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Experts: More research needed on electronic cigarettes

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Jean Duncan sat at a bar inside Crazy Vapors while her son, Charlie, puffed on a small cylinder that flashed a green light. He is trying the electronic cigarette because he would like to quit smoking.

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CDC Director Thomas Frieden said there are over 200 e-cigarette products out there in a variety of styles and colors.  MICHAEL HOLAHAN/STAFF
MICHAEL HOLAHAN/STAFF
CDC Director Thomas Frieden said there are over 200 e-cigarette products out there in a variety of styles and colors.

“I want to start living a little healthier,” Charlie Duncan said.

Electronic cigarettes were added to the proposed tougher smoking ordinance that would ban their use as well as smoking tobacco in most public places in Augusta. The ordinance will come before the Augusta Commission on Nov. 5.

But a panel of experts at the international meeting of the American Association for Cancer Research said much is not known about electronic cigarettes and much more research is needed. One of the big questions is how the devices will be regulated. The Food and Drug Administration, through the Family Smoking Prevention and Tobacco Control Act, has asserted its authority to regulate cigarettes, roll-your-own tobacco and smokeless tobacco.

“(The) FDA is moving to release for public comment a proposed rule to regulate additional categories of tobacco products,” spokeswoman Jennifer Haliski said in a statement but she could not elaborate further. The agency had given October 2013 as the date for releasing the proposed rule but it could be later, she said.

Experts say the agency should help clear up some of the uncertainty surrounding electronic cigarettes through its work, said Dr. Peter Shields, deputy director of the Ohio State University Comprehensive Cancer Center.

“Let the FDA do its job,” he said. “Let it finish the research over the next couple of years and we’ll figure that out.”

Until then, there is a “Wild West” of scores of products being marketed to young consumers, particularly through social media, said Dr. Scott Leischow, co-leader of the Cancer Prevention and Control Program at Mayo Clinic in Scottsdale, Ariz. YouTube, for instance, has scores of videos for “hookah pens” that are not marketed as electronic cigarettes.

“Hookah pens are e-cigarettes in terms of their design and their function but they’re called something else,” he said. “The challenge of this is a regulatory one and how they ultimately become marketed is going to be one of the fundamental regulatory challenges facing the U.S. FDA as well as in Europe and other regulators.”

Public health officials were alarmed to see the number of students in grades 6-12 who had tried an e-cigarette more than doubled from 2011 to 2012, from 3.3 percent to 6.8 percent, and nearly doubled among middle school students, from 1.4 to 2.7 percent, the Centers for Disease Control and Prevention reported last month.

Overall, the use of the devices has “skyrocketed,” Leischow said. Sales in retail stores like Crazy Vapors already have topped $700 million this year and online sales added another $600 million, Leischow said. Overall, sales will be at least $1.7 billion this year alone, he said. According to one Wells Fargo analysis, e-cigarettes will eclipse traditional cigarettes in the next decade, Leischow said.

Part of the problem in studying them is the sheer variety of different devices and how they work, said Dr. Maciej Goniewicz, assistant professor of oncology at Roswell Park Cancer Institute in Buffalo, N.Y.

“There is a huge variability and variation of the products,” from how they function to what kind of heat source to what goes in them, he said. “We need to be careful even using the same term for electronic cigarettes.”

Crazy Vapors has row after row of glass cases offering different devices, some made to look like cigars or pipes but most with no resemblance to traditional tobacco products. CDC Director Thomas Frieden said there are over 200 e-cigarette products out there and “there are definitely that many, if not more,” said Crazy Vapors owner Craig Perryman. Part of the problem with doing the research is the products being studied may change in a year or two and may be replaced by something else by the time a study is completed, Leischow said.

“The science is not right now keeping up with the product changes,” he said. “That is a fundamental challenge for the FDA.”

Because of that variability, it is difficult to generalize about the safety of the devices, Goniewicz said. One study found the device emitted metallic particles but that could be peculiar to that device, he said. Many of the devices use propylene glycol, which FDA considers safe for use in food or on the skin, Shields said.

“But we don’t know about what happens when you inhale it, especially when it gets heated,” he said.

Proponents of e-cigarettes have said they should not be subject to smoking bans because they only emit vapor, but that is not true, Goniewicz said.

“Unfortunately we found a few toxicants there that are of concern,” he said. “We are aware that these products can generate some toxicants, some carcinogens even. Though when we compared the levels we found in the vapor (to) what we know in the tobacco smoke, these levels are very, very low.”

And that is part of the appeal of e-cigarettes, Perryman said. The store can adjust nicotine levels, helping wean people off it if they so desire, “and it doesn’t change the taste much,” he said. The stores has 170 different flavors and unlike tobacco cigarettes they know exactly what is going in each device, Perryman said.

“We know what chemicals are in this,” he said.

While it can’t be marketed as a smoking cessation aide, Perryman said it has helped some people quit entirely and for others offers what he thinks is a safer alternative even as more research is being done.

“What they do know is it is much safer than cigarettes,” he said.

That is why Perryman said he hopes the proposed smoking ban does not include e-cigarettes.

“That’s my biggest fear is if Augusta bans smoking in public places with this, then they may just turn back to the cigarettes themselves, which we know is not healthier for them,” he said.

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Little Lamb
40104
Points
Little Lamb 10/29/13 - 10:53 pm
8
3

No Ban

There is absolutely no logical reason to include e-cigarettes in the upcoming ban on secondhand tobacco smoke in Augusta bars, nightclubs, and other adult entertainment venues.

E-cigarettes do not emit secondhand tobacco smoke, plain and simple.

bubbasauce
17142
Points
bubbasauce 10/29/13 - 11:58 pm
5
4

Little lamb, it is all about

Little lamb, it is all about total control of everyone. If you ever get a chance to listen to Alex Jones, Michael Savage or Mark Levine for just a little while you will get an idea of what's really going on in this Country.

oldredneckman96
4454
Points
oldredneckman96 10/30/13 - 05:55 am
3
4

Smoking

Unpublished

Little Lamb and Bubba must be nicotine addicts, judging from their post. E-ciggs, used to make liquid nicotine inhaleable, supply the user with a dose of the posion with every draw. Some of this toxin stays in the users lungs and most is exhaled. Just as you breathe air in, about 20.9% is oxygen and you exhale about 17% O2. Your lungs do not have the magic needed to completely extract the one chemical in tobacco most related to heart attacks. This posion is then spread to the other users in the room just as with regular smokes. The claim that e-ciggs are safer is like the claim that a .22 cal bullet is safer than a .50 cal. Take your e-cigg to your home, run the childern out, close the doors and windows and smoke your head off. Our just use the patch to get your dose and suck a lolly pop like Kojack.

Riverman1
70456
Points
Riverman1 10/30/13 - 06:20 am
3
0

E-Cigarettes Work

I know several people who have used the e-cigs to quit smoking. The nicotine level is gradually dialed down to zero. Many continue to use them with the setting on zero as a way to stay away from the real cigs habit. If the e-cigs are not perfect yet, then work to fix them. It's the best innovation to help people quit smoking that's ever come along.

Make no mistake tobacco in all forms is a killer. About 90% of cardiac surgery patients are tobacco users. Vascular pathology in all parts of the body is associated with tobacco use. Lung cancer, we all know about.

dichotomy
26594
Points
dichotomy 10/30/13 - 09:55 am
4
2

Well I see oldredneckman and

Well I see oldredneckman and BANTOBACCODRUG both seem to have some magical data that NOBODY else has.

Both seem to be crusaders who totally ignore the facts. E-cigarettes have been around a while. We all know that if the government had ANY data that they were harmful they would have been banned. In fact, the biggest concern the government has about E-cigarettes is the loss of TAX REVENUE from the loss of sales of real tobacco products. It is ALWAYS ABOUT THE MONEY. Nothing to do with health. The only reason the government agencies are even whimpering about E-cigarettes is that they have to find SOME reason to take CONTROL and TAX them. They will be PERFECTLY LEGAL WHEN THEY FIGURE OUT HOW TO TAX THEM.

Most doctors I have talked to are endorsing the use of E-cigarettes as an alternative to smoking. AND THERE IS NO DATA THAT THEY ARE HARMFUL TO NON-SMOKERS. And my experience is that non-smokers cannot smell them and would not even be aware someone was using them except for the trace of WATER VAPOR that is exhaled.

The ingredients in E-cigarettes are propylene glycol, an FDA approved food additive, and vegetable glycol, another FDA approved food additive, and an OPTIONAL percentage of nicotine. These things are helping MILLIONS of smokers lay down cigarettes and NOBODY has even hinted that they are harmful, OR EVEN OFFENSIVE, to non-smokers nearby.

Tell your commissioners to approve E-cigarettes for use EVERYWHERE. Some hospitals are even letting their smoker patients use them IN THEIR ROOMS IN THE HOSPITAL.

Ignore oldredneckman and what's his name. Neither of them have EVEN ONE FACT to support banning E-cigarettes. Go out and FIND SOMEONE USING AN E-cigarette and stand beside them and see for yourself if they bother you.

itsanotherday1
34586
Points
itsanotherday1 10/30/13 - 10:15 am
2
2

Agree with LL's post, but......

I would add that I support the regulation of the product since it is ingested.

Other than that, people puffing on e-cigs in my presence do not bother me at all. I can't imagine that the miniscule dose of nicotine that might waft my way is any more significant than normal background pollution.

I might add, I think they are a great tool for those wanting to quit. They satisfy both the addiction to nicotine and the "habit".

Riverman1
70456
Points
Riverman1 10/30/13 - 10:29 am
6
0

Don't forget e-cigs can be

Don't forget e-cigs can be used on the zero nicotine setting also.

David Parker
7919
Points
David Parker 10/30/13 - 12:40 pm
4
2

Sounds like a personal

Sounds like a personal freedom that our government wanted to get involved with for the purpose of infringing and control.

oldredneckman96
4454
Points
oldredneckman96 10/30/13 - 05:24 pm
0
3

Addiction

Unpublished

Separating a person from his addiction is hard. They lose all rational thought in an effort to believe what they are doing is OK. This is the reason drug addicts have to be controlled. We can not let the bad behavior of an addict to harm the public. Tobacco has no place in public same as any other drug.

Little Lamb
40104
Points
Little Lamb 10/30/13 - 05:47 pm
2
0

Nicotine

The chemicals in tobacco that lead to lung disease are not the nicotine. There are dozens of other chemicals in tobacco smoke. Pure nicotine (though habit forming) is not harmful.

CobaltGeorge
138588
Points
CobaltGeorge 10/30/13 - 08:49 pm
0
1

E-Cigarettes, The Second Best Thing To Oxycontin.

Been a pack a day for 53 years, I am now down to a nicotine level of about 3 cigarettes a day. The best part is I can go in non-smoking locations and hit the rest rooms, pull a drag and no odor, walk back out and tell your friends that you don't smoke those nasty things. It cost me around 9 dollars a month for the refill liquid instead of the $99.00 I was spending. When I started a month ago, had a low case of COPD, I now feel 100% better and no longer cough. So say what you want about e-cigs.

Gage Creed
12341
Points
Gage Creed 10/30/13 - 08:52 pm
1
0

Separating fact from fiction

Separating fact from fiction is so very hard for some... they are so irrationally blinded they lose sight of individual rights and freedoms

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