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E-cigarettes: a burning question for U.S. regulators

Marina Lopes, Reuters
NEW YORK (Reuters) – At the Henley Vaporium, one of a growing number of e-cigarette lounges sprouting up in New York and other U.S. cities, patrons can indulge in their choice of more than 90 flavors of nicotine-infused vapor, ranging from bacon to bubble gum.
The lounge, located in Manhattan’s trendy Lower East Side, features plush seating, blaring rock music, and fresh juice and coffee. A sprawling sign on one wall lists all the carcinogens that e-cigarette users avoid by kicking their smoking habits and using the e-devices instead.
But the growing popularity of e-cigarettes has not escaped the notice of the industry’s critics, who have stepped up calls for new regulations, including bans on their use in public places, even though the scientific evidence about exposure to their vapors remains inconclusive.
Selling for about $30 to $50 each, e-cigarettes are slim, reusable, metal tubes containing nicotine-laced liquids that come in exotic flavors. When users puff on the device, the nicotine is heated and releases a vapor that, unlike cigarette smoke, contains no tar, which causes cancer and other diseases.
The product, introduced in China in 2006, has become a worldwide trend at least in part because it may help smokers of regular cigarettes break the habit.
“It’s an addiction – not everyone can quit cold turkey,” said Nick Edwards, 34, a Henley employee who says he kicked a 15-year cigarette habit the day he tried his first e-cigarette. “E-cigarettes give you a harm-reduction option.”
That’s one reason why the market for e-cigarettes is expected to surge, reaching $2 billion by the end of 2013 and $10 billion by 2017, according to Bonnie Herzog, an analyst at Wells Fargo Bank in New York.
Herzog said the U.S. market alone could top $1 billion this year. She predicts that by 2017 e-cigarettes sales will overtake sales of regular cigarettes. That estimate does not take into account the impact of potential government regulations on sales.
E-cigarettes may help smokers save money too. Edwards, for one, says he cut his $60 monthly cigarette bill in half when he switched. On top of the cost of the device, the smoking liquids cost around $10 per refill.
Despite the perceived benefits, critics worry that the addictive nicotine found in e-cigarettes could lure more people into smoking and discourage others from quitting all together.
“Essentially e-cigarette companies are selling nicotine addiction,” said Dr. Neil Schluger, chief scientific officer for the World Lung Foundation, which advocates for tobacco control.
“Once you have them addicted to nicotine, you can sell them all sorts of things, including conventional cigarettes,” he said. “This is a giant Trojan horse.”
In the United States, such concerns have led to calls for increased government regulation.
The U.S. Food and Drug Administration currently has no regulations on e-cigarettes, but it is expected to release rules this month that would extend its “tobacco product” authority over the devices. New FDA rules could follow.
“Further research is needed to assess the potential public health benefits and risks of electronic cigarettes and other novel tobacco products,” said Jenny Haliski, an FDA spokeswoman.
To be sure, no one is expecting the federal government to go as far as Brazil, Norway and Singapore, where the devices are banned outright.
In the United States, Utah, North Dakota, Arkansas and New Jersey have already passed legislation outlawing e-cigarettes wherever smoking is prohibited.
Other jurisdictions are considering new rules of their own. New York City could decide as early as next week whether to prohibit e-cigarette use in public places.
Under Mayor Michael Bloomberg, who leaves office January 1, New York was one of the first cities to ban cigarette smoking in public places, and its decision could influence Chicago and other cities that are considering a similar controls.
The outcome is crucial for tobacco companies, which are banking on the devices to make up for a sharp decline in sales of regular cigarettes in the United States. Smoking among U.S. adults dropped to 18 percent in 2012 from 24.7 percent in 1997, according to the Centers for Disease Control and Prevention.
Reynolds American Inc, which makes Camel cigarettes, began selling its Vuse vapor cigarettes in Colorado retail stores in July and plans on expanding nationwide by mid-2014.
Other companies have also dipped into the e-cigarette business, too. Last year Lorillard Inc, maker of Newport cigarettes, acquired the best-selling blu eCigs brand, while Altria Group Inc, best known for the Marlboro brand, followed suit in August with the launch of MarkTen e-cigarettes.
“As society is transforming, so must the tobacco industry,” said Reynolds spokesman Richard Smith. “It’s just good business sense.”
The arrival of Big Tobacco could mean fierce competition for small e-cigarette companies that do not have the resources or experience to deal with tight government regulation.
But many e-cigarette companies say Big Tobacco is late to the game and has a lot to catch up on. “They are going to need to boost up their game if they want to compete,” said Christina Lopez, a saleswoman at Smokeless Image, an e-cigarette shop that sells smaller brands in Hoboken, New Jersey.
HEALTH RISKS UNCERTAIN
To be sure, there is still a dearth of scientific evidence about the safety of e-cigarettes and their effectiveness in helping smokers quit. For regulators, the big question is, are e-cigarettes a treatment for would-be quitters or “gateway” products to nicotine addiction?
Supporters say some e-cigarettes allow users to slowly reduce their nicotine intake and wean themselves off nicotine completely. A study published in the September issue in Lancet, the British medical journal, said the e-cigarettes are as effective as nicotine patches for smokers trying to quit.
Worldwide, conventional cigarette addictions kill 6 million people a year, in part because of the 250 harmful chemicals found in tobacco smoke, which can cause cancer, heart disease and stroke, says the Centers for Disease Control and Prevention.
But e-cigarettes may not be harmless, either. Nicotine addictions, fed by smoking, chewing tobacco or e-cigarettes, can cause high blood pressure, disrupt heart rhythms and lead to obesity and diabetes.
Electronic devices that feature fruit and candy flavors are even more worrying, critics say, because they could introduce children to smoking.
E-cigarette vendors say the sweet flavors make the process of quitting smoking less painful.
“By taking a sort of ‘Willy Wonka,’ fun approach to a serious matter, it breaks down people’s perceptions of e-cigarettes,” said Talia Eisenberg, owner of the Henley Vaporium, referring to the fictional candy maker.
The Centers for Disease Control and Prevention said 10 percent of high school students surveyed reported using e-cigarettes in 2012, up from 4.7 percent in 2011.
About 60 percent of current users are over 35 years old, and 43 percent are college-educated, according to Reynolds American.
Twelve states, including New York, have passed laws preventing e-cigarette sales to minors.
At a hearing on the proposed New York City ban on e-cigarette use in public places, Health Commissioner Thomas Farley said allowing it could glamorize all types of smoking and encourage teenagers and children to take up the cigarette habit.
“While more research is needed on electronic cigarettes, waiting to act could jeopardize the progress we have made over the last few years,” he said.
(Reporting By Marina Lopes; Editing by Jilian Mincer and Tim Dobbyn)
http://www.chicagotribune.com/news/sns-rt-us-usa-ecigarettes-20131211,0,720952.story?page=2

E-cigs: Just how safe are they?

Article by: JEREMY OLSON , Star Tribune
One of the great unanswered questions for smokers who are trying to quit — and for the advocacy groups trying to help them — is whether electronic cigarettes are friends or foes.
University of Minnesota researchers aim to address that dilemma with a study examining exactly what smokers inhale when they breathe e-cigarette vapors and how “vaping” affects the body. Researchers will collect blood, urine and saliva samples from at least 25 smokers who use only e-cigarettes and at least 25 who use them with traditional cigarettes.
“The first step is to say, ‘Well, how toxic are these products? What is actually in them?’ ” said Dorothy Hatsukami, associate director for cancer prevention and control in the U’s Masonic Cancer Center.
E-cigarettes, rechargeable devices that heat liquid nicotine or other flavored substances into a vapor that the user inhales, have been marketed as a safer alternative to tobacco. Yet a lack of regulation on their manufacture and contents makes it hard to know if they’re safer than traditional cigarettes and whether they can be used to safely help wean people off tobacco, Hatsukami said.
“It’s like a Wild West out there,” she said.
Some e-cigarettes that are promoted as nicotine-free, for example, have been found to contain the addictive substance, while others contain little or no nicotine despite claims to the contrary.
Some previous studies have chemically analyzed the contents of e-cigarettes. The Minnesota study aims to go a step further by examining how the contents of different kinds of e-cigarettes affect the body.
The market for e-cigarettes has grown rapidly — sales have doubled annually since 2008 and are expected to reach $1.6 billion this year. About 6 percent of adults have tried them, and the share of high school students who have tried them hit 10 percent last year, according to the U.S. Centers for Disease Control and Prevention.
Heidi Scholtz, 20, a German and theater student at Hamline University, tried her first one two years ago because she was tired of going outside in the snow and cold to smoke. Before long, she said, she was using only e-cigarettes and was surprised at what happened when the weather warmed up and she tried a cigarette.
“It tasted disgusting,” she said.
Now Scholtz uses only e-cigarettes, and has kicked a cigarette habit that started when she was 15. A close friend tried them at her urging, but now uses both.
Help smokers quit?
Studies nationally have produced mixed results about whether e-cigarettes help people quit or reduce smoking — or simply supplement real tobacco. Clearway Minnesota, a nonprofit quit-smoking group, has taken a noncommittal stance on them.
Spokesman Mike Sheldon said it’s great if they help some people quit. But, he added, the lack of science about their contents makes it hard to endorse them over proven stop-smoking strategies of counseling combined with such well-studied supplements as nicotine patches or gum.
The recent increase in youth use of e-cigarettes also is troubling, Sheldon said. “We just don’t know enough about these,” he said.
The Minnesota Clean Indoor Air Act does not apply to e-cigarettes, which can be smoked indoors unless banned by local laws or individual establishments. The city of Duluth banned them from public indoor locations because so little is known about their effect on people who inhale the vapors secondarily.
Clearway would support extending the state ban to e-cigarettes, Sheldon said. However, a group of former cigarette smokers have formed the Minnesota Vapers Advocacy Group to fight the idea.
The group’s president, Matt Black, said his first e-cigarette meant his last real cigarette. A device that physically mimicked his smoking mannerisms was key to to quitting.
“For 17 years, I was constantly hand to mouth (with a cigarette),” Black said. “I was blowing out smoke. I was breathing differently. All of those things play a role in that addiction. We found a way to maintain those habits in a way that’s not going to kill us.”
Black said he hopes the U study will ultimately find e-cigarettes safe, so more people would use them to quit real cigarettes.
Hatsukami said a key aspect of the study is looking at the different types of e-cigarettes to see if some are more harmful than others. (To enroll, call 612-624-4568.)
“Although the majority of the products don’t contain toxicants that are cancer-causing, there are a few that do,” she said. “There is a lot of variability out there.”
http://www.startribune.com/lifestyle/health/235430591.html?page=2&c=y

E-cigarettes cause alarming increase in calls to poison control center

Kentucky Regional Poison Control Center sees 333-percent increase

LOUISVILLE, Ky. — As the debate about electronic cigarette regulation continues with the U.S. Food and Drug Administration (FDA) and device manufacturers, data from one state poses concerns that should be part of the conversation.
E-cigarettes consist of a rechargeable lithium battery, a liquid cartridge and an LED light at one end that simulates the burning effect of a regular cigarette. When the user inhales, or “vapes,” a heating element converts the liquid in the cartridge into a vapor. Cartridges typically contain nicotine, propylene glycol or glycerol, flavoring and other additives.
E-cigarettes consist of a rechargeable lithium battery, a liquid cartridge and an LED light at one end that simulates the burning effect of a regular cigarette. When the user inhales, or “vapes,” a heating element converts the liquid in the cartridge into a vapor. Cartridges typically contain nicotine, propylene glycol or glycerol, flavoring and other additives.
The Kentucky Regional Poison Control Center of Kosair Children’s Hospital has received 39 calls about e-cigarettes so far this year, a 333-percent increase from nine calls received in 2012. Nationally, poison control centers have seen a 161 percent increase in calls from people with concerns about these devices. With sales of e-cigarettes doubling to $1.5 billion in the past year, the calls are likely to increase.
E-cigarettes consist of a rechargeable lithium battery, a liquid cartridge and an LED light at one end that simulates the burning effect of a regular cigarette. When the user inhales, or “vapes,” a heating element converts the liquid in the cartridge into a vapor. Cartridges typically contain nicotine, propylene glycol or glycerol, flavoring and other additives.
“More than half of the calls we have received were concerning children,” said Ashley Webb, Pharm.D., board-certified toxicologist and director of the Kentucky Regional Poison Control Center of Kosair Children’s Hospital.
“Kids are picking up the liquid cartridge when cartridges are left accessible or when an adult is changing the cartridge,” she said. “They’re also getting a hold of the e-cigarette and taking it apart to expose the liquid. They then either ingest the liquid or get it onto their skin. Even on the skin, the nicotine is absorbed and can create adverse side effects.”
These exposures raise a concern because of the concentrated nature of the cartridge fluid.
“The amount of nicotine in the cartridges is not regulated, but many contain more than 14 milligrams of nicotine,” said Dr. George Rodgers, associate medical director, Kentucky Regional Poison Control Center and professor and division chief of pediatric pharmacology and toxicology at the University of Louisville School of Medicine. “Severe cases of toxicity requiring hospitalization have been reported with children consuming 1.4 milligrams per kilogram of weight — equivalent to an average 2-year-old consuming the amount found in a cartridge,” he said. “And since children are not used to consuming nicotine, their symptoms may be more severe at lower levels.”
“Accidental exposure by children to e-cigarettes is a public health concern that we need to take seriously,” said Dr. LaQuandra Nesbitt, director of the Louisville Metro Department of Public Health and Wellness in Louisville, Ky. “Parents need to be aware of the potential dangers to their children.”
Symptoms of severe nicotine exposure include a pale appearance, flushing, sweating, headache, dizziness, hyperactivity or restlessness, vomiting, diarrhea, rapid heart rate, increased blood pressure, salivation and teary eyes. In very severe cases, the heart rate and blood pressure begin to drop to dangerously low levels and the patient can lapse into a coma, followed by difficulty breathing and even death.
When on the skin, nicotine in liquid form is easily absorbed. Even small amounts can cause irritation and a burning sensation.
“Only a few of the calls we have received have been from children inhaling nicotine from the e-cigarette,” Webb said. “And so far only two of the calls involved symptoms severe enough to require emergency care. But it’s only a matter of time before a child experiences a severe reaction.”
“Parents need to consider these devices as a potential harm to children and, like other poisons, keep them out of reach,” said Dr. Stephen P. Wright, pediatrician and medical director of Kosair Children’s Hospital. “Since e-cigarettes are also unregulated, we don’t know what other toxins may be in them.”
An analysis done by the FDA in 2009 showed that e-cigarettes contain carcinogens and other hazardous chemicals, including diethylene glycol, an ingredient used in antifreeze. Researchers from the University of Athens in Greece found that e-cigarettes, thought by some to be a safer alternative to tobacco smoking, do have a harmful effect on the lungs, as reported in Medical News Today.
“Since the industry is still so new, we don’t yet know all of the long-term health effects of e-cigarettes to the user, in addition to any effects of secondhand vapor,” said Wright, who is also a professor of pediatrics at the University of Louisville School of Medicine. “While they are touted as a healthier alternative to cigarettes, the jury is still out. We do know that not smoking anything — especially around children — is always the best bet.”
About the Kentucky Regional Poison Control Center of Kosair Children’s Hospital
The primary mission of the Kentucky Regional Poison Control Center is to reduce illness and death from poisoning in Kentucky. The center provides 24/7 free and confidential access to specially trained nurses, physicians and pharmacists who are certified in toxicology. They are specialists in communicating advice to health care professionals, first responders, patients, parents, family members, the general public and the media. Some of the more common calls received involve medications, household cleaning products, plants and personal care items.
Calls also are answered about work-related exposures in farming and industry, food poisoning, insect and snakebites and a variety of other potential hazards. On average, the poison control center’s hotline at (800) 222-1222 receives a call every 7 minutes, 24 hours a day, 365 days a year — more than 72,000 calls annually — from all of Kentucky’s 120 counties. Three of every four patients from those calls are successfully managed safely and inexpensively at home, reducing unnecessary emergency room visits and/or shortening hospital stays. For additional information, visit KosairChildrensHospital.com/PoisonControl.
http://www.lanereport.com/27431/2013/12/e-cigarettes-cause-increase-in-calls-to-poison-control-center/?fb_action_ids=10151744182160059&fb_action_types=og.likes&fb_source=other_multiline&action_object_map=%5B267785540038122%5D&action_type_map=%5B%22og.likes%22%5D&action_ref_map=%5B%5D

E-cigarettes: Should They Be Regulated as Cigarettes?

., Commissioner, Chicago Department of Public Health

Should e-cigarettes be regulated as cigarettes?
I think so.
E-cigarettes are designed to look like cigarettes. They are labeled and marketed like cigarettes. They contain nicotine like cigarettes. They should be regulated like cigarettes.
The single most important reason a regulation on e-cigarettes is vital at this time is to protect kids from a product that we know is addictive. Electronic cigarettes now come in dozens of flavors like passion fruit, cotton candy, bubble gum, gummy bear, Atomic Fireball, and orange cream soda. These kid-friendly flavors are an enticing “starter” for youth and non-smokers, increasing nicotine addiction and frequently lead to use of combustible cigarettes.
Like other gateway products Big Tobacco has masked to entice its next generation of smokers, e-cigarettes follow suit as its popularity with youth nationwide more than doubledfrom 2011 to 2012. Ten percent of our students have already used these addictive products — and they have only been on the market for a few years. This meteoric rise in popularity among youth is concerning. It is also the main reason Mayor Rahm Emanuel has introduced a new ordinance to regulate e-cigarettes as tobacco products.
Simply put, kids should not have easy access to e-cigarettes any longer. Right now in Chicago, a 14-year-old can walk into a store and purchase an e-cigarette with no question asked. This is unacceptable. Retailers should be required to have a tobacco-retail license in order to sell e-cigarettes, which would place these products behind the counter with the other tobacco products and out of arms reach of our children. The government has a duty to protect children from ever picking up a nicotine habit. The preventive action Mayor Emanuel is taking right now is a long-term investment in the health and well-being of Chicago’s youth.
Some might argue that e-cigarettes should not be regulated because they are safer than regular cigarettes. While it’s true that they may be safer than regular cigarettes, they have not been proven to be safe. The truth is e-cigarette companies have not provided any scientific studies or toxicity analysis to the FDA to show that e-cigarettes pose any reduced health risk over conventional cigarettes, nor have they demonstrated that e-cigarettes are safe. Laboratory tests have found that the so-called “water vapor” from some e-cigarettes can contain nicotine and volatile organic compounds like benzene and toluene; heavy metals like nickel and arsenic; carbon compounds like formaldehyde and acrolein, in addition to tobacco specific nitrosamines.
Moreover, no federal regulations have been imposed on e-cigarettes, which means that there currently are no restrictions on ingredients manufacturers can or cannot use and no restrictions on the kinds of chemicals they can emit into the indoor environment. Until more is known about these products, limiting their use in indoor areas is just good common sense.
I am also concerned that widespread use of e-cigarettes is re-normalizing smoking in our society, which in turn, makes this a very pertinent public health issue. E-cigarettes intentionally were developed to mimic the act of smoking. This distorted reinforcement of smoking as cool and acceptable sends the wrong message to our youth and undermines the existing smoking bans put in place to protect the health of the public.
In Chicago, smoking rates are lower than ever. This progress is a direct result of life-saving policies like the Chicago Clean Indoor Air Act. Health advocates worked tirelessly to ensure we all have the right to breathe clean in-door air. We’re not turning our backs on their hard work to promote clean air.
Our residents expect a healthy environment when they walk into a restaurant, bar or theater. We can’t allow any regression in our progress to change the landscape of public health by reverting back to a culture we’ve worked so hard to change. We need to, and can do, better for the children in our city.
Chicago’s new ordinances are part of an overall comprehensive strategy to reduce the negative consequences tobacco use has on our youth.
With the introduction of these expanded tobacco-control policies, Mayor Emanuel is inspiring cities across the nation to take action to ensure that residents avoid preventable disease and live healthy and productive lives.
http://www.huffingtonpost.com/bechara-choucair-md/e-cigarettes_b_4352410.html

Keep E-Cigarettes Away From Teens

Chicago Sun Times Editorial Board
Electronic cigarettes, those hip new cigarettes that blow a thick white vapor rather than smoke, are clearly less harmful than real cigarettes.
But that doesn’t mean e-cigarettes are harmless.
And until we know something different, that’s how we ought to treat them.
Folks who are wary of e-cigarettes — battery-operated nicotine inhalers that do not produce smoke — are going after them on two fronts. This group includes Mayor Rahm Emanuel, New York’s city council, other municipalities and states as well as the U.S. Food and Drug Administration.
The first is a no-brainer: keeping e-cigarettes out of the hands of teens and pre-teens. We cheer on efforts to do that in the city of Chicago and at the national level.
E-cigarettes don’t burn tar or tobacco, removing the risk of exposure to carcinogens in cigarette smoke. But they contain nicotine and the risks there, particularly to young people, are well documented. Nicotine is highly addictive, can impact the development of young brains, raises the heart rate and is one of the elements of smoking associated with heart disease.
E-cigarettes are being marketed aggressively to young people and come in flavors clearly meant to entice, such as bubble gum, pina colada and cherry. It appears to be working: between 2011 and 2012, use among middle and high school students more than doubled, according to the U.S. Centers for Disease Control. The risks of young people getting hooked on e-cigarettes and then switching to the more noxious traditional cigarettes are all too real.
Fortunately, Illinois already has joined about half the states in banning the sale of e-cigarettes to anyone under 18, effective Jan. 1. The FDA appears poised to take action across the country, with the agency noting with “great concern” the rise in youth e-cigarette usage. The wisest course is to ban the sale or marketing to anyone under 18.
The Chicago City Council could take that a step farther under an ordinance introduced last week. The mayor proposed prohibiting the sale of methol and flavored tobacco products, including e-cigarettes, within 500 feet of Chicago schools, up from 100 feet.
The mayor also wants to ban the smoke-less cigarettes anywhere that regular cigarettes are banned, including virtually all of indoor Chicago expect homes and cars, and at least 10 feet from business entrances. This is the second front that critics of e-cigarettes are pursuing. New York City will consider a similar ban this month.
This one is a little trickier but not by much. Without smoke, the risks to non-smokers nearby are clearly diminished. But the risks are not eliminated — there is concern that nicotine and chemicals such as formaldehyde and acetone are present in the e-cigarette vapor as well as other particles that can cause heart problems.
There is only limited and preliminary research on the potential hazards of e-cigarette vapors to others, leaving us in the do-no-harm category.
Until we know the full second hand effects of smoke-less cigarettes, it’s prudent to restrict them in the same way we do regular cigarettes. The City Council can and should be a forerunner in this area.
If and when the science on this questions is settled, a ban could be reconsidered.
Until then, do no harm.
http://www.suntimes.com/opinions/24065452-474/keep-e-cigarettes-away-from-teens.html

E-cig boom leads to taxation, regulation questions

WOODBURY, Minn. (AP) — Stores that sell increasingly popular e-cigarettes are popping up around the Twin Cities, highlighting the lack of regulation or taxation of the tobacco alternative.
E-cigarettes are battery powered and produce a nicotine vapor. Owners of stores that sell the devices told the St. Paul Pioneer Press that demand skyrocketed in July when a state tax increase sent cigarette prices up to about $7.50 a pack.
“Sales were insane,” said Angie Griffith, who owns several Smokeless Smoking stores and kiosks.
The surging sales have left regulators scrambling to react. The federal Food and Drug Administration is expected to release regulations on e-cigarettes soon, but for now there are very few state or federal rules applying to the devices.
That’s raised concern that some varieties could serve as an introduction to nicotine for youths. Some come in flavors including root beer, and cookies and cream.
But some former traditional smokers said e-cigarettes helped them kick a tobacco habit. A new Smokeless Smoking store in Woodbury, which opened Nov. 18, has already become a social hub for e-puffers, with its dimly lit lounge with sofas, TVs, games and books.
Griffith said the ability to form friendships and impromptu support groups with fellow e-cigarette smokers is important in helping customers kick tobacco.
“Smoking” an e-cigarette involves pushing a button on the small metal cylinder, examining its tiny computer screen, applying drops of flavoring and keeping an eye on the battery, then inhaling and exhaling the vapor. The vaporized liquids come in standard varieties but can be custom-made. Flavors mimic brands of cigarettes including Marlboro and Camel.
Gus Menth, a White Bear Lake truck driver, smoked cigarettes for 15 years. He tried to quit with nicotine patches but got so frustrated he once popped one in his mouth and chewed it. He can still remember the exact date he successfully switched to e-cigs: Jan. 15, 2011.
“I was tired of smelling bad,” Menth said. “And the cost savings is incredible.”
The metal e-cigarette costs from $30 to about $200, but is reusable. Menth and his wife, who also smokes e-cigs, estimate they are saving about $170 a month since their switch.
Menth said his breathing has improved. “I can run and play with my kid now,” he said.
___
Information from: St. Paul Pioneer Press
http://minnesota.publicradio.org/display/web/2013/11/30/health/ecigarettes-twin-cities

New E-cigarette shop opens in downtown Fargo

Fargo, ND (WDAY TV) – A new store opening to customers Friday on Broadway in Fargo hopes to tap into the growing business of electronic cigarettes.
E-cigarette sales hit the $500 million mark in 2012, and with that number expected to triple, Infinite Vapor hopes to get a piece of that $1.7 billion pie.
Kelsey Eaton- Manager, Infinite Vapor: “E-Cigarettes are a different way; an alternative to quitting smoking.
Cody Fruehling- First Infinite Vapor Customer: “Yeah, I’m addicted to the nicotine, but I’m also addicted to the feeling of smoking and that’s what the vapor offers.”
The E-cigarettes use flavored nicotine liquid to produce vapor that is then inhaled; therefore, no tobacco or tar is present.
Eaton: “A, they taste good, and B, they don’t smell, so you’re not smelly and it’s not all over your stuff and your hands don’t reek.”
With liquid flavors like banana and yummy gummy, public officials are concerned that E-cigarettes are catering to a younger crowd.
Robyn Litke Sall- Tobacco Prevention Coordinator, Fargo Public Health: “Sounds to me more like frozen yogurt flavor than it does E-cigarette flavor, so I really would strongly caution parents that this could be very attractive to their youth.”
With zero FDA regulation, E-cigarettes are allowed to be sold to minors, but Infinite Vapor manager Kelsey Eaton says they are taking the moral high ground.
Eaton: “We treat it just the same as any tobacco or nicotine product as in we take IDs. We don’t sell to anyone under 18.”
And just like traditional tobacco, E-cigarettes are banned in public places in North Dakota, while Minnesota still allows them.
The FDA is expected to place regulations on E-cigarettes in the near future.
http://www.wday.com/event/article/id/90738/

E-cigarette store to open in downtown Fargo

By: Dave Olson, INFORUM
FARGO – A chain of stores that began selling electronic cigarettes in the Twin Cities this past April is setting up a shop in downtown Fargo.
Bill Boldenow said he plans to open his Infinite Vapor store at 68 Broadway by Friday, but if that doesn’t happen, it’ll open “at the very latest the second week of December.”
Boldenow said the store will sell e-cigarettes and the e-juice that goes into them. E-cigarettes are pen-like devices that use a small battery and heating element to vaporize the e-juice, mimicking a cigarette.
While proponents such as Boldenow say e-cigarettes are safer than smoking, but some anti-smoking advocates are concerned the increasingly popular product isn’t regulated and has not been extensively tested.
Safe alternative?
E-juice typically contains nicotine along with some type of flavoring. When vaporized, e-juice is inhaled similar to the way smoke from a cigarette is inhaled, but without the carcinogens found in tobacco.
“We feel it’s a much safer alternative than tobacco, which we know is unsafe,” Boldenow said, adding that the e-juice Infinity Vapor sells is made in Minnesota and tested for consistency at a lab at St. Cloud State University.
“Infinity Vapor is a premium electronic cigarette shop that carries really high-quality products,” Boldenow said.
“A lot of the stuff you see out there these days – in gas stations and whatnot – are kind of a knockoff version,” he added.
Boldenow said e-juice nicotine levels can be adjusted to personal tastes, and he said many people who use e-cigarettes do so as a way to quit smoking.
“I want to promote people getting off of smoking,” he said. “I truly in my heart believe it is (a way to do that).”
Heather Nelson, part owner of the SnG Vapor store in Grand Forks, said more than a few of her customers kicked their smoking habit by turning to e-cigarettes.
“I’ve got a lot of people that (say), ‘I was smoking two packs a day for 30-plus years’ and in just a couple months they’ve gotten to a point where they are nicotine-free,” said Nelson, whose business has been operating in Grand Forks for about three years.
Nelson said the shop makes its own e-juice using a combination of four ingredients – nicotine; vegetable gelatin; coffee/tea flavorings; and pharmaceutical-grade propylene glycol.
Though propylene glycol is a chemical found in antifreeze, Nelson said it is a safe ingredient.
Regulation-free
But because e-juice is not regulated by the U.S. Food and Drug Administration, it is difficult to say just how safe or unsafe a particular batch may be, said Robyn Litke Sall, a tobacco prevention coordinator at Fargo Cass Public Health.
“We don’t yet know what all is contained in e-cigarettes. We don’t know if the vapor is harmful or not,” Sall said, adding that because of the lack of information, many health officials are concerned about statistics that indicate use of e-cigarettes among young people has doubled in recent years. In 2011, the market for e-cigs was $2 billion worldwide, according to an estimate by an industry group.
Because e-cigarettes look much like regular smokes, some wonder if they could be a gateway to smoking, said Sall, who added that scientific evidence is lacking when it comes to claims e-cigarettes help people stop smoking.
“Until there might be such evidence, we certainly can’t endorse it, or use it as a cessation device,” Sall said.
Both Boldenow and Nelson said they will not sell products to people under 18, assertions that don’t quell Sell’s concerns. She said a store may have a policy against selling to people under 18, but there is no law that prevents a business from doing so.
If a business decides to change their policy due to factors like competition, “there’s no penalty there,” Sall said.
Competitive advantage
E-cigarettes were included in North Dakota’s recently passed ban on indoor smoking in public places, meaning anyplace that is smoke-free by law must also be vapor-free.
Minnesota’s state law banning smoking in workplaces, bars and restaurants does not include e-cigarettes, but some communities in the state have their own ordinances regulating such products.
Moorhead is a city with no e-cigarette regulations, and that might give businesses an edge over their competition on the North Dakota side of the Red River, said Jake Bruns, owner of Mick’s Office, a downtown Moorhead bar.
Bruns said few of his customers use e-cigarettes, which are already widely available at convenience stores in the area. But he said that might change with a store opening that is devoted to the devices.
“There could be some marketing opportunities there,” he said.
http://www.inforum.com/event/article/id/419678/group/homepage/

Letter to the Editor: E-cigarettes aren’t a solution for those addicted to nicotine

By: Jim Tennant, Napa
After reading the story about a new e-cigarette store in Napa, I was disappointed that your reporter uncritically repeated the propaganda that the e-cigarette industry (which is being taken over by the traditional tobacco industry) has been feeding the public (“E-cig entrepreneur hopes to blow away tobacco cigarettes,” Nov. 20).
In fact, there is no evidence that e-cigarettes are any safer than the deadly, traditional tobacco products. E-cigarettes are not useful as a way to quit or cut down smoking. Nicotine is one of the most addictive drugs known to man and e-cigarettes are another way of delivering this terrible drug to your body. E-cigarettes seem to me to be like washing your glass before drinking poison.
Flavored e-cigarettes are a blatant attempt to market to children — adult smokers would not buy them. Napa County has regular, free, effective quit-smoking classes available to the public and I hope that anyone who wants to quit smoking will use this service and not switch to another form of this deadly drug.
 http://napavalleyregister.com/news/opinion/mailbag/e-cigarettes-aren-t-a-solution-for-those-addicted-to/article_a25bbf74-5705-11e3-9c78-001a4bcf887a.html

Study: Teens' E-Cigarette Use Promotes Heavy Tobacco Use

By: Jessica Berman
WASHINGTON — According to the first-ever study on the use of electronic cigarettes, or e-cigarettes, by young people, researchers have found that the devices, marketed as an alternative to real cigarettes, appear to fuel heavy smoking among youth.
E-cigarettes are battery-powered devices that look like cigarettes and deliver a smokeless aerosol of nicotine, flavorings and other chemicals. They are promoted as a safer alternative to cigarettes and an aid to stopping smoking.
However, a new study looking at the use of electronic cigarettes in nearly 76,000 Korean teenagers found they are less likely to have succeeded in kicking the habit and that electronic cigarettes made them heavier smokers.
Stan Glantz directs the Center for Tobacco Control Research and Education at the University of California, San Francisco.  He is also the senior author of the study.
Glantz said that while there is evidence electronic cigarettes help a small percentage of adult smokers stop, the same is not true for adolescents, who he says are being bombarded with appealing ads.
“They are being marketed with flavors, with images of sex and independence, and also marketed with the claim they will help you quit smoking and, in fact, the kids who are trying to quit smoking were more likely to be using e-cigarettes. But, as I said before, [they are] much less likely to actually quit,” said Glantz.
Glantz said that the nicotine in e-cigarettes makes them addictive even though users do not inhale as many toxic chemicals. He also claimed that tobacco companies, which manufacture the devices, take advantage of the lack of regulation of e-cigarettes to try to hook new smokers.
“We have the kind of Wild West marketing that we did in the bad old days for cigarettes. And the kids are clearly responding to that, and youth use of e-cigarettes in Korea is going up very rapidly just as it did here in the United States,” said Glantz.
U.S. regulators report the number of middle and high school students who use e-cigarettes doubled from 2011 to 2012, to a total of 1.7 million students.
Regulations to ban the smokeless devices are being proposed in Chicago, which may become the first U.S. city to restrict the sale of electronic cigarettes.
The article on e-cigarette use among Korean teens is published in the Journal of Adolescent Health.
http://www.voanews.com/content/study-teens-e-cigarette-promotes-heavy-tobacco-use/1798525.html