Electronic Cigarettes

I have seen the increasing use of electronic cigarettes but I didn’t know much about them.  I know there is concern in some communities about them.  Some have passed ordinances outlawing or limiting their use : Chicago, Birmingham, MI are examples.  Auburn Hills does NOT have any ordinance addressing e cigarettes.  There is at least one bill currently in the Legislature on the issue but I don’t think there is any action imminent.  I’ve learned that they are not a more healthy alternative to smoking real cigarettes.  I found a great article from the website of our friends at the RAHCC-the Rochester Auburn Hills Community Coalition–a group of volunteer folks dedicated to healthy living in our communities.  You’ll find a link to their website in the lower left of this page.

Electronic cigarettes (e-cigarettes or e-cigs), known formally as electronic nicotine delivery systems (ENDS), are devices designed to look similar to cigarettes in shape, size, and general appearance.

They operate by vaporizing a solution containing nicotine, creating a mist that is then inhaled.

The tips of these devices often have an indicator light, designed to emulate the burning ash of a traditional cigarette.

According to product manufacturers, e-cigarette cartridges are available in various flavors, such as vanilla, menthol, and piña colada, and varying claimed levels of nicotine. Using an e-cigarette is commonly referred to as “vaping.”

Popular brands of e-cigarettes, sold at convenience stores and gas stations, include “blu” and “NJOY.”

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BACKGROUND

  • The components of a typical e-cigarette are illustrated below:
  • Cartridges generally contain up to 20 mg of nicotine.
  • Some users refill their own cartridges, which may be dangerous because it involves dealing with potentially dangerous concentrations of nicotine. Refill bottles contain up to 7 grams of nicotine; 5 the fatal dose of nicotine in adults is estimated at 30–60 mg while for children it is estimated at only 10 mg — or approximately 4 drops of a maximum strength refill solution. This risk is more consistent with nicotine-based pesticides, rather than traditional tobacco products and pose a danger via inhalation, ingestion, and skin contact.

PREVALENCE

  • Between 6.4% and 7.1% of current smokers have ever used an e-cigarette, compared to ever use of e-cigarettes among never smokers (less than 1.0%).

SAFETY & QUALITY

  • On July 22, 2009 the U.S. Food and Drug Administration’s (FDA) Division of Pharmaceutical Analysis analyzed the ingredients in a small sample of cartridges from two leading brands of e-cigarettes and found that the tested products contained detectable levels of known carcinogens and toxic chemicals. Diethylene glycol, a potentially lethal organic compound, was found in one cartridge, while nitrosamines were detected in several cartridges.
  • Other important findings from the FDA include the following:
  • The quality control processes used to manufacture e-cigarettes seem to be inconsistent or non-existent. Three different e-cigarette cartridges with the same label were tested and each emitted a distinct amount of nicotine with each puff.

Indicator Light Mouthpiece

  • In all but one, the e-cigarette cartridges that were labeled as containing no nicotine had low levels of nicotine.
  • The vapor from one high-nicotine cartridge delivered twice as much nicotine when inhaled than was delivered by the control, a sample of FDA-approved nicotine inhalation products.
  • Studies suggest adverse effects associated with e-cigarettes, but additional non-biased national and international research is needed to understand the effects of both short- and long-term use.

LEGAL STATUS & REGULATION

  • The FDA attempted to regulate e-cigarettes as drug-delivery devices but failed after the courts determined that e-cigarettes were properly regulated under the FDA’s tobacco authority pursuant to the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) and not the FDA’s drug delivery device authority.
  • In April 2011, the FDA issued a statement announcing that they intend to regulate e-cigarettes as “tobacco products.” This includes: (1) marketing restrictions, (2) mandated ingredient listing, and (3) pre-market review.12 However, to date, FDA has not asserted its authority over e-cigarettes and they remain unregulated.
  • Several state and local governments, including New Jersey and King County, Washington,have included or are in the process of adding e-cigarettes to their smoking bans. Additionally, the U.S. Department of Transportation has proposed banning the use of e-cigarettes on planes. However, several airlines have prohibited smoking e-cigarettes on their aircrafts on their own accord.
  • California, Minnesota, New Hampshire, New Jersey, New York, Kansas, Vermont, and Utah have prohibited the sale of e-cigarette to minors since March 2011.

MARKETING & COMMERCIAL APPEAL

  • The e-cigarette companies advertise their products as a better-smelling, cheaper, and guilt-free alternative to smoking. They are also marketed as a way to circumvent some smoking bans.
  • E-cigarettes are promoted heavily online, and are more widely searched than snus and NRTs (nicotine replacement therapy).
  • There is concern that e-cigarettes may appeal to youth because of their high-tech design, easy availability online or via mall kiosks, and the wide array of flavors of cartridges.

ATTITUDES & CONCERNS

  • A nationally-representative survey found that 40.2% of Americans have heard of e-cigarettes and more than 70.0% of smokers believe that e-cigarettes are less harmful than regular cigarettes.
  • The most commonly cited reasons for use by e-cigarette users include: the perception that they are healthier/less toxic than traditional cigarettes, aid in tobacco craving/withdrawal symptoms, smoking cessation facilitator, and relapse avoidance.
  • In addition to the health concerns cited above, recent studies suggest that e-cigarettes could be worrisome regarding relapse of former smokers, the “re-normalization” of tobacco, and a gateway for cigarettes. It is also thought that e-cigarettes can contribute to tobacco use by allowing smokers to use nicotine despite ever-increasing smoking bans (dual use). Since they recently emerged on the market, however, more research must be done to fully understand the consequences.
  • The World Health Organization (WHO) expressed concern with e-cigarettes, stating they may undermine tobacco control efforts, such as smoking bans and FDA-approved NRTs. Several countries, including Australia, China, and Brazil have banned the sale and marketing of e-cigarettes.