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Are Vapers At Risk From Hazardous Metals?

skull

 

A group of researchers from Johns Hopkins and other universities are getting a lot of attention with a study that claims to show dangerous levels of various metals in e-cigarette vapor.

The press release was in newsrooms before the study had even been published, and the researchers were on the phone with reporters before the ink on the press release was dry. And the story is still spreading. Unfortunately, most reporters simply repeat the authors’ version of what the results mean, and don’t bother seeking out experts who might challenge the paper’s conclusions. And they definitely need challenging.

“Toxic metals linked with brain damage are ‘leaking from e-cigarettes into vapour’, experts have found,” said The Mirror. “Oh good, e-cigarette vapor contains toxic metals, too,” shouted the sarcastic Mashable banner. And those weren’t even the worst headlines.

Do the headlines match the study’s findings? And, for that matter, do the researchers’ own conclusions even describe the findings of the research? (more…)

Vape tax opponents rally around repeal effort, election challenge

New Taxes Threaten Pennsylvania Vape Stores
Wallace McKelvey | WMckelvey@pennlive.com By Wallace McKelvey | [email protected] The Patriot-News
Email the author | Follow on Twitter
on September 19, 2016 at 2:10 PM, updated September 19, 2016 at 3:09 PM

Opponents of Pennsylvania’s 40 percent tax on e-cigarettes are rallying around new legislation that would repeal what vape store owners describe as the death knell of the industry.

Lawmakers and Gov. Tom Wolf avoided another protracted budget impasse this year by relying on new revenues from an expansion of gambling, reforms to the liquor system and higher taxes on smokers and the businesses that cater to their nicotine habits. That includes a 40 percent tax on the wholesale price on vaping supplies as well as a 40 percent “floor tax” on the inventory currently sitting on vape shop shelves.

(more…)

POV: New FDA Regulations on Vaping Products a Failure

POV: New FDA Regulations on Vaping Products a Failure

They do not protect public’s health, do impose a public safety hazard

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On May 5, the US Food and Drug Administration (FDA) released its long-awaited regulations on electronic cigarettes and vaping products. These rules, which require every one of the more than 10,000 vaping products on the market to submit a pre–market approval application simply to stay on the market, were widely applauded by antismoking and health groups. What may not have been apparent at the time, but what I have discovered through a detailed analysis of the 499-page regulations, is that these regulations not only fail to protect the public’s health, but they impose a public safety hazard.

(more…)

Promote e-cigarettes widely as substitute for smoking says new RCP report

Promote e-cigarettes widely as substitute for smoking says new RCP report

The Royal College of Physicians’ new report, Nicotine without smoke: tobacco harm reduction, has concluded that e-cigarettes are likely to be beneficial to UK public health. Smokers can therefore be reassured and encouraged to use them, and the public can be reassured that e-cigarettes are much safer than smoking.

Royal College of Physicians: Vaping Can ‘Prevent Almost All The Harm From Smoking

Royal College Of Physicians Says E-Cigarettes Can ‘Prevent Almost All The Harm From Smoking’

“Smokers who use nicotine products as a means of cutting down on smoking are more likely to make quit attempts,” the RCP says. “Promoting wider use of consumer nicotine products, such as e-cigarettes, could therefore substantially increase the number of smokers who quit.”

In England, the RCP notes, e-cigarettes have surpassed nicotine replacement therapy (NRT, i.e., gum, patches, nasal spray, etc.) as an alternative to smoking. While the evidence so far is limited, it suggests that e-cigarettes are at least as effective as NRT in helping smokers quit, and there is reason to believe they will work better for many people, since vaping more closely resembles the activity it is supposed to replace.

The National Health Service’s Stop Smoking Services (SSSs) recently started to help smokers trying to quit with e-cigarettes, and the early data are promising. “The average quit rate in all smokers using SSSs was around 51%, and among e-cigarette users it was 66%,” the RCP reports. “Although factors other than the product itself are likely to be involved in this difference, the finding is certainly consistent with high efficacy as a cessation therapy.”

Data from England indicate that “smokers who use e-cigarettes at least daily are indeed twice as likely to make a quit attempt, or else to reduce their smoking, [as] those who do not.” Although that study did not find that e-cigarette use made success more likely, “independent clinical trials and observational data from the Smoking Toolkit Study [a British survey] indicate that e-cigarette use is associated with an increased chance of quitting successfully.”

Ilona Orshansky uses a vaping device at her e-cigarette shop in Brooklyn (Image: Timothy Fadek/Bloomberg News)

 Are e-cigarettes a gateway to smoking?

Critics of e-cigarettes worry that they will “renormalize” smoking and increase its incidence by fostering nicotine addiction among people who otherwise never would have used tobacco. But there is very little evidence that is happening. To the contrary, smoking rates and vaping rates are moving in opposite directions, and regular use of e-cigarettes does not seem to have much appeal among people who have never smoked.

“There is no evidence that either NRT or e-cigarette use has resulted in renormalisation of smoking,” the RCP says. “None of these products has to date attracted significant use among adult never-smokers, or demonstrated evidence of significant gateway progression into smoking among young people.”

If there were a significant gateway effect, surveys should identify people who have never used tobacco but who regularly use e-cigarettes (often enough to get hooked on nicotine) and eventually move on to smoking. But if such people exist, there are not many of them.

“E-cigarette use in Britain is, to date, almost entirely restricted to current, past or experimental smokers,” the RCP notes. “As with NRT, there is no evidence thus far that e-cigarette use has resulted, to any appreciable extent, in the initiation of smoking in either adults or children; the extremely low prevalence of use of e-cigarettes among never-smoking adults and children indicates that, even if such gateway progression does occur, it is likely to be inconsequential in population terms.”

By contrast, the impact of turning large numbers of smokers into vapers could be dramatic. “The growing use of electronic cigarettes as a substitute for tobacco smoking has been a topic of great controversy, with much speculation over their potential risks and benefits,” says John Britton, chairman of the RCP’s Tobacco Advisory Group. “This report lays to rest almost all of the concerns over these products, and concludes that, with sensible regulation, electronic cigarettes have the potential to make a major contribution towards preventing the premature death, disease and social inequalities in health that smoking currently causes in the UK. Smokers should be reassured that these products can help them quit all tobacco use forever.”

It’s Too Early to Prove Absolute Safety, But Smokers Shouldn’t Wait to Vape

It’s Too Early to Prove Absolute Safety, But Smokers Shouldn’t Wait to Vape

Electronic cigarette

Tobacco opponents say that we’ve had too little experience with e-cigarettes to know whether they are safe.  While it is true that we don’t yet know the health consequences of long-term use, that should not discourage smokers from switching.

We know that smoke contains high levels of thousands of agents, many of which are toxic or carcinogenic.  In contrast, e-cigarette vapor contains water, propylene glycol and/or vegetable glycerin, nicotine, flavors and perhaps a few contaminants at minuscule levels.  None of these – with the exception of buttery flavors (here) – are linked to any specific disease.  This difference alone justifies encouraging smokers to switch to e-cigarettes.

In the case of cigarettes, the effects of long-term use were not apparent for 20 years.

As I discuss in my book, For Smokers Only, smoking prevalence increased substantially around World War I (1914-1918).  The first clinical report of an increase in lung cancer and the suggestion of a link to smoking was published in 1939 by Alton Oschner and Michael Debakey in the journal Surgery, Gynecology & Obstetrics (68: 435-451, 1939). “Until recently,” they wrote, “[cancer] of the lung has been considered a relatively infrequent condition.  However, recent studies demonstrate that [lung cancer] is one of the most frequent [cancers] of the body.”  But they acknowledged, “…it is controversial whether the increase in [lung cancer] is apparent or real.”  Oschner and DeBakey described 79 previous cases and presented seven cases that they had seen.

German pathologist Dietrich Eberhard Schairer and colleague Erich Schöniger published perhaps the first epidemiologic case-control study of smoking and lung cancer in their native language in 1943. Now considered a groundbreaking study, it was republished in English by the International Journal of Epidemiology in 2001 (reference here).  They confirmed “the [earlier] report of Müller [1940] that non-smokers rarely get lung cancer whereas heavy smokers get it more frequently than average.”

The smoking-lung cancer link did not appear in mainstream medical literature until 1950, when studies by Ernst Wynder and Evarts Graham (Journal of the American Medical Association,here), and by Richard Doll and Austin Hill in the (British Medical Journal, here) were published.

While the strong link between smoking and lung cancer was not discovered for decades, today’s advanced surveillance techniques may detect a vapor-linked problem sooner.  It should be noted, however, that evaluating the effects of vaping will likely be complicated by the fact that most vapers already have smoking histories.

Smokers shouldn’t wait to vape.

Scientist Exposes ‘Sham’ Methodology Linking E-Cigarettes To Smoking

Scientist Exposes ‘Sham’ Methodology Linking E-Cigarettes To Smoking

Vaping Study Wrong
Image:   Vaping360.com(Vaping360)
A Swiss study claiming vaping can lead to smoking and harms current smokers’ chance of quitting suffers from “fatal” flaws, and the paper’s conclusions are misrepresentative, according to a leading public health expert.

“We found no beneficial effects of vaping at follow-up for either smoking cessation or smoking reduction,” the authors conclude in the study.

But Dr. Michael Siegel, a professor in the Department of Community Health Sciences, Boston University School of Public Health, has written a damning critique of the study, which was published in Swiss Medical Weekly.

“Instead, the study measures – at follow-up – whether the participants had used an electronic cigarette any time in the past year,” he continued. “They could have used an e-cigarette for the first time the previous day, for example, and would still be considered as vapers in the analysis.” (RELATED: CDC Data Blows Away Popular E-Cigarette Criticism)

Siegel points out that the researchers don’t compare the changes in smoking behavior over time between vapers and non-vapers. The study only measures changes in smoking over the past year and whether the subjects had ever used an e-cigarette. So, in Siegel’s words, the “study methods do not allow the investigators to determine which came first.”

“Because it is a cross-sectional study, it is impossible to know whether the change in smoking status preceded the use of electronic cigarettes or whether the use of electronic cigarettes preceded the smoking status change,” he wrote.

This omission is critical, as it casts severe doubt over the claim that e-cigarettes are a cause of smoking initiation or failure to quit. The second fatal flaw is that the question used to assess vaping behavior only asked about ever use of e-cigarettes,” Siegel wrote. “It does not assess the frequency of use or its duration. According to the methodology, participants were merely asked whether they had ‘used’ e-cigarettes at any point in the past 12 months.”

But the term “used” was not clarified. Vapers, as defined in the study, included anyone who so much as tried one e-cigarette. “It is entirely possible that many of the participants who the study called vapers were actually not vapers at all, but merely people who had tried an e-cigarette,” Siegel added. (RELATED: CDC Admits, No ‘Concrete’ Evidence E-Cigarettes Are Gateway To Smoking

Siegel’s criticism comes soon after a meta-study arguing that e-cigarettes made it harder for people quit smoking received widespread criticism from health professionals, and was branded an “unscientific hatchet Job.”

https://flickr.com/vaping360

Vaping: UK Grants License For E-Cigarettes As Quit Smoking Aid

UK Grants License For E-Cigarettes As Quit Smoking Aid

In the UK, vaping is now legally licensed as a smoking aid, and e-cigarettes can now be prescribed to be used as a way for smokers to quit. Britain officially gives license to the product e-Voke as a medicinal quitting alternative.

This is sort of controversial since ironically – e-Voke is produced by a British American Tobacco – one of the world’s biggest tobacco brands. UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) tells that the decision to regulate e-cigarettes is in the interests of people who can use it as a quit smoking device.

Still, many health communities are concerned about the potential risks of vaping. Since it is still a new habit, long-term studies has not yet been conducted. The long-term effects are also not clear as of now, and will be further investigated by scientists.

But it is claimed that vaping is a much safer alternative, since tobacco-based cigarettes still claims nearly 6 million deaths per year, as reported by the US Centres for Disease Control and Prevention.

Public Health England reported that e-cigarettes are 95% less harmful to people’s health than regular cigarettes. Still, moderation and more research is needed on this area.

British Prime Minister David Cameron made headlines before when he endorsed e-cigarettes as a quitting aid, since he himself is an admitted smoker who struggles to quit.

“Certainly as somebody who has been through this battle a number of times, eventually relatively successfully, lots of people find different ways of doing it and certainly for some people e-cigarettes are successful. So I think we should be making clear that this is a very legitimate path for many people to improve their health and the health of the nation,” according to the Prime Minister.

 

‘Popcorn Lung’ disease claim linked to vaping exaggerated, says cardiologist

CAUSEWAY BAY (Hong Kong), Dec 13, 2015:

A recent research finding which suggested that e-cigarette usage could lead users to develop the chronic respiratory condition known as “Popcorn Lung” disease has been blown out of proportion, says a leading cardiologist.

Dr Konstantinos Farsalinos, of the University of Patras in Greece, said the recent finding was exaggerated as the report on the matter failed to mention that the chemicals that caused bronchiolitis obliterans, were also present in tobacco cigarette smoke and in larger quantities, too.

Dr Farsalinos was referring to a recent publication in the journal Environmental Health Perspectives by researchers from the Harvard T.H. Chan School of Public Health who evaluated the presence of diacetyl, acetyl propionyl and acetoin in 51 cigarette-like products of different flavours.

The researchers, he pointed out, found at least one of the chemicals in 92% of the samples, with 76% containing diacetyl and recommend urgent action to evaluate the extent of diacetyl exposure from e-cigarettes.

“We did that same study last year and they used our example.

“We found higher levels last year than what they found and those ‘high’ levels were 100 times lower than what was present in tobacco cigarette smoke, so they created, again, this media frenzy,” he said.

Dr Farsalinos said this when met on the sidelines of the “Harm Reduction in Asia – Developing a Regulatory Framework for E-cigarettes Symposium” here on Thursday.

The symposium was organised by regional consumer advocacy group, Factasia.org, in wake of the intense debate over the harm reduction potential of e-cigarettes as a less harmful alternative for adult smokers.

The group’s initiative comes at a time when the Hong Kong and Macau governments are considering completely banning the sales of e-cigarettes, with authorities in Malaysia announcing they will regulate rather than ban, and as proposals are expected to be reviewed and voted on by legislators in 2016.

Dr Farsalinos also said there had yet to be a single case of e-cigarette users who had developed the disease, which causes inflammation and scarring to the lungs and constricts breathing, from prolonged use of the device, although it was said that 75% of the vaping liquid refills contained the chemicals involved.

In response to the Harvard study, Dr Farsalinos, in his blogsite, said the article had created false impressions and exaggerated the potential risk from diacetyl and acetyl propionyl exposure through e-cigarettes.

“They failed to mention that these chemicals are present in tobacco cigarette smoke and violated a classical toxicological principle that the amount determines the toxicity and the risk.

“Whether you are healthy or not, smoking will be a much stronger risk factor for health damage compared to any exposure coming from e-cigarettes, at least at the average levels found in our study and the new study,” he wrote.

However, he said he was a strong supporter of removing diacetyl and acetyl propionyl from e-cigarettes.

“Smokers need to be informed about the risk from continuing smoking versus a risk coming from use of diacetyl containing e-liquids.

“We should not forget that the risk of discouraging smokers from using e-cigarettes as a smoking cessation tool is higher than the risk of being exposed to diacetyl and acetyl propionyl at the average levels found in this study,” he said.

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