deadly Marlboros, Winstons, Kools, Newports, Camels and others.
The FDA and anti-smoking groups are on the verge of losing sight of the actual objective of public health regulation: to improve the overall population’s health. The combination of FDA approval of conventional cigarettes and FDA banning of the much safer electronic ones would be ludicrous, would have detrimental population health effects and would send exactly the wrong message to the public.
The real threat to our children’s health is not electronic cigarettes. It’s the real ones.
]]>By Dr. Elizabeth M. Whelan | Thursday, August 6, 2009
http://www.washingtontimes.com/news/2009/aug/06/fda-smoke-screen-on-e-cigarettes/
At a time when the government is ostensibly trying to cut health costs, why is it trying to ban something that might help people quit smoking tobacco, perhaps the most devastating health problem in the U.S.?
The Food and Drug Administration (FDA) held a press conference late last month to scare Americans about the so-called “e-cigarette” — claiming it was loaded with harmful “toxins” and “carcinogens.” The agency was implicitly saying: Stay away from these newfangled, untested cigarette substitutes — better to stick with the real ones, the ones that we are more familiar with, the ones that cause over 450,000 deaths annually in the U.S.
In making its distorted, incomplete and misleading statement, FDA was violating its long-cherished tradition of sticking to sound science as the basis for its policies. And in doing so, it is putting the lives and health of millions of Americans at risk.
The truthful part of the FDA statement was that e-cigarettes have not been through formal efficacy and safety tests at the FDA, and they have only been around a few years. But in the press conference, here is what the FDA did not tell you but should have:
c Traditional cigarettes are lethal not because of the trace level presence of specific “carcinogens” and “toxins,” but because by using them, smokers inhale enormous amounts of smoke — otherwise known as “products of combustion.” It is the inhaled smoke that kills in so many ways — from cancers, cardiovascular and lung disease, and more.
c The cigarette was a relatively obscure product in our society until the invention of a cigarette rolling machine, and sales rose quickly prior to World War I.
Before that, tobacco was used relatively safely — in chew, pipes, cigars — because little if any smoke was inhaled. Cigarettes changed all of that.
c The e-cigarette — a cigarette-mimicking device made up of a battery, an atomizer and a cartridge — allows smokers to inhale, getting a dose of the nicotine they crave, and then sending steam out the other end (with little or no odor) to mimic the ritual and feel of smoking normal cigarettes.
c The FDA complained that the e-cigarette was a “nicotine-delivery system.” Well, it got that much right. But again, it’s the smoke that kills, not the nicotine. Yes, nicotine is highly addictive, and it is what keeps the smoker hooked. But getting the nicotine without the smoke is an enormous health advantage for cigarette smokers (the nicotine inserts come in various strengths and the users can adjust them downward as they wish).
c The FDA has approved other nicotine-delivery systems in the form of gums and patches — and they have been abysmal failures. The smoking cessation rates using these devices is less than 15 percent after one year, condemning millions of addicted smokers to a lingering death. We desperately need other alternatives. But the FDA has now joined a long list of so-called public-health organizations — including the Campaign for Tobacco Free Kids and the American Lung Association — whose collective motto seems to be “quit or die.” Not only do they reject e-cigarettes, but they also condemn other smokeless products like snus, which have a mere fraction of the health risks associated with smoking cigarettes.
c More than 1 million smokers are now using the e-cigarette — a product that offers some, if not all, of the “social amenities” of the real thing — holding the cigarette, taking a drag, seeing a plume of “smoke.” The FDA, lacking data that e-cigarettes pose a health hazard, was so desperate, it called on consumers to phone in adverse side effects of e-cigarettes so they could begin to build a case against them and proceed with their intended ban. They neglected, however, to request smokers who successfully quit using the e-cigarette to also call in.
Cigarette smoking remains the leading cause of preventable disease and death in the United States today. Any alternative acceptable to addicted smokers should be taken seriously. Instead of condemning the e-cigarette, the FDA should be sponsoring studies to evaluate its safety and efficacy — leaving it on the market in the interim.
Dr. Elizabeth Whelan is president of the American Council on Science and Health.
]]>A new scientific report – commissioned by NJOY and conducted by Exponent, Inc., a scientific consulting firm – reviewed the FDA report and other studies of electronic cigarettes and concluded that the FDA failed to provide evidence that NJOY products are more dangerous than any FDA-approved nicotine replacement products currently on the market. The report also concluded that the FDA report actually confirms that NJOY electronic cigarettes are much safer than conventional ones and should therefore be welcomed rather than cause for concern.
Exponent Inc. is a large engineering and scientific consulting firm with substantial expertise in the areas of toxicology and mechanistic biology, including chemical risk assessment. Exponent has extensive experience in the development of toxicity criteria and safety levels for chemicals. Its analyses have been incorporated into risk assessments conducted by OSHA and the EPA, and its scientists serve on a number of expert government panels.
The report made a number of important points, many of which I have been making over the past two weeks:
The report concludes as follows:
1. “In summary, the report “Evaluation of e-cigarettes” suffers from several limitations, that taken together result in it failing to adequately support the FDA claims of potential adverse health consequences from the use of NJOY e-cigarette products tested as compared to other FDA-approved nicotine containing products.”
2. “The detection of trace and non-measurable levels of TSNAs and tobacco-associated impurities in the liquid, rather than the vapor phase of NJOY’s products, at levels that are many orders of magnitude below conventional cigarettes, and at or below FDA-approved nicotine containing products, should be considered as indicators of the regulatory acceptability of the NJOY products rather than reason for concern. When considering the relative potential health risks posed by these trace levels, it is worth noting that the approved NRTs, which have been shown to contain these substances, were not judged to contain levels sufficient to warrant toxicity information or reference to these substances in their own product literature.”
The Rest of the Story
This independent scientific report by an expert consulting firm in the area of toxicology and risk assessment confirms many of the critical points I have been making in commentaries over the past two weeks.
First, the FDA’s presentation of its own laboratory results was very misleading because the Agency failed to mention the levels of the carcinogens that were detected in electronic cigarette cartridges (which were at trace levels) and failed to mention that these same carcinogens are also present (at similar trace levels) in FDA-approved nicotine replacement products.
Second, the FDA inexplicably failed to test the nicotine inhaler – which was the control device in the study – for the presence of the same carcinogens as in the electronic cigarettes. Such testing would likely have revealed the same trace levels of carcinogens, and would have nullified the FDA’s and the anti-smoking groups’ major points at the press conference.
Third, the FDA failed to compare the carcinogen levels in electronic cigarettes with those in real cigarettes which the FDA now approves. Such a comparison would have revealed that the real ones are 1400 times more dangerous. Thus, the FDA lab testing actually supports a conclusion that electronic cigarettes are much safer than the FDA-approved tobacco cigarettes and that electronic cigarettes should be embraced in the regulatory environment, rather than banned (as anti-smoking groups are widely calling for).
The Exponent report also notes that all of the NJOY electronic cigarette cartridges tested were negative for diethylene glycol. This suggests that propylene glycol cartridges that are derived from pharmaceutical grade propylene glycol are not a problem, and that the source of the problem with one electronic cigarette brand that contained diethylene glycol at a level of 1% is most likely the failure to use pharmaceutical grade propylene glycol, a problem that could (and should) be easily corrected.
The rest of the story is that an independent scientific expert report has now confirmed that – at least in the case of NJOY electronic cigarettes – there is no evidence that these products pose any increased health risks compared to FDA-approved nicotine replacement products and that they pose much less health risk than FDA-approved tobacco cigarettes.
Is it not inappropriate that while the FDA has had jurisdiction over both electronic cigarettes and tobacco cigarettes for the past several months, it has already held an alarmist press conference about the electronic ones, but has yet to put forward any warning to the public about the deadly real ones?
]]>LONDON, ENGLAND — (OfficialWire) — 05/22/09 —
Dear President Obama
A distinguished and respected American Professor of Medicine, Brad Rodu, recently wrote to us, stating:
“The American legislative process is closed to all but a few powerful interests, who will soon be gloating over their “success” in passing FDA regulation of tobacco.”
We are hoping that the American people, with your help, will prove them wrong.
The Tobacco Bill (S.982)
The Legislation the Professer was referring to was the Kennedy Tobacco Bill, a bill which is likely to lead to a defacto ban on electronic cigarettes and other safe alternatives to smoking.
The electronic cigarette is a device which allows consumers to inhale nicotine without the carcinogens and tar contained in normal cigarettes. Besides nicotine, the main ingredient in the electronic cigarette is propylene glycol, a compound which Dr Murray Lauderson, one of the few to have carried out research into the product, says has an excellent safety profile.
This device, according to the eminent professors, doctors and researchers we have spoken to, has the potential to save the lives of hundreds of thousands of American smokers every year.
Dr Joel Nitzkin, for example, predicts that if every smoker in America switched to the electronic cigarette, the worst case scenario would eventually see the death toll falling from 400,000 a year to 4,000 deaths a year.
The best case scenario would see less than 400 deaths a year.
However, the electronic cigarette is likely to be banned because the Kennedy Tobacco Bill will require research into the electronic cigarette which experts say is physically impossible to carry out.
Big Money
There are many set to gain financially from the demise of the e-cigarette.
These include:
Perhaps this is also why millions of dollars have been spent lobbying for the Tobacco Bill by Philip Morris – which has spent more money lobbying this year than all the other tobacco companies in the US put together.
In contrast, those who support the e-cigarette – researchers, smokers and the very new Electronic Cigarette Association – have little money. The campaign against the electronic cigarette has been forced to take place on forums and on blog posts, on You Tube and on Twitter – the very places which provided the upswell of support which gave you your historic victory.
What the Experts Say
While those who support the e-cigarette have few funds, they have many respected voices in the medical and tobacco harm reduction community to support their cause:
Professor Brad Rodu, a Professor of Medicine and Holder of an Endowed Chair in Tobacco Harm Reduction Research at the University of Louisville, who wrote: “I am convinced that these anti-tobacco extremists [Tobacco Free Kids] will eventually be held partially responsible for the deaths of millions of uninformed smokers.”
Professor Michael Siegel, a tireless campaigner for Tobacco Harm Reduction and Professor in the Social and Behavioral Sciences Department, Boston University School of Public Health, who wrote: “It is clear that the real purpose and effect of the FDA tobacco legislation is to protect the conventional cigarette market from competition. And … that competition – in the absence of FDA legislation – would come from truly reduced risk products, such as e-cigarettes.”
Dr Joel Nitzkin, Chair of the Tobacco Control Task Force for the American Association of Public Health Physicians, who said: “We have every reason to believe that the hazard posed by e-cigarettes would be much lower than one percent, probably lower than one tenth of one percent of the hazard posed by regular cigarettes.”
David Sweanor, who has worked with numerous companies and organisations, including the International Union Against Cancer, the World Health Organization, the World Bank and the Pan American Health Organization, on the issue of tobacco control, and who told us: “If there is anyone who believes cigarettes are no more hazardous than e-cigarettes I’d recommend a remedial course in basic sciences.”
Dr Adrian Payne, Managing Executive of Tobacco Harm Reduction Agency Tobacco Horizons and with thirty years of post-doctoral experience in the field of tobacco and nicotine,who said: “It really would be a cruel irony if smokers who had switched to E-cigarettes were … forced to revert to smoking regular cigarettes.”
Smokers Need Your Help
We are not asking for the blind acceptance of the electronic cigarette. This product needs ongoing assessment, improved regulation and in-depth research. However, on behalf of the four hundred thousand Americans who die every year from smoking, we do ask for the time and support necessary to carry out feasible research into this product.
President Obama, since you have taken over the reins of government in America, a new hope and optimism has spread throughout the world. People and nations who had lost faith in America as one of the first truly free and democratic nations in the world have begun to regain it. And ordinary people have begun to believe your promise that now is the time for change.
We believe that that you will maintain that hope of fairness and optimism. With your help it will be the small people, the researchers and the smokers who will bring about the changes they need and deserve, and not the large organisations who have only their own interests and profits at heart.
Thank you for your consideration, and please feel free to contact me at any time.
Yours sincerely
James Dunworth
Director
E Cigarette Direct (http://www.ecigarettedirect.co.uk)
james.dunworth@ecigarettedirect.co.uk
Last update: 3:03 p.m. EDT May 4, 2009
WASHINGTON, May 04, 2009 (BUSINESS WIRE)—Today the Electronic Cigarette Association (ECA) issued an official statement on its website – www.ecigaretteassociation.org – in response to the FDA’s recent inquiry into electronic cigarettes, many of which are being withheld from entering the country in what prominent harm reduction and policy experts are calling a potential public health disaster.
“The message that is being sent by the FDA to those who cannot stop smoking, or who do not wish to stop smoking, is that it is better to keep smoking tobacco, which kills more than 400,000 people in the US per year, is the leading cause of preventable death in our country and results in more death than AIDS, drugs, homicides, fires and auto accidents combined,” said Matt Salmon, former US Congressman and President of the ECA. “It is time to stop misinformation, to put the needs of consumers ahead of special interests, to put public health ahead of stifling process, and to embrace the first true innovation in a centuries-old space.”
View Video Message from Matt Salmon:
http://www.ecassoc.org/resources/eca-president-video
The topic of electronic cigarettes has gained momentum with hundreds of thousands of US and global consumers successfully using the products, and then last week, the FDA was sued by an electronic cigarette company, Smoking Everywhere. The “Family Smoking Prevention and Tobacco Control Act” will also play a role and is being marked up in the Senate next week.
The ECA Web site provides the following resources:
—Expert Interview Sources: www.ecassoc.org/resources/interview-sources-and-bios
—Data Resources: www.ecassoc.org/resources/data-resources
—Eye-opening Quotes: www.ecassoc.org/resources/quotes
—Electronic Cigarette Myths & Facts: www.ecassoc.org/resources/myths-and-facts
—Smoking Fact Sheets: www.ecassoc.org/resources/smoking-fact-sheet
The ECA ( www.ecigaretteassociation.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.
SOURCE: Electronic Cigarette Association
McMurry
Emily Barna
(M) 602-663-2467
(O) 602-395-5850×168
emily.barna@mcmurry.com
Amy Linert
(M) 480-529-8326
(O) 602-395-5850×169
amy.linert@mcmurry.com
Copyright Business Wire 2009 End of Story
]]>Last update: 3:03 p.m. EDT May 4, 2009
WASHINGTON, May 04, 2009 (BUSINESS WIRE)—Today the Electronic Cigarette Association (ECA) issued an official statement on its website – www.ecigaretteassociation.org – in response to the FDA’s recent inquiry into electronic cigarettes, many of which are being withheld from entering the country in what prominent harm reduction and policy experts are calling a potential public health disaster.
“The message that is being sent by the FDA to those who cannot stop smoking, or who do not wish to stop smoking, is that it is better to keep smoking tobacco, which kills more than 400,000 people in the US per year, is the leading cause of preventable death in our country and results in more death than AIDS, drugs, homicides, fires and auto accidents combined,” said Matt Salmon, former US Congressman and President of the ECA. “It is time to stop misinformation, to put the needs of consumers ahead of special interests, to put public health ahead of stifling process, and to embrace the first true innovation in a centuries-old space.”
View Video Message from Matt Salmon:
http://www.ecassoc.org/resources/eca-president-video
The topic of electronic cigarettes has gained momentum with hundreds of thousands of US and global consumers successfully using the products, and then last week, the FDA was sued by an electronic cigarette company, Smoking Everywhere. The “Family Smoking Prevention and Tobacco Control Act” will also play a role and is being marked up in the Senate next week.
The ECA Web site provides the following resources:
—Expert Interview Sources: www.ecassoc.org/resources/interview-sources-and-bios
—Data Resources: www.ecassoc.org/resources/data-resources
—Eye-opening Quotes: www.ecassoc.org/resources/quotes
—Electronic Cigarette Myths & Facts: www.ecassoc.org/resources/myths-and-facts
—Smoking Fact Sheets: www.ecassoc.org/resources/smoking-fact-sheet
The ECA ( www.ecigaretteassociation.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.
SOURCE: Electronic Cigarette Association
McMurry
Emily Barna
(M) 602-663-2467
(O) 602-395-5850×168
emily.barna@mcmurry.com
Amy Linert
(M) 480-529-8326
(O) 602-395-5850×169
amy.linert@mcmurry.com
Copyright Business Wire 2009 End of Story
]]>6:38 PM PDT, April 24, 2009
Reporting from Beijing — Hon Lik used to light up first thing in the morning. He smoked between lectures at the university where he studied Oriental medicine, between bites at lunch, in the lab where he researched ginseng health products. He’d usually burn through two packs by dusk and smoke a third over dinner and drinks with colleagues.
It wasn’t until his father, also a heavy smoker, died of lung cancer that Hon finally kicked the habit.
Hon’s story could be that of any other nicotine-addicted, middle-aged man in China, where 60% of the men smoke. What distinguishes the 52-year-old pharmacist and inventor is that he found inspiration in the addiction.
One of the strangest gizmos to come out of China in recent years, Hon’s invention, the electronic cigarette, turns the adage “where there’s smoke there’s fire” on its head.
It doesn’t burn at all. Instead, it uses a small lithium battery that atomizes a liquid solution of nicotine. What you inhale looks like smoke, but it’s a vapor similar to the “stage fog” used in theatrical productions. (Take that, smoke-free bars!) It even has a teeny red light at the tip that lights up with each drag, just like the ember of a real cigarette.
“It’s a much cleaner, safer way to inhale nicotine,” said Hon, blowing curlicues of e-smoke as he showed off the cigarette in his Beijing office. (He says he doesn’t smoke at all anymore, only for such demonstrations.)
Hon got his first patent on the e-cigarette in 2003 and introduced it to the Chinese market the next year. The company he worked for, Golden Dragon Holdings, was so inspired that it changed its name to Ruyan (meaning “like smoke” in Chinese) and started selling abroad.
This year, it’s planning a big push in the United States. A disposable e-cigarette called the Jazz ($24.95 for the equivalent of five packs) is due to hit 7-Elevens in the Dallas-Fort Worth area shortly. Many rival versions, all made in China, are making their way to the U.S. market, sold mostly over the Internet by small marketing firms.
Unlike nicotine patches and gum, electronic cigarettes are designed to be fun. There are regulars and menthols, as well chocolate and strawberry. For the ultimate tech experience, a company in Japan is selling one that is charged by the USB port of a computer.
The e-cigarettes aren’t marketed as a way to quit smoking, but as an alternative to smoking.
“It’s safe smoking—like smoking with a condom on,” said William Taskas, a Canadian distributor who is marketing a product called SmokeStik.
What makes the electronic cigarette more than just the latest curiosity from China is the enthusiasm it has inspired among respected anti-tobacco activists.
“This is exactly what the tobacco companies have been afraid of all these years, an alternative method of delivering nicotine that is actually enjoyable,” said David Sweanor, an adjunct law professor at the University of Ottawa who specializes in tobacco issues. “It took the Chinese, who are very entrepreneurial, and not burdened with all kinds of regulation, to take the risk.”
Even without smoke or fire, electronic cigarettes are sparking controversy. Australia, Canada and Hong Kong have banned them on the grounds that they have not been sufficiently tested for safety.
“The way they were being sold, there was no control. A kid could buy it and take too many puffs. You could overdose on nicotine,” said Ronald Lam, tobacco control chief of the health department in Hong Kong, where 800 shops were raided last month and the entire e-stash confiscated.
The Food and Drug Administration last month confiscated shipments from three Chinese companies on the grounds they were making false health claims. The agency said in a recent letter to prospective importers of electronic cigarettes that it had not decided on their legality, but was “evaluating them on a case-by-case basis.”
Although they’re not exactly kicking Marlboro off the shelves in China, the electronic cigarettes have commanded a small but loyal following.
“They’re quite popular with both men and women,” said Sun Shujuan, a clerk at the tobacco counter of the Beijing City Department Store. Each day, she sells one or two of the reusable cigarettes (a $145 appliance), and a much larger number of the replacement cartridges, which run $9 for the equivalent of five packs of cigarettes. “We have many repeat customers.”
Chinese smokers complain that the electronic cigarettes are so much more expensive than the real thing (most brands here are still less than $1 a pack) and that they can’t be easily shared. In China, cigarettes are the essential lubricant for opening a conversation—the smoke offered to the cop who has pulled you over, the pack held open by a salesman approaching a prospect.
“What is the point of having cigarettes if you can’t give one to a friend?” said Liu Hai, who works as a driver and lives in Chengdu, in Sichuan province.
Although China is the birthplace of the electronic cigarette, the United States is considered a far more promising market because of the higher price of cigarettes and the prohibition on smoking in many indoor spaces.
“When you’re in Minneapolis in the winter, it’s a lot more attractive to spend $24.95 on an electronic cigarette than it is to go out to smoke where it is 20 degrees below,” said Alex Chong, chief executive of Ruyan America, the Minneapolis-based U.S. affiliate of Hon’s company. “We are finding that bars and restaurants are a great venue to introduce the products. It’s an impulse purchase.”
E-cigarettes are already being sold legally in some British pubs, where smoking is also banned.
Even though the devices are not yet widely available in the United States, the battle lines are being drawn.
“Just in the last few weeks, I’ve gotten a flurry of calls about the electronic cigarette. It presents some novel issues from a regulatory standpoint,” said Kathleen Dachille, director of the Legal Resources Center for Tobacco Regulation, Litigation and Advocacy at the University of Maryland.
The electronic cigarette marketers refrain from calling e-cigarettes a smoking-cessation aid—in part because under U.S. law, if they made any health claims, they would be subject to FDA approval.
Bill Godshall, head of Smokefree Pennsylvania, estimates that at least 100,000 electronic cigarettes already have been sold in the United States. (The gizmo got a surprising boost last month when Leonardo DiCaprio was photographed riding a bicycle while smoking one.)
“You have these abstinence-only extremists who want to eradicate all nicotine product. But as you’ve seen, whether we’re talking about sex or alcohol or nicotine, abstinence doesn’t really work,” said Godshall, who has collected 4,000 signatures on a petition to allow e-cigarettes to be legally sold in the United States.
Chong, the Ruyan America executive, said his company was willing to put its product up for safety testing to win U.S. regulatory approval but not immediately, explaining that it is a $20-million, three-year process. He said that seven laboratories the company commissioned to test the product found no dangerous level of chemicals.
Inventor Hon says the idea of the electronic cigarettes came to him in a dream in 2000: Coughing and wheezing, he imagined he was drowning, until suddenly the waters around him lifted into a fog.
He gave one of the first prototypes to his dying father.
“It was too late for my father, but not for me. I switched over myself to electronic cigarettes.”
barbara.demick@latimes.com
Nicole Liu of The Times’ Beijing Bureau contributed to this report.
]]>By Richard Leiby
Washington Post Staff Writer
Tuesday, April 7, 2009; HE01
I had lunch, a cup of coffee and a smoke the other day at the offices of the American Legacy Foundation in downtown Washington. I puffed away for a good 15 minutes, savoring the irony.
Here I was, surrounded by zealous anti-smokers—Legacy is among the nation’s most influential and well-funded tobacco-fighting organizations—yet I had been invited over to partake in all the nicotine I could handle.
Of course there was a catch: What I puffed on wasn’t a Marlboro or any other combustible cancer stick. I didn’t need an ashtray. The “smoke” was more accurately fog—small, vaporous clouds. I was trying out a controversial new nicotine-delivery device that somewhat resembles a cigarette but is actually a plastic tube with a glowing LED at its tip.
“If you just suck on it, it should work,” scientist David B. Abrams said, handing me an Njoy brand e-cigarette. (That’s “e” for electronic; nothing to do with the Internet, except that the devices are sold there in abundance.) Inside the tube is a lithium battery that warms and aerosolizes a nicotine solution; Njoy says it works like a vaporizer.
After a few puffs, I found myself wreathed in a fine mist of nostalgia. An e-cig supplies none of the flavor or warmth of a real smoke (“Joy of the palate, delight of the nose!” as one forgotten poet put it), yet I was transported back to the days when smoking didn’t equal social opprobrium, when hacks like me hammered on typewriters with nicotine-stained fingers, inhaling madly as deadline loomed.
In a word, I got a buzz.
True, you might be sucking on plastic, but the experience is, as Abrams said, “close to the real deal.”
As the Legacy foundation’s resident expert on addiction and smoker behavior, Abrams and other researchers are intrigued by the devices but also deeply concerned. Could they become another weapon in the smoking-cessation arsenal? Or could they hook more young people on nicotine and serve as a gateway to tobacco use? The products are unregulated, untested in this country and not approved by the Food and Drug Administration, which has sanctioned other nicotine-supplying substitutes such as patches and gum.
Late last month, Sen. Frank Lautenberg (D-N.J.), author of the law that banned smoking on airplanes years ago, sent a letter urging the FDA to take “immediate enforcement action against manufacturers of ‘electronic cigarettes’ and take these products off the market until they are proven safe.” FDA is beginning to get on the case: Although the devices are available online and in scattered retail outlets, the agency says it has halted some imports and is evaluating whether sales require FDA approval.
E-cigs supply nicotine via the lungs—albeit without the tar, carbon monoxide and other nasties in tobacco smoke—and thus provide the almost instantaneous “hit” that smokers crave. They offer that “exquisite regulation of brain chemistry that makes smoking so powerful and rewarding,” said Abrams, a PhD health psychologist who has studied addiction for 30 years.
“People don’t realize that we know of no other way to finely tune the brain than puffing on a cigarette,” he told me.
Later, as I sat dragging on the vapor tube, I thought about that. Nicotine truly is a remarkable drug, because it seems to span the spectrum of psychological effects: Some people relax with tobacco products (a fine cigar after dinner); others get an instant boost that helps them focus. One of my editors swears she never wrote better headlines, faster, than when you could smoke in The Post’s newsroom.
Abrams, who smoked as a teenager and has tried e-cigs in the name of science, is no knee-jerk foe of nicotine. “I see no problem with giving people lifetime medicinal nicotine,” he said. But he certainly doesn’t endorse e-cigs, especially since studies have only begun on their safety and efficacy.
Scientists also worry that e-cigarettes may de-motivate hard-core smokers from quitting, by allowing them to stave off nic fits by “smoking” in offices, restaurants and other places where they can’t normally light up. Thus the e-cigs become what Abrams calls a “bridge product.”
In a joint statement, the American Cancer Society Cancer Action Network, the American Heart Association, the American Lung Association and the Campaign for Tobacco-Free Kids blasted e-cigarettes for being “marketed towards young people, who can purchase them in fruit flavors and online, without having to verify their ages.”
Njoy literature claims that one of its cartridges (which contain water, flavoring, propylene glycol and nicotine) will last the equivalent of a half-pack of real butts. Unlike those 10 cigarettes, though, which burn down and get stubbed out one at a time, the e-cig doesn’t go “out.” There’s a danger of sucking down too much at one sitting: Nicotine affects heart rate and blood pressure. At least one controlled study is underway, at Virginia Commonwealth University in Richmond, to find out the impact of e-cigs on nicotine levels in the blood.
“I’m not necessarily saying these products are dangerous,” said psychology professor Thomas Eissenberg of VCU’s Institute for Drug and Alcohol Studies. “I just think we ought to know what people get when they use them before we sell them.”
His study of 40 smokers, supported by the National Cancer Institute, endeavors to determine how e-cigarettes deliver nicotine and whether they actually suppress withdrawal symptoms.
“For example, if you wake up in the morning craving nicotine, will this take care of that craving?” Eissenberg asked “If it doesn’t, then it’s a failure. If it makes you go back to your own brand, it’s a failure.”
Well, at least a failure as a smoking-cessation product. But evidently trying to avoid government regulation, Njoy and other distributors don’t make any claim to helping people quit.
“Our target market is the legal-age smoker looking for a product to partake of their dependency in places they cannot smoke—and to save a few dollars,” James Leadbeater, chief executive of Njoy, said from company headquarters in Scottsdale, Ariz. “We are not breaking the nicotine habit, just giving people a better way to get the nicotine.”
Given that federal taxes on cigarettes rose significantly on April 1, cost may push some smokers toward alternatives. On the Internet, the Njoy “starter kit,” including batteries, a charger and four cartridges, goes for $75. Leadbetter estimates that after the initial investment in hardware, use of his product costs the equivalent of $2.50 per pack. (A pack of smokes runs something like $5 to $9, depending on brand and sales location.)
But “one of the issues that the smoker has to get over is to get used to the taste,” said Leadbeater, adding that he has never smoked. (As an ex-smoker, I’d have to agree: The Njoy doesn’t taste anything like the real deal. Its vapor delivered a moist, fruity flavor, reminiscent of a hookah session more than anything else.) “They have to make a trade-off so they can use it as an alternative in places that they can’t smoke now.”
I haven’t heard of any celebrity e-cig endorsers, but at least one politician is an aficionado. Rep. Cliff Stearns (R-Fla.) said he uses the device—but chooses a nicotine-free cartridge. “Frankly, I enjoy ‘vaping’ as a relaxing way to enjoy ‘smoking’ without nicotine and the harmful effects of smoke and combustible tobacco,” he told us in a statement.
The congressman says he’s such a fan, “I hope to send a package to President Obama to help him quit or to meet with him and enjoy a harmless, carcinogen-free smoke.” Such bipartisanship is touching, and I can’t help but steal a friend’s joke about why cigarettes are such a great social cohesive, transcending race, religion and class: We smokers are all black on the inside.
As for me, I found “vaping” too, well, plastic to be enjoyable. After I left the Legacy Foundation—established through proceeds of the great tobacco settlement of 1998 and dedicated ever since to saving lives—I walked past smokers clustered under the eaves of nearby buildings. A tantalizing wisp of tobacco smoke wended its way through the gentle rain, reaching my nostrils. I inhaled. It smelled delectable.
The old genie beckoned.
Just then there developed a burning in my mouth and an accumulation of phlegm in my throat—the aftereffects, I realized, of liquid nicotine and just a whiff of secondhand smoke. I walked on, resisting the addictive draw of nostalgia.
Comments: leibyr@washpost.com
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