Safety of e-cigarette vapors questioned

, Buffalo Business First Reporter-Business First
It’s been years since viewers have sat through a cigarette commercial during the Super Bowl, with commercials for beer and cars dominating advertising.
But this weekend’s game included for the second consecutive year an ad for NJOY King, an electronic cigarette, with a theme of friends helping friends.
The response has been mixed from health advocates. While some say inhaling vapors or “vaping” is safer than smoking traditional tobacco cigarettes, others insist quitting entirely is the healthiest course of action. And it turns out vaping also exposes non-users to nicotine in the same way secondhand smoke affects those who spend time around smokers, though at much lower levels.
That’s according to research by Maciej Goniewicz, an assistant professor of oncology at Roswell Park Cancer Institute’sDepartment of Health Behavior, published by the journal Nicotine and Tobacco Research.
Goniewicz and his team studied vapor from three different brands of e-cigarettes, as well as secondhand smoke exposure of vapors and tobacco smoke generated by dual users. The results showed the e-cigarettes emit nicotine at levels of about 10 times less than conventional tobacco cigarettes, though they did not emit substantial amounts of carbon monoxide and toxic volatile organic compounds.
The study was a collaboration between Roswell Park and researchers at the Medical University of Silesia in Poland.
Though exposure to toxins is substantially lower, there’s still no definitive data on short and longterm health: The U.S. Surgeon General has not yet evaluated the short and longterm health risk from secondhand exposure to vapors.
“We don’t know yet the longterm affects of using these products,” Goniewicz said. “We know there are some traces of some potentially dangerous chemicals in the vapor. We don’t know what will happen after 10-20 years of inhaling this vapor.”
Still, vaping is considerably less dangerous than regular cigarettes, since users and those around them are exposed to significantly less toxins.
“The clear conclusion is that these products are safer than tobacco cigarettes. When you compare them, we believe these products are safer than tobacco cigarettes, but there is no doubt for smokers that quitting is the best way,” he said.
The other growing issue is how to handle vaping indoors, including in public places, restaurants and the workplace. The Food & Drug Administration and individual states place limits on advertising and how and where tobacco cigarettes are sold, but there have not yet been any rulings on exactly whether e-cigarettes fall into the same category.
A number of companies have already taken steps to limit vaping in the workplace, while in other places, it’s the state or municipality making the rules: New York City Council in December voted to ban the use of e-cigarettes in all places where smoking is prohibited. The Niagara Frontier Transportation Authority is now considering a ban on its transit vehicles and within its properties.
Goniewicz said he believes vaping should be limited as well to protect non-users, but it’s a difficult question.
“The main reason we have the indoor smoke-free law is to protect non smokers from being exposed to tobacco smoke,” he said. “We should protect these people from being exposed to vapor. But some people also believe that since we know this product is safer for smokers and it has the potential to save the lives of smokers, how can we encourage smokers to use electronic cigarettes instead of smoking? Any regulation should balance between the potential benefits and harm from the products.”
http://www.bizjournals.com/buffalo/blog/health_matters/2014/02/safety-of-e-cigarette-vapors-questioned.html

Altria Acquires E-Cig Maker Green Smoke for $110M

RICHMOND, Va. February 3, 2014 (AP)

Marlboro maker Altria Group Inc. says it is buying electronic cigarette company Green Smoke Inc. for about $110 million.

The Richmond, Va.-based owner of Philip Morris USA said Monday that the transaction is expected to close in the second quarter.

Read more:  http://abcnews.go.com/Business/wireStory/altria-acquires-cig-maker-green-smoke-110m-22344353

Public hearing scheduled on proposed e-cigarette ban

By LeAnn Eckroth, Bismarck Tribune
BISMARCK, N.D. –A Feb. 11 public hearing is scheduled on a proposed Bismarck ordinance that bans selling e-cigarettes to minors.
The Bismarck City Commission set the hearing date Tuesday. Under the ordinance, those providing or selling e-cigarettes to people under age 18 could be fined up to $500. Minors found possessing or using the product could be fined up to $70.
The proposal also states that devices marketed and sold as e-cigars and e-pipes cannot be sold or provided to minors, and that minors cannot possess or use them. Commissioners did not comment about the ordinance at the meeting.
The Bismarck ordinance also would bar minors from having or using electronic oral devices with a heating element — battery or electric circuit — to inhale as if smoking cigarettes. They include devices that both contain nicotine or simulate cigarette use.
http://bismarcktribune.com/news/local/govt-and-politics/public-hearing-scheduled-on-proposed-e-cigarette-ban/article_c777742a-8882-11e3-b9e4-0019bb2963f4.html

Lawmakers look again at possible tobacco tax increase

By Shauna Johnson, Metro News
CHARLESTON, W.Va. — Tobacco users may be asked to pay more to fund health programs in the Mountain State.  A proposal to add to West Virginia’s tobacco tax is again being taken up at the State House.
Del. Don Perdue (D-Wayne, 19) has introduced a bill that would raise the state tax on a pack of cigarettes by $1, taking it to $1.55 total or equal to the national average.  On all other tobacco products, an excise tax equal to 50 percent of the wholesale price would be imposed.
Perdue said the state needs the estimated more than $90 million such a tax increase could generate every year.
“I think the interest is very high and getting higher,” he said of the potential for passage of the bill which has been proposed several times in recent years.  “Whether there’s enough there (for passage) this year, in 2014, that remains to be seen.”
As proposed, for ten years, the first $90 million generated from the increase would be designated for the Bureau for Medical Services with $6 million going into tobacco control annually and $1 million per year for five years going to the West Virginia University School of Public Health.
Any additional money beyond that would be allocated as follows: 30 percent for oral health improvement programming, 30 percent for substance abuse prevention and treatment programming, 24 percent for in-home elderly care services and 16 percent for early childhood development programming.
“We just saw it exacerbated by this water crisis,” said Perdue on Tuesday’s MetroNews “Talkline.”  “We need the money to do the things that have to be done for our population.”
The House Health and Human Resources Committee, which Perdue leads, was scheduled to take up HB 4191 during a Wednesday afternoon meeting at the State Capitol.
Perdue has also proposed a separate bill to raise the state tax on alcohol.
http://wvmetronews.com/2014/01/28/lawmakers-look-again-at-possible-tobacco-tax-increase/

Colorado lawmakers look to outlaw tobacco use for those under 21

By Lynn Bartels
The Denver Post
A bill that would raise the age for buying cigarettes and other tobacco products from 18 to 21 is intended to try to keep young kids from picking up the habit.
The bipartisan measure, from two Democrats in the House and two in the Senate, could be introduced as early as Tuesday.
Jodi L. Radke of the Campaign for Tobacco-Free Kids said most 18-year-olds are seniors in high school.
“They are able to go off campus during the lunch hour and buy tobacco products and oftentimes they are coming back to use them across the street or near campus and sharing them with their peers,” she said. “The push behind this is to delay the initiation with kids; 95 percent of tobacco users begin using tobacco before the age of 21.”
The bill will cover tobacco products, including cigarettes, electronic cigarettes and chewing tobacco. It does not increase penalties, only the age.
An underage person who buys a tobacco product commits a Class 2 petty offense and faces a $100 fine or community service. It also is a petty offense to sell to a minor, with fines varying depending on the number of offenses.
In addition to Colorado, legislatures in Utah and Maryland will take up the issue this year, Radke said. Already, New York City and Hawaii County in Hawaii have raised the age from 18 to 21.
The sponsors of the Colorado measure are Sens. Steve King, R-Grand Junction, and John Kefalas, D-Fort Collins, and Reps. Beth McCann, D-Denver, and Cheri Gerou, R-Evergreen.
“Drinking is 21. Marijuana is 21. Gambling is 21. We’re just making tobacco 21 also,” King said. “It’s a consistency across those laws.”
He added that studies show people who haven’t started smoking by age 18 generally don’t start.
Colorado lawmakers look to outlaw tobacco use for those under 21 – The Denver Post http://www.denverpost.com/politics/ci_25006278/colorado-lawmakers-look-outlaw-tobacco-use-those-under#ixzz2rp7x2OXR 

Bismarck mulls age limits on e-cigarette users

By LeAnn Eckroth, Bismarck Tribune
BISMARCK, N.D. —The Bismarck City Commission might crack down on the sale of e-cigarettes to minors under age 18. Minors found having or using the products also would be fined under the proposed ordinance.
Commissioners will review the first reading of the proposal today for a possible February hearing, City Attorney Charlie Whitman said.
Those selling or furnishing electronic cigarettes to minors could face up to a $500 fine under the proposed ordinance, Whitman said, and minors possessing or using the devices could pay up to a $70 fine.
E-cigarettes were banned in or near public places by the Legislature. State law also requires no vapors be emitted by e-cigarettes inside or 20 feet from public places.
The Bismarck ordinance would ban minors’ use of electronic oral devices with a heating element — battery or electric circuit — that provides nicotine or any other substance to be inhaled to simulate smoking.
The ordinance states devices marketed and sold as e-cigarettes, e-cigars and e-pipes cannot be sold or provided to minors, and that minors cannot possess or use them.
Pat McGeary, coordinator for the Bismarck Tobacco Free Coalition, said Monday that the group requested that Bismarck include the ordinance because the devices have not been proven safe. She said the electronic cigarettes are not controlled by the Federal Drug Administration. “There is no scientific evidence of the safety of e-cigarettes. The FDA has done preliminary testing that detected cancer-causing material in them and traces of nicotine,” she said.
“Our concern is that American tobacco companies have bought the e-cigarette companies and marketing it ‘kid friendly,'” she said. “They sell it in flavors like chocolate. We also are looking at e-cigarettes as a possible gateway drug.”
She said a Centers for Disease Control and Prevention survey showed that the use of e-cigarettes by minors has jumped from 4 percent in 2011 to 10 percent in 2012 nationwide.
“These are not FDA-regulated,” McGeary said. “These products have emerged more frequently in the last two years and (their companies) seem to be marketing more aggressively to the youth,” she said.
She said the FDA does not now control the levels of nicotine in the e-cigarette products. “(The levels) are all over the board, according to a preliminary study by the FDA,” she said. “The e-cigarettes have not been found to be safe. It’s not established.”
The Federal Drug Administration found that cartridges labeled as containing no nicotine contained nicotine and that three different electronic cigarette cartridges with the same label emitted a markedly different amount of nicotine, according to the North Dakota Center for Tobacco Prevention and Control Policy.
“I think it’s a natural and reasonable restriction,” Bismarck City Commissioner Josh Askvig said. “If the city won’t allow the sale of tobacco products and nicotine to minors, the same argument stands for this product.
“My personal opinion is this is a loophole into (minors) smoking that we can control before they get hooked on it before they are of legal age,” he added.
“I’m OK with the ordinance,” Bismarck Commissioner Mike Seminary said. “I don’t think we should encourage minors to smoke anything.”
The Tribune contacted some stores Monday that sell e-cigarettes and they assured that they already set limits on who buys the product.
“We only sell to those over 18,” said Chris Pribyl, manager of Tobacco Row.
“Minors cannot come through our doors. We card everyone who looks under age 27,” said Suzanne Willis, manager of Discount Smoke. “It says right on the package: ‘Not for sale for minors.'”
Sara Lang, manager of Red Carpet Car Wash, said employees card buyers of the product to ensure they are eligible. “We treat it like we were selling tobacco,” she said.
The proposed e-cigarette ordinance mirrors two passed by the Fargo City Commission on Jan. 6. The ordinances both prohibit the sale of e-cigarettes to minors and the use and possession by minors. Minors who violate the Fargo law will pay a $25 fine and complete a tobacco education program.
Under the Fargo law, a clerk who sells e-cigarettes to a person under age 18 will pay a $50 fine. A business that sells e-cigarettes to a minor will get a warning for the first sale in 12 months, have its tobacco license suspended for the second violation in a year and have its tobacco license suspended for 10 days for the third illegal sale within 12 months.
Whitman said Bismarck’s ordinance wording does not mention suspension of tobacco licenses because it would not affect stores that do not sell tobacco, but sell e-cigarettes.
http://bismarcktribune.com/news/local/govt-and-politics/bismarck-mulls-age-limits-on-e-cigarette-users/article_201fa2e8-87aa-11e3-9659-001a4bcf887a.html

E-Cigarette Makers Give Public the Finger

Rob Waters, Contributor, Forbes
With Sarah Mittermaier and Lily Swartz
In 1964, smoking was everywhere: on television, on airplanes, in workplaces and movie theatres, college campuses, doctors’ offices, restaurants and bars. In the 50 years since the first Surgeon General’s report on smoking and health was released, smoking has gradually faded to the margins of public life. TheMarlboro man was bounced from the airwaves, comprehensive smoking bans were passed in hundreds of cities and 28 states, and smoking rates were cut almost in half. The struggle to protect the public’s health is far from over—and shocking disparities in tobacco use and exposure to tobacco marketing remain—but we’re now reaping some rewards, with eight million lives saved over the past half-century.
But now a new threat is emerging. The use of e-cigarettes is rising rapidly, with teenagers a key target of marketing efforts. “Vaping” is making smoking acceptable—even cool—once again as the tobacco industry returns to its old ways, putting e-cigarette commercials back on the airwaves for the first time since the 1970s.

Right now, e-cigarettes exist in what tobacco control researcher Stanton Glanz calls a regulatory “Wild West,” with no federal regulation of the manufacturing, marketing and sales of these products. This regulatory vacuum threatens to undo the hard-won victories of the past 50 years in tobacco control.
E-cigarette companies are taking a page right out of Big Tobacco’s old-school playbook: marketing their products with sex appeal, celebrity endorsements, even cartoons. The companies argue that “vaping” is safer than traditional smoking and that may or may not be true—there are far too few studies to back up that claim or refute it. But it’s also a smokescreen.
The tobacco industry is out to hook kids, and it’s working. E-cigarettes come in an array of kid-friendly flavors, from“Cherry Crush” to “Coca Cola.” And unlike conventional cigarettes, e-cigarettes can legally be sold to kids in most US states. Data released last year by the Centers for Disease Control and Prevention showed that e-cigarette use more than doubled among middle and high school students in the previous year. For 20 percent of the middle schoolers, e-cigarettes were their first experience with smoking, raising concerns that e-cigarettes may act as a gateway to the use of other tobacco products.
E-cigarettes also threaten to reintroduce smoking to workplaces, restaurants, bars and other public spaces where hard-fought public health campaigns have succeeded in banning cigarettes. These policies have changed our communities from the ground up, creating new expectations and norms around smoking. The science is still out on whether e-cigarettes threaten non-smokers with toxic exposure, but their use in public legitimizes their use, making them seem acceptable, even Golden Globes-glamorous. We can’t let e-cigarettes undo the hard work tobacco control advocates have achieved over the past 50 years.
Some cities and states are pushing back against e-cigarettes, taking steps to regulate the sale and public use of e-cigarettes. Over the past few months, New York and Chicago city councils voted to regulate e-cigarettes as tobacco products, extending existing smoking bans to cover vaping. The Los Angeles City Council voted unanimously to regulate the sales of e-cigarettes. Boston has banned e-cigarette smoking in workplaces. States such as Utah, New Jersey, and North Dakota ban the use of e-cigarettes in indoor public spaces.
These local and state efforts should be followed—and strengthened—by federal action. Attorneys general from 40 states have called on the Food and Drug Administration to regulate e-cigarettes as tobacco products, a move that would give the FDA the power to impose age restrictions and limit marketing of e-cigarettes. Proposed rules drafted by the agency have not yet been released publicly.
We can’t wait years for scientists to conduct new studies on the health risks of vaping before we take action. We know better than to trust the tobacco industry’s health claims about their products—or to trust the industry with our children’s future. The time for action is now. To paraphrase one anti-cigarette commercial in California: “Some people will say anything to sell (e-) cigarettes.”
http://www.forbes.com/sites/robwaters/2014/01/27/e-cigarette-makers-give-public-the-finger/

Nicotine Levels In US Cigarettes Went Up 15% Between 1999 And 2011

By: , Business Insider
Nicotine levels in cigarettes went up 15% between 1999 and 2011, according to a study published this week in the journal Nicotine and Tobacco Research.
The data were collected from the annual report filed with Massachusetts Department of Public Health by four major manufacturers of cigarettes from 1997 to 2012.
“Young people could have an easier time becoming addicted to cigarettes the first few times they do smoke,” lead author Thomas Land, director of the Office of Health Information Policy and Informatics at the State Health Department, told Deborah Kotz of The Boston Globe.
From The Globe:
Each day, 3800 American teens try their first cigarette and 1000 become hooked, according to a 2012 Surgeon General’s report. Those who are unable to quit as adults will die, on average, 13 years earlier than their peers.
This is not the first study to find rising nicotine levels in cigarettes. In 2007, a Harvard study found nicotine levels had gone up by nearly 11% between 1997 and 2005, the Globe noted. Industry executives disputed the findings and attributed the increase to agricultural and rainfall variations that led to more concentrated levels of nicotine in tobacco crops.
But Land told The Globe that if that were the case, “we would have seen a similar trend of increased nicotine yield for all cigarette makers since they tend to buy their tobacco from the same regions. We did not.”
The study concludes that nicotine levels “are controllable features of cigarettes, and should be monitored and regulated by government agencies.”
While federal law lets the FDA set new regulations to lower nicotine content, according to Kotz, he noted that the agency has not set new limits on the amount of nicotine allowed in each cigarette.
http://www.businessinsider.com/nicotine-levels-up-15-since-1990-2014-1#ixzz2qh357qlT

Surgeon General Sets Tobacco End-Game as Smoking Persists

By Anna Edney, Bloomberg News
A half century after linking smoking to lung cancer, the U.S. is confronting stalled progress in kicking the habit of 42 million Americans with new evidence that many common ailments such as diabetes, arthritis and impotence can be tied to tobacco use.
Acting Surgeon General Boris Lushniak in a report today criticized the “fraudulent campaigns” by cigarette companies, weaknesses in regulation and a rebound in smoking depicted in Hollywood films. He said he’s considering greater restrictions on sales to achieve “a society free of tobacco-related death and disease.”
While a landmark 1964 report on smoking and lung cancer helped cut cigarette use by more than half to 18 percent of U.S. adults, the decline has slowed. Smoking remains the leading preventable cause of death, killing 480,000 people each year, and the U.S. may miss a 2020 goal of limiting to 12 percent the share of smoking adults, today’s report shows.
“Enough is enough,” Lushniak said repeatedly at a press conference in Washington where he presented the more than 900-page report. “It’s astonishing that so many years later we’re still making these findings.”
The report shows the U.S. must be more aggressive in promoting tobacco control than regulators have been, he said.
“What we really need to do is say ‘Now is the time,’” Len Lichtenfeld, deputy chief medical officer at the Atlanta-based American Cancer Society, said in a telephone interview.

Further Stalling

Maintaining the status quo on tobacco control will lead to further stalling in the declining rate of smoking, said Lushniak, whose job serves as the nation’s main public-health advocate. He placed part of the blame on tobacco companies.
“The tobacco epidemic was initiated and has been sustained by the aggressive strategies of the tobacco industry, which has deliberately misled the public on the risk of smoking cigarettes,” he said in the report.
Earlier this week, Altria Group Inc. (MO:US), Reynolds American Inc. (RAI:US)and other tobacco companies agreed with the U.S. on how they will publicize admissions that they deceived the American public on the dangers of smoking. Altria is the largest tobacco company in the U.S. and its Philip Morris unit makes the popular Marlboro brand of smokes.

Overwhelming Evidence

“Philip Morris USA agrees with the overwhelming medical and scientific consensus that cigarette smoking causes lung cancer, heart disease, emphysema and other serious diseases in smokers,” David Sutton, a spokesman for parent company Altria Group Inc., said in an e-mail.“ Smokers are far more likely to develop serious diseases, like lung cancer, than non-smokers. There is no safe cigarette.”
The report lists smoking as a cause of liver cancer and colorectal cancer, which is responsible for the second-largest number of cancer deaths each year. Cigarette use may cause breast cancer and women smokers’ chances of dying from lung cancer have caught up to men, the surgeon general said. Even secondhand smoke can now be linked to a higher risk of stroke, Lushniak said.
The first surgeon general report on tobacco’s ill effects was made in January 1964, when at least half of all men in the U.S. and almost 40 percent of women smoked. Congress later adopted an act that required warning labels about the health consequences of smoking and in 1970 it prohibited cigarette advertising on television and radio.

Extend Lifespans

Measures, such as city and state bans on smoking in workplaces, restaurants and bars, also have helped to prevent 8 million early deaths and extended lifespans by two decades. About 5.3 million men and 2.7 million women live longer thanks to tobacco control, according to one of six studies on the topic published last week in the Journal of the American Medical Association.
Advertising and promotional activities entice younger smokers and nicotine addiction keeps people smoking as they grow older. Portrayals of tobacco use in U.S. films rebounded in the past two years and the use of multiple tobacco products may increase initiation rates among teens and young adults, according to the report.
While the share of teens and young adults who smoke is down, the number of them who start to smoke has increased since 2002. In addition, the prevalence of U.S. students in middle and high school who used electronic cigarettes doubled in 2012, the Centers for Disease Control and Prevention said in a September report.
“There are a substantial number of diseases, not just cancer, but certain cardiovascular disease, stroke, respiratory disease, whether it’s chronic lung disease or asthma, the list goes on and on about how tobacco impacts this country,” Lichtenfeld said.

Erectile Dysfunction

Smokers also have as much as a 40 percent higher risk of developing Type 2 diabetes and the habit is attributable to erectile dysfunction and deadly ectopic pregnancies where the embryo implants in the Fallopian tube or elsewhere outside the uterus, according to the report. People exposed to second-hand smoke are as much as 30 percent more likely to have a stroke.
Women smokers were 2.7 times more likely to develop lung cancer in 1959, a number that jumped to 25.7 percent by 2010. Male smokers were 12.2 times more likely to get lung cancer in 1959 and now smokers of both genders carry almost an equal chance of being diagnosed with the disease.
In the last 50 years almost 25 trillion cigarettes have been consumed in the U.S. costing at least $130 billion a year for direct medical care and $150 billion annually in lost productivity from premature death, according to the surgeon general.

Kicking the Habit

The surgeon general recommended helping people kick the habit with more national media campaigns like the federally funded graphic advertisements that featured former smokers with missing limbs and holes in their throats. He also advocated consideration of additional cigarette taxes and legislation to extend smoke-free indoor protections.
Banning smoking “is a bigger societal issue,” Lushniak said at the press conference. “We need to have that discussion.”
The tobacco companies and the Justice Department resolved this week that “corrective statements” will appear in the print and online editions of newspapers and on television as well as on the companies’ websites. Expanded information on the adverse health effects of smoking will appear on cigarette packages, according to the agreement filed Jan. 10 in federal court in Washington.

Altria Support

“Moving forward, we believe FDA regulation, particularly as it applies to product innovation, has the potential to substantially reduce the harm caused by smoking,” Altria’s Sutton said. “We support extending its regulatory authority over all tobacco products, including those containing tobacco-derived nicotine such as e-cigarettes.”
The FDA regulates cigarettes and is poised to extend its oversight to their electronic counterparts.
While smoking substitutes such as e-cigarettes may help reduce tobacco use, more needs to be known about their health effects and how much they may help, the report said.
“However, the promotion of electronic cigarettes and other innovative tobacco products is much more likely to be beneficial in an environment where the appeal, accessibility, promotion, and use of cigarettes are being rapidly reduced,” Lushniak said.
http://www.businessweek.com/news/2014-01-17/surgeon-general-sets-tobacco-end-game-as-smoking-decline-stalls

Jury is out on health effects of e-cigarettes

By Monte Morin, Los Angeles Times
Electronic cigarettes are either a potent weapon in the war against tobacco, or they are an insidious menace that threatens to get kids hooked on nicotine and make smoking socially acceptable again.

There are health experts who back each point of view. But they do agree that the empirical evidence that will tell them who is right will not be in for several years.
“There are a few studies out there right now, but scientists like to have a gazillion,” said Stanton Glantz, a professor of medicine and director of the Center for Tobacco Control at UC San Francisco.
Among the most pressing questions for researchers: What are the long-term health effects of e-cigarettes on users and people around them? Do e-cigarettes help people kick the smoking habit, or do they actually make it harder? If kids start smoking e-cigarettes, are they likely to graduate to regular cigarettes?
“My big question with e-cigarettes is whether it puts youth on a pathway to smoking,” said acting Surgeon General Boris Lushniak, who will join other U.S. health officials Friday at the White House to commemorate the 50th anniversary of the surgeon general’s first report on the hazards of smoking.
When that landmark report was released in 1964, the proportion of U.S. adults who smoked was at an all-time high of 43%. By 2012, that figure had dropped to 18%. But without a renewed focus on the campaign against tobacco, the U.S. will miss its goal of reducing the national smoking rate to 12% by the end of the decade.
E-cigarettes are uniquely positioned to undo recent public health gains, Lushniak and others fear.
The battery-operated devices heat nicotine, propylene glycol and glycerin into a vapor, which is inhaled by the user. Unlike conventional tobacco-burning cigarettes, e-cigarettes do not deliver poisonous tars or carbon monoxide.
Currently, the devices are regulated only by a smattering of local governments who have passed laws concerning their sale and use. The Food and Drug Administration has the legal authority to regulate e-cigarettes as a tobacco product, but has not yet done so. In the meantime, e-cigarettes have grown to become a $2-billion industry with no federal oversight.
Though the FDA says propylene glycol and glycerin food additives are “generally regarded as safe,” the long-term effects of inhaling the substances are unknown. The FDA’s Center for Tobacco Products has begun collecting reports of adverse effects from e-cigarettes, and those complaints include claims of eye irritation, headaches and coughing.
E-cigarette backers say the health effects of the key component — nicotine — are well established and minimal for most everyone except pregnant mothers. They note that nicotine gum and patches have been used as smoking cessation tools for many years.
“It’s not the nicotine that’s the real enemy; it’s the way it’s burned and delivered in cigarettes,” said psychologist David Abrams, executive director of the American Legacy Foundation’s Schroeder Institute for Tobacco Research and Policy Studies in Washington. “In reasonable doses, and assuming good quality control, nicotine might raise your heart rate two or three beats per minute, but it really has few adverse effects.”
Yet that might not be true for teens. A surgeon general’s report released Friday says evidence now suggests that nicotine exposure during adolescence “may have lasting adverse consequences for brain development.”
And then there are the potential health effects on bystanders, who are also exposed to nicotine and propylene glycol emitted by the e-cigarette and its user.
Studies performed on e-cigarette vapor have detected heavy metals and volatile compounds such as formaldehyde, but the concentration and threat they pose has been hotly debated.
In a review of studies that examined e-cigarette mist, Drexel University environmental and occupational health expert Igor Burstyn concluded that “while these compounds are present, they have been detected at problematic levels only in a few studies that apparently were based on unrealistic levels of heating.”
Abrams took heart in that assessment, though he acknowledged that the vapor was not benign. Even so, the bystander effects are “almost immeasurable compared to the toxins in secondhand cigarette smoke,” he said.
That assessment may change when several studies examining fine particulate matter from e-cigarette vapor and their effects on the cardiovascular system are completed, Glantz said.
The burning question for most experts is whether e-cigarettes actually help people to quit smoking.
Researchers have conducted surveys that give them a “snapshot” of smoker behavior at a particular moment, but not over an extended period. Some results suggest e-cigarette users are continuing to smoke conventional cigarettes and relying on the electronic substitutes to satisfy nicotine cravings in the workplace, restaurants and other places where cigarettes are forbidden.
Another study published in the journal Lancet compared the effectiveness of e-cigarettes to nicotine patches and gum. Researchers said they expected e-cigarettes to be the clear winner, but it was a tie.
Now experts are looking toward long-term behavioral studies that will reveal how smokers actually use e-cigarettes. One such analysis by the FDA is set to begin field work this year, and will track about 60,000 smokers and nonsmokers for two years.
“It should tell us if people are using them for cessation, or as a gateway to traditional tobacco use,” said Brian King, an epidemiologist at the Centers for Disease Control and Prevention.

http://www.latimes.com/science/la-sci-e-cigarettes-science-20140117,0,7562029.story#ixzz2qh59hXu7