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CASAA Assessment of FDA Deeming Regulation, April 25, 2014

Yesterday’s FDA draft deeming regulation regarding e-cigarettes, other smoke-free alternatives, and other products is not as bad on its face as it might have been. However, a full review -- in the context of background knowledge and institutional analysis -- reveals that the proposed regulation is inappropriate, ill-founded, and potentially devastating for consumers.

1. The proposed regulation of non-combustible tobacco products, particularly including e-cigarettes, does almost nothing to address any real problems.

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What’s so bad about e-cigs?

The Food and Drug Administration says it plans to regulate e-cigarettes, along with cigars and other tobacco products. Health advocates say it’s about time, but many “vapers” who use e-cigarettes say regulation will damage a product that’s a far safer substitute for cigarettes.“The FDA has over stepped their boundaries,” supporters wrote in an online petition posted this week. “DoNot, allow the FDA to take control of a life saving product (sic).”Even health experts agree that electronic cigarettes, which deliver nicotine in a heated mist of water, glycerin and propylene glycol, might be useful in helping people who want to quit smoking. So where’s the harm in them?Mostly, it’s the unknown, the FDA says. “We can’t even tell you what the compounds are in the vapor,” FDA’s Mitch Zeller told reporters.This Video Player Requires JavaScriptIt has come to our attention that the browser you are using is either not running javascript or out of date. Please enable javascript and/or update your browser if possible.FDA regulation would require the companies to tell the agency, but not necessarily the public, what’s in their products. FDA is sensitive to protecting competitive secrets.The FDA is also asking for research on potential harms from inhaling the heated mixture. It might not be as harmful as burning tobacco leaves, but it might not be completely benign, either, says Dr. John Spangler, who runs a smoking cessation clinic at Wake Forest Baptist Medical Center in North Carolina.“It is true that electronic cigarettes are safer than regular cigarettes. On the other hand there are some effects in the lung of the vapors which mimic the same kind of changes that go along with asthma,” Spangler told NBC News.“That happens within 5 minutes of using an electronic cigarette. We don’t know how long that will last or whether it will lead to permanent lung damage.”Vaping enthusiasts will argue that using the products allows them to skip regular tobacco cigarettes, whose harms are well-documented. If that’s the case, many health advocates say they are all for them. But there’s not much research to say whether that’s true.Spangler’s been studying this and doesn’t have final data yet. But in general, e-cigarettes appear slightly less effective than nicotine gum or patches or drugs such as Chantix, he says.“I do have about 20 percent of my smoking patients in my clinic who are using electronic cigarettes,” he said. “Of the patients who use them, about 10 percent of them actually quit smoking using electronic cigarettes.”"Most consumers would be shocked to realize the products they buy have less oversight than a bag of dog food."And experts argue that if e-cigarette makers wanted their products used as quit-smoking aids, they’d have submitted them to the FDA as such. Instead, manufacturers fought FDA’s attempts to regulate them in that way, and won in federal appeals court.Either way, people who use them should want them regulated, says pulmonologist Dr. Nathan Cobb of Georgetown University School of Medicine.“Electronic cigarettes may represent the next evolution of nicotine replacement, supplanting the gum, patch and the existing inhaler. However, most consumers would be shocked to realize the products they buy have less oversight than a bag of dog food, and are often manufactured and imported from countries that have histories of tainted pharmaceutical and food products,” Cobb added.The fear is that smokers will use e-cigarettes as a bridge that gets them through the day in a society that increasingly restricts cigarettes. And the even bigger fear is that e-cigarettes will appeal to children, who will get addicted to nicotine.“Kids should not be initiating even an e-cigarette that contains no burning tobacco leaves because of the effect that nicotine can have on the developing brain,” Zeller says. Several studies suggest nicotine might slow the growth of the adolescent brain.The Centers for Disease Control and Prevention and FDA say 10 percent of high school students have tried vaping, with numbers rising steadily. More than 21 percent of adults have tried vaping at least once.The e-cigarette industry itself welcomes the FDA’s proposal. “We have no problem divulging our ingredients,” says Miguel Martin, president of e-cigarette maker Logic. Martin and other makers also say they support restricting sales to people 18 or older."FDA has worked over three years to meet the regulatory challenges presented by this very new and technology-driven industry, while preserving and supporting the enormous potential for harm reduction it offers. We share that goal," added the Smoke Free Alternatives Trade Association.“You should always be suspicious when the tobacco industry applauds something."Public health advocates say even that worries them. “You should always be suspicious when the tobacco industry applauds something,” says Tom Glynn, senior director of cancer science and trends for the American Cancer Society.Glynn and others remember that the tobacco industry first told Americans that cigarettes were healthful, and then battled the U.S. government in court for decades when the Surgeon General declared that smoking caused cancer. It took decades to prove that tobacco companies colluded to make cigarettes ever more addictive and to cover up research showing tobacco caused not only cancer, but heart disease, stroke, emphysema and other diseases.They also point to industry attempts to market “light” cigarettes as less dangerous — research shows they are not — and companies have pushed menthol cigarettes despite evidence that menthol worsens the health effects.“Like cigarette companies, e-cigarette makers claim they don't market to kids. But they're using the same themes and tactics tobacco companies have long used to market regular cigarettes to kids,” says Matthew Myers, president of the Campaign for Tobacco-Free Kids.And nicotine itself may not be so harmless. The concentrated nicotine juice used in vaping can poison people, and Spangler says nicotine build-up in vaping salons could be dangerous, also.“We don’t know what will happen to nicotine that settles into the environment,” he said.First published April 25 2014, 6:26 AM
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E-cigarette hazards, merits unclear

1:00 AMAs the FDA gets set to regulate, health and public policy experts await more research on the devices.By Michael FelberbaumThe Associated PressWASHINGTON — The federal government’s move to regulate e-cigarettes is a leap into the unknown.click image to enlargeTalia Eisenberg, co-founder of the Henley Vaporium, uses her vaping device in New York on Feb. 20. Soon, the Food and Drug Administration will propose rules for e-cigarettes. The rules will likely have big implications for a fast-growing industry and its legions of customers.The Associated PressE-CIGARETTE FACTSThe Associated PressPipes are displayed at the Avail Vapor shop in Richmond, Va. The industry is facing regulation.THE BATTERY-POWERED devices made of plastic or metal heat a liquid nicotine solution, creating vapor that users inhale. Some models are disposable, and some are designed to be refilled with cartridges or tanks containing what enthusiasts call “e-juice.”Some e-cigarettes are made to look like a real cigarette with a tiny light on the tip that glows like the real thing.THE INGREDIENTS used in most e-cigarettes include nicotine, water, glycerol, propylene glycol and flavorings. Propylene glycol is a thick fluid sometimes used in antifreeze but also used as a food ingredient. While some e-cigarette makers are limiting offerings to tobacco and menthol flavors, others are selling candy-like flavors like cherry and strawberry.USERS SAY E-CIGARETTES address both the addictive and behavioral aspects of smoking. Smokers get their nicotine without the thousands of chemicals found in regular cigarettes. And they get to hold something shaped like a cigarette, while puffing and exhaling something that looks like smoke without the ash, odor and tar.SCIENTISTS HAVEN’T finished much research on e-cigarettes, their safety and whether they help smokers quit, and the studies that have been done are inconclusive. The federal government is pouring millions of dollars into research to supplement independent and company studies looking at the health risks of e-cigarettes and other tobacco products – as well as who uses them and why.– The Associated PressMost everyone agrees a ban on selling them to kids would be a step forward. But health and public policy experts can’t say for certain whether the electronic devices are a good thing or a bad thing overall, whether they help smokers kick the habit or are a gateway to ordinary paper-and-tobacco cigarettes.The proposed rules, issued Thursday by the Food and Drug Administration, tread fairly lightly. They would ban sales to anyone under 18, add warning labels and require FDA approval for new products.Some public health experts say a measured approach is the right one. They think that the devices, which heat a nicotine solution to produce an odorless vapor without the smoke and tar of burning tobacco, can help smokers quit.“This could be the single biggest opportunity that’s come along in a century to make the cigarette obsolete,” said David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation.Still, some wonder whether e-cigarettes keep smokers addicted or hook new users and encourage them to move on to tobacco. And some warn that the FDA regulations could have unintended consequences.“If the regulations are too heavy-handed, they’ll have the deadly effect of preventing smokers from quitting by switching to these dramatically less harmful alternatives,” said Jeff Stier, senior fellow at the National Center for Public Policy Research, a conservative think tank in Washington.Scientists haven’t finished much research on e-cigarettes, and the studies that have been done have been inconclusive. The government is pouring millions into research to supplement independent and company studies on the health risks of e-cigarettes and other tobacco products – as well as who uses them and why.“There are far more questions than answers,” acknowledged Mitch Zeller, director of the FDA’s Center for Tobacco Products.But he said the proposed rules “would result in significant public health benefits, including through reducing sales to youth, helping to correct consumer misperceptions, preventing misleading health claims and preventing new products from entering the market without scientific review by FDA.”The FDA has left the door open to further regulations, such as a ban on TV advertising and fruit- or candy-flavored e-cigarettes – measures that some anti-smoking groups and members of Congress are demanding.“It is inexcusable that it has taken the FDA and the administration so long to act. This delay has had serious public health consequences as these unregulated tobacco products have been marketed using tactics and sweet flavors that appeal to kids,” the Campaign for Tobacco-Free Kids said in a statement.The FDA said it wants more evidence before it rushes into more regulations.Any further rules “will have to be grounded in our growing body of knowledge and understanding about the use of e-cigarettes and their potential health risks or public health benefits,” FDA Commissioner Dr. Margaret Hamburg said.Electronic cigarettes are becoming a big business. The industry started on the Internet and at shopping-mall kiosks and has rocketed from thousands of users in 2006 to several million worldwide, with a choice of more than 200 brands.Sales are estimated to have reached nearly $2 billion in 2013. Tobaacco companies have noticed that e-smokes are eating into cigarette sales, and they have jumped into the business, too. Tweet
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FDA proposals may help e-cigarette sales

The proposed regulations are broadly speaking "as expected, and not as restrictive as some had feared," wrote Herzog, who has predicted that e-cigs could overtake traditional cigarettes in total sales within a decade. Tobacco cigarette sales are currently about $80 billion annually.Herzog warned, however, that "our main concern remains around e-cig/e-vapor innovation, which, if stifled, could dramatically slow down industry growth and conversion from combustible cigs, which would ultimately result in net negative public health impact."Rob Burton, director of corporate regulation affairs at White Cloud Electronic Cigarettes, was pleased there was no outright ban on flavoring proposed by the FDA. White Cloud sells e-cig liquid in five different strengths—including zero-percent nicotine—and in 19 different flavors.Read MoreReynolds brings back Susan Cameron as CEO"We feel that just because you're an adult doesn't mean that you shouldn't have a choice of flavors," Burton said. "The wider the choice, the better the opportunity for them to switch to the alternative" from traditional cigarettes, he said.Burton also was happy that the proposed rules open the door to the possibility that e-cig manufacturers will be able to make health-based claims. The FDA said Thursday that such "direct and implied claims of reduced risk" could be made "if the FDA confirms that scientific evidence supports the claim and that marketing the product will benefit public health as a whole."Although e-cig companies currently do not make such health-based claims, many of their users have adopted the products in the belief that they are significantly safer than tobacco cigarettes, even as extensive studies on the new products has yet to be performed.Smoking tobacco products leads to the deaths of an estimated 480,000 people in the U.S. each year.That death toll was echoed in a response to the proposed regulations by Craig Weiss, president and CEO of NJOY, one of the top-selling e-cig companies.Read MorePassenger claims Air Canada let man 'vape' onboard"By resisting calls to regulate ahead of—and indeed in opposition to—the science and the data, today the FDA has brought NJOY a giant step closer to achieving its corporate mission of obsoleting cigarettes," Weiss said. "There are encouraging signs that 10 years from now, this date will be remembered as the beginning of the end of the tobacco epidemic."That said, the tobacco companies themselves are poised to exploit their huge piles of cash and retail-channel distribution networks as they try to gain market share in e-cigs.Wells Fargo's Herzog, in her research note, wrote that she expects the "e-cig battleground" to get hotter this year, "especially as the 'Big 3' tobacco manufacturers push further into the category.""We expect the 'Big 3' to ultimately have a meaningful presence and to accelerate growth in the category," Herzog wrote.Altria, in a prepared statement, said it and its tobacco companies "have expressed support of the FDA extending appropriate regulatory authority over cigars and e-vapor products.""With these proposed deeming regulations, we believe FDA has an unprecedented opportunity to advance public health goals by recognizing that some types of tobacco products may have significantly lower risks compared to cigarettes," Altria said. "We believe FDA should adopt a regulatory framework that recognizes the differences in tobacco products and fosters innovation that may benefit public health. The framework must be grounded in science and evidence. FDA is in the best position to assess the science and determine how best to communicate relative risk information to consumers.""We are in the process of reviewing the proposed regulations and will provide our perspective to the FDA."In its own statement, Reynolds American said, "We are currently reviewing the proposed deeming regulation and are not in a position to comment on anything specific at this time.""It's important to note that the issuance of the draft deeming regulation simply begins a process that includes a 75-day public comment period. We will provide comments on the draft regulation and participate in the rulemaking process," Reynolds said. "Additionally, the issuance of the proposed deeming regulation does not affect the current marketplace for e-cigarettes."—By CNBC's Dan Mangan.
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Durbin, Democrats say proposed e-cigarette regulations don’t go far enough

WASHINGTON - The Food and Drug Administration's proposed new regulations on the burgeoning e-cigarette industry don't go far enough for Democrat critics in Congress, who wanted the agency to clamp down on advertising they say is aimed at minors.Last week 11 Democrats in Congress, including Sen. Dick Durbin, D-Ill., issued a report they said showed that companies were aiming at youth audiences by spotlighting flavored cigarettes and advertising around youth-oriented events.The proposed regulations announced today by the FDA would prohibit the sale of e-cigarettes to minors and require health labels warning smokers of nicotine''s addictive properties. Marketers could not declare the product was safer than cigarettes or other tobacco products, would have to disclose ingredients, and register their products with the FDA.Critics, including Durbin, issued a statement saying they were "extremely disappointed by (FDA's) failure to take comprehensive action to prevent e-cigarette companies from continuing to deploy marketing tactics aimed at luring children and teenagers into candy-flavored nicotine addiction."Prohibiting sales of e-cigarettes to minors "is a positive step," the congressional critics' statement said, "but it isn't enough."In his own statement, Durbin was even harsher."Shame on the FDA," he said, adding that "parents across America lost their best ally in protecting their kids from this insidious product."E-cigarettes use a small battery to atomize a liquid solution of nicotine without burning. Among other things, its advocates say it is a way to allow cigarette and cigar smokers to quit. The proposed FDA regulations would not allow e-cigarette advertisers to use terms like "light" to describe the product. The e-cigarette industry is rapidly growing. U.S. sales are expected to rise from about $1.6 billion last year to $3 billion in 2014, according to Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, which represents roughly 300 e-cigarette manufacturers and distributors. He said manufacturers do not want to sell to children, either.When Durbin and Rep. Henry Waxman, D-Calif., released last week's report criticizing the industry's advertising, Kiklas accused them of "trying to demonize us by using kids." He said manufacturers of e-cigarettes did not want to market to children, and denied that the advertising of flavored cigarettes was aimed at them.His association issued a statement on its Web site Thursday that was generally supportive of the proposed FDA regulations, and pointed out that the industry had worked successfully with European regulators."We strive for a consistent, reliable, and less harmful product that has been subjected to the scrutiny that products should face for human consumption," the statement said. "This allows the category to compete with conventional tobacco as a less harmful alternative." 
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Call to Action! Iowa - Support Ban on Sales to Minors (HF 2109 with Dotzler Amendment S-5088)

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Iowa: Ask Iowa State Senators to to Vote YES on HF 2109 with Dotzler Amendment (S-5088)

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FDA releases e-cigarette rules

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Today the FDA finally released its long-awaited proposed rules on e-cigarettes.

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Federal E-Cigarette Data AWOL

Americans are familiar with the census, taken every 10 years by the U.S. Census Bureau, but few are aware that the Bureau regularly collects information on a range of demographic, social and economic characteristics through Current Population Survey (CPS) supplements, which are sponsored by various government agencies.The National Cancer Institute regularly sponsors the CPS Tobacco Use Supplement (TUS), which was conducted most recently in May and August 2010, and January 2011 (information here). These datasets and accompanying technical documentation are available for download and analysis by tobacco researchers (here). Surprisingly, another TUS, conducted in May 2011 and described in a technical document as a follow-up survey that includes information on e-cigarettes (here), has never been released. This conflicts with Census Bureau guidance that supplements “are available anywhere from 6 to 18 months after data collection.” (here) The 36-month-and-counting delay is troubling. High ranking government officials have been campaigning against e-cigarettes for some time, creating demand for FDA regulation. The NCI, sponsor of this TUS, has been a powerful opponent of anything related to tobacco harm reduction. Is it possible that NCI officials are not releasing e-cigarette data until FDA regulations are issued?The NCI has suppressed positive positive data in the past. An NCI-sponsored supplement to the 2000 National Health Interview Survey asked current and former smokers the method they had used to try to quit smoking. One response was “switch to smokeless tobacco.” Carl Phillips and I published an analysis of this survey, noting that it provided the first population-level evidence that American men have quit smoking by switching to smokeless tobacco (here). Five years later, despite the fact that tobacco harm reduction had gained increased visibility and more American smokers were likely making the switch, the NCI struck the switch-to-smokeless query from the survey, denying the public information about this cessation option. Public health requires public access to taxpayer-funded survey data. NCI should be an ally in this regard, not an obstacle.
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Timeline of electronic cigarettes milestones leading to proposed FDA regulations

Late 2006: Electronic cigarettes first marketed in U.S. via kiosks in shopping malls and online. Early 2009: E-cigarette sellers sue the Food and Drug Administration after the agency told customs officials to refuse entry of shipments into U.S. June 2009: The Food and Drug Administration said testing of products from two leading electronic cigarette makers turned up several toxic chemicals, including a key ingredient in antifreeze. January 2010: Federal judge rules that the FDA can't stop those shipments, saying the agency had overstepped its authority. December 2010: Federal appeals court rules e-cigarettes should be regulated as tobacco products by the FDA rather than as drug-delivery devices. February 2011: U.S. Department of Transportation prohibits use of e-cigarettes on commercial airlines. April 2011: FDA announces plans to regulate electronic cigarettes as tobacco products. July 2011: FDA announces intent to have e-cigarette regulations proposed by October 2011. April 2012: Lorillard Inc., the nation's third-biggest tobacco company, buys Blu Ecigs. Summer 2012: No. 2 tobacco company Reynolds American Inc. begins limited distribution of first electronic cigarette under Vuse brand. February 2013: The Centers for Disease Control and Prevention releases study showing increased awareness and use of electronic cigarettes in the U.S. March 2013: Former U.S. surgeon general Dr. Richard Carmona joins board of directors for e-cigarette maker NJOY Inc. July 2013: Reynolds American launches test market of revamped version of Vuse e-cigarette. August 2013: Subsidiary of Altria Group Inc., owner of the nation's biggest tobacco company, Philip Morris USA, launches test market first e-cigarette under MarkTen brand name. September 2013: CDC releases study showing growing use of e-cigarettes by middle and high school students. End of 2013: Sales of e-cigarettes reach nearly $2 billion with more than 200 brands. April 24, 2014: FDA issues proposed regulations for electronic cigarettes.
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No longer blowing smoke? E-cigarettes could surpass traditional brands, experts say

When change has come for tobacco during its nearly two centuries as a star of North Carolina’s economy, it usually has arrived at a leisurely pace.Not this time. The crop and products made from it face something that has gutted or transformed many other industries in recent years: a disruptive technology.Electronic cigarettes are winning over smokers so quickly that some analysts predict the battery-powered newcomer could come out on top of traditional cigarettes within a decade. That’s unsettling for the farmers and manufacturers who still make North Carolina the national leader in tobacco production and rivaled only by Virginia in cigarette manufacturing.E-cigarettes heat a liquid, usually containing the highly addictive stimulant nicotine, into a vapor that users inhale. Nicotine for the liquid is extracted from tobacco, but experts think it may take less tobacco to make the “juice” than required for an equivalent amount of traditional cigarettes.That economic threat can also be an opportunity, partly because of the state’s decades of tobacco expertise and partly because of an odd bit of luck involving a plant called clary sage.Some think that e-cigarettes may even offer a way to slow the gradual slide in tobacco sales for domestic use, a slide that began decades before the advent of e-cigarettes.“It has been interesting to watch e-cigarettes move from almost a novelty to a trend,” said state Agriculture Commissioner Steve Troxler. “The bad news is, if it results in the decline of demand for traditional tobacco, then we are going to have a new set of problems, but the good news is, yes, we are poised to take advantage of it.”This may be the key year in North Carolina’s effort to muscle into that leadership role. One reason is that Big Tobacco is becoming Big Vapor, too: Major tobacco companies are moving to get ahead of the potential shift in the market by selling e-cigarettes themselves, either by buying companies already in the business or starting their own. And two of the nation’s three largest tobacco companies are here.With their deep pockets, intimate knowledge of the market, powerful research-and-development capacity and massive sales and distribution networks, they are in a position to quickly seize the majority of the market for e-cigarettes, said Bonnie Herzog, an analyst with Wells Fargo Securities who follows the e-cigarette and tobacco industries.She and other experts believe that the big companies will market devices that simply work better, which will win over more smokers.Greensboro-based Lorillard, the nation’s third-largest tobacco company, has been perhaps the most aggressive, snapping up an established e-cigarette company called Blu in 2012 for $135 million. Lorillard now has nearly half the national market share for e-cigarettes.And the nation’s second-largest tobacco company, Reynolds American Inc., based in Winston-Salem, has launched its own e-cigarette subsidiary, R.J. Reynolds Vapor Co. It has developed an e-cigarette that, unlike nearly all its rivals, is made in the United States.Reynolds is planning to launch its Vuse brand nationwide this summer. Its test-marketing results suggest the impact will be huge. In July, it started sales in Colorado and quickly gained more than half the market in that state. And RJR Vapor Co. President Stephanie Cordisco said in an interview that a second phase of test marketing that began in Utah in late January is showing similar results.The largest tobacco company, Richmond, Va.-based Altria Group, has test-marketed its own e-cigarette, MarkTen, in two states and plans to go national in the second quarter of the year. Altria is the parent company of Philip Morris.Transforming a marketThe stakes are huge. Last year, Herzog forecast that by 2023, Reynolds could earn $5.2 billion in revenue from e-cigarettes and $3.1 billion from traditional ones. And it, Lorillard and Altria would all see about half their revenue from traditional cigarettes vanish by 2023.If analysts such as Herzog are right, the tobacco companies have to get involved to protect not just their profits, but perhaps their future, said Blake Brown, a professor of agriculture and resource economics at N.C. State University and an extension economist who specializes in tobacco issues.“They can’t afford not to do this,” he said. “If you’re a tobacco company, you don’t want to be the next Eastman Kodak. They didn’t understand that they were in the image business. They thought they were in the film business.”This shift in history doesn’t seem lost on Big Tobacco. Lorrillard has a research and development team based in Silicon Valley. And at a Reynolds American media event in June, company President Daan Delen, tieless and in a sports jacket, roamed a stage at Pier 59 in New York, channeling the late Apple founder Steve Jobs as he unveiled Vuse. In interviews, Reynolds executives frequently use words such as “transformative” and “game-changing” for their new venture.The drop in domestic tobacco consumption, which has come at an annual rate of 3 percent to 4 percent in recent years, had already been eroding cigarette manufacturing for decades. Tobacco manufacturing employment in North Carolina is about a quarter of what it was at its peak half a century ago.Reynolds now declines to specify where its 5,200 U.S. workers are located, but in 2012 it reported that roughly 2,100 were in the Winston-Salem area. Like many other tobacco-related companies, it has seen its workforce drop substantially, from about 15,000 tobacco manufacturing workers in 1987 in the Winston-Salem area.The chance to reverse that erosion isn’t lost on Reynolds executives.“One of the things that I communicate to my team is that if we’re successful, we see jobs happening here,” Cordisco said. “We’re bringing jobs back to this company, and that’s what’s exciting.”She declined to give employment numbers but said that RJR Vapor Co. has created jobs in several states, some within the company, some with suppliers. In Kansas, it makes the cartridges. In its Tobaccoville manufacturing complex near Winston-Salem, it does the final packaging.For now, the number of employees working for e-cigarette companies is relatively small because the industry is small, said Herzog, the analyst.“Just to put it in perspective, retail sales (of e-cigarettes) were $1.8 billion in the U.S. last year, estimated, and that compares to an $85 billion combustible cigarette market,” she said. “But I certainly expect that consumption of e-cigs will pass consumption of combustible cigarettes in the next 10 years, and as that trajectory continues, absolutely you’re going to see companies get larger and hire more employees.”For now, most e-cigarette companies, including Lorillard’s Blu, have their devices made in China, though Blu gets its liquid from a company in Wisconsin.Herzog believes that it’s likely others will follow Reynolds’ path and move the manufacturing to the United States, where they can better control quality. Federal regulations, which are widely expected to come soon from the U.S. Food and Drug Administration, may include standards that would push more companies to make e-cigarettes in the U.S., she said.The magic of clary sageThe potential upside to e-cigarettes also may include farmers.For much of tobacco’s history in North Carolina, the state’s climate and soil were natural advantages that helped them produce a product of high quality and good taste. Farmers could fend off tobacco produced in countries where the labor was cheaper, or the climate so hot year round that two crops were possible.But one potential competitive advantage North Carolina farmers have for any e-cigarette comes from good luck: Avoca, a large botanical extraction company, is located in Bertie County near Edenton, not far from many of the state’s top tobacco-producing counties.There, it mainly has been extracting a fixative from a type of sage that helps scents last longer in perfumes and things such as laundry products. Farmers are now growing thousands of acres of the purple-flowered clary sage in the area.Last fall, Richmond, Va.-based Universal Leaf, the top vendor of leaf tobacco in the world, and Avoca announced a joint venture called AmeriNic that’s already extracting nicotine from tobacco and is planning to begin commercial sales this year, company leaders said in an emailed response to questions.The partners believe it to be the only operation in the country that extracts and purifies nicotine, an addictive stimulant in tobacco and a crucial ingredient in most e-cigarette “juice.”Farmers are watching the venture closely.“We think there is an opportunity, and we want to be the ones to fill that need,” said Graham Boyd, executive vice president of the Tobacco Growers Association of North Carolina.It’s unclear how much tobacco e-cigarette makers will need and where they will get it. In its response to questions, Universal Leaf declined to say where it plans to get its tobacco for extraction but said that its efforts to breed plants specifically for nicotine production were being done here, at least in part.“At this time, we are evaluating various sourcing options,” the company said. “Given our long history of purchasing quality tobaccos in North Carolina, we have included farms in the state as part of our R&D effort.”The need for nicotineDr. Loren Fisher, an associate professor of crop science and extension tobacco specialist at NCSU, said one advantage that North Carolina has in trying to reap some benefit from e-cigarettes is its centuries of hard-won knowledge about breeding and growing tobacco. He thinks it will be relatively easy to develop plants that are efficient little green factories for producing large amounts of nicotine, as opposed to the current goals of taste and the quality of the leaves.“I think we know right now what it takes to breed plants that would produce more nicotine,” he said.For the short term, growing tobacco for nicotine could turn out to be mainly an additional market, he said, rather than just a way to replace declining sales form the domestic market. That’s because most of the state’s tobacco crop is now exported and its foreign customers are feeling less effect from e-cigarette competition.For now, Troxler said, North Carolina’s tobacco crop seems to have stabilized, mainly because of overseas demand. Chinese demand for tobacco is rising, and last summer China’s national tobacco company opened an office in Raleigh as a base for its American tobacco-buying operations.But foreign demand may not remain steady, particularly if e-cigarettes also start making strong inroads overseas.The pace of the e-cigarette revolution could be affected by the nature of federal regulations that are believed to be in the pipeline. It also could be slowed by factors such as the emergence of other new kinds of tobacco products, or accelerated by something that Big Tobacco is likely to prove good at: advances in technology that make e-cigarettes even more attractive to smokers, Herzog said.It also could be slowed if e-cigarettes are hit with taxes by governments desperate to make up for lost revenue from the drop in traditional cigarette sales.Cigarettes are the largest cause of preventable deaths; e-cigarettes are believed to be significantly safer, but there is little research on their health effects. There is a debate among public health officials about how much to encourage smokers to switch to e-cigarettes by doing things like keeping taxes on them low. Some worry that the devices, with available flavors such as custard, berry or apple pie, encourage use by children.Brown, the NCSU tobacco economist, believes that something will bring big changes to the market, though he says it’s still too early to say that it will be e-cigarettes.Philip Morris, he noted, recently announced that it’s investing $680 million in a new Italian plant that would make noncombustible cigarettes, devices in which tobacco is heated just enough to give off inhalants, but not enough to burn.“There may not be smoking in five years, but there will be something different, whether it’s e-cigarettes or noncombustibles or something, but it’s going to be changed dramatically,” Brown said. “And to predict how it will change, and how that will affect manufacturing is difficult right now.”By Jay Price CallSend SMSAdd to SkypeYou’ll need Skype CreditFree via Skype No longer blowing smoke? E-cigarettes could surpass traditional brands, experts say
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It’s Vaping, Not Smoking

If it’s okay with you all, I’d like to vent a little.

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electronic cigarette reviews

23Apr, 2014by Brooke Taylor on April 23, 2014When shopping for e cigarettes, it is wise to have a list by your side indicating all of the features you are going to come across. Don’t go searching for the lowest price. Instead, create a budget and get started. The Lowest Budget For someone who sets only $10 aside to try an electronic cigarette, disposables are the best and only choices. No complete rechargeable products cost as little as this, though separate parts might. Your goal with a disposable is to experiment with the way a mini cig feels when you hold it and draw on the vapor. If you plan to buy disposables online, add shipping fees into the cost. Not all companies charge shipping, but most of them state that the cost of mailing out your goods is free only when you reach a particular amount: as little as $20 and as much as $150. Without shipping, disposable e cigarettes are priced from $4 to $10 online. Those prices represent varying markups and the number of puffs you should get out of them. Disposable e-cigs and e-hookahs are sold at convenience stores and gas stations. While many companies have introduced multiple flavors, most brands provide one-time e-cigs in just tobacco or menthol and one or maybe two choices of nicotine level. Next Step Either you liked the disposable you tried or you skipped their one-time wastefulness and you want to start with a small kit. Your budget is around $25 to $30, in which case an essentials package would suit your needs. An essentials package goes by many names, but what it amounts to is almost always the same. You receive one rechargeable battery, a USB charger, and two refill cartridges. Like disposables, these packages typically contain either menthol or tobacco in a specified nicotine level. There are always exceptions. Some kits contain 4 refills. Certain brands offer four or five levels of nicotine. Prices swing widely: from $15 to $30 for the same thing. Packaging is also varied with a number of companies opting for the cigarette-pack look and at least one choosing a metal tin. For More Money Customers don’t really understand how e cigarettes work until they have owned a rechargeable one. Starter Kits from $30 and upwards contain at least one battery, but buying a two-battery unit is much more efficient. They are small and run out quickly. Starter kits also contain more refills, at least five, and there is more choice of flavors and strengths when you pay more for a bigger package. That is, more choice is afforded to customers wherever companies sell multiple flavors. A few brands only sell tobacco and menthol, continuing to appeal to ex-smokers and refusing to encourage underage vaping with fruit and chocolate filters. If you plan to keep vaping into the future, choose a company with lots of options. Bigger starter kits come with pass-through batteries, charging cases, wall adapters, and car adapters. It’s ultimately cheaper to buy a kit with all the things you
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FDA reveals its views on ecigs in new publication (part 3), and some thoughts on their new deadlines


by Carl V Phillips This continues from the previous post, in a series that started here. I realize that mining journal articles for insights gets a little dry, as important as it is.  So I will start with something related.  In a new … Continue reading →Original author: Carl V Phillips
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FDA will propose e-cigarette regulations

A customer holds the electronic cigarette he purchased at the Vapor Shark store on September 6, 2013 in Miami, Florida. E-cigarette manufacturers have seen a surge in popularity for the battery-powered devices that give users a vapor filled experience with nicotine and other additives, like flavoring. Joe Raedle, Getty ImagesThe Food and Drug Administration for months has vowed to crack down on the sales and marketing practices of e-cigarette companies. Now the regulatory agency says it plans to propose rules for makers of the products as early as this month.The policies will have big implications for a fast-growing, largely unregulated industry and its legions of customers.If the regulations are too strict, they could kill an industry that offers the hope a safer alternative to cigarettes that could potentially help smokers quit. But the agency also has to be sure e-cigarettes really are safer and aren't hooking children on an addictive drug."This is a very complicated issue and we must be quite careful how we proceed," said David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation, in a recent panel discussion. "I call this sort of the Goldilocks approach. The regulation must be just right. The porridge can't be too hot, and it can't be too cold."The regulations will be a step in a long process that many believe will ultimately end up being challenged in court.Play VideoCBS This MorningE-cigarette debate smolders over health claimsSales of electronic cigarettes are on fire, at nearly $2 billion a year, but they're not regulated by the FDA. CBS News contributor Dr. David Agu...Recently, members of Congress and several public health groups have raised safety concerns over e-cigarettes, questioned their marketing tactics and called on regulators to address those worries quickly. Research conducted so far on e-cigarettes -- even by the FDA -- indicates they might not be completely safe, and suggests the devices don't help smokers quit.The FDA is likely to propose restrictions that mirror those on regular cigarettes, which includes banning sales to minors. Federal regulators also are expected to set product standards and require companies to disclose their ingredients and place health warning labels on packages and other advertising.Where the real questions remain is how the agency will treat the thousands of flavors available for e-cigarettes. While some companies are limiting offerings to tobacco and menthol flavors, others are selling candy-like flavors such as cherry and strawberry which may appeal to children.Regulators also must determine if they'll treat various designs for electronic cigarettes differently, some of which have been linked to nicotine poisoning. To prevent that, the FDA could mandate child-resistant packaging.The FDA also will decide the grandfather date that would allow electronic cigarette products to remain on the market without getting prior approval from regulators -- a ruling that could force some, if not all, e-cigarettes to be pulled from store shelves while they are evaluated by the agency.Many also anticipate the agency will address issues surrounding the marketing of such products. Companies won't be able to tout e-cigarettes as stop-smoking aids, unless they want to be regulated by the FDA under stricter rules for drug-delivery devices.The FDA's proposals could curb advertising on TV, radio and billboards, ban sponsorship of concerts and sporting events, and prohibit branded items such as shirts and hats. The agency also could limit sales over the Internet and require retailers to move e-cigarettes behind the counter.
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E-Cig Industry Awaits Looming Federal Regulation

Smokers are increasingly turning to battery-powered electronic cigarettes to get their nicotine fix. They're about to find out what federal regulators have to say about the popular devices.The Food and Drug Administration will propose rules for e-cigarettes as early as this month. The rules will have big implications for a fast-growing, largely unregulated industry and its legions of customers.Regulators aim to answer the burning question posed by Kenneth Warner, a professor at the University of Michigan School of Public Health: "Is this going to be the disruptive technology that finally takes us in the direction of getting rid of cigarettes?"The FDA faces a balancing act. If the regulations are too strict, they could kill an industry that offers a hope of being safer than cigarettes and potentially helping smokers quit them. But the agency also has to be sure e-cigarettes really are safer and aren't hooking children on an addictive drug.Members of Congress and several public health groups have raised safety concerns over e-cigarettes, questioned their marketing tactics and called on regulators to address those worries quickly.Here's a primer on e-cigarettes and their future:WHAT ARE E-CIGARETTES?E-cigarettes are plastic or metal tubes, usually the size of a cigarette, that heat a liquid nicotine solution instead of burning tobacco. That creates vapor that users inhale.Smokers like e-cigarettes because the nicotine-infused vapor looks like smoke but doesn't contain the thousands of chemicals, tar or odor of regular cigarettes. Some smokers use e-cigarettes as a way to quit smoking tobacco, or to cut down.The industry started on the Internet and at shopping-mall kiosks and has rocketed from thousands of users in 2006 to several million worldwide who can choose from more than 200 brands. Sales are estimated to have reached nearly $2 billion in 2013.Tobacco company executives have noted that they are eating into traditional cigarette sales. Their companies have jumped into the business.There's not much scientific evidence showing e-cigarettes help smokers quit or smoke less, and it's unclear how safe they are.WHAT IS THE FDA LIKELY TO DO?The FDA is likely to propose restrictions that mirror those on regular cigarettes.The most likely of the FDA's actions will be to ban the sale of e-cigarettes to people under 18. Many companies already restrict sales to minors, and more than two dozen states already have banned selling them to young people.Federal regulators also are expected to set product standards and require companies to disclose their ingredients and place health warning labels on packages and other advertising.Where the real questions remain is how the agency will treat the thousands of flavors available for e-cigarettes. While some companies are limiting offerings to tobacco and menthol flavors, others are selling candy-like flavors like cherry and strawberry.Flavors other than menthol are banned for regular cigarettes over concerns that flavored tobacco targets children.Regulators also must determine if they'll treat various designs for electronic cigarettes differently.Some, known as "cig-a-likes," look like traditional cigarettes and use sealed cartridges that hold liquid nicotine. Others have empty compartments or tanks that users can fill their own liquid. The latter has raised safety concerns because ingesting the liquid or absorbing it through the skin could lead to nicotine poisoning. To prevent that, the FDA could mandate child-resistant packaging.The FDA also will decide the grandfather date that would allow electronic cigarette products to remain on the market without getting prior approval from regulators — a ruling that could force some, if not all, e-cigarettes to be pulled from store shelves while they are evaluated by the agency.The regulations will be a step in a long process that many believe will ultimately end up being challenged in court.WHAT ABOUT MARKETING?There are a few limitations on marketing. Companies can't tout e-cigarettes as stop-smoking aids, unless they want to be regulated by the FDA under stricter rules for drug-delivery devices. But many are sold as "cigarette alternatives."The FDA's proposals could curb advertising on TV, radio and billboards, ban sponsorship of concerts and sporting events, and prohibit branded items such as shirts and hats. The agency also could limit sales over the Internet and require retailers to move e-cigarettes behind the counter.WHAT DOES THE INDUSTRY THINK?The industry expects regulations, but hopes they won't force products off shelves and will keep the business viable.E-cigarette makers especially want the FDA to allow them to continue marketing and catering to adult smokers — some of whom want flavors other than tobacco. They believe e-cigarettes present an opportunity to offer smokers an alternative and, as NJOY Inc. CEO Craig Weiss says, make cigarettes obsolete."FDA can't just say no to electronic cigarettes anymore. I think they also understand it's the lesser of the two evils," said James Xu, owner of several Avail Vapor shops, whose wooden shelves are lined with vials of liquid nicotine flavor, such as Gold Rush, Cowboy Cut and Forbidden Fruit.WHAT DO PUBLIC HEALTH OFFICIALS THINK?Some believe lightly regulating electronic cigarettes might actually be better for public health overall, if smokers switch and e-cigarettes really are safer. Others are raising alarms about the hazards of the products and a litany of questions about whether e-cigarettes will keep smokers addicted or encourage others to start using e-cigarettes, and even eventually tobacco products."This is a very complicated issue and we must be quite careful how we proceed," said David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation, in a recent panel discussion. "I call this sort of the Goldilocks approach. The regulation must be just right. The porridge can't be too hot, and it can't be too cold."———Michael Felberbaum can be reached at http://www.twitter.com/MLFelberbaum.
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E-cigarette sellers borrowing a page from Big Tobacco

Reset your passwordEnter your email and we will send you a link to reset your password.Email Reset my password CancelOK Resend EmailYou must have browser cookies enabled to view our site.Account issueWe're sorry, your shared access privileges have been removed by the subscriber. You can still look at a limited number of articles per month.Account issueWe're sorry, this account no longer has full access. You can still look at a limited number of articles per month.
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FDA reveals its views on ecigs in new publication (part 2)


by Carl V Phillips This continues from the first post on the series (which you should read to understand what I am doing and why). It has been an interesting few days in the world of rumor and inference about forthcoming FDA … Continue reading →Original author: Carl V Phillips
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White Cloud and the Environment: Celebrating Earth Day, Every Day

Every Earth Day, nearly every type of company – from e-cigs to eHarmony – boasts about how “green” their practices are, and how dedicated they remain to bettering our planet. White Cloud is no exception.

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Vaping: The battle for acceptance is rising

“The main thing is this is an alternative to smoking cigarettes.”Kate AckermanThe Electronic Cigarette Trade Association of CanadaNatalia Jakobowska has not tried any of the cheesecake varieties yet.“But I’d love to,” says the 29-year-old nurse, who has settled so far on plain old vanilla as her flavor of choice.There are dozens and dozens of other taste options she could pick from in the connoisseur market that is emerging around electronic cigarette smoking in Canada.But ah, that word — smoking! It’s verboten among the tens of thousands of people in this country who have taken up the tobacco alternative in recent years.“We’re vapers,” Kate Ackerman says emphatically.“Cigarettes produce smoke. So that’s smoking. Electronic cigarettes produce vapour. So that’s vaping,” says Ackerman, a director of the Electronic Cigarette Trade Association of Canada.The vapour electronic cigarettes produce is all but odourless and, many argue, far, far safer than tobacco smoke for users and anyone within second-hand range.While odourless, however, so called e-cigarettes are producing the stench of controversy as their popularity rises.Take our pollThis mostly revolves around regulatory questions about their actual safety and where they can be used. There is also concern among many that electronic cigarettes could be a gateway to the tobacco variety.Jakobowska has vaped in shopping malls, on smoking-restricted patios and at the Cambridge cosmetic clinic where she works, all without a whisper of complaint, she says.“No one has ever said anything,” says the long-time smoker, who hasn’t had a puff of tobacco since she took up e-cigarettes last year.Just last month, however, complaints were launched about a passenger vaping on an Air Canada flight from Calgary to Toronto, the CBC reported.Air Canada forbids in-flight vaping.In several jurisdictions, both here and in the United States, there are now concerted attempts to shrink vaping spaces to the dismal, butt-strewn plots allotted smokers.“But smoking legislation was created because smoke has been proven to be dangerous,” says Ackerman, who runs her own e-cigarette company outside Calgary. “It’s dangerous to the bystander, it’s unpleasant, it stinks. It’s a bad thing.”Lacking evidence to show second-hand health impacts — and any offensive smell — electronic cigarettes have largely escaped indoor bans.But that’s left a free-for-all in terms of allowable vaping space, with businesses and institutions largely left to classify their premises as they see fit.No one knows quite how many vapers there are across the country right now. Last month Health Canada said it would commission a $230,000 study on the number of e-cigarettes sold here over the past two years.But Ackerman says usage is booming, with the number of shops and web vendors specializing in the devices and their muliplying accessories having risen from half a dozen to more than 200 since 2010.And the number of available flavours has grown proportionately.The flavourings are among e-cigarettes’ key selling points says Ackerman, with everything from cherry cheese cake and blueberry pie to tobacco, liquor and wine tastes being infused into the products.And as with cigar or wine aficionados, Ackerman says a burgeoning vaping culture, “an incredibly huge social network,” has gown up around the devices.Ackerman says Facebook pages and Internet chat rooms now abound and attract thousands of vapers to discussions about flavorings, recipes and the myriad delivery devices coming onto the market. These can range from $10 corner store disposable products to refillable, rechargeable systems that can run between $25 and $150.There are also handmade, “artist” models. Some hard-core vapers will pay up to $300 and $400 for one of those.The problem with these customized devices is that some of the artists have proved poor electrical engineers. “There have been stories of batteries blowing up,” Ackerman says.But electronic cigarettes’ main selling point, says Ackerman, is the presumed health improvements over burned tobacco products.“The main thing is this is an alternative to smoking cigarettes, it’s a harm reduction product,” she says.The e-cigarettes utilize small heating elements to vapourize a propylene glycol liquid. It’s the same stuff that produces fog at rock concerts.“It’s also what’s used in asthma inhalers, it’s used in hospitals to purify the air,” says Ackerman, who smoked for decades before turning to e-cigarettes. “And it doesn’t take a lot of heat. It vaporizes very readily.”While propylene glycol is a known irritant, Ackerman says, it has none of the carcinogenetic or artery-hardening properties that tobacco smoke carries.And the myriad tastes, when blended by reputable manufacturers, come from the same regulated, flavour additives the food industry uses every day, she says.“Some people like crème de menthe, some people like whiskey flavours, cooler flavours,” Ackerman says. “And because it’s just food flavoring, you can really do a lot, you can get very connoisseur driven.”In many countries outside of Canada, however, the propylene glycol fuel is also infused with nicotine. Though it’s the addictive agent in cigarettes, nicotine itself is not a carcinogen and is classified most often as a stimulant in the same vein as caffeine.But citing nicotine’s addictiveness — and a lack of evidence that smoking-cessation benefits outweigh potential risks — Health Canada has refused to approve the sale or import of devices or liquid refills containing nicotine.That hasn’t stopped many — likely the majority — of Canadian vapers from buying the nicotine juice online.Yet even with a nicotine additive, electronic cigarettes remain far safer than their tobacco alternatives, many experts say.Dr. Gopal Bhatnagar, a cardiac surgeon at Mississauga’s Trillium Health Centre, is so certain of their health benefits that he founded the e-cigarette company 180 Smoke to help people quit the tobacco version.Bhatnagar, who has seen his share of cigarette-ravaged hearts, says vapor is far safer than tobacco smoke as a nicotine delivery medium.“Tobacco smokers, people who take combustibles, they want the nicotine, it’s the tobacco byproducts that kill them,” the former Trillium chief of staff says. “Tobacco has over 6,000 carcinogens in it . . . stuff that also stiffens arteries, which leads to cardiovascular disease as well.”Importantly, Bhatnagar says, vaping can calm the powerful psychological cravings for cigarettes — whether it’s delivering nicotine or not. He says traditional nicotine replacement products — like gum and patches — wean only a quarter of smokers who try them off of cigarettes.“People want the oral and manual sensation of a cigarette . . . they want to put something in their mouth, they want to hold something,” Bhatnagar says. “I do feel the electronic cigarette, it provides that.”That was nurse Jakobowska’s experience when she was quiting tobacco.“It helped psychologically,” she says. “When you’re talking on the phone, when you go outside, have a drink, when you’re driving, it’s helpful in those situations.”One of the key e-cigarette critiques, however, has been that the nicotine-laced varieties could be gateways to tobacco smoking for young people.But Bhatnagar says vaper demographics would argue strongly against this, with the vast majority of e-cigarette users being former smokers, or people trying to quit. While he cites U.S. Food and Drug Administration studies showing e-cigarettes produce exceedingly low levels of toxins, Bhatnagar admits there is no conclusive evidence that vaping is an effective smoking cessation therapy.“But if you’re asking me as a physician in terms of tobacco harm reduction, I strongly believe from a public health policy point of view that electronic cigarettes (could be) a very significant answer.”He has the backing of Dr. Peter Selby, one of Canada’s leading tobacco experts. Selby, the head of addictions at Toronto’s Centre for Addiction and Mental Health, says e-cigarettes have the potential to be a winning weapon in the long battle against tobacco.“If this is part of a bigger plan to figure out a way to get rid of combustible cigarettes and ban them, then it’s a fantastic opportunity,” says Selby. “It will be revolutionary, similar to when we decided to get rid of leaded gasoline.”Should Canada find the will to ban tobacco products, e-cigarettes would provide a safe, cheap and acceptable replacement for those who would otherwise smoke, Selby says.As it stands now, however, Health Canada is blocking their widespread use as nicotine alternatives by insisting that they be approved under the agency’s medical device category.“If this comes in as a medicine it will kill it and it will keep combustible cigarettes on the market,” Selby says. “We’ve seen that with other nicotine replacements. It’s never been able to replace cigarettes.”Instead, Selby says, regulations should ensure that the percentage of people who need or will turn to nicotine have the safest delivery product available. He says the federal health agency is likely having trouble classifying e-cigarettes because they are neither tobacco nor medicines.“The way I look at it, they have a round hole and a square hole, and this is a triangle,” he says. “And they are trying to stuff it into one of those two holes and both are wrong. They need to create a triangle.”
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E-cigarette ban planned by council

There are few restrictions on the use of e-cigarettes throughout the UK Electronic cigarettes could be banned from use in council-owned buildings and vehicles in the Caerphilly county borough. If agreed, the move would see so-called e-cigarettes treated in the same way as conventional cigarettes. A report on the proposals says the move is in line with the stance taken by Aneurin Bevan University Health Board. The Welsh government recently announced its intention to ban e-cigarettes in public places in Wales. Caerphilly council said the proposal was sparked "because of a number of incidents with employees wishing to use electronic cigarettes within council premises". A separate report by the Directors of Public Protection Wales, looking at the impact of e-cigarettes since their introduction in 2007, found they often caused problems for enforcement officers. 'Normalise smoking' Caerphilly council had received complaints of taxi drivers smoking in vehicles, which were later found to be e-cigarettes, it said. The same problem was also reported in Cardiff, Swansea and Wrexham. The proposal to prohibit their use in Caerphilly council premises must be agreed by its cabinet before it can be introduced. Earlier this month ministers in Wales said they would consider banning the devices - which can contain nicotine - in public places. This was in response to concerns they normalise smoking and undermine the smoking ban.
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Five Flavor Review

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