Based on existing evidence the electronic cigarette carries less than one percent of the risks of regular cigarettes and possible as little of the one tenth of one percent of the danger of normal cigarettes. This is what Dr Joel Nitzkin, Chair of the Tobacco Control Task Force for the American Association of Public Health Physicians, told us in a detailed interview on the electronic cigarette, its safety and thedevastating potential effect of the upcoming tobacco bill.
The estimates of the safety of the electronic cigarettes have been made by comparing them with equivalent substances which also deliver nicotine with tobacco combustion:
“…the safest of the tobacco products are what they call snus. And the literature on snus, which is evaluated on our website, basically shows that in the best of the epidemiological studies available today snus doesn’t increase any cause of death. So that means if there is a health hazard there it is smaller than can be measured with these studies, and with that in mind we would figure that a tobacco product that is delivered with just the nicotine and without any of the other toxic chemicals should be at least as safe.”
There are, Dr Nitzkin admitted, ongoing concerns. In particular, ongoing quality control of the products is required to make sure that the products are not contaminated by cancer causing substances. However, the answer to these concerns is not the tobacco bill which would, by requiring research that is simply not feasible, ensure a defacto ban on products which are at least a hundred times safer than regular cigarettes.
The problem with the research that would be required by the bill is not only the timescale (at least a decade) and the cost (tens of millions) but the risks associated with the trials.
“Now the problems with controlled and clinical trials is that it would be a physical impossibility to do that research. Why would it be physically impossible? Because it would involve recruiting a large number, probably several thousand, non smokers, and then getting them to agree to be randomised into one or two or more groups. One of these groups would smoke cigarettes which clearly poses a severe health hazard, and others would test various smokeless products, including e-cigarettes.”
No American Academic Center, Dr Nitzkin went on to explain, would allow a product that was known to be hazardous but was unlikely to have a therapeutic effect on the patient to be tested. As a result the effect of the tobacco ban will be a permanent ban on electronic cigarettes as well as other alternative products:
“They’ll say well, you can’t sell the cigarettes until you can show you have completed these studies to the satisfaction of the food and drug administration and if the studies are impossible to conduct you simply have the products banned. Period.”
The effects of the ban would be devastating. Dr Nitzkin estimated that if every smoker changed to e-cigarettes the death toll caused by smoking related diseases would eventually fall from 400,000 to between 400-4000.
Even if every man, woman and child in America became addicted to e-cigarettes, the doctor pointed out, using the worst case scenario the death toll would be 20,000 – still a fraction of the current toll.
You can read the full interview here: Electronic Cigarette Interview with Dr Joel Nitzkin.
40 comments ↓
[...] of an interview with Dr Joel Nitzkin on the safety of the electronic cigarette . More here: E-Cigarette Interview | TobaccoToday Post a [...]
Very interesting. I hope the truth prevails. I saw the discovery show feature Carl Philips from Alberta. Really good info. Let’s hope enough people call the Senate Health Committe to get the amazing device secured in the FDA regulation bill. Haven’t enough folks died from the governments inability to let people know the truth!
i quit smoking traditional cigarettes with the help of a low dose patch and an electronic cigarette from blucigs.com –
banning it would be shame!
Interesting article!
E-Cigarette Interview with Dr Murray Laugesen
Interviewer: James Dunworth, E Cigarette Direct May 26, 2009 http://www.ecigarettedirect.co.uk/interviews/murray-interview.html
We have been fortunate enough to talk to the man who, outside the labatories of the electronic cigarette manufacturers themselves, probably knows most about the electronic cigarette. Respected reseacher, Dr Murray Laugesen of Health New Zealand http://www.healthnz.co.nz/ is one of the few to have carried out an indepth analysis of the contents of the electronic cigarette, and has presented on his findings at international conferences.
In this interview we talk to him about concerns over the electronic cigarette.
ECD In previous interviews we have conducted scientists have estimated that, based on the evidence available, the risk to health from electronic cigarettes is between 1% and 1/10th of 1% of real cigarettes. You have actually done a product assessment of Ruyan electronic cigarette. What’s your assessment of the risks?
ML We would rate the Ruyan electronic cigarette two to three orders of magnitude safer (100 to 1000 times safer) than a tobacco cigarette. We say this because our testing of the Ruyan e-cigarette for nearly 60 major toxicants has not found any cigarette smoke toxicants in any but trace quantity so far. This is not surprising, as the operating temperature of the atomiser of an e-cigarette is 5 to 10% that of a burning tobacco cigarette, so the volatile cigarette smoke toxicants are not created.
Provided each e-cigarette maker has certified good manufacturing practices, plants and uses pure ingredients their emissions should be harmless also.
The problem is that most manufacturers do not comply in this respect. Ruyan has taken a risk in publicly testing their product. They come out squeaky clean.
ECD: When we first requested an interview with you several months ago, you suggested we wait, as you might well have some more information regarding the products. There has also been more research conducted in New Zealand since that time. What are the latest developments?
ML: New Zealand researchers at the Dublin conference of the international Society for Research on Nicotine and Tobacco in late April 2009 presented research showing the Ruyan e cigarette is free of cigarette smoke toxicants, is able to increase nicotine in the bloodstream of users, and relieve cravings.
ECD: The position taken by most public health groups in the US is that these devices should not be used until they have undergone further extensive testing. Is this a position you agree with?
ML: With prescription drugs, we would agree. But nicotine is one of the safest of drugs, and is being sold as the alternative to the most dangerous consumer product – the tobacco cigarette. Low risk compared to cigarettes is the real world risk that smokers face. The risk that distributors face is of being sued for defective product – an insurable risk and not huge for sellers of e-cigarettes.
Further “extensive testing” to prove near zero absolute safety in the USA means testing to FDA protocols. In the USA this costs millions of dollars, and several years delay, and implies large price markups on medicinals under near monopoly conditions. There needs to be either a simpler or provisional slate of tests required, short of medicinal registration, or, as in the UK, these devices and refills need clearance to be sold as non-medicines (with the option of some brands later qualifying as medicines).
So my hope would be that the FDA and other regulators will review their stance on e-cigarettes with the aim of how to save the most smokers’ lives most effectively, balance this public health imperative against their brief to protect consumer safety, and possibly fashion a new regulatory approach for faster acting nicotine products.
The product is safe, efficacious, and possibly effective in stopping smoking. E-cigarettes have been on sale in the UK since 2007 (classed as non-medicines), and in the USA for over one year without any harm reported in the media or medical journals, or by doctors reporting adverse reactions. It is a product that potentially just might assist smokers to quit and therefore cut the 1 in 2 cumulative death rate in smokers. Further research is needed.
So far the only response from almost every government regulator has been to say that the nicotine in e-cigarettes means they classify as medicines, requiring millions of dollars and years of delay and thousands of pages of paper work to follow the regulatory processes to bring this product to market. This cost is repeated as each new product is patented and tested, for approval. Patents are in dispute, and further patents and improvements in design are in the pipeline.
There is a clash also between the absolute safety of a cigarette substitute (in fact, no drug is 100% safe) and the relative safety of e-cigarettes compared with tobacco smoking. Regulators decree what is good for populations, and this can clash with fundamental rights of citizens to be able to buy any reasonably safe product that will diminish their risks of dying early from continuing use of smoking tobacco.
Government tobacco control agencies could assist by sitting down with medicine regulators, to balance these considerations, and produce relaxed safety regulations for fast acting nicotine products as proposed by the tobacco group of the Royal College of Physicians London recently.
The tobacco control community could assist by working with government health and research agencies, to fast track this product’s research and development as the first of a new generation of possible substitutes to replace tobacco smoking. But one thing is clear – smokers need a whole generation of better products to provide their needs for safe nicotine, and the sooner these can be coaxed to market, the better.
ECD: The WHO amongst others have raised concerns about the delivery of nicotine to the lungs via the device. Is this a concern you share?
ML: First we now know that the nicotine dose per puff is low, and more puffs need to be taken to satisfy cravings as do tobacco cigarettes.
Secondly we find that the e-cigarette nicotine is more likely absorbed in the upper airways rather than in the lungs – and so it will not be delivered very rapidly to the brain as in the case of the tobacco cigarette.
The lower nicotine per puff in the e-cigarette and the slower uptake compared with tobacco cigarettes means the addiction risk is probably low.
Perhaps e-cigarettes could be made more satisfying, without impairing the taste. Such e-brands may already exist, but the lack of research funds means we just do not know which they are. E-cigarette distributors wishing to move product, and public health agencies, wishing to save lives, need to pay much closer attention to nicotine deliveries, because without sufficient nicotine, e-cigarettes will not satisfy as cigarette substitutes.
ECD: By using an electronic cigarette, using what we know of the ingredients, in what ways could a smoker expect their health to improve?
ML: The main health advantage of using the electronic cigarette is if and when it replaces tobacco cigarettes, which carry a one in two risk of early death. Those who quit smoking tobacco by any other means such as cold turkey also reap that advantage as long as they do not relapse.
E-cigarette users should switch completely or quit nicotine completely and avoid even one tobacco cigarette per day, as even a single cigarette daily greatly increases the risk of a heart attack.
Propylene glycol, the main ingredient of e-cigarette mist, is known to kill airborne flu virus and bacteria, and tends to protect those exposed to it in inhaled air, whereas in contrast smoking tobacco doubles the risk of death in a flu epidemic. However we don’t have any data as to the extent that propylene glycol inhaled intermittently from an e-cigarette might prevent inhalation of live bacteria and viruses. This merits research.
ECD: What conditions are not likely to improve after switching to the electronic cigarette?
ML: Electronic cigarettes will not protect from diseases and damage due to past tobacco smoking, but they can help the smoker to stop making things much worse by continued inhalation of irritant and toxic tobacco smoke.
ECD: Despite your own studies in New Zealand and many supporters in the Tobacco Harm Reduction community, electronic cigarettes have been banned in Australia and in your own country, New Zealand; there seems to be a defacto ban in Canada and they look likely to be made illegal in the US under requirements which require testing which is physically impossible to carry out. Yet such a ban on a product so much safer than cigarettes seems absurd. What is the reason for the opposition to the electronic cigarette?
ML: Most regulators would privately agree the system is absurd.
E-cigarettes are caught in a two-box regulatory trap. Nicotine products are in law usually either tobacco products or medicines. A choice between only two options is a dilemma for the regulator.
E-cigarettes, seeking to be tobacco-free, no longer fit the first box.
So regulators classify it in the second box, as a medicine.
From a smoker’s viewpoint, however, it belongs in a third box, as a lifestyle choice or cigarette alternative. It is also a question of market power. Big Tobacco controls Box no. 1, Big Pharma and the white coat health professional prescribers and dispensers control box no 2, while many smokers addicted to nicotine, the ones most likely to be sitting on death row, are powerless. They would like to buy from Box no. 3, but it is empty.
ECD: One study in Europe has suggested that making Snus illegal has cost thousands of European lives. While obviously difficult to quantify, in your opinion would a ban on the electronic cigarette in the US cost the lives of smokers?
ML: Making snus illegal in Europe has helped ensure that the popularity of snus in Swedish men, the low cigarette smoking rates in men, and the low Swedish lung cancer rates in men have not benefited men in Europe. Compared with snus, the e-cigarette has the advantage of appealing to both women and men. Bans on electronic cigarette in countries such as the United States could frustrate efforts to know whether the e-cigarette can wrest market share from tobacco cigarettes.
If I can, then a ban on their sale would crimp their potential to save lives. However, we need some statistics as to how many e-cigarettes have sold industry-wide, and how many of these customers are still smoking.
Research on e-cigarettes by Dr. Laugesen and others is available att:
http://www.healthnz.co.nz/coynews.htm
Taz, have you never head of duplicate content issues!
James – I found that which Taz posted was supportive of Mr Dunworth’s posting. It’s good to know that Mr Dunworth is out fighting the cause or are you just one that wants to hide the fact that Mr Dunworth is interviewing very respected individuals that are supporting the argument for reduced harm.
Well, I am James Dunworth, so I am hardly going to hide the fact! The problem is that if you post the identical article (or interview) in two places it can be counted as duplicate content by the search engines, so there is a chance the original interview could be de-indexed.
James is absolutely right, but you guys can always go ahead and just block off this page from the search engine spiders, so they won’t know about it, and this will save you the duplicate content problem. With that said, I have been using an electronic cigarette lately and I think it is a really cool product. I got it from… http://www.electroniccigarettesource.com
E-cigarettes are dead, just as I told all of you they would be.
In contrast to OTP Kid’s assertion, sales of electronic cigarettes have skyrocketed in the past six months (thanks largely to the FDA).
While the FDA has reported blocking 50 shipments of e-cigarettes due to mislabelled product (i.e. someone wrote “smoking cessation product” or something similar on the package), hundreds (perhaps thousands) of other shipments have not been blocked.
The lawsuits by Smoking Everywhere and NJoy against the FDA could bring some very possitive results.
Interesting fact is that as the companies get larger that have not been stopped they will get stopped!
Yes Bill, they have sold extremely well; however, in the long run they will be portrayed as “entry level” products tha encourage smoking, as opposed to a cessation/replacement device for cigarettes, and that will be the end of the products. Just be patient and you will see I’m correct. I am not passing judgment on the products, just telling you how this will go.
Come on OTP kid the same has been said about Smokeless tobacco and its still around. Entry level products.
OTP KID, you probably work for a tobacco company
and just want to smokers stay hooked to your income stream.
United States: Health Expert Says FDA Warning On E-Cigarettes Misleading
In a commentary published on August 6th in the Washington Times, Dr. Elizabeth M. Whelan, president of the American Council on Science and Health, said the Food and Drug Administration’s recent claims that electronic cigarettes contain carcinogenic and toxic chemicals are “distorted, incomplete and misleading,” adding that the agency, through its out of the ordinary non-science-based warning, is implicitly asking smokers to stay away from a potentially life-saving alternative and continue using conventional cigarettes, which, she noted, are responsible for more than 450,000 deaths every year in the US. Dr. Whelan said with no real evidence about the health effects of e-cigarettes, the FDA has invited users to report any adverse effects in order to build a case against the product, while failing to ask smokers who have successfully quit with the e-cigarette to also call in. Considering that the FDA-approved alternative nicotine-delivery systems like gums and patches have been “abysmal failures” in helping people quit smoking, Dr. Whelan said any alternative acceptable to addicted smokers should be taken seriously, and the FDA should be sponsoring studies to evaluate the safety and efficacy of e-cigarettes, instead of condemning them or considering a ban on them (Washington Times 8/6).
Listen Blowing Smoke and Smoker Gal, it doesn’t matter to me one way or another, I would be happy to sell these if they remain viable. All I am saying is what I think will happen, and I am usually correct. So…there’s no need to debate, I put my opinion on the record and we’ll see what happens over time. And just for the record, my opinion was posted before the FDA ruled on this subject, so far I’ve been correct.
It appears that those responsible for the business side of e-cigs are unwilling invest in the necessary QA systems to protect their products from inadvertent contamination (e.g., DEG) and to take the lead by picking-up product from the marketplace, having it analyzed, and publishing the results. Likewise, they need to get the aerosol analyzed under simulated conditions of use and get the results into the peer-reviewed literature. If those interested claim they do not know how to do this, I can help them. I am sure that the owners of this website will provide my contact information, if needed.
The Contradictions continue!
United States
Prof. Michael Siegel of the Boston University School of Public Health pointed out on August 17th that although Action on Smoking and Health (US) told the public not to trust information or “representations” from anyone with connections to e-cigarette companies because they “may have been financed by the industry itself (thereby creating a clear conflict of interest),” ASH itself has a conflict of interest of its own since it received $100,000 from Pfizer according to the drug company’s civic organization funding report for 2Q09. (tobaccoanalysis.blogspot.com 08/17)
United States: Siegel Points To ASH’s Conflict Of Interest
Prof. Michael Siegel of the Boston University School of Public Health pointed out on August 17th that although Action on Smoking and Health (US) told the public not to trust information or “representations” from anyone with connections to e-cigarette companies because they “may have been financed by the industry itself (thereby creating a clear conflict of interest),” ASH itself has a conflict of interest of its own since it received $100,000 from Pfizer according to the drug company’s civic organization funding report for 2Q09. ASH was making its claim in a press release that responds to an E Cigarette Direct letter regarding an article in The Peninsula which erroneously reported that e-cigarettes are more harmful than cigarettes, Siegel noted. Pfizer’s funding report also revealed that it also gives money to the American Cancer Society, American Lung Association and American Heart Association, all of which are calling on the removal of electronic cigarettes from the market, Siegel said. Major drug companies that make smoking cessation products stand to lose substantial profits if smokers use e-cigarettes to quit smoking, he said. While it was nice of ASH to tell the public to be skeptical of information from groups with financial ties to e-cigarette companies, the anti-smoking group should have been forthcoming in disclosing its own financial conflict of interest, he said (tobaccoanalysis.blogspot.com 8/17).
Hey folks is it true that the FDA lifted it’s edict and is now allowing nicotine cartridges to come into the country?
In Response to Jak:
James is absolutely right, but you guys can always go ahead and just block off this page from the search engine spiders, so they won’t know about it, and this will save you the duplicate content problem. With that said, I have been using an electronic cigarette lately and I think it is a really cool product. I got it from…
You are absolutely right. The best way to do this is through the Robots.txt file. It can be modified like so:
Disallow: /surveys/ survey. htm
You would of course change this to the path of the page you would like Google not to index. You can also do it through Google Webmaster tools if you like, but it will only block the page from Google. Google is really cracking down on duplicate content, so its a good idea to use it. Hope this helps…
Johnny Blaze
Webmaster, Halo Electronic Cigarettes
http://www.halocigs.com
anyone know if the fda is any closer to doing any testing for the e liquids safety? also where can i find the most up to date info regarding its “safeness”?
Of course, by blocking the search engine spiders from indexing the page you would also be stopping other users from reading or entering the discussion. The correct way to use material like this is either to summarise it, quote the relevant section or quote part of it and include a link to the complete article/interview.
I reaD THRU THIS POST AND i THINK ITS PRETTY INTERESTING. sOME OF YOU HIGH TECH GUYS ARE WAY ABOVE THE NORM HERE. i LIKE THE INFO POSTED! iT’S OBVIOUS THESE GUYS LET FOLKS JUST POST WHAT THEY WANT NOT LIKE OTHER BLOGS THAT YOU HAVE TO GET OK’D BEFORE IT GOES ON. i SAY GET OVER IT AND FIGHT THE CAUSE. eLECTRONICS NEED TO STAY!!!!
Johhny Blaze – You have got to be kidding! Smoke juice. Wait till the big guys see your site and take you on. Have you not heard of the flavor decision, vanilla? Mango. better fix your site. Stuff like what your doing is only going to make it hard on those that have a better understanding and are trying to bring the e-cigs on.
not all of the e-cigs are the liquid form!
I agree that robots.txt should be used. In some cases you can do 301 redirects to avoid the duplicate content.
Joye 510
Great week for Electronic cigarettes and E-Liquid in the courts!
Judge sides with e-cigarette companies over FDA
Judge Leon’s court order is at:
https://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2009cv0771-55
Judge Leon’s 32 page opinion is at:
https://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2009cv0771-54
Smoking Everywhere issued the following response to Judge Leon’s ruling
Smoking Everywhere, Inc. is pleased with the ruling issued today that its electronic cigarette should be legally viewed as a tobacco product. Smoking Everywhere has maintained that the appropriate marketplace for its electronic cigarette is the tobacco product marketplace not the “drug” marketplace as FDA has asserted. Smoking Everywhere’s electronic cigarette is designed to compete with traditional burned tobacco products. FDA has gone to great lengths to improperly cast the electronic cigarette into the drug marketplace but Judge Leon’s ruling properly focuses the review to the proper legal area. As the Judge stated in his ruling, “This case appears to be yet another example of FDA’s aggressive efforts to regulate recreational tobacco products as drugs or devices . . .[and] [u]nfortunately, its tenacious drive to maximize its regulatory power has resulted in its advocacy of an interpretation of the relevant law that I find, at first blush, to be unreasonable and unacceptable.”
Smoking Everywhere, Inc. believes its electronic cigarette plays an important role in bringing an alternative to the use of smoked tobacco by providing the effect of a traditional cigarette without the more than 4000 toxic and harmful compounds found in cigarette smoke. The company is hopeful that with the issuance of this ruling, the focus on the risk of its product can now properly turn to a comparison of its electronic cigarette to the appropriate tobacco product benchmark, the smoke producing lit cigarette.
My question is the vapor released after inhaling the e cig. Is it water and if so what does it do to the lungs. Can it cause pneumonia or other breathing problems.
William Klinger – Actually can help breathing.
I quit smoking with the joye 510. Thank you for the Electronic Cigarette.
Eric,
Quess what that’s exactly why folks are fighting the e-cigs.
Lost tax revenue!
VV
I love my Joye 510. It has paid for itself over and over. I’ve just ordered my Joye eGo and can’t wait.
I love my Joye 510. It has paid for itself over and over. I’ve just ordered my Joye eGo and can’t wait. I got it at http://www.ecigbestsave.com.
I love hearing good news about electronic cigarettes! It is even better when there are rulings in favor of electronic cigarettes. I was just sitting here smoking my T-rex electronic cigarette while I was reading this article and smiling!
It’s really a good article for smoker.it reduce the harmful affect.useful information like this one must be kept and maintained so I will put this one on my bookmark list. Thanks for sharinng….
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