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Mountain Vapor Blog

Welcome to the blog area of our site where we hope to keep you updated on the trends of the e-cigarette industry as well as product reviews.

E-Cigarette Safety: Only use equipment designed for your e-cig!

In an event that is bound to set the anti-e-cig media into a propaganda frenzy, another e-cigarette-related accident has occurred – this time, in the United Kingdom, when, according to news sources, a fire broke out in a user’s bedroom from a recharging e-cigarette.

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How Sad? Journal Article Needs to Remind Tobacco Control Researchers to Be Honest and Rigorous

An editorial published in the current issue of Addiction recounts the many ways in which tobacco control researchers have been dishonest with the public about the science regarding electronic cigarettes. It then discusses what needs to happen moving forward, and concludes that what is needed is for tobacco control researchers to be honest.The authors provide several examples of the dishonesty and misinformation being provided by tobacco control researchers, groups, and policy makers.Their chief example is striking: many tobacco control researchers are referring to electronic cigarettes as "tobacco products." However, e-cigarettes are not tobacco products. They contain no tobacco whatsoever.The authors write:"Many publications and statements by researchers, nongovernmental and governmental agencies and the wider mass media mistakenly refer to e-cigarettes as tobacco products. For example, e-cigarettes were referred to as tobacco products in approximately one in four abstracts about e-cigarettes at the 2014 Annual Meeting of the Society for Research on Nicotine and Tobacco in Seattle [1]. The same error can also be found in the peer-reviewed literature and in writing by influential agencies. For example, the US Center for Disease Control and Prevention website states that ‘emerging tobacco products such as e-cigarettes and hookahs are quickly gaining popularity’ [2]. While it is true that the vast majority of e-cigarettes use a nicotine containing solution that is extracted from the tobacco plant, this is similar to nicotine replacement therapies (NRT) and, unlike ordinary tobacco cigarettes,the current e-cigarettes on the market operate with ‘no tobacco, smoke, or combustion’ [3]. Furthermore, although traces of tobacco-specific nitrosamines (TSNAs) have been found in some e-cigarettes, similar traces of TSNAs are present in licensed NRTs [4–7]. This mislabelling is exacerbated by national and international regulations including e-cigarettes in their tobacco regulations or proposing to do so."The authors conclude with a section entitled "What Needs to Happen?"Simply put, they argue that what needs to happen is for tobacco control scientists to start being honest, to adhere to good scientific practice, and to guide their conclusions by evidence rather than emotions.They write: "We believe that statements from the research community need to be evidence-based. While lively debates help to advance science and policy, adherence to good scientific practice is paramount. We need more rigour and oversight to ensure that interpretation of evidence is guided by data, not emotions, and that strong statements based on weak evidence are avoided. We need those reviewinggrants and research papers, and also those publishing such papers, to be accountable."The Rest of the StoryI find quite sad that an article needs to be published imploring tobacco control researchers to be honest and rigorous and to use good scientific practice and draw conclusions based on evidence rather than emotions.Is there any other area of science where the researchers have to be reminded to be honest and rigorous?While I agree with the editorial, it is quite a condemnation of the current field of tobacco control research.Original author: Michael Siegel
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No action, talk only at e-cigarette hearing

LOCKPORT – The Common Council held a public hearing Wednesday on a proposed special-use permit for an e-cigarette store, but it was unclear if there ever will be a vote on it.“No one would sponsor it,” Corporation Counsel John J. Ottaviano said. Since the Planning Board opposed the request, city ordinances require that a unanimous Council vote would be needed to grant the permit.Jordan Bork wants to open an electronic cigarette store in the front portion of Hairport, a salon at 343 Walnut St. Landlord Dennis J. Stachera handed in a petition with 22 signatures in favor.Planning Board member Jeffrey Tracy said at the hearing that he thinks e-cigarettes are bad. “I don’t want this temptation in my neighborhood,” he said.Stachera said, “I know six people who have quit smoking” by switching to e-cigarettes.Ottaviano said comments on the safety of the product are irrelevant to the question of whether the city should make an exception to the zoning ordinance to permit the store.He asked Bork questions about whether the e-cigarette units or the liquid nicotine burned in them are a fire hazard. Bork assured him they are not, and also promised not to allow people to lounge around the store. Bork said selling e-cigarettes to minors is illegal, and he will enforce that ban.Stachera said he walked door to door in the neighborhood and found no opposition to the store. But he also admitted the building in which the store would be located is for sale.The Council voted to pay the Bonadio Group of Amherst $13,700 for its work, which originally was to cost $7,000.The firm interviewed staff, met with officials and the Council, and drafted a report in late March that showed personnel shortages were a primary cause of the city falling behind on record-keeping, leading to incorrect financial reports.Also Wednesday, the Council voted to pay attorney David Haylett $2,400 for filling in as traffic court prosecutor from Feb. 25 until last week. That equals $200 an hour for two hours every Tuesday.Haylett took the place of Deputy Corporation Counsel Matthew E. Brooks, who was recovering from surgery, Ottaviano said. The city has two other deputy attorneys, but both also work for the county as assistant public defenders, meaning they couldn’t serve as prosecutors, even in traffic court.The Council also:• Approved a contract with Mayor Anne E. McCaffrey’s new secretary, Brandy Martucci, for a salary of $28,700 a year.• Spent $173,629 in state highway aid to buy a new front-end loader that could be used to plow snow. That brings the city’s fleet to four loaders, although two are currently broken down.• Authorized bidding for repairs to the Main Street waterline, which burst three times in front of City Hall in late April. The resulting damage left Main Street in extremely rough condition, and also left a hole in the City Hall parking lot.email: This email address is being protected from spambots. You need JavaScript enabled to view it.l author: Wilbur
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New Study of Trajectory of E-Cigarette Use Suggests a Pattern of Decreasing Cigarette and Nicotine Addiction

In one of the first studies to examine the trajectory of electronic cigarette use over time, Lechner and colleagues have shown that extended duration of electronic cigarette use is associated with reductions in cigarette use and in the strength of nicotine used during vaping.(See: Lechner et al. Effects of duration of electronic cigarette use. Nicotine and Tobacco Research. Published online May 13, 2014. doi: 10.1093/ntr/ntu061.)The methods of the study were as follows: "Individuals were recruited at e-cigarette retail locations in a large metropolitan city in the midwestern portion of the United States in July 2013. A total of 159 participants completed a brief 29-item self-report measure that assessed behaviors and perceptions of use."The results were reported as follows: "Increased duration of e-cigarette use was associated with fewer cigarettes smoked per day and differing patterns of dependence to e-cigarettes contingent upon smoking history. Additionally, increased duration of e-cigarette use was associated with increased frequency of use; however, this finding became nonsignificant when current tobacco cigarette use was accounted for, suggesting that individuals may increase e-cigarette use frequency as they decrease cigarette use. Overall, e-cigarette users tended to decrease the strength of nicotine in their e-cigarette products regardless of duration of use."The Rest of the StoryThere are three major findings -- all preliminary -- from this study.First, in contrast to what Stan Glantz is arguing, dual use does not appear to be an "adverse consequence" of e-cigarette experimentation. Instead, it appears to be a positive effect that results in a substantial reduction in cigarette consumption among smokers who would almost certainly not have quit smoking altogether in the absence of electronic cigarettes.Second, in dual users, the total amount of nicotine intake declines. The increase in electronic cigarette use over time is accompanied by a concomitant decline in cigarette smoking. Thus, overall nicotine declines.Third, e-cigarette users tend to decrease the strength of nicotine in their products, leading one to believe that overall levels of addiction to nicotine decline compared to their baseline smoking status.Combined with previous evidence, these results suggest that the natural history of electronic cigarette use over time is characterized, in general, by:a. Substantial reductions in cigarette use;b. Reduction in daily nicotine intake; andc. Movement to a lower level of overall nicotine addiction.The bottom line: it appears that the use of electronic cigarettes has tremendous health benefits not only for those who quit smoking, but also for those who become dual users. While it may take longer for these individuals to eventually get off of nicotine altogether, it appears that the switch to e-cigarettes yields a much lower level of nicotine addiction, making it easier, not harder, to subsequently cease using nicotine if they so desire.One of the main criticisms of electronic cigarettes leveled by its opponents in the tobacco control movement is that there are many dual users of e-cigarettes and tobacco cigarettes and that this has adverse public health consequences.For example, Stan Glantz argued against electronic cigarettes in a Scientific American article, claiming that: "We’ve found very high levels of dual use [traditional cigarettes along with e-cigarette use]. Very few people have switched away from cigarettes or managed to use them as a bridge to eventually go off cigarettes."While Dr. Glantz's statement that few people have switched away from cigarettes or used e-cigarettes as a bridge to eventually go off cigarettes was not science-based, but pure speculation, there are now two studies which actually examine the trajectory of electronic cigarette and conventional cigarette use among a cohort of e-cigarette users. We are able to empirically examine Glantz's dual use argument and his claim that very few smokers are using e-cigarettes as a bridge to eventually go off cigarettes.The results from these two studies demonstrate that in contrast to the claims of many anti-smoking advocates, dual use of electronic cigarettes and conventional cigarettes does not necessarily have adverse public health consequences. Instead, it appears that for many smokers, dual use serves as a gateway to decreased nicotine addiction, and perhaps ultimately to smoking cessation.The results of this study suggest that anti-smoking advocates such as Dr. Glantz are wrong in asserting that very few smokers "have switched away from cigarettes or managed to use them as a bridge to eventually go off cigarettes." Instead, there appears to be a large number of smokers who have indeed switched completely from smoking to vaping, and there also appears to be a large number of smokers who have successfully used electronic cigarettes as a bridge to complete smoking cessation.The rest of the story is that dual use is not necessarily a bad thing. In fact, it may for some be a gateway to smoking cessation.Original author: Michael Siegel
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For Smokers Only: The E-Book With Bonus E-Cig Chapter

In 1994, I published the first professional medical articles documenting that smokeless tobacco contained satisfying doses of nicotine (in the Journal of the American Dental Association, here) and was vastly safer than smoking (in Nature, here), and I proposed “that smokeless tobacco be recommended as a cigarette substitute by persons who cannot stop smoking.” (in the American Journal of the Medical Sciences, here).My scientific articles drew massive opposition. The National Cancer Institute investigated my university, claiming that my strategy was unethical (documented in Jacob Sullum’s excellent book, For Your Own Good, available here) as other medical groups launched vicious attacks. One fact was beyond contradiction: Smokeless tobacco use was at least 98% safer than smoking. While scientific evidence for tobacco harm reduction was overwhelming, smokers were completely uninformed about the lifesaving option of switching to a smoke-free delivery system. This led me, in 1995, to address smokers directly with a book, “For Smokers Only: How Smokeless Tobacco Can Save Your Life.”Recognizing the continuing relevance of this groundbreaking work, publisher Rick Newcombe of Sumner Books has just released it as an e-book, updated with a bonus chapter on e-cigarettes. From exaggerated health scares to bogus gateway claims, opponents of e-cigarettes are using the same tactics they’ve used against other smokeless tobacco products for decades. Dr. Dean Edell, physician and host of an award-winning health radio program for 31 years (here), described For Smokers Only as “credible, logical and eminently do-able.”The FDA Tobacco Product website offers as an example of “Health Fraud” (here) the suggestion “that a tobacco product is safer, less harmful, contains a reduced level or is free of a harmful substance, or presents a lower risk of tobacco-related disease compared to other tobacco products…To date, no tobacco products have met the requirements that would permit them (sic) to make claims of reduced risk or harm to users and nonusers of their regulated tobacco products.”Applying that absurd definition, I have been conducting health fraud for 20 years.Smokers, smokeless and e-cig users, get the help you deserve. Download For Smokers Only from Amazon (here), Barnes and Noble (here) or ITunes (here).Original author: Cody
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Second Call to Action for FDA Proposed Regulations - Consumer Comment on Paperwork Reduction Act

On Thursday, May 8th, CASAA released the Overview of its Action Plan Regarding Proposed FDA Regulations.  On May 11, 2014, CASAA released the first of several Calls to Action anticipated in CASAA's Action Plan.   This is the second Call to Action in CASAA's Action Plan.

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E-cigarettes safe; no need for S.F. to ban them

There’s a new product on the market that offers a chance to find a workable middle ground in America’s smoking debate. Called vapes, electronic cigarettes or e-cigarettes, they deliver nicotine with a big twist: Instead of burning tobacco, they vaporize – hence the nickname – a nicotine-containing liquid.Despite the uniqueness of this product, overzealous lawmakers are champing at the bit to ban e-cigarettes, egged on by career activists who see a public health threat wherever they look. Chicago and New York City have already caved to activist pressure. And now, thanks to a swift vote, Los Angeles is set to extend its blanket prohibition of public cigarette smoking to e-cigs, which emit only vapor, not smoke. But before San Francisco heads in a similar direction, voters should know the truth about e-cigarettes.First and foremost, e-cigarettes are not cigarettes and do not carry the associated harms. The American Association of Public Health Physicians has noted that smokers could reduce their risk of tobacco-related death “by 99.9 percent or better” by switching to products like e-cigarettes. That’s quite a reduction.It’s not enough, however, for the overzealous activists and officeholders who know how easy it is to mobilize knee-jerk political action against anything with the “c”-word in it.To get their way, regulators are changing the rules. Instead of having to prove that vapes are harmful before they can regulate or ban them – as is the norm with essentially all other consumer products – activists and lawmakers are demanding that consumers and businesses prove they are not dangerous before stifling restrictions can be lifted.That may seem like an exercise in wordplay, but in reality, it turns hundreds of years of established legal thinking on its head. It puts businesses in the position of proving a negative – a logical fallacy that busybody regulators and fans of expansive government are perfectly happy to exploit.This is a dangerous precedent. If businesses are not able to sell technologically advanced products – and consumers not able to benefit from the same – until they are proved unharmful, we’ll quickly succumb to unscientific and demagogic fear campaigns. Business owners will be forced to devote their time and energy to warding off baseless attacks from finger-wagging do-gooders. Commerce will be blunted and innovation will be suffocated as fewer new products are brought to market.Making the switch from smoking cigarettes to inhaling smokeless nicotine could be beneficial to smokers, ex-smokers, and nonsmokers alike. After all, many of the arguments in favor of banning smoking in places like bars and restaurants were out of concern for the health of employees and patrons. But since vapes aren’t regular cigarettes, there’s no smoke to afflict nonsmokers.San Franciscans don’t have to give in to the same scare tactics and faulty logic that turned the Los Angeles City Council against vapes. Rushing into a sweeping “solution” for a problem that doesn’t exist makes it all too likely that consumer health and common sense will soon go up in smoke.Sarah Longwell is the communications director for the Center for Consumer Freedom, a nonprofit group “devoted to promoting personal responsibility and protecting consumer choices.” Headquartered in Washington, D.C., it receives support from businesses – primarily in the food and beverage sectors – foundations, and individuals. (The credit line to this essay has been changed from the print version.) E-cigarettes safe; no need for S.F. to ban themOriginal author: James
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New Population-Based Study Reports that E-Cigarettes Outperform NRT for Self-Assisted Smoking Cessation Among Smokers Who Choose These Approaches

A new study published online ahead of print in the journal Addiction provides evidence that electronic cigarettes may have the potential to outperform nicotine replacement therapy (NRT) for self-assisted smoking cessation.(See: Brown J, Beard E, Kotz D, Michie S, West R. Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction. 10.1111/add.12623.)In this cross-sectional study, a sample of adults who smoked at any point in the past 12 months was identified from a national household survey conducted in England between 2009 and 2014. Criteria for inclusion in the study were: (1) having made a serious quit attempt in the past year; (2) having used e-cigarettes alone, NRT alone, or an unaided quit attempt during their most recent quit attempt; and (3) not having used a prescription cessation drug or behavioral counseling during their most recent quit attempt.Smoking status was then assessed at the time of the interview to determine the rates of successful quitting during the most recent quit attempt, comparing the three groups: (1) e-cigarettes only; (2) NRT only; and (3) no cessation aids. The total sample size was 5,863.The odds ratio for successful quitting for the e-cigarette group compared to subjects who used NRT was 2.23 (95% confidence interval, 1.70-2.93).The odds ratio for successful quitting for the e-cigarette group compared to subjects who used no cessation aid was 1.38 (95% confidence interval, 1.08-2.93). In the above analyses, the authors controlled for level of nicotine dependence.The study concludes: "Among smokers who have attempted to stop without professional support, those who use e-cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over-the-counter or no aid to cessation."The Rest of the StoryThis study provides data to support the hypothesis that among smokers who choose to quit using e-cigarettes or over-the-counter nicotine replacement products (and without behavioral support), the e-cigarettes produce about a two-fold increase in the quit rate.Readers should be cautioned that this study should not be used to conclude that e-cigarettes are twice as effective as NRT for smoking cessation generally, for reasons explained articulately by Carl Phillips in his commentary on this study.Perhaps the most useful contribution of this paper is that it readily demonstrates why the approach being used by Stan Glantz to assess the effectiveness of e-cigarettes for smoking cessation is inappropriate and leads to erroneous conclusions.The main difference between this study and those touted by Glantz as showing that e-cigarettes are ineffective is that unlike Glantz's cited studies, this one actually examines cessation rates among smokers who reported using e-cigarettes for smoking cessation. In other words, Brown et al. included smokers who reported having used e-cigarettes with the intention to quit smoking. In the studies cited by Glantz, smoking cessation rates for all e-cigarette users were examined, even if a smoker just tried a puff of an electronic cigarette to see what all the hype is about.For obvious reasons, the Glantz approach is the wrong one to take, and the Brown et al. approach is correct. This study demonstrates that when you analyze the data the proper way, it appears that electronic cigarettes -- for the right smokers -- can be an effective smoking cessation tool.The key qualifier is "for the right smokers." There is a subset of smokers who try electronic cigarettes and find them satisfactory. They may then go on to make a decision to try to quit using e-cigarettes. The results of this study do not imply that if a smoker were "forced" to use e-cigarettes to quit, one would find the same favorable results.However, from a public health perspective, the relevant question is not what results one would obtain if smokers were forced to use a particular strategy, but what results are obtained when smokers make the choice to use a particular strategy. This is why Stan Glantz's approach is inappropriate.Ironically, Stan Glantz criticized the study specifically because it examined the effect of electronic cigarettes on quitting among smokers who desired to quit. According to an article in the New York Times: "Stanton A. Glantz, a professor of medicine at the University of California, San Francisco, said the study’s limitation was that it tried to measure the effect of e-cigarette use only among smokers who were trying hard to quit, not all smokers."By Stan's logic, we should throw out all the clinical trials upon which the established effectiveness of NRT is based because every one of these trials was designed to assess the efficacy of NRT among smokers who used these drugs with the specific intent to quit. Instead, according to Glantz's logic, we should examine the rate of smoking cessation among everyone who has ever used an NRT product. Doing that would lead to the conclusion that NRT is completely ineffective for smoking cessation.The biggest problem with Stan's approach is that when you examine e-cigarette users who are not using the product to quit, you are introducing a huge sampling bias. For example, why might someone use e-cigarettes, but not to quit? Most likely, the majority of vapers who are using e-cigarettes for a purpose other than cessation are using e-cigarettes to cut down on the amount they smoke. They are likely to derive benefits from smoking reduction. However, they are almost assuredly not going to quit smoking because they are not trying to quit, nor do they have such a desire.  The rest of the story is that if you ask the wrong question, you are going to get the wrong answer. By asking the wrong question about the effectiveness of electronic cigarettes, Dr. Glantz has obtained the wrong answer.From a public health perspective, the effectiveness of e-cigarettes for smoking cessation must be assessed by examining how effective the product is for smokers who are trying to quit. When you do that properly, this initial evidence suggests that you find out e-cigarettes are a viable smoking cessation aid for a subset of smokers.The degree to which electronic cigarettes stimulate or depress overall interest in quitting is a separate and empirically answerable question. In fact, evidence from the UK indicates that the spread of electronic cigarettes has been associated with a substantial increase in the desire to quit smoking at a population level.Original author: Michael Siegel
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E-Cigarettes at the Office: What’s the right protocol?

In the salad days of the e-cig boom, nearly every vaper and vaping company boasted about our rights to “smoke wherever you want, whenever you want.”

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Electronic cigarettes help smokers quit in ‘real world,’ study finds

A new study based on real-world data from England lends support to the idea that electronic cigarettes can help smokers quit using regular cigarettes.Among a sample of 5,963 adults who tried to kick the habit without prescription medications or counseling, those who turned to e-cigarettes were about 60% more likely to succeed than those who used nicotine replacement therapy or went cold turkey. Researchers from University College London published their results online Tuesday in the journal Addiction.Electronic cigarettes are battery-powered devices that burn a nicotine solution to create a vapor resembling the smoke from a tobacco cigarette. Advocates say they promote health by providing an alternative to traditional cigarettes and the poisonous tars and carbon monoxide that come with them. Critics – including Dr. Tom Frieden, director of the Centers for Disease Control and Prevention – counter that e-cigarettes get people (especially kids) to get hooked on nicotine, increasing the risk that they will move on to regular cigarettes. Scientists and public health officials are eager to sort out the pros and cons of e-cigarettes, which are lightly regulated and increasingly popular. Surveys and clinical trials designed to measure the effectiveness of e-cigarettes as a smoking cessation tool have produced mixed results.For the new study, researchers turned to data from the Smoking Toolkit Study, an ongoing survey of English smokers. They examined survey responses gathered between July 2009 (when e-cigarettes were relatively new) and February 2014 from smokers who said they tried to quit at least once in the previous year. For the sake of simplicity, they focused on three groups of would-be quitters: Those who used only e-cigarettes (8% of the sample); those who used only non-prescription nicotine replacement items like gum or patches (33% of the sample); and those who didn’t use any kind of smoking cessation treatment (59% of the sample). The raw data were strongly in favor of e-cigarettes, with 20% of those who used them saying that they had quit smoking. That compared with 10% of those who used non-prescription nicotine replacement therapy and 15% of those who went cold turkey.But the people who opted for electronic cigarettes were not the same as other smokers, so the researchers controlled for factors like age, gender, socioeconomic status and the degree of their nicotine dependence. With these factors taken into account, the researchers found that people who used electronic cigarettes were 1.63 times more likely to to quit smoking than those who opted for nicotine replacement therapy. In addition, they were 1.61 times more likely to succeed than people who didn’t use any smoking cessation aids.The study participants did not have to verify their nonsmoking status by taking a urine test or anything else, the researchers noted. But they said that given the survey’s design, people would have had little incentive to lie.The findings provide reliable information on the value of e-cigarettes “in the real world,” the study authors concluded.“E-cigarettes may prove to be both an efficacious and effective aid to smoking cessation,” they wrote. “Insofar that this is true, e-cigarettes may substantially improve public health because of their widespread appeal and the huge health gains associated with stopping smoking.”The study was funded in part by Pfizer, which makes the smoking cessation drug varenicline (sold under the trade names Chantix and Champix). In addition, four of the five researchers disclosed that they had received grants and other fees from “companies that develop and manufacture smoking cessation medications.” None of the five has a financial relationship with a company that makes electronic cigarettes.Senior author Robert West, a professor of health psychology and director of tobacco studies at University College London, is the editor in chief of Addiction. Copyright © 2014, Los Angeles TimesOriginal author: Margrett
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E-Cigarette Users May End Up Paying More For Insurance

hide captionA customer holds the electronic cigarette he purchased at a store in Miami.Joe Raedle/Getty ImagesA customer holds the electronic cigarette he purchased at a store in Miami.Joe Raedle/Getty ImagesPeople may think that e-cigarettes are a safer alternative to tobacco, but insurers might not agree.Tobacco use is one of just four things that insurers that sell health plans on the individual market can take into account when determining someone's premium: age, geographic location, and family size are the other three. People who use tobacco can be charged up to 50 percent more than nonsmokers.Under the rules, use of any tobacco product four or more times a week on average in the past six months could subject someone to the tobacco surcharge.But 10 states prohibit or restrict insurers from applying the tobacco surcharge in the individual market, according to the Centers for Medicare and Medicaid Services.So the big question will be if insurers end up classifying e-cigarettes as tobaco products. The battery-powered devices simulate cigarette smoking, producing a smoke-like vapor that usually contains nicotine and flavoring agents.The Food and Drug Administration moved toward deeming e-cigs tobacco products in April when it proposed regulating e-cigarettes, although the proposed regulations aren't as strict as those for regular cigarettes.The Centers for Medicare and Medicaid Services also is looking into the use of e-cigarettes and the tobacco surcharge, according to an agency official.But a lot of this will rest on the science, and the jury is still out the health effects of e-cigarettes.In a recent review of research on e-cigarettes, researchers at the University of California-San Francisco found that although the long-term health effects of e-cigarettes are still largely unknown, they emit potentially harmful substances into the air and can be a source of indoor pollution.The researchers also found that e-cigarettes actually reduce the likelihood that people will quit smoking, in contrast to advertising claims that firing up an e-cig will help people kick the habit.The potential role of e-cigarettes as a smoking cessation tool has insurance coverage implications too. The health law requires most health plans to cover FDA-approved smoking cessation products and counseling without any out-of-pocket cost to consumers. The federal government recently released guidance clarifying which services and products must be covered.Since e-cigarettes aren't FDA-approved for quitting smoking — and in fact are on the brink of being labeled by the agency to warrant regulation like cigarettes — they aren't covered as a free preventive benefit under the law.Clearly more specific guidance will be needed. "The Affordable Care Act does not specify e-cigarette use for purposes of cessation coverage or tobacco surcharge application," says Catherine McMahon, policy principal at the American Cancer Society Cancer Action Network. "The lack of clarity may allow health plans to try to add the surcharge for e-cigarettes."Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.Original author: Daren
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Formaldehyde release in e-cigarette vapor The New York Times story explained in detail

A study to be published in Nicotine and Tobacco Research was featured in the New York Times and has generated a lot of interest. The article mentioned that e-cigarette vapor can be the source of carcinogens, depending on the heating process.

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E-cigarettes more effective than patches to help quit smoking, says study

E-cigarettes are more effective than nicotine patches and gum in helping people to quit smoking, according to a study that challenges the negative views of some public health experts.

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Tobacco Control Legal Consortium Supports Deeming Regulation Changes that Would Take Almost All Electronic Cigarettes Off the Market

The Tobacco Control Legal Consortium (TCLC) is urging the public to write to the FDA and encourage the agency to strengthen the proposed deeming regulations on electronic cigarettes. In a set of talking points provided by the TCLC, the Consortium attacks the 24-month grace period for the submission of substantial equivalence or new product applications by electronic cigarette products, calling for the removal of this grace period:"The FDA proposal would significantly delay the implementation of premarket review for newly covered products. Most egregiously, the proposal creates a twenty-four month provisional period for the submission of tobacco product marketing applications. Applications received during the provisional period enable the continued marketing of the product until the FDA acts on the application which may be well beyond the twenty-four month period. A similar loophole was established during the passage of the Act to apply to cigarettes and smokeless products. The FDA received 3,517 applications but three years later has only issued an order removing four products from the market. After the withdrawal of 117 applications, the tobacco companies are still able to market the unapproved products represented by the 3,396 outstanding applications."The Rest of the StoryAs a public health advocate, the position of the Tobacco Control Legal Consortium is perplexing to me. The Consortium appears to be calling for the removal of the 24-month grace period for submission of substantial equivalence or new product applications by electronic cigarette products. If this advice were to be implemented, then the only electronic cigarettes that could remain on the market are those which were actually marketed as of February 15, 2007. This means that 99.9% of the electronic cigarettes currently on the market would have to be taken off the market.In other words, the TCLC is calling for a virtual ban on electronic cigarettes. The upheaval created by this ban would destroy all but the largest of the electronic cigarette companies, and would essentially deliver the industry to the tobacco companies. However, even the tobacco companies would have to remove their electronic cigarettes from the market until their applications were approved, a process that would likely take many years.The effects of such a regulation would be to force thousands of ex-smokers back to cigarette smoking. It would also result in thousands of dual users who have substantially cut down on their smoking to return to their pre-vaping cigarette consumption levels. Of course, the net effect of such a policy would be to substantially harm the public's health.It's not clear to me whether the TCLC has simply not considered the impact of its recommendations or whether the Consortium actually wants to see a de facto e-cigarette ban. Either way, if the FDA adopts these recommendations, it would be a total disaster for the public's health and a great victory for the cigarette market.Original author: Michael Siegel
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Special report: Clouded youth

Monday, May 19, 2014 - 4:16pmEL PASO (KTSM) — The electronic cigarette industry has bloomed into a $2 billion industry. E-cigs are intended for use by adults who are looking for a healthier alternative to smoking, and those who are looking to quit.Abad Garcia, e-cig smoker and employee at The Vape Shop said he's seen many people reduce their nicotine intake by using e-cigs.But studies show they are being picked up by teenagers as well.According to the Centers for Disease Control, the use of e-cigs in high school students more than doubled in a period of year. In 2011, 4.7 percent of high school students said they had tried an e-cig. In 2012, that number was 10 percent.About 90 percent of smokers say they started as teens, which is why many are working to put an end to the rise in e-cig use among teens.The Food and Drug Administration recently announced they will start regulating electronic cigarettes.Something many say, is overdue.The Vape Shop, an electronic cigarette store, says popular flavors include Red Bull, mint lemon, raspberry and strawberry. They have a signed posted on their door that says they do not sell to minors. However, they say they are aware of the growing popularity among teens."They're drawn to things that are new and novel, and also a lot of the solutions have flavors in them, like gummy bear, cotton candy. these are flavors that don't usually appeal to adults. they appeal to children," said Jana Renner, Paso Del Norte associate program officer.She adds, flavoring in banned in traditional cigarettes. The e-cig industry spent $20 million in advertising in 2012. Using flashy ads to capture the attention of potential users."Kids just pulling it out and just smoking and trying to impress other kids in class," said Marco, a high school student."They use them in public and restaurants like everywhere. The odor, sometimes it smells like cherry, it smells good and they think it tastes good too," said Adrian, a high school student.While there are nicotine free options, experts say zero doesn't always mean zero due to the lack of FDA regulations."Zero level to them might be .13 milligrams of nicotine... Since it's not regulated by the FDA, you don't really know what you're consuming and you really don't know what you're buying," said Sarai Garcia, an educator with the Department of Health.Long term effects, and the exact ingredients remain unknown.For the developing adolescent body, any amount of nicotine could be dangerous."The youth that are using it are putting themselves at a potential risk for addiction and since they are at an age where they are developing, that addiction can come a lot stronger and a lot sooner at their age," Garcia said.Garcia visits schools and talks to students about tobacco and other substance use. She said questions regarding e-cigs have become common.The students unfortunately that ask us the most on e-cigarettes are the kindergartners and the first graders and the fifth graders. Mostly because out kindergartners and first graders, they don't really know what the product is, but they see their older sisters using it, their older brothers, their parents, their family members and they're seeing these products being used in public places," Garcia said.This is why districts such as EPISD and YISD have stepped in."The policy that specifically dealt with electronic cigarettes was first put in the 2013-2014 school year which is this first year. We went ahead and felt that since it is a growing trend we wanted to make sure it was officially in the student handbook," said Patricia Ayala, spokesperson with YISD.It's not just on the school level, the City is jumping on it as well.Officials say they are working to change the city ordinance to include e-cigs, banning them on city owned or leased property.  Original author: Barry
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CDC and FDA are Undermining Anti-Smoking Messages and Protecting the Cigarette Industry

Data published last week in the American Journal of Preventive Medicine suggest that the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are doing an effective job of helping protect the cigarette industry. These data show that despite widespread marketing of electronic cigarettes, half of the adult public still thinks cigarettes are no more hazardous than the fake ones.According to the new study, of adults who are aware of electronic cigarettes, about half (49.3%) believe that cigarettes are no more harmful than e-cigarettes, which contain no tobacco, involve no combustion, and have been shown to have much lower levels of carcinogens and other toxins.The Rest of the StoryIt is remarkable that despite all of the widespread marketing of electronic cigarettes and the claims that these products represent a safer alternative to smoking, the public is still split down the middle as to whether cigarette smoking is any more hazardous than vaping. These results demonstrate that the public health messages regarding the severe hazards of cigarette smoking (and the safer alternative represented by e-cigarettes) being disseminated by e-cigarette companies are being successfully undermined by opposing messages from the CDC, FDA, policy makers, and other health groups.This is an ironic reversal from the past, where it was the public health groups sending the anti-smoking messages and the tobacco industry which was undermining those anti-smoking messages.Instead, in 2014, it is the electronic cigarette companies which are sending the anti-smoking messages and the health groups which are undermining those messages.This irony is bizarre, but also quite unfortunate, as the undermining of anti-smoking messages from the e-cigarette industry by health groups is contributing to an unhealthy and incorrect perception that cigarette smoking is no worse than vaping. This incorrect perception is no doubt deterring many smokers from quitting or cutting down substantially on their cigarette consumption by trying e-cigarettes. Thus, the efforts of the FDA, CDC, and other health groups are actually aiding the cigarette companies by helping to protect cigarette sales from competition from the fake, non-tobacco variety.I find it quite ironic that the health groups, including CDC and FDA, are undermining the efforts of even tobacco companies to develop the non-combustible market and shift a proportion of their sales from combustible to non-combustible products. And the CDC and FDA are completely undermining the efforts of the non-tobacco-related e-cigarette companies to promote e-cigarettes over real tobacco cigarettes.The rest of the story is that in a tragic reversal of the historical functions of public health viz a viz industry, it is now the e-cigarette companies that are attempting to undermine cigarette smoking while the health groups, led by CDC and FDA, are protecting the cigarette market by undermining the anti-smoking messages from the e-cigarette industry.Moreover, the FDA is poised to undermine industry messages even more by prohibiting these companies from continuing to use anti-smoking messages in their product promotion campaigns (by applying section 911 of the Tobacco Act to electronic cigarettes).If the Senate truly wants to reduce cigarette smoking and protect the public's health, it will shift its attack from e-cigarette companies which are trying to get the public off tobacco cigarettes and over to the federal government, which is doing everything it can to protect the cigarette market.Original author: Michael Siegel
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Study: E-cigs increase ‘superbug’ MRSA resistance

[unable to retrieve full-text content]Vapors also hurt immune cells, says study by UCSD, VA researchers.Original author: Reyes
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Hitchman, McNeill, Brose (2014) Addiction paper on ecigs


by Carl V Phillips This recent paper in Addiction by Hitchman, McNeill, and Brose, is a commentary calling for an “accurate and evidence-based debate” about e-cigarettes.  I will admit that my favorite part of it is this reference: 14. Phillips … Continue reading →Original author: Carl V Phillips
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Call to Action Baltimore, MD - Indoor Use Ban

This legislation would prohibit the indoor use of “electronic smoking devices” (aka e-cigarettes, despite the fact that they emit no smoke) in any area where actual smoking is prohibited.  The bill could also regulate the placement of e-cigarettes in retail establishments that sell e-cigarettes with exemptions.  The proposed legislation also restricts the sale of e-cigarettes to minors and imposes civil citations for any violations.

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In Senate Testimony, CDC Lies in Order to Obscure the Issues Surrounding Electronic Cigarettes

In 1994, so many of us in the tobacco control movement, including myself, castigated the chief executive officers of the tobacco companies who testified before Congress that nicotine is not addictive. In fact, some of us went so far as to suggest that these executives should be prosecuted for perjury.Clearly, those of us in tobacco control believe it is essential that testimony before Congress be accurate, honest, truthful, transparent, and not at all misleading.Unfortunately, CDC's testimony yesterday before the Senate Health, Education, Labor, and Pensions Committee fell way short of that mark. Specifically, in describing the benefits of switching from tobacco cigarettes to electronic cigarettes, the CDC called such benefits "hypothetical," thus casting doubt on whether such benefits actually exist.The CDC stated: "It is not fair to our children to ask them to pay a price for that for a hypothetical benefit for adult smokers." [emphasis is mine]The Rest of the StoryIn characterizing the benefits of switching to electronic cigarettes as merely "hypothetical," the CDC has misled the Senate and the American public about the clear science on this issue. There is no question that vaping is much safer than smoking. There is therefore no question that smokers who quit smoking by switching to electronic cigarettes are improving their health. In addition, there is clear evidence that smokers who become dual users are also improving their health. Just this week, a study demonstrated that dual users experience substantial improvements in their asthma symptoms. Moreover, there is abundant clinical evidence, both anecdotal and published, that smokers who switch to electronic cigarettes experience substantial improvement in their respiratory health.Ironically, the truth is actually the opposite of what the CDC suggests. The benefits of switching to electronic cigarettes for adult smokers are quite clear. In contrast, the harms to youth of trying electronic cigarettes are hypothetical because there is no evidence that e-cigarette use leads to cigarette smoking among adolescents. In fact, the present evidence suggests that e-cigarettes may be serving as a partial deterrent to real cigarette use, as the overwhelming proportion of youth regular e-cigarette users are adolescents who have previously experimented with tobacco products and are therefore at high risk of becoming addicted smokers.There is an abundance of information about electronic cigarette use that we do not know. However, there is one thing that is clear: electronic cigarettes are much safer than the real ones, and smokers who switch to e-cigarettes or even who cut down substantially on their cigarette use by taking up vaping are greatly improving their health. In other words, the benefits of electronic cigarettes for adult smokers are not hypothetical, but well established.Why would the CDC deceive Congress and the public in this way? Why misrepresent the nature of the scientific evidence on this issue? Why throw dirt in the face of every vaper who has quit smoking and is proud of himself or herself for having improved their health and perhaps saved their life? Why give ex-smokers throughout the country pause about their switch to vaping and perhaps cause them to return to smoking because of doubt over whether they are experiencing any health benefits?If the benefits of a switch from smoking to vaping are only "hypothetical," then why should vapers continue to vape? Why not just return to cigarette smoking, since there is no proven benefit to their vaping?The CDC's misinformation to Congress is therefore not only deceptive, but potentially harmful and destructive as well. It certainly undermines the public's well-established appreciation of the severe hazards of cigarette smoking. If there are no known benefits to smokers of switching to electronic cigarettes, then it appears that smoking isn't as bad as we thought. The rest of the story is that the tobacco executives are not the only ones who have pulled the wool over the eyes of Congress and the public. Sadly, the CDC has added itself to that shameful category.Am I equating the lies of the tobacco executives with that of the CDC? Of course not. The nature of the deception was very different and so was the motivation beyond the deception (the tobacco companies lied for profit; the CDC is lying because of an apparent underlying ideology, although its ultimate intentions are good ones). However, misinformation is misinformation and if we are going to attack the tobacco companies for deceiving Congress, then we cannot stand by and allow public health groups to mislead Congress without being willing to also criticize them. In fact, public health should be beyond reproach in providing accurate and scientifically supported information to Congress and the public.AddendumThis may be the most difficult blog post I have ever written. I was deeply saddened to see the CDC completely obscure the critical issues surrounding electronic cigarette use by arguing that the harms being done to adolescents are definite, while the benefits to adult smokers as being merely hypothetical. In fact, it is exactly the opposite. In contrast, I thought Mitch Zeller presented a well-balanced and evidence-based perspective.I hope my readers understand how difficult it is for me to see this. It literally pains me to see, especially since I once worked at CDC, in the Office on Smoking and Health, and have a very deep attachment to that office. However, I also can’t stand the idea of a public health agency deceiving the Congress and that has to take precedence over my deep affections for the office that I love.Second AddendumI want to emphasize that this position of the CDC's - that the benefits of e-cigarettes are hypothetical but the harms are real - is not new. Dr. Frieden has been saying this for some time and the CDC testimony yesterday merely reflected this long-standing (but wrong) summary of the scientific evidence.For example, in a CNN interview, Dr. Frieden concluded that while the reported benefits of electronic cigarettes -- aiding smoking cessation -- are merely "possible," the speculated and undocumented potential harms -- such as hooking kids to smoking -- are "definite": "I think what we can say basically is they might or might not be able to help you quit, but there are definite harms that they can cause. And those definite harms are in different environments. So, if they get kids hooked on nicotine, that's a really bad thing. If they get a smoker who would have quit smoking to continue smoking, that's a bad thing. If they get a smoker who stopped mo smoking and going back to nicotine addiction and then smoking, that's a bad thing. And if they re-glamorize the act of smoking, that's a bad thing. So, we have possible benefits and definite harms."Original author: Michael Siegel
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