Electronic cigarettes

A harm reduction strategy for tobacco control? 

          First of all, to give you a clue, an electronic cigarette is a battery-powered device that provides inhaled doses of nicotine vaporized solution. The vapor can also provides a flavor and physical sensation similar to that of inhaled tobacco smoke, although there is no tobacco, combustion or smoke present. They use a rechargeable lithium ion battery.

           It was invented by a Chinese pharmacist Hon Lik in 2003. The company he worked for, Golden Dragon Holdings, changed its name to Ruyan (meaning "to resemble smoking") and started exporting its products in 2005-2006.

          Nicotine solutions are sometimes referred to as "e-liquid" or "e-juice", with hundreds of different flavors available, including regular tobacco and menthol, fruit , chocolate, vanilla, caramel, coffee, and cola. Also different nicotine solution concentrations are available, to let the user decide the amount of nicotine to be taken in. Concentrations range from Zero Nicotine, low and mid-range doses (6–8 mg/ml and 10–14 mg/ml respectively), to high and extra-high doses (16–18 mg/ml and 24–36 mg/ml respectively).


            The solutions consist of nicotine dissolved in propylene glycol (PG) and/or vegetable glycerin (VG). Both PG and VG are common food additives. PG has been used as a water-based chemical additive in asthma inhalers and nebulizers since the 1950s, with no serious side effects known. Seems like a good idea to help people quit smoking. So why don't we see them being sold in stores in Canada?

          Health Canada hasn't approved the electronic cigarettes for use until they have completed their studies to evaluate their safety. They are concerned they may cause nicotine poisoning or addiction. "Although these electronic smoking products may be marketed as a safer alternative to conventional tobacco products and, in some cases, as an aid to quitting smoking, electronic smoking products may pose risks such as nicotine poisoning and addiction," Health Canada said. 

          A study done by the U .S. Food and Drug Administration (FDA) Division have identified several problems with the e-cigarettes:

·        Diethylene glycol (poisonous) was detected in one of the cartridges.

·        Tobacco-specific nitrosamines (TSNAs) were detected in all of the cartridges from one brand and two of the cartridges from the other brand.

·        Actual nicotine levels did not always correspond to the amount of nicotine the cartridges purported to contain

·        The analysis found traces of nicotine in some cartridges that claimed to be nicotine-free

·        Inconsistent amounts of nicotine delivered when drawing on the device

          In New Hampshire a group of students, joining with a group called “Breathe New Hampshire” petitioned the state government to ban the sale of electronic cigarettes to minors. While sale of electronic cigarettes to minors remains legal, some worry that electronic cigarettes will serve as a gateway to smoking cigarettes, especially with flavours such a chocolate. One teen involved in the legal proceedings claims that her peers will see electronic cigarettes as similar to “having a new cell phone. It’s cool. It’s electronic.”

          However there are many organizations such as the American Association of Public Health Physicians which support the use of e-cigarettes. In their petition to the FDA, they stated: "We have generated these petitions because reclassification of E-cigarettes to tobacco products could open the door to a new harm reduction component to current tobacco control programming. That new component, in turn, could rapidly and substantially reduce tobacco-related illness and death without increasing the numbers of teens initiating nicotine use"

          Numerous studies point out the potential of harm reduction in using e-cigs. They generally say that an e-cigarette produces less harm than the 4000 chemicals and 40 known carcinogens in tobacco smoke A recent study led by Boston University School of Public Health (BUSPH) researchers reports that electronic cigarettes are a promising tool to help smokers quit, producing six-month abstinence rates nearly double those for traditional nicotine replacement products. 


          Many countries including the UK, Netherlands, and China allow the sale of e-cigs, and even allow their use indoors in pubs. So is Electronic cigarettes good or bad? You decide!


http://www.sciencedaily.com/releases/2011/02/110208171442.htm
http://www.cbc.ca/news/health/story/2009/03/27/electronic-smoking.html