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The Health Claims Of E-Cigarettes Are Going Up In Smoke

Jasper Hamill, Contributor | Forbes

The sales pitch of electronic cigarette manufacturers seemed too good to be true. Could nicotine addicts around the world really get their fix whilst dodging the health risks of puffing away on cancer sticks?

Sadly for smokers and “vapers”, the answer is far from clear. Over the past week, new evidence has emerged which suggests that E-Cigarettes can be dangerous too – in some cases carrying higher amounts of certain toxins than the blazing tobacco of old.

Researchers at the University of South California have found that although E-Cigarettes are less harmful than ordinary smokes, the vapour emitted by the gadgets contains the toxic element chromium, which is not found in traditional cigarettes, as well as levels of nickel four times higher than in real tobacco. The electronic replacements also contain lead, zinc and other toxic metals, although in lower levels than cigarettes.

English: Two electronic cigarette models. Self...

Two electronic cigarette models. (Photo credit: Wikipedia)

“Our results demonstrate that overall electronic cigarettes seem to be less harmful than regular cigarettes, but their elevated content of toxic metals such as nickel and chromium do raise concerns,” said Constantinos Sioutas, professor at the USC Viterbi School of Engineering.

There is a bit of good news for reforming smokers, as E-Cigarettes contain virtually no detectable polycyclic aromatic hydrocarbons, which are known to cause cancer. The researchers also said the metal particles were likely to come from the cartridge of the E-Cigarette devices, opening up the possibility that a change in the production process could eliminate the dangerous chemicals.

But this isn’t the only bit of bad news for vape inhalers. In the UK, the BBC reported that E-Cigarette liquid sold in the north east of England was found to contain a chemical called diacetyl, which is used to add butterscotch flavor to liquid tobacco.

Whilst this substance is harmless to eat, it is extremely dangerous to inhale. The chemical is known to cause a serious condition called popcorn lung, orbronchiolitis obliterans, an irreversible disease which scars the lung and makes it impossible to breathe properly. This illness has struck workers in popcorn factories, who are known to breathe in vast quantities of diacetyl, as well as ordinary people who eat a lot of popcorn.

Commenting on the report, Dr Graham Burns, a respiratory expert at Newcastle’s Royal Victoria Infirmary, said the illness is often “serious enough to warrant lung transplantation”.

VP, the firm which manufactured the cigarettes, immediately withdrew the liquid from sale, and Lynne White, head of retail distribution, admitted there were concerns about inhaling the liquid on a long-term basis.

“We are very sorry it has happened, we are investigating how it has happened,” she added.

“Because of the small amount the vaper would actually consume it was deemed in the short term there would be no health concerns.

“Long-term yes there could well be, however we decided it was a withdrawal rather than a recall of the product and that was based on Ecita’s (Electronic Cigarette Industry Trade Association) guidelines.”

But for many health-conscious people, the damage is likely to have been done. Once upon a time, the world didn’t know about the many terrible effects of cigarettes. It was only after a concerted campaign by scientists, doctors and activists that the risks began to be publicized and governments began to act on them. The long term implications of switching to E-Cigarettes have not yet been tested, so anyone using the devices has to ask themselves if they are willing to take the risk of becoming a guinea pig.

Marlboro Cigarettes

Marlboro Cigarettes (Photo credit: Wikipedia)

The World Health Organisation has issued a report advising that use of E-Cigarettes should be banned indoors and and all advertising stopped until the emerging industry produces “convincing supporting scientific evidence and obtains regulatory approval”.
Backing this call, the British Medical Association board of science deputy chair Ram Moorth said “tighter controls are needed to ensure their use does not undermine current tobacco control measures and reinforces the normalcy of smoking behaviour”.

‘There is a need for research to understand the health impacts of E-Cigarettes on both the user and bystanders, and it is vital that the sale of e-cigarettes is appropriately regulated to ensure they are not sold to minors, and are not aggressively marketed to young people as tobacco was in the past,” he continued.

“Any health claims must be substantiated by robust independent scientific evidence to ensure that the consumer is fully informed regarding potential benefits and risks of E-Cigarettes.”
Are you willing to take the chance and keep on vaping?
For more news and comment, follow me on Twitter @jasperhamill
http://www.forbes.com/sites/jasperhamill/2014/08/31/the-health-claims-of-e-cigarettes-are-going-up-in-smoke/

CDC: E-cigs may be tempting non-smoking youths to smoke

By Reuters Media

CHICAGO – Electronic cigarettes may be more tempting to non-smoking youths than conventional cigarettes, and once young people have tried e-cigarettes they are more inclined to give regular cigarettes a try, U.S. researchers said on Monday. A report, released by a team at the U.S. Centers for Disease Control and Prevention, lends evidence to the argument that electronic cigarettes encourage youth smoking.

The study, based on nationally representative youth surveys, found that more than a quarter-million adolescents and teens who had never smoked used an electronic cigarette in 2013, a threefold increase from 2011.

Youths who had tried e-cigarettes were nearly twice as likely to say they would try a conventional cigarette in the next year compared with those who had never tried an e-cigarette, according to the study in the journal Nicotine and Tobacco Research.

E-cigarettes are slim, reusable, metal-tube devices containing nicotine-laced liquids that come in exotic flavors. When users puff, the nicotine is heated and released as a vapor containing no tar, unlike conventional cigarette smoke.

Health experts have raised concerns that the burgeoning $2 billion e-cigarette industry, which has been virtually unregulated, would reverse gains in the decades-long effort to curb youth smoking in the United States. Just 15.7 percent of U.S. teenagers reported smoking in 2013, the lowest rate on record.

In April, the U.S. Food and Drug Administration proposed rules that would ban the sale of e-cigarettes to anyone under 18 but would not restrict flavored products, online sales or advertising, which public health advocates say attract children.

Earlier this month, attorneys general from 29 states urged the FDA to strengthen those rules to better protect young people from nicotine addiction.

“We are very concerned about nicotine use among our youth, regardless of whether it comes from conventional cigarettes, e-cigarettes or other tobacco products,” Dr. Tim McAfee, director of CDC’s Office on Smoking and Health, said in a statement.

“Not only is nicotine highly addictive, it can harm adolescent brain development.”

In the CDC study, researchers analyzed data from the 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. They found that more than 263,000 who had never smoked a conventional cigarette used e-cigarettes in 2013, up from 79,000 in 2011.

Among non-smoking youth who had tried electronic cigarettes, 43.9 percent said they intended to smoke conventional cigarettes within the next year, compared with 21.5 percent of those who had never used e-cigarettes.

Lorillard Inc leads the U.S. e-cigarette market, while Reynolds American Inc and Altria Group Inc are rolling out their own brands nationwide this summer. A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

http://www.inforum.com/content/cdc-e-cigs-may-be-tempting-non-smoking-youths-smoke

New E-Cigarette Store Opening in Mandan

By Steph Scheurer, Reporter, KX News

A new store specializing in e-cigarettes opens in Mandan tomorrow.

But there are concerns about the vaporizers.

“Tried anything, everything from the gum, the patch, chantix, nothing’s worked for me,” says Craig Russell, Owner, Borealis Vape.

Until he discovered the latest trend…

“Something like this has just worked really well for me,” says Russell.

Craig is the owner of the new e-cigarette store, Borealis Vape on Main in Mandan.

With over 100 likes on Facebook in the first 48 hours of advertising his business, Craig says people are pretty excited about this type of product…

A product that he says is much safer than regular cigarettes.

“The only chemicals that are in e-juice are VG (vegetable glycerin), PG Propylenee Glycol), your flavoring, and your nicotine,” says Russell.

Craig says that e-cigarettes contain four ingredients and emit four chemicals versus a traditional cigarette which he says contains 600 ingredients and emits 7,000 chemicals.

So it may seem like the e-cigarette is the safer choice, however, they’re not FDA approved.

“There’s over 250 e-cigarette brands on the market and not a single one of them have been proven safe or effective as a cessation device to help people quit smoking,” says Kristie Wolf, Program Manager, Tobacco Control & Advocacy.

Kristie Wolf says another big concern is that this new business might lead to more young people starting up smoking e-cigarettes.

“I see quite a bit of it at school. I try not to be around it too much. But I know it’s kind of popular with the younger crowd.”

“I feel like kids nowadays, they think it’s a cool way to do stuff and they think it’s less harmful but I feel like they’d end up smoking and using the real stuff anyway.”

Although he has a business to promote, Craig says he will set the bar high…

For obeying the law.

“Any teenager could walk in here and purchase but me, as an owner, that’s high risk so we have to card. We have to card these kids, we have to tell these kids hey, why are you smoking, get out there play football, basketball, there’s other stuff to be doing than to be smoking,” says Russell.

Wolf also says e-cigarettes are included in the North Dakota smoke free law, so anywhere traditional cigarettes are not allowed, neither are e-cigarettes.

If you’re wanting to quit smoking, she urges you to try ND Quits.

For more information you can visit their website or call 1-800-QUIT-NOW.

Website: www.ndhealth.gov/ndquits

http://www.kxnet.com/story/25908937/new-e-cigarette-store-opening-in-mandan

Partial indoor e-cigarette "vaping" ban heads to Dayton for signature

Posted by: Abby Simons, Star Tribune

A retooled measure that would ban the use of electronic cigarettes—commonly known as “vaping”– in some public places head to Gov. Mark Dayton’s desk for signature into law.

The measure re-passed the House 93-35 and the Senate 52-13 Thursday as part of the Health and Human Services Policy omnibus bill, which also includes a ban on the use of indoor tanning beds by children under 18.

The final version of the bill prohibits vaping in most government-owned buildings including correctional facilities, daycare facilities including home daycares, hospitals and any buildings owned by the University of Minnesota or Minnesota State Colleges and Universities, including dorm rooms. The bill does not ban use in city-owned buildings, but they have the option of adopting by equal or more strict bans.

The bill also require4s child-proof packaging for all e-cigarette liquids p[prohibits e-cigarette use in public schools, bans retail sales from mall kiosks and allows local governments to pass stronger restrictions and ensure penalties for sale of e-cigarettes to minors.

The final result was a compromise between a stricter Senate versions authored by Sen. Kathy Sheran, DFL-Mankato, which placed e-cigarettes under the Clean Indoor Air Act, banning their use in all public places. A House version narrowed the ban to state buildings and public schools. The bill’s House author, Rep. Laurie Halverson, DFL-Eagan, removed the Clean Indoor Air Act provision in hopes of garnering enough votes to pass the bill.

In the past year, 80 percent of Minnesota’s 200 e-cigarette retailers have set up shop in kiosks and brick-and-mortar stores, garnering gratitude from users who say the devices are a safe alternative for those trying to quit smoking. But the devices, which can contain nicotine laced with various flavors that emit a vapor rather than smoke, concern some who say little is known about what chemicals secondhand vapors contain, and whether they’re harmful. However, opponents of an indoor use ban say there’s no proof that the vapor emitted from the products is harmful or dangerous.

Despite earlier reservations about a ban, Gov. Mark Dayton said he intends to sign the bill.

E-Cigarette Makers Going After Youth, Report Finds

BY MAGGIE FOX, NBC News

E-cigarette makers may say they welcome regulation and don’t want to sell to teenage nonsmokers, but their advertising dollars paint a very different picture, according to a report released Thursday.

E-cigarette makers spent $39 million on ads from June through November 2013, much of it on programming targeting youth, the anti-tobacco organization Legacy found.

“Overall, these research findings indicate that, despite their publicly stated intentions, some e-cigarette companies are reaching youth with their advertising,” Legacy says in its report.

“Moreover, the only national brand owned by a major tobacco company, blu, is reaching a significant portion of young Americans with its advertising. The effects of this are apparent, with nearly all young people aware of these products and use among young people rising rapidly.”

Health officials from several major U.S. cities say that’s why federal regulators need to act. They can restrict sales and limit where people may smoke or “vape,” but they cannot restrict national ads.

“There are some areas where our hands are tied and that particularly is in marketing,” said New York City health commissioner Dr. Mary Travis Bassett.

“They need to do more to protect kids from the effects of TV,” added Los Angeles County health commissioner Dr. Jonathan Fielding.

The fear is a whole new generation of people will become addicted to nicotine before federal regulations can be written, let alone take hold, the health commissioners told a news conference. New York, Chicago, Boston and Los Angeles County are among the big city areas that have restricted sales and use of e-cigarettes.

Even some public health experts say e-cigarettes may be a useful alternative to burned tobacco cigarettes for smokers. But they also agree that it would be bad to encourage or even allow non-smoking children to become addicted to the nicotine in e-cigarettes.

Legacy was set up in 1999 as part of the Master Settlement Agreement when major tobacco companies agreed to pay more than $200 billion to states and territories. The states wanted some of the money to be used for an organization dedicated to studying and providing public education about the impact of tobacco.

Just last week, the U.S. Food and Drug Administration said it would seek to regulate e-cigarettes, because they contain nicotine, the addictive substance in tobacco. Most e-cigarette makers said they’d welcome some regulation.

Legacy did two studies looking at the marketing of e-cigarettes, and asking teens and young adults what they knew about them. It found e-cigarette TV ads reached 29.3 million teens and young adults from January through November 2013, including 58 percent of 12- to 17-year-olds.

Taken together, the two reports show e-cigarette makers using tactics that have long been banned for regular cigarettes, the report says.

E-cigarette makers dispute this. “The products are being advertised to adults,” said Cynthia Cabrera, executive director of the Smoke Free Alternatives Trade Association. “If children are watching during that time, it’s possible, but they are being marketed to adult consumers, to adult smokers.”

Public health experts say 90 percent of smokers start by the age of 20. They worry that e-cigarettes sold in flavors such as bubble gum and Gummi bear are targeted mainly to younger teens.

“While cigarette advertising is prohibited on television, it is currently fair game to use television to promote electronic cigarettes. Using broadcast and online advertising has allowed the e-cigarette industry to promote its products in a way that has broad reach and is largely unregulated,” Legacy says.

“Every day that industry is growing very, very rapidly,” LA’s Fielding said. “And you can be sure that big tobacco is going to wind up in the driver’s seat with respect to marketing. Don’t let them undo decades of efforts to de-glamorize smoking.”

http://www.nbcnews.com/health/kids-health/e-cigarette-makers-going-after-youth-report-finds-n94166

E-Cigarette Sales to Minors: Hooking a New Generation?

Margaret I. Cuomo, M.D., HuffPost Healthy Living Blog
“Vaping” is the term used by many middle and high schoolers to describe the inhalation of vapors from an electronic cigarette. Celebrities have advertised e-cigarettes in advertisements and in the movies, and until now, it has been legal for a teenager to purchase them.
In April, 2014, the FDA issued a document in the Federal Register, which would regulate electronic cigarettes nationally as a tobacco product, including age restrictions similar to those for conventional cigarettes. The proposed rule will be enforceable once it is finalized. The American Medical Association, the American Lung Association, and the American Association for Cancer Research are all in support of the FDA’s announcement.
This proposed regulation will also include cigars, pipe and water pipe tobacco, nicotine gels and some dissolvable tobacco products, and anything else that meets the definition of a “tobacco product” according to the Tobacco Control Act.
At this point, the FDA will not restrict flavored e-cigarettes or advertising on television or print media. Hopefully those restrictions will follow soon, because Gummy bear, Fruit Loop and bubble gum flavors clearly target middle and high school students. Only menthol is permissible as a flavor for conventional cigarettes, as mandated by the Tobacco Control Act.
Originally, e-cigarettes were designed as an aid to quit smoking conventional cigarettes.
Nicotine is a highly addictive substance, and is present in most e-cigarettes.
E-cigarettes also contain cancer-causing nitrosamines and diethylene glycol, a toxic chemical found in anti-freeze. Are they effective in helping people quit smoking? Until large, randomized controlled trials are conducted, no one will know for sure.
We do know that e-cigarette manufacturers have been very clever in marketing to middle- and high-school students with colorful packaging, fun flavors and cool accessories.
The Centers for Disease Control and Prevention (CDC) reported in September, 2013 that the use of electronic cigarettes doubled in young people between 2011 and 2012, increasing to 10 percent for high school students, and 2.7 percent for middle schoolers. In total, 1.78 million United States students have used e-cigarettes as of 2012.
Should we allow manufacturers to entice our youth with a nicotine-delivery device that can lead to addiction to conventional cigarettes?
Some researches warn that e-cigarettes are a gateway device for nicotine addiction among youth. In a study of nearly 40,000 youth around the USA, the authors, Lauren M. Dutra, ScD and Stanton A. Glantz, PhD, of the Center for Tobacco Control Research and Education at UCSF concluded that, “Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.”
We have come too far, and battled far too long with the tobacco industry, to make the mistake of trusting the e-cigarette manufacturers to do what is right for America’s children. How long was it before the tobacco industry would admit that smoking causes cancer?
Dr. Janie Heath, Associate dean and professor of nursing at the University of Virginia School of Nursing, and an expert on the effects of tobacco on smokers, offers this insight into the problem: “When we look at 95 percent of individuals that smoke cigarettes, they all started that initiation before age 21. So, there’s the likelihood of these younger ones starting on electronic cigarettes, and wanting to have more and more of a hit.”
Dr. Heath also warns that “It’s harder to help an individual quit smoking than it is to get them off crack cocaine, heroin or any of the other drugs.”
Hopefully celebrities will resist the allure of advertising e-cigarettes in magazines, and also in movies, knowing that their endorsement have a powerful effect on teenagers.
Where are the famous athletes. actors and athletes who are willing to say: “There’s nothing cool about smoking or vaping, because there is nothing cool about cancer”?
While we wait for the scientific data to prove the harms of vaping, let’s protect our middle and high schoolers from a lifelong addiction and a high risk of cancer.
http://www.huffingtonpost.com/margaret-i-cuomo-md/healthy-living-news_b_5213382.html?ncid=fcbklnkushpmg00000063

Proposal would ban e-cigarette sales to minors, allow advertising

By: Reuters, INFORUM
WASHINGTON – The U.S. Food and Drug Administration proposed rules on Thursday that would ban the sale of e-cigarettes to anyone under 18, but would not restrict flavored products, online sales or advertising, which public health advocates say attract children.
The long-awaited proposal, which would subject the $2 billion industry to federal regulation for the first time, is not as restrictive as some companies had feared and will likely take years to become fully effective.
Bonnie Herzog, an analyst at Wells Fargo, said the proposal is “positive for industry.”
But public health advocates lamented the fact that the proposal does not take aim at e-cigarette advertising or sweetly-flavored products, which they say risk introducing a new generation of young people to conventional cigarettes when little is known about the long-term health impact of the electronic devices.
“It’s very disappointing because they don’t do anything to rein in the wild-west marketing that is targeting kids,” said Stanton Glantz, a professor at the Center of Tobacco Control Research and Education at the University of California, San Francisco.
FDA Commissioner Margaret Hamburg said at a briefing on Wednesday that the proposal represented the first “foundational” step toward broader restrictions if scientific evidence shows they are needed to protect public health.
That declaration worries some companies.
“The window is still open for a more draconian approach,” said Jason Healy, president of Lorillard Inc’s blu eCigs unit, which holds roughly 48 percent of the market. “I think the proposal shows a good science-based reaction here from the FDA, but there is a lot we have to go through during the public comment period.”
Lorillard, together with privately-held NJOY and Logic Technology account for an estimated 80 percent of the market. Other big tobacco companies, including Altria Group Inc and Reynolds American Inc, are also entering the market.
E-cigarette advocates welcomed the FDA’s light touch.
Dr. Michael Siegel, a professor of community health sciences at Boston University, said a ban on flavorings would have “devastated the industry, as the flavors are a key aspect of what makes these products competitive with tobacco cigarettes.”
Similarly, a ban on all e-cigarette advertising “would have given tobacco cigarettes an unfair advantage in the marketplace,” he said.
NO FREE SAMPLES
A law passed in 2009 gave the FDA authority to regulate cigarettes, smokeless tobacco and roll-your-own tobacco and stipulated the agency could extend its jurisdiction to other nicotine products after issuing a rule to that effect. E-cigarettes use battery-powered cartridges to produce a nicotine-laced inhalable vapor.
In the short term, the new rules would prohibit companies from distributing free e-cigarette samples, forbid vending machine sales except in adult-only venues and prohibit sales to minors.
Companies would also be required to warn consumers that nicotine is addictive, but no other health warnings would be required. The addiction warning would have to be added no later than two years after the rule is set and the e-cigarette companies would not be allowed to make health claims in any advertising.
The proposal is subject to a public-comment period of 75 days.
Vince Willmore, a spokesman for the Campaign for Tobacco Free Kids, said the proposal “by no means does everything we think needs to be done, but it starts the process. What is critical now is that they finalize this rule and then move quickly to fill the gaps.”
He said the FDA should aim to establish the rule within a year, but many are skeptical the agency will act that quickly.
“The reality of these things is that every step takes years,” said UCSF’s Glantz. “By not addressing the youth-directed marketing it means it won’t be addressed for a very long time.”
Some e-cigarette companies that sell primarily through convenience stores were surprised at the lack of restrictions on online sales, since it can be difficult to verify a customer’s age over the Internet.
“The Internet thing is very surprising to me,” said Miguel Martin, president of Logic Technology. “It reduces the visibility of the sales of the products and the type of products that the government has awareness of.”
The new rules would also require companies to submit new and existing products to the FDA for approval. They would have two years to submit applications from the time the rule goes into effect. Companies may continue selling their products and introducing new products pending the FDA’s review.
In the meantime, e-cigarette companies would be required to register with the FDA and list the ingredients in their products. They would not be required to adhere immediately to specific product or quality control standards. That could come later, Hamburg said.
THE “VAPING” INDUSTRY
E-cigarettes and other “vaping” devices generate roughly $2 billion a year in the United States, and some industry analysts expect their sales to outpace the $85 billion conventional-cigarette industry within a decade.
Advocates of e-cigarettes claim they are a safer alternative to conventional cigarettes, since they do not produce lung-destroying tar, though long-term safety data is thin.
The FDA’s proposal leaves many questions unanswered about how new products would be regulated over the long run. One key question relates to how products are approved.
Under current law, new tobacco products can be approved if they are “substantially equivalent” to a product that was on the market before Feb. 15, 2007. It is unclear whether any e-cigarettes were on sale before then, to be used as a benchmark.
Mitch Zeller, head of the FDA’s tobacco division, said at a briefing that the agency would be seeking more information during the public-comment period on whether the “substantial equivalence” pathway is even valid for e-cigarettes.
If it is not, e-cigarette companies would have to use a different process, which would require them to prove their products are appropriate for public health, a higher hurdle to clear.
Also up in the air is the regulatory fate of some cigars. The current proposal would include e-vaping products and other tobacco products, but premium cigars may be excluded.
The FDA said it would seek public comment on whether all cigars should be regulated equally. One option proposed by the agency is to regulate them all. The other is to define a category of premium cigars that would not be subject to the FDA’s authority.
Physicians said the possible exemption of premium cigars from regulation was troubling.
“Any exemption for any kind of tobacco product proven to cause lung and heart disease and cancer is unacceptable,” said Harold Wimmer, chief executive of the American Lung Association.
Cigar companies, backed by some members of Congress, had lobbied heavily for a regulatory carve-out for premium cigars. In a December 2013 letter to Hamburg and Sylvia Mathews Burwell, director of the White House’s Office of Management and Budget, 24 Republican lawmakers asked that premium cigars be exempt.
“As you know,” they wrote, “premium cigars are a niche product with an adult consumer base, much like fine wines. The majority of people who enjoy a cigar do so occasionally, often in social or celebratory settings.”
Under the proposed rule, premium cigars are considered those wrapped in whole tobacco leaf, made manually by combining the wrapper, filler and binder, have no characterizing flavor, have no filter, tip or non-tobacco mouthpiece and are relatively expensive.
http://www.inforum.com/event/article/id/432967/group/homepage/

Other Views: E-cigarette sellers take page from Big Tobacco’s book

— USA Today
Just when smoking has finally lost its glamour, along come electronic cigarettes and an avalanche of sexy new ads that promote “vaping.”
In one, actor Stephen Dorff, shirtless, talks about taking “back your freedom” while inhaling vapor on Lorillard’s blu eCig. (Can anyone say Marlboro Man?) In another ad for blu, former Playboy centerfold Jenny McCarthy leans forward seductively into the camera before saying: “I feel free to have one almost anywhere.”
For a product whose main appeal is supposed to be that it’s not a traditional cigarette, e-cigarette makers have sure taken a lot of pages from Big Tobacco’s playbook. Which is not surprising. Many of the sellers are the same companies that made billions of dollars addicting people to a product that kills 480,000 a year.
The marketing push is enough to trouble anyone who believed that, after a half-century battle, the nation finally had smoking on the run and that fewer teenagers would get hooked and die prematurely.
E-cigarettes — battery-operated nicotine inhalers that contain no tobacco — have the potential to help some smokers quit. But the jury is still out on whether and how well they may work. In the meantime, the potential for nicotine addiction is high, and there’s no good reason to use e-cigarettes other than trying to quit smoking.
Federal law prohibits cigarette makers from sponsoring sports and entertainment events, handing out free samples and selling certain flavored cigarettes. TV ads were banned in 1970.
But for e-cigarettes, it’s open season. Makers have sponsored music festivals, fashion shows and IndyCar racing. You can buy e-cigarettes or liquid refills in everything from Cherry Blast to Gummy Bear. Is the public really supposed to believe that e-cigarettes are not being marketed to minors?
The dangers of e-cigarettes may not be as obvious as those of traditional smokes, but new problems are emerging.
For example, the nicotine-laced liquid the devices use, which comes in small vials and large containers, can be toxic if touched or consumed. Calls to poison control centers about misuse, mostly by children, have risen to 217 a month this year, almost 10 times the number in 2011.
Also troubling is that more teenagers are experimenting with e-cigarettes. In 2012, 1.8 million middle-school and high-school students tried them, double the number the year before. One in five of the middle-schoolers who experimented said they’d never smoked before. It doesn’t help that about 20 states allow sales of e-cigarettes to minors.
So what’s the right response? At least until more studies are done, all states should treat the new devices as they treat cigarettes, with bans on youth sales and indoor use. And the Food and Drug Administration, which has been slow to assert its authority to regulate e-cigarettes, ought to get on with it.
More independent research would determine if e-cigarettes really can help smokers quit. Or if they carry other health risks. For now, the nation ought to ensure that a new generation doesn’t get hooked on a different and potentially dangerous product.
http://www.theadvertiser.com/story/opinion/2014/04/20/other-views-e-cigarette-sellers-take-page-from-big-tobaccos-book/7951623/

E-Cigarettes, by Other Names, Lure Young and Worry Experts

By , NY Times

SAN FRANCISCO — Olivia Zacks, 17, recently took a drag of peach-flavored vapor from a device that most people would call an e-cigarette.

But Ms. Zacks, a high school senior, does not call it that. In fact, she insists she has never even tried an e-cigarette. Like many teenagers, Ms. Zacks calls such products “hookah pens” or “e-hookahs” or “vape pipes.”

These devices are part of a subgenre of the fast-growing e-cigarette market and are being shrewdly marketed to avoid the stigma associated with cigarettes of any kind. The products, which are exploding in popularity, come in a rainbow of colors and candy-sweet flavors but, beneath the surface, they are often virtually identical to e-cigarettes, right down to their addictive nicotine and unregulated swirl of other chemicals.

The emergence of e-hookahs and their ilk is frustrating public health officials who are already struggling to measure the spread of e-cigarettes, particularly among young people. The new products and new names have health authorities wondering if they are significantly underestimating use because they are asking the wrong questions when they survey people about e-cigarettes.

Marketers of e-hookahs and hookah pens say they are not trying to reach young people. But they do say that they want to reach an audience that wants no part of e-cigarettes and that their customers prefer the association with traditional hookahs, or water pipes.

“The technology and hardware is the same,” said Adam Querbach, head of sales and marketing for Romman Inc. of Austin, Tex., which operates several websites that sell hookahs as well as e-cigarettes and e-hookahs. “A lot of the difference is branding.”

Sales of e-hookahs have grown “exponentially” in the last 18 months, Mr. Querbach said.

Public health authorities worry that people are being drawn to products that intentionally avoid the term “e-cigarette.” Of particular concern is use among teenagers, many of whom appear to view e-cigarettes and e-hookahs as entirely different products when, for all practical purposes, they are often indistinguishable.

Indeed, public health officials warn that they may be misjudging the use of such products — whatever they are called — partly because of semantics. A survey by the Centers for Disease Control and Prevention found that 10 percent of high school students nationwide said that they had tried e-cigarettes in 2012, double the year before. But the C.D.C. conceded it might have asked the wrong question: Many young people say they have not and will not use an e-cigarette but do say they have tried hookah pens, e-hookahs or vaping pens.

The C.D.C. is sending a tobacco-use survey to 20,000 students nationwide that asks about e-cigarette experimentation but does not identify the devices by other names. The state of California, through a nonprofit partner called WestEd, is asking virtually the same question of 400,000 students.

Brian King, senior adviser to the Office on Smoking and Health at the C.D.C., said the agency was aware of the language problem. “The use of hookah pens could lead us to underestimate overall use of nicotine-delivery devices,” he said. A similar problem occurred when certain smokeless tobacco products were marketed as snus.

Other health officials are more blunt.

“Asking about e-cigarettes is a waste of time. Twelve months ago, that was the question to be asking,” said Janine Saunders, head of tobacco use prevention education in Alameda County in Northern California.

In October, Ms. Saunders convened a student advisory board to discuss how to approach “e-cigs.” “They said: ‘What’s an e-cig?’ “ Ms. Saunders recalled, and she showed what she meant. “They said: ‘That’s a vape pen.’ “

Health officials worry that such views will lead to increased nicotine use and, possibly, prompt some people to graduate to cigarettes. The Food and Drug Administration is preparing to issue regulations that would give the agency control over e-cigarettes, which have grown explosively virtually free of any federal oversight. Sales of e-cigarettes more than doubled last year from 2012, to $1.7 billion, according to Wells Fargo Securities, and in the next decade, consumption of e-cigarettes could outstrip that of conventional cigarettes. The number of stores that sell them has quadrupled in just the last year, according to the Smoke Free Alternatives Trade Association, an e-cigarette industry trade group.

The emergence of hookah pens and other products and nicknames seems to suggest the market is growing well beyond smokers. Ms. Zacks was among more than 300 Bay Area high school students who attended a conference focused on health issues last month on the campus of the University of California, Berkeley. Many students talked about wide use of e-hookahs or vaping pens — saying as many as half of their classmates had tried one — but said that there was little use of e-cigarettes.

Ms. Zacks said the devices were popular at her high school here. “E-cigarettes are for people trying to quit smoking,” she said, explaining her understanding of the distinction. “Hookah pens are for people doing tricks, like blowing smoke rings.”

James Hennessey, a sophomore at Drake High School in San Anselmo, Calif., who has tried a hookah pen several times, said e-hookahs were less dangerous than e-cigarettes. He and several Drake students estimated that 60 percent of their classmates had tried the devices, that they could be purchased easily in local stores, and that they often were present at parties or when people were hanging out.

“E-cigarettes have nicotine and hookah pens just have water vapor and flavor,” said Andrew Hamilton, a senior from Drake.

Actually, it is possible for e-cigarettes or e-hookah devices to vary in nicotine content, and even to have no nicotine. Mr. Querbach at Romman said that 75 percent of the demand initially was for liquids with no nicotine, but that makers of the liquids were expanding their nicotine offerings. Often, nicotine is precisely the point, along with flavor.

Take, for example, the offerings of a store in San Francisco called King Kush Clothing Plus, where high school students say they sometimes buy their electronic inhalers. On a counter near the back, where tobacco products are sold, are several racks of flavored liquids that can be used to refill e-cigarettes or hookah pens. The flavors include cinnamon apple, banana nut bread, vanilla cupcake, chocolate candy bar and coconut bomb. They range in nicotine concentration from zero to 24 milligrams — about as much as a pack of 20 ordinary cigarettes — but most of the products have some nicotine. To use the refills, it is necessary to buy a hookah pen, which vary widely in price — around $20 and upward.

It is also possible to buy disposable versions, whether e-cigarettes or hookah pens, that vary in nicotine content and flavor. At King Kush, the Atmos ice lemonade-flavored disposable electronic portable hookah promises 0.6 percent nicotine and 600 puffs before it expires.

Emily Anne McDonald, an anthropologist at the University of California, San Francisco who is studying e-cigarette use among young people, said the lack of public education about the breadth of nicotine-vapor products was creating a vacuum “so that young adults are getting information from marketing and from each other.”

“We need to understand what people are calling these before we send out large surveys,” Dr. McDonald said. Otherwise the responses do not reflect reality, “and then you’re back to the beginning.”

E-cigarettes: Are manufacturers using flavors to lure minors to vape?

By Ivey DeJesus | idejesus@pennlive.com , The Patriot-News, Central PA

To understand the concern that the marketing of electronic cigarettes might lure minors into a life of nicotine addiction, consider some of the flavors: cherry, bubble gum, cola, milk chocolate and sugar cookie.
Since their introduction into the U.S. market in 2009, e-cigarettes have grown exponentially in popularity and sales, to the tune of $1.7 billion. Legions of lifelong users have converted to vaping, trading the tar and carcinogens of cigarettes for the seemingly safer alternative.
But with such an aforementioned variety of flavors in e-cigarettes, health experts, substance abuse prevention officials and lawmakers are increasingly concerned that e-cigarette manufacturers are targeting teens.
“They are adding all these interesting flavors and they are pandering to people who are nonsmokers or more specifically kids,” said Dr. Richard Bell, a Berks County pulmonologist and a member of the Pennsylvania Medical Society. “I’m not sure an adult would be attracted to a bubblegum flavor cigarette.”
Bell echoes widely held concerns in the public health community that Big Tobacco is increasingly marketing the electronic devices to minors — using many of the same promotional techniques it used to hook generations to cigarettes — with television and magazine ads, sports sponsorships and cartoon characters.
“Whether e-cigarettes can safely help people quit smoking is also unknown, but with their fruit and candy flavors, they have a clear potential to entice new smokers,”The American Medical Association recently opined.
E-cigarettes are not subject to the federal ban on television advertising. Those calling for action say that much the same same way Big Tobacco used the Marlboro Man, Joe Camel and attractive celebrities to promote their product, e-cigarette manufacturers are doing with modern-day celebrities. 
The market saturation amazes Linda Doty, prevention specialist with the Cumberland Perry County Drug and Alcohol Commission. Doty recently Googled e-cigarettes near her Carlisle office and learned that between the West Shore and Newville, there are 100 e-cigarette retailers, the majority of them convenience stores, which draw heavy traffic from young people stopping in for sodas and snacks.
Doty said she is concerned that the increase in young e-cigarette users is playing out amid a dearth of medical evidence regarding their safety. She said a recent study by the the Smoking and Health Behavior Research Laboratory at the Pennsylvania State University found that 20 percent of middle school students who had tried e-cigarettes said they had never smoked regular cigarettes.
“Even e-cigarette manufacturers recommend that breast-feeding women and those with health complications not use the products,” Doty said. “To me that’s an acknowledgment that this could have potential for harm.”
Indeed, a study last year by the U.S. Centers for Disease Control and Prevention found that use of e-cigarettes among teens in 2012 had more than doubled from the previous year. However, at the same time, cigarette smoking among teens continued to decline.
Currently, no federal or state law governs the sale of e-cigarettes. A bill in the state Senate would restrict the sale of the devices to people 18 and older.
Harrisburg resident Keith Kepler challenges the notion that e-cigarettes — and their fruity, candy flavored choices — will lure kids into smoking.
“I’m 57 and, doggone it, I still like strawberry and chocolate,” said Kepler, who began to smoke at 14 and recently quit with the help of e-cigarettes. “That’s the most ridiculous thing I’ve heard of. I still chew bubble gum. You’re telling me we can’t have things flavored bubble gum, because it will lure kids? I don’t get that.”
http://www.pennlive.com/midstate/index.ssf/2014/02/post_662.html