E-Cigs and the USB-Pass-Through

One of the best things about electronic cigarettes is the fact that in UK can be used almost anywhere. This includes the right to smoke wile sitting at yor desk or during normal working hours. But this advantage is shown one of the disadvantages of electronic cigarettes, there is not tobacco in cig: you have a spare battery with us during the day. For vapers, who works at the computer, there is a solution to the USB pass-through device.
USB pass-through allows vaper use your electronic cigarette without batteries. It connects directly to the e-cigarette and is powered by USB port, just USB board does. And because the power from the USB port so low voltage compared to a conventional electrical outlet, it is the ideal power to give you a whole day without using the battery vaping.
Do the Swap
Pass-through USB devices is such a great tool allows you to do without vapers of extra batteries. They just put a new battery before you leave home in the morning, so that they can VAPE commute, then switch to the USB pass, when they come into the office. On the way home, they come back to the battery so that they can VAPE on the way home. Could it be easier?
For the same reasons many of the electronic cigarette starter kits, such as those sold VAPESTICK included USB charger battery and / or charger. USB charger is connected to the computer as a pass-through device. Thus, even if you forget to put a fresh battery before you leave for work you can charge it directly to your desktop once you get there. This ensures that you are always fully charged battery ready to go for the evening commute.
Innovation is interesting
Innovations are constantly introduced into the electronic cigarette industry is one of the things that make vaping so exciting. Looking back, with a 20/20 point of view, it is easy for vapers to see how limiting tobacco cigarettes were. They are all pretty much taste the same, they all work the same way, and they force smokers find smoking areas where their exposure to secondhand smoke does not affect the other. With electronic cigarettes on the other hand, vapers offer much more freedom in how they are doing.
This freedom is expressed into much happier and more productive former smokers. For example, being able to vape at work means they’re no longer taking a break every couple of hours for a smoke. Being able to commute VAPE means that they are no longer outcasts, with whom none of the other passengers want to be mixed. Electronic cigarette is one tool that helps vapers rid of all limitations and restrictions of tobacco. It is no wonder that so many people make the switch to the UK and around the world.

The Top E Cigarettes for 2011 Reviewed

Electronic cigarettes have quickly become the preferred alternative to traditional cigarette smokers.
These chemical free devices resemble traditional cigarette, but does not contain thousands of chemical carcinogens. Unlike the products of smoking, electronic cigarettes have helped thousands to quit.Studies have shown that smoke and carcinogens in traditional cigarettes, which cause respiratory and other health problems. Electronic cigarettes contain nicotine vapor. Since the pair is released there will be no second-hand smoke.
Most smokers are addicted to nicotine. Nevertheless, some of them are actually dependent on the habit of smoking. E Cigarette smokers also save money. Smokers do not have to worry about smelling like smoke, or having smoker’s breath.
There are many electronic cigarette companies on the market. Industry is increasingly grown in popularity over the past few years. There are many options to consider when choosing a device, the better. Smokers must first decide whether they want to use two or three of the design. Many companies also offer one-off projects. Smokers can choose from different strengths of nicotine. Full power of nicotine, as a rule, most companies offer. Flavors such as cherry, are also offered by most to enhance the experience. E cigarette reviews that contain information about the top of the electronic cigarette in 2011 may help smokers to make the right choice.
Blu cigarettes quickly become the premier brand of electronic cigarettes in the industry. They have recently launched their new two-piece design. This design combines flavor cartridges with their spray. The combination of these units provides a more intense flavor. Flavors offered by Blu contain Johnson Creek Smoke Juice. They are proudly made in the USA exclusively for Blu cigarettes. Blu maintains the highest quality, keeping prices affordable. They also have excellent customer service.
South Beach Smoke, one of the new companies in the industry is becoming more popular. They offer affordable 2 and 3 of the structure. Smokers are automatically enrolled in South Beach FREE Home Delivery Program when purchasing starter kit. This program automatically sends customers to refill cartridges every month at reduced prices.
V2Cigs offers a wide variety of tastes. In addition to his car battery, they also offer a manual battery. Manual battery to increase battery life, and provide a stronger vapor hit. V2Cigs also has a great line / awards program called Smoke4Free. Smokers who are new customers will receive credits every time new directions purchase starter kit. More customers is a smoker, the greater your savings! The new customer will also receive a discount on the starter kit.
White Cloud has recently launched an updated version of his original model.
The new model is shorter, lighter and twice as steam supply. Smokers may use original cartridges because they are compatible with the updated model. White Cloud is also preparing to launch its new Cirrus 3 models. This model is an inch shorter than a traditional cigarette. Starter kits are available for preorder, and will be shipped in early April.
Smoke Council offers quality two-piece design at an affordable price. Their Eazy-Drag system allows effortless tightening. They offer a wide variety of tastes and orders are shipped within 24 hours for free very soon.
Volcano offers offers a variety of starter kits for any budget. Their V-Kit Sampler starter kit is perfect for smokers who are not fully decided to switch to electronic cigarettes. The kit is affordable, and includes everything needed to test the product. They also offer disposables for those who do not smoke often, or just wish to try an e cig. Smokers can choose from prefilled cartridges, or try their hand at filling their own for the Inferno Kit.
SmokeStik has introduced their new model; the PitBull. This new model, while containing a half inch longer battery, lasts hours longer than the regular SmokeStik. The PituBull is compatible with other SmokeStik products. Smokers, however, must purchase a PitBull carrying case since it is longer than the other batteries. A percentage of the profits are being donated to Compassion Revolution. This charity supported by Katherine Heigl is dedicated to pet overpopulation.
Factors on which brand is best depends on the willingness of the smoker. The choice can be made after the decision, which features are most important. E cigarette reviews such as the ones found on CigaretteReviews.org provide information to help smokers make an informed decision. Smokers will also find detailed product information about the most popular electronic cigarette in 2011.
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Electronic cigarettes

To the uninitiated, walking into this suburban Toronto bar must look like a throwback to the 1980s. A cloud of what appears to be smoke can be seen hovering over a group at the far end of the establishment. But a quick check of the sense confirms that looks can be deceiving.
The air is fresh, lacking aroma of tobacco; the eyes aren’t watering with the sting of fresh smoke seeping into the sockets; and instead of ash trays and cigarette packs, the tables are full of small bottles of liquid and other pieces of equipment. On this night, a group of Toronto area electronic cigarette, enthusiasts are getting together for their monthly meet-up.
E-cigarettes were invented in 2003 by a Chinese pharmacist named Hon Lik. The company he worked for, Golden Dragon Holdings, was so impressed, it changed its name to Ruyan that is translated “like smoke” and began marketing the product the following year. Since that time, a vibrant international market in e-cigarette equipment and supplies has developed.
The devices contain a heating element that turns a liquid made of propylene glycol, vegetable glycerin (two common food additives) and nicotine into a water vapor, which simulates the act of smoking and delivers nicotine to the body, without exposing it to the carcinogens found in tobacco smoke. The liquids are available in a divertissement of flavors and nicotine strengths.
Most experts agree that more research needs to be done to determine just how much safer it is than smoking. But consider this: Detailed studies have been conducted to determine the chemical composition of e-cigarette liquid and it has not been found to contain more than trace elements of any of the carcinogens found in tobacco smoke. Cigarettes, on the other hand, contain over 10,000 chemicals (only 5,300 of which have been identified) and 40 known carcinogens.
It’s clear that since nothing is being combusted in an e-cigarette; their use is significantly less harmful than smoking. A 2010 paper published in the Journal of Public Health Policy reviewed the available data and concluded that; “electronic cigarettes are a much safer alternative to tobacco cigarettes.” Researchers at the Canadian organization TobaccoHarmReduction.org called e-cigarettes “the tobacco harm reduction phenomenon of the year.”
But just because a technology has the potential to save millions of lives, doesn’t mean someone hasn’t tried to ban it.
In 2009, Health Canada issued a warning on its website, saying that e-cigarettes fall under the Food and Drugs Act and must therefore be approved by the government for sale in Canada. But, so far, “no electronic smoking products have been granted a market authorization in Canada.”
In practical terms, Health Canada cannot stop the sale of the e-cigarettes or liquids that do not contain nicotine. So Canadians have no trouble buying the equipment, which is generally sold over the Internet. A number of studies have shown that the illusion of smoking created by the device helps to satisfy cravings, but without nicotine, it cannot help smokers get over the physiological dependence that is created by the drug.
A number of Canadian vendors have continued to sell nicotine-containing liquids, in defiance of Health Canada’s edict. But some of the more popular companies have had to shut down, after being threatened by Health Canada and the RCMP. This forces many Canadians to make purchases from U.S. and other foreign companies, but they risk having their shipments intercepted at the border.
Most of the harm caused by tobacco use comes from inhaling smoke and all the carcinogens that come with it. Nicotine itself, while highly addictive, is one of the more benign elements of tobacco. Efforts to reduce the harm caused by other substances, like drugs and alcohol, often place a considerable burden on the taxpayer. But what we have here is a solution to reduce the negative effects of tobacco use, which has been developed without any government intervention or funding. Many people have successfully kicked their tobacco habit in favor of these less-dangerous electronic products. As University of Ottawa professor and tobacco control expert David Sweanor put it, e-cigarettes are “exactly what the tobacco companies have been afraid of all these years” – a tobacco-free cigarette alternative.
To figure out why the government would try to prohibit the use of these products, one simply has to follow the money. Between 2001 and 2008, the federal government collected $20.4-billion worth of tobacco taxes. Rather than implementing policies that are in the best interests of Canadians, it is the government that has become addicted to the lucrative tobacco industry.
It’s time to break the addiction: End the Canadian ban on electronic cigarettes.

The War on E-Cigarettes

Earlier this month, the Centers for Disease Control (CDC) reported that from 2005 to 2010, the nation’s smoking rate experienced a measly decline, from 20.9 percent to 19.3 percent. This, despite hundreds of millions of dollars in government anti-smoking campaigns and higher cigarette taxes. The CDC now estimates that the smoking rate will be 17 percent in 2020, far short of the sub–12 percent goal set by the 2009 Family Smoking Prevention and Tobacco Control Act.
If there’s any chance of reaching the goal, influential anti-tobacco activist groups should quit stubbornly relying on the government to solve the problem, especially when the private sector is coming up with innovative approaches to reduce the risks related to tobacco use.
The Campaign for Tobacco Free Kids, perhaps the most prominent anti-tobacco group, wrote in a press release that the decline in smoking rates was “nothing to cheer” about and that the news “underscores the need for elected officials at all levels to more aggressively implement proven measures to reduce tobacco use.” Except by their own admission, the only thing proven about the current government approach is that it isn’t working.
In fact, groups like Campaign for Tobacco Free Kids have remained steadfast in their adamant opposition to many commonsense strategies for making tobacco less deadly. The most egregious example is their continued prohibitionist stance towards electronic cigarettes. E-cigarettes, which deliver nicotine to the user in a water-like vapor that does not contain the deadly amalgamation of particles found in tobacco smoke, have caught on over the last half-decade with smokers looking for less risky ways to get nicotine, or even trying to quit entirely. Published surveys suggest that e-cigarettes have helped a significant number of people remain abstinent from traditional cigarettes. Furthermore, despite fear-mongering by activist groups, tests performed on e-cigarette liquid and vapor demonstrate that the product is no more toxic than other nicotine-replacement therapy products such as the nicotine patch, gum, and inhaler.
Apparently, the city of Boston hasn’t gotten the memo. Earlier this month, the Boston Public Health Commission took the first step toward banning the use of e-cigarettes in workplaces, restaurant patios and decks, and loading docks. If passed by the Health Commission, Boston will join a small but growing list of communities — one of the most significant being King County, Wash., (which includes the city of Seattle) — that have voted to force e-cigarette users, many of whom are ex-smokers, back into the smoking section based on nothing but pure hype and conjecture. There is no evidence whatsoever that e-cigarette vapors contain anything more harmful than small amounts of nicotine, which is not a carcinogen.
Unfortunately, these are not isolated examples of local governments’ interfering with effective private-sector solutions. In fact, these campaigns have been bankrolled by the CDC, the very same federal bureaucracy that’s spending recklessly — and ineffectively — to fight smoking.
When Congress passed the Patient Protection and Affordable Care Act, it created a CDC slush fund called Communities Putting Prevention to Work. Initially created as part of the 2009 stimulus package to distribute $400 million in grants to state departments of health and local governments, the CPPW program, like most big spending programs, refused to die. Its funding now stands at $750 million a year, and will rise to $2 billion a year beginning in 2015. The cash handouts are supposed to be targeted at “reducing chronic disease morbidity and mortality associated with obesity and tobacco use . . . through implementing evidence- and practice-based approaches.”
What is the “evidence” supporting a CDC-funded campaign to restrict the use of e-cigarettes? The Boston Public Health Commission declined to share with us a report issued by their CPPW advisory council to Mayor Thomas Menino on the topic. And the CDC dismissed any notion of accountability and transparency by referring our questions back to the (non-responsive) grant recipient.
Whether achieved by national or local policy change, governmental micromanagement of health behaviors not only restricts freedom, but is failed policy. Boston’s proposed law is undoubtedly a waste of money and resources. But by creating obstacles for smokers to switch to e-cigarettes, it will actually do far more harm than good.
Most important, it again illustrates what the few rational voices in the tobacco-control movement have been saying for years: The so-called public-health community simply strives for more control over our lives, even at the expense of shortening them.
By Jeff Stier

U.S. seeks to ban electronic cigarettes on airplanes

The Department of Transportation has proposed a federal rule that would explicitly ban electronic cigarettes on all domestic and international commercial flights in the U.S.
Smoking electronic cigarettes would be explicitly banned on all domestic and international commercial flights in the U.S. under a new rule proposed by the U.S. Department of Transportation.
Current federal law prohibits passengers from smoking any tobacco product on a commercial plane but does not single out the use of electronic cigarettes.
Most electronic cigarettes do not burn tobacco but use a lithium battery to heat up a liquid nicotine solution, creating a vapor that can be inhaled to deliver the chemical directly into the lungs.
“Airline passengers have rights, and this new rule would enhance passenger comfort and reduce any confusion surrounding the use of electronic cigarettes in flight,” U.S. Transportation Secretary Ray LaHood said in a statement Wednesday.
For years, flight attendants have spoken out against electronic cigarettes, saying passengers have confronted attendants over electronic cigarettes because some air travelers argue that the federal tobacco ban does not apply to electronic cigarettes.
The proposed ban on electronic cigarettes was blasted Wednesday by Ray Story, chief executive of the Tobacco Vapor Electronic Cigarette Assn., a Washington-based trade group that promotes the use of electronic cigarettes as an alternative to traditional tobacco products.
Story said the vapor produced by an electronic cigarette would pose no danger to nearby passengers on a plane. He said the ban would relegate electronic cigarette smokers to airport smoking sections where they would be exposed to the proven harmful effects of traditional tobacco cigarettes.
“How do you ban a product from a plane when it doesn’t do anything?” Story said.
Under the federal rule-making process, the public has until Nov. 14 to submit comments on the proposed ban. People can file comments at http://www.regulations.gov. Once there, the public can comment by searching for the keywords “electronic cigarettes.”
Federal officials said they could not estimate how long it would take to review the comments and prepare a final rule for adoption.
By Hugo Martín, Los Angeles Times
hugo.martin@latimes.com

Boston proposes new restrictions on e-cigarettes, other tobacco products

The Boston Public Health Commission this afternoon unanimously approved proposed rules that would crack down on the sale of electronic cigarettes, popularly known as e-cigarettes, regulating them like actual cigarettes.
The battery-powered products, which usually look like cigarettes, deliver nicotine in the form of vapor and have been largely unregulated.
The commission’s proposal would require retailers to obtain a permit to sell them and prohibit their sale to minors. It would also ban use of e-cigarettes in the workplace.
“We don’t know what people are inhaling with these e-cigarettes,” said Nikysha Harding, director of tobacco control for the commission. “We see these as a gateway for youth to become addicted to nicotine.”
The board gave initial approval, as well, to doubling the fines for retailers who sell tobacco products to consumers under age 18 or violate other tobacco control regulations. The rules also would prohibit the sale of low-cost, single cigars just slightly larger than cigarettes that have become an attractive option for price-conscious youth looking for alternatives to cigarettes. Called cigarillos, they sell for as little as 50 cents each.
After a month-long public comment period and a public hearing next month, the commission will vote on Nov. 10 whether to make the rules final. They would become effective within 30 days, except the cigarillo restrictions would go into force 60 days later.
If the rules become final, retailers would have to apply for a permit through the commission’s Tobacco Control office to sell e-cigarettes, which are often marketed as nicotine replacement therapy.
The products are made of plastic and metal and heat a liquid nicotine solution in a disposable cartridge to create vapor that the smoker inhales. Currently, it is legal to sell e-cigarettes to children.
A handful of convenience stores in Boston sell e-cigarettes, according to a survey conducted by the Northeastern University School of Law Public Health Legal Clinic — and more stores are interested in selling them, according to the commission.
The regulations would require that e-cigarettes be placed behind the store counter, like tobacco products, and that they not be sold to minors. E-cigarette use would be banned in the workplace, which includes restaurant patios and decks, and loading docks.
At least two other Massachusetts communities — South Hadley and North Attleboro — already regulate the sale of e-cigarettes, according to the Boston commission.
As for cigarillos, they would have to be sold in their original manufacturer packaging of at least five and bear a health warning — measures intended to combat single-sales marketing to youth and discourage their initiation into cigarette smoking.
Fines for retailers found in violation of the city’s tobacco control regulations would double — from $100 for the first offense and $400 for the fourth offense in 12 months, to $200 for the first offense and $800 for the fourth offense in 24 months.
A public hearing on the proposed regulation is scheduled for 6 p.m. Tuesday, Oct. 4, in the Hayes Conference Room on the second floor of commission’s offices at 1010 Massachusetts Ave. Written comments are being accepted by the commission from Sunday, Sept. 11, through Oct. 10. They can be sent to the Boston Public Health Commission, Board Office, Attention: Jamie Martin, Board Secretary, 1010 Massachusetts Ave., 6th floor, Boston, MA 02118, or e-mailed to boardofhealth@bphc.org.
By Kay Lazar, Globe
klazar@globe.com

E-Cigarette or Drug Delivery Device?

Washington, D.C. – Devices marketed as “electronic cigarettes” are in reality crude drug delivery systems for refined nicotine, posing unknown risks with little new benefits to smokers, according to tobacco control experts.
In a “Perspective” published today in the New England Journal of Medicine, researchers from the Legacy’s Steven A. Schroeder National Institute for Tobacco Research and Policy Studies explore the current regulatory climate around electronic cigarettes (“e-cigarettes”) and their safety. The authors, Nathan K. Cobb, MD, a pulmonologist and assistant professor at Georgetown University Medical Center, and David B. Abrams, PhD, executive director of the Schroeder Institute, also question future implications for physicians, policy makers and e-cigarette users.
E-cigarettes are constructed to mimic real cigarettes in size and appearance, but contain no tobacco and are not cigarettes at all. In reality they are delivery devices for refined nicotine, having more in common with inhalers used to treat asthma or other delivery devices for both approved and illicit drugs. Though individual brands vary in construction, the products generally produce a propylene glycol mist containing nicotine along with flavorings and other chemicals.
Currently, three interrelated products are being sold: the delivery device itself; cartridges that can contain up to 20 mg of nicotine; and refill kits that allow consumers to fill used cartridges with replacement nicotine solution. Some refill bottles, easily obtained over the Internet, contain enough nicotine to kill an adult if accidentally ingested.
The U.S. Food and Drug Administration (FDA) announced April 25, 2011, that it would regulate e-cigarettes as “tobacco products” and not as “drug-delivery devices.” That action came after federal courts blocked the agency from regulating the products as drug-delivery devices. The courts maintained that, under the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA), the FDA must regulate as tobacco products any product that contains nicotine from tobacco and that makes no claims to be therapeutic. These decisions together, the authors note, “upend[ed] the status quo” by having the effect of allowing the sale of unregulated refined nicotine directly to consumers, unless and until the FDA takes further action.
“The court’s decision that e-cigarettes should be regulated as tobacco products and not as drug-delivery devices has substantially delayed the FDA regulatory process that normally protects the public health. It has the practical effect of allowing manufacturers to sell potentially dangerous refined nicotine products directly to consumers,” said Cobb. “It is entirely possible that future modifications to the products will improve the efficiency of nicotine delivery and could dramatically increase the risks of addiction, abuse and serious overdose.”
While most devices and nicotine fluids are produced by small manufacturers, Cobb and Abrams note that the fact that leading cigarette manufacturers Philip Morris International and British American Tobacco recently purchased sophisticated nicotine inhaler technologies may be an indication that both companies are developing next generation nicotine delivery devices of their own.
Abrams, a professor at Johns Hopkins Bloomberg School of Public Health added “Any refined nicotine product, whether used for smoking cessation and tested and approved by the FDA (like the Nicotrol inhaler) or a new product designed for ‘reduced or modified’ risk, can and must be tested and strictly regulated before being introduced to the market”.
The authors argue that a comprehensive approach to regulating products containing refined nicotine is needed to protect the public’s health and should involve Congress, the courts and the FDA.
In this piece, Cobb and Abrams discuss several safety concerns:

  • Testing of cartridges reveals poor quality control, variability in nicotine content among brands, and deviations between label claims and cartridge content.
  • The devices do not reliably deliver nicotine, and have not been sufficiently evaluated in scientific studies the way the FDA requires of other drugs and devices used for smoking cessation. Smokers attempting to use e-cigarettes as quitting aids will most likely find them ineffective due to the fluctuating nicotine content and unpredictable delivery.
  • Manufacturers sell cartridges with a range of up to 20 milligrams of nicotine. However, refill kits allow consumers to fill used cartridges with replacement solutions at much higher doses. In fact, the devices are not limited to delivering nicotine. The paper notes that instructions for filling cartridges with marijuana hash oil can be easily accessed on the Internet.
  • The safety of inhaling propylene glycol over an extended period of time has not been studied in humans.
  • E-cigarettes may serve as a “bridge product” that smokers use in places where traditional tobacco smoking is prohibited, thus perpetuating their addiction and use of real cigarettes. Additionally, they may be used as a ‘starter’ product for young people considering smoking, especially since the cartridges can be purchased over the Internet with tempting flavoring like grape and chocolate.

In their conclusion, Cobb and Abrams counter the argument made by e-cigarette advocates that taking the devices off the market could mean current users would be forced to return to traditional tobacco products. Instead, the two researchers point to the multiple pharmaceutical-grade nicotine products on the market that have been regulated, approved and deemed safe and effective by the FDA, including patches, gums, lozenges, nasal sprays and even an FDA-approved inhaler. The two researchers also state that current users should pursue research-proven effective cessation tools, such as nicotine replacement products, telephone quit lines, and Web-based cessation services, as well as non-nicotine pharmacotherapies like bupropion and varenicline.
By Julia Cartwright, 202.454.5596, jcartwright@legacyforhealth.org
Karen Mallet, 215.514.9751, km463@georgetown.edu

Electronic Cigarettes Revisted: Public Health and Medical Opinion

A few weeks ago I posted a little essay here on “electronic cigarettes,” alleging that this relatively new nicotine delivery device might be more dangerous in various ways than some of the aggressive marketing of “e-cigs” might portray. Given the nefarious history of tobacco and smoking wars in this country and beyond, that one seemed fairly innocuous at the time.
However, the response from quite a few readers was vehement, and often less than complimentary – in fact, there was more angry response than anything I’d written on since gun control issues. Not all the input was critical – some readers had used e-cigs to quite or curtail tobacco smoking – a good thing, obviously, and evidence that the product can be used for “harm reduction” purposes in some cases. Some folks in the e-cig industry thanked me for critiquing the less ethical among their colleagues. Some clinicians were glad to see confirmation of their suspicion that e-cigs were being marketed to kids, who were using them and then wound up smoking regular cigarettes, as I had also noted.
But others accused me of all manner of perfidy, stupidity, and so forth. Others “yelled” at me in all caps while calling me things like “blowhard” – without sensing the irony, it seemed. I did learn new things from some of the comments, and would have written the original post differently in light of that information – in essence, the subtitle should have been “A Pack of Lies?” – with a question mark added, as I was trying to raise questions about safety, funding, regulation, and the so forth. I said nothing about favoring banning the product – at this time, anyway – but that we needed to be more cautious in allowing the open marketing, sales, and use.
But perhaps I should have just waited for our local health and medical authorities to weigh in, as they now have. The following policy statement has just been adopted by the San Francisco Health Commission, at the request of the San Francisco Department of Public Health, with the full endorsement of the San Francisco Medical Society’s board of (physician) directors. Clearly there are multiple sides to this story, and we have more to learn, but in the meantime, a cautious approach is warrented, as reflected in this new statement. It’s a long one (and for the record, I had no input on it), but for those interested, here it is.
Health Commission City and County of San Francisco Resolution No. 7-11
Endorsing the San Francisco Department of Public Health Proposal to Regulate Electronic Cigarettes
WHEREAS the United States Food and Drug Administration (FDA) has not yet issued any regulations regarding electronic cigarettes, also called e-cigarettes, and these products are available for purchase in this city; and
WHEREAS the U.S. Court of Appeals for the D.C. Circuit recently issued a decision that e-cigarettes and other products “made or derived from tobacco” can be regulated as “tobacco products” under the Federal Food, Drug, and Cosmetic Act, but that these products cannot be regulated as drugs/devices unless they are marketed for therapeutic purposes; and
WHEREAS electronic cigarette manufacturers and retailers are making unproven health claims about their products by asserting that they are safe or safer than traditional cigarettes and that they can be used as an aid to smoking cessation; and
WHEREAS the FDA has warned the public about the potential health risks of using electronic cigarettes; and
WHEREAS initial FDA studies found that electronic cigarettes contain known carcinogens; and
WHEREAS the FDA issued a statement on April 25, 2011 that it intends to propose a regulation that would extend the Agency’s “tobacco product” authority under the Family Smoking Prevention and Tobacco Control Act to other categories of tobacco products that meet the statutory definition of “tobacco product” under the Act; and
WHEREAS electronic cigarette packages do not supply any warnings about possible adverse effects on health comparable to FDA-approved nicotine replacement products or conventional cigarettes; and
WHEREAS there is no scientific evidence that electronic cigarettes can help smokers to quit smoking; and
WHEREAS the World Health Association does not consider electronic cigarettes to be a legitimate therapy for smokers trying to quit tobacco; and
WHEREAS FDA studies found that certain electronic cigarettes misrepresent nicotine content on their labels and sometimes contain far more nicotine than FDA-approved smoking cessation products; and
WHEREAS FDA studies found that certain electronic cigarettes emitted a markedly different amount of nicotine with each puff; and
WHEREAS the Surgeon General has found that the chemical nicotine is a powerful pharmacologic agent that acts in the brain and throughout the body and is highly addictive; and
WHEREAS withdrawal symptoms from nicotine include cognitive and attention defects, cravings, inability to sleep, and sleep disturbance; and
WHEREAS use of nicotine may cause or contribute to cardiovascular disease, complications of hypertension, reproductive disorders, cancer, and gastrointestinal disorders, including peptic ulcer disease and gastro esophageal reflux; and
WHEREAS electronic cigarettes may not be legally sold to minors in California; and
WHEREAS some electronic cigarette producers market their product to children by flavoring their products with candy, fruit, and other flavors popular with children; and
WHEREAS the FDA has raised concerns that electronic cigarettes, including but not limited to flavored electronic cigarettes, can increase nicotine addiction among young people and may lead youth to try conventional tobacco products; and
WHEREAS according to the 2009 San Francisco Unified School District High School Youth Risk Behavior Survey, 10.4% of San Francisco high school students reported current cigarette use; according to the 2009 California Health Interview Survey, 11.9% of San Francisco adults were current smokers, and according to the 2008 California Adult Tobacco Survey, 17.6% of California adults 18-24 years of age were current smokers; and
WHEREAS there is no evidence that the vapors released into the air through the use of an electronic cigarette do not present a danger to others who breathe them; and
WHEREAS electronic cigarettes’ resemblance to conventional cigarettes has caused the San Francisco Airport Health and Safety Office and Department of Public Health Secondhand Smoke Prevention and Enforcement Program to observe that the use of electronic cigarettes in places where smoking is prohibited increases the likelihood that people will break the law by lighting up cigarettes because they see what appears to be someone smoking, undermining compliance with existing smoking regulations; and
WHEREAS the use of an electronic cigarette in public is virtually indistinguishable from the use of traditional tobacco products in public, prompting confusion and concern by the owners of establishments seeking to comply with the City’s laws prohibiting smoking in certain locations; and
WHEREAS the Department of Transportation has banned the use of electronic cigarettes on U.S. carrier and foreign carrier flights in scheduled intrastate, interstate, and foreign air transportation; and
WHEREAS on April 5, 2011 the San Francisco Airport Commission amended its Rules and Regulations regarding smoking to include a ban on the use of electronic cigarettes due to the problems associated with electronic cigarette use in public outlined above; and
WHEREAS the American Cancer Society Cancer Action Network, American Heart Association, Campaign for Tobacco Free Kids, and American Lung Association support including electronic cigarettes in smoke-free laws; and
WHEREAS electronic cigarettes have been banned in indoor public places and workplaces by King County (Seattle), Washington, New Jersey and Suffolk County, New York while electronic cigarette sales have been banned throughout Canada; now therefore be it
RESOLVED, that the Health Commission endorses the policies proposed by the San Francisco Department of Public Health to
1. Prohibit the use of electronic cigarettes (and other nicotine delivery devices not approved by the FDA as smoking cessation aids) in those areas where smoking is prohibited in the San Francisco Health Code.
2. Require a tobacco permit for the sale or furnishing of electronic cigarettes and other nicotine delivery devices not approved by the FDA as smoking cessation aids.
– That’s it, although the many references are available in the online version:
http://www.sfdph.org/dph/files/hc/HCres/Resolutions/2011Res/ecig%20reso.pdf
I expect that many who have read this far – if anyone does – will include previous readers, and that some won’t like it. But some had asked for better information and what doctors think; here it is.
ps: If you intend to comment here, please do indicate who you really are, with a real name, and whether you have any financial or other stake in the sale or use of tobacco or e-cigs. Seems only fair to me (My name is above; I have no such conflict of interest).
pps: For other tobacco-related news, see:

PEDIATRICIANS CALL ON ALL MOVIE COMPANIES TO ADOPT SMOKE-FREE POLICIES THAT WORK
A new study in the CDC’s Morbidity and Mortality Weekly Report, “Smoking in Top-Grossing Movies, United States’ 2010,” shows promise for the ability of movie producers to positively affect young people’s health by reducing the number of teens who smoke. The American Academy of Pediatrics (AAP) calls on all movie producers to adopt policies that create a healthier movie experience for kids.
For more information, visit http://www.aap.org/richmondcenter/smokefreemovies.html
By: Steve Heilig

Can Cigarette Alternatives Deliver a Safer Fix?

Tobacco harm reduction—encouraging the use of cigarette alternatives as a way to reduce the public health impact of smoking—is the subject of fierce debate in the public health community.1 Some believe such alternatives perpetuate nicotine addiction in smokers and may even be manufactured and marketed specifically to keep smokers smoking.3 “The goal should be relief from addiction to nicotine, not long-term maintenance,” says Norman Edelman, chief medical officer for the American Lung Association.
Others see cigarette alternatives as a way for smokers to cut their health risk. “I saw patients with lung cancer or COPD (chronic obstructive pulmonary disease) who, despite their serious illness, could not quit,” says Brad Rodu, a professor of medicine and Endowed Chair of Tobacco Harm Reduction Research at the University of Louisville. “For smokers who can’t quit, we are obligated as a society to inform them that they have far safer ways to use tobacco.”
One familiar alternative is smokeless tobacco, which is sold as chewing tobacco or moist snuff (including tiny teabag-like sachets known as snus). A newer alternative is dissolvable tobacco, or finely milled tobacco shaped into pellets, strips, or toothpick-size “sticks” that dissolve in the mouth. Still another option is the battery-operated electronic cigarette, which produces nicotine vapor.
On one point proponents and opponents of these products agree—they’re less harmful than cigarettes. They typically have no more nicotine than cigarettes, and some have far less. However, Scott Tomar, a professor in the University of Florida Department of Community Dentistry and Behavioral Science, points out, “It is not just the amount of nicotine but the route of administration and speed of absorption that determine its physiological effects.” He adds, “It is not the nicotine per se that is the primary harmful substance in tobacco products.”
Perhaps more important, most alternatives contain fewer tobacco-specific N-nitrosamines (TSNAs) and other carcinogens than cigarettes because the tobacco is cured differently. Moreover, much of the harm attributed to cigarettes—for both active and passive smokers—comes from combustion of the tobacco during smoking.
But “not as harmful” is not necessarily the same as “safe,” says Danny McGoldrick, vice president of research for the Washington, DC–based nonprofit Campaign for Tobacco-Free Kids. McGoldrick and many public health researchers are concerned about how few studies have been conducted on the health effects of cigarette alternatives. The exception is smokeless tobacco, which has been listed as a known human carcinogen by the National Toxicology Program since 2000. The most common side effect of smokeless tobacco use is oral leukoplakia (white lesions on the inside of the mouth).
A better understanding of the chemical composition of dissolvable tobacco products would open the door to research on oral health effects of using these products. The first published chemical analysis of dissolvable tobacco was published in 2011 by analytical and forensic chemist John Goodpaster and colleagues at Indiana University–Purdue University Indianapolis. His analysis showed that dissolvables contain nicotine levels comparable to those in a single cigarette.
Although the authors did not study health effects of using dissolvable tobacco, they point out that nicotine can be converted into carcinogenic TSNAs in the body, and that nicotine itself can adversely affect gum and tooth health as well as inhibit apoptosis in oral cancer cells. “Oral cancer is a major [potential] concern,” Goodpaster says.
The analysis also revealed numerous flavor compounds, sweeteners, binders, and humectants. Of the flavor compounds identified, ethyl citrate is acutely toxic with oral dosing; cinnamaldehyde is an oral irritant; and coumarin, a liver and kidney toxicant, has been banned for decades as an additive in foods, although not in tobacco. Moreover, the fact that dissolvable tobacco is meant to be fully dissolved in the mouth and eventually swallowed “introduces questions in terms of its effect on the gastrointestinal tract,” Goodpaster says.
The e-cigarette departs from tobacco altogether. Instead, users add drops of liquid nicotine to the battery-powered device, which delivers a propylene glycol/nicotine vapor that users inhale. Because e-cigarettes contain no tobacco, they have not been regulated by the Food and Drug Administration (FDA), although a recent court decision changed that.10 The FDA expects soon to propose regulation of e-cigarettes under the Family Smoking Prevention and Tobacco Control Act.
A large number of e-cigarettes are imported from China, and “we have no idea of the variation and extent of quality control,” says David Abrams, executive director of the Washington, DC–based Steven A. Schroeder National Institute for Tobacco Research and Policy Studies. A 2009 FDA study of 18 types of e-cigarettes found only trace levels of TSNAs in the devices, comparable to levels found in nicotine patches and nicotine gum and orders of magnitude lower than those found in tobacco cigarettes.
This and other laboratory studies suggest e-cigarettes may be safer than the real thing. However, the FDA study did reveal two problems: wide variation in the amount of nicotine, even in samples of the same product; and in one brand of e-cigarette, the presence of diethylene glycol, a toxic chemical found in antifreeze.
E-cigarette manufacturers are not allowed to claim their products aid in smoking cessation because they have not conducted clinical trials. Yet some researchers believe the devices may in fact prove helpful. “E-cigarettes are a promising strategy in helping people quit,” says Michael Siegel, a Boston University School of Public Health physician and community health professor.
Siegel recently reported on a survey he conducted of smokers who had purchased e-cigarettes for the first time several months earlier. Of 216 respondents, 66.8% reported cutting down how many cigarettes they smoked, and 31.0% reported quitting cigarettes altogether for at least 6 months. Of those who reported quitting smoking, 34.3% were using no nicotine at all, while 56.7% were still using e-cigarettes.
Siegel and his coauthors pointed out a number of limitations to the study, including the low response rate (4.5%) and the possibility that smokers who had tried but failed to quit would be less likely to complete the survey. Nevertheless, they write, “The finding that most individuals who used e-cigarettes at least reduced the number of tobacco cigarettes they smoked suggests that if proven safe, e-cigarettes may be a potentially important tool for harm reduction.”
But Jonathan Winickoff, a Boston pediatrician and former chair of the American Academy of Pediatrics Tobacco Consortium, worries about the public health impact of seeing an influx of people who appear to be smoking. “When these products are smoked in areas where smoking is prohibited, they may cause former smokers to crave cigarettes,” he says. Antismoking advocates also fear that sweet flavors and easy use make cigarette alternatives particularly alluring to teens. Moist snuff, dissolvable tobacco, and e-cigarettes are all available in different flavors, which the FDA prohibits in regular cigarettes to discourage youth from smoking.12
In 2010 the Centers for Disease Control and Prevention reported a nationwide prevalence of smokeless tobacco use of 15% for high-school boys and 2% for high-school girls, with white students using these products the most. An earlier study indicated teenage boys who used smokeless tobacco were three times as likely as nonusers to be smoking cigarettes four years later.16 “If I wanted to get large numbers of people addicted to nicotine,” Winickoff says, “I would probably promote these products.”
By Cynthia Washam
Environmental Health Perspectives

Electronic Cigarettes: how do they work and are they safe?

It looks like a cigarette and tastes like a cigarette- even gives a “nicotine rush” like a cigarette, but it’s not one. It’s a way “smokers” are getting a nicotine fix anywhere they want– from bars and restaurants to the mall.
John Sawyer’s been smoking since he was in the Navy. “Cigarettes were ten cents a pack. Everybody smoked,” Sawyer said.
Sawyer used to smoke 2 packs a day. Now he’s cut that in half, because he now smokes electronic cigarettes as well.
Sawyer took a puff to demonstrate how they work. “The more you pull on it the more you’re going to take it in,” Sawyer said. As he puffs, a light at the end of the e-cigarette lights up.
The electronic cigarette delivers nicotine into the lungs and only releases water vapor. So why did Sawyer begin buying them? “Why?, because you’re welcome everywhere with one of these, where you’re not welcome anywhere with a cigarette,” Sawyer said.
Now it seems electronic cigarettes are sold everywhere form the mall to local convenience stores.
Mike Ferguson started buying them five months ago. “And so I started with the mild. I think it’s like 6 percent nicotine,” Ferguson explained, but he had an unexpected result after starting on e-cigarettes.
He lowered the nicotine level to zero and now merely puffs on e-cigarettes because it’s part of his routine. “It helped me to quit even though I didn’t want to quit,” Ferguson said. “I think it’s just the mouth-to-hand coordination. I need something.”
Now Ferguson can puff almost anywhere, even the mall and local restaurants.
The electronic cigarette basically has two parts, the filter which contains the nicotine and the battery that powers it. Basically all you do is put it together it’s two pieces, said John Neuse, an e-cigarette vendor for the company, Frii, that has kiosks at Valley View Mall in Roanoke and malls in Lynchburg, Danville and Blacksburg.
“It’s pretty close to an actual cigarette. It’s a little different but you can definitely feel the nicotine hitting your lungs,” said Neuse.
The nicotine filters come in different flavors and deliver different strengths of nicotine.
Neuse told News 7 the e-cigarettes are safer than real cigarettes. “There’s no chemicals to it. It’s completely safe for you. You don’t have all the carcinogens, the tar,” Neuse said.
We asked Carilion Clinic lung specialist Dr. Moises Cossio if e-cigarettes are safer than lighting up. “No question in my mind that whatever a person does as far as nicotine replacement, it’s better than smoking actual cigarettes,” Dr. Cossio said.
John Sawyer says he can breath better because e-cigarettes have helped him cut back on the real thing. “It’s as close as you can get without having the fire of a real cigarette,” Sawyer said.
Electronic Cigarette Facts
They’re such a new trend Dr. Cossio says there really haven’t been any scientific studies done in the U-S on them like there have been on the nicotine patch or gums to show how much nicotine is released into the body.
The Food and Drug Administration is trying to regulate them.
While e-cigarettes are allowed in public places in Virginia, several other states have included e-cigs in public smoking bans.
There are start up costs for e-cigarettes. You have to buy the device and the battery charger, but the actual filters are cheaper than real cigarettes.
Prices and quality may vary between e-cigarettes sold at mall kiosks and e-cigarettes sold at convenience stores.
By Jean Jadhon