Cigarette

Smoke 1 Cigarette a Day? It Can Still Kill You

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If you think having just one cigarette a day won’t do any harm, you’re wrong.

British researchers say lighting up just once a day was linked to a much higher risk of heart disease and stroke than might be expected.

The bottom line: “No safe level of smoking exists for cardiovascular disease,” wrote the team led by Allan Hacksaw, of UCL Cancer Institute at University College, London.

“Smokers should quit instead of cutting down, using appropriate cessation aids if needed, to significantly reduce their risk,” the study authors said.

And it’s a warning to the young that even so-called “light” smoking carries a heavy price, one expert said.

Young adults “often smoke lesser amounts than older adults,” noted Patricia Folan, who directs the Center for Tobacco Control at Northwell Health, in Great Neck, N.Y.

“These lighter-smoking young adults frequently do not even consider themselves smokers,” she said, but they are still at “risk of developing coronary heart disease from smoking even a small amount of cigarettes.”

For the new study, Hackshaw’s team looked at data from 141 studies. Since the average cigarette pack contains 20 cigarettes, the researchers expected that the risk of heart disease or stroke for a 1-cigarette-per-day smoker would be just 5 percent of that of a pack-a-day user.

But that just wasn’t the case. Instead, men who smoked just one cigarette a day still shared a full 46 percent of the increased odds for heart disease that a heavy smoker had, and 41 percent of the risk for stroke.

And women who smoked one cigarette a day had 31 percent of the pack-a-day smokers’ increased risk of heart disease, and 34 percent of their increased risk of stroke, Hackshaw’s group said.

When the researchers focused on studies that controlled for several other risk factors, they found that smoking just one cigarette a day still more than doubled women’s risk of heart disease.

The study was published Jan. 24 in The BMJ.

“We have shown that a large proportion of the risk of coronary heart disease and stroke comes from smoking only a couple of cigarettes each day,” Hackshaw said in a journal news release. “This probably comes as a surprise to many people. But there are also biological mechanisms that help explain the unexpectedly high risk associated with a low level of smoking.”

Dr. Rachel Bond directs Women’s Heart Health at Lenox Hill Hospital in New York City. She agreed that “no amount of smoking is safe.”

She said that quit-smoking efforts can work, but “true success is to avoid [initiating] tobacco exposure altogether.”

What Is In A Cigarette? Chemicals and Ingredient List Confirm How Dangerous Smoking Really Is.

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Over 3,200 Americans under the age of 18 smoke their first cigarette every day, and most of them are unaware of what they are getting into. Many new smokers may not realize how quickly their new habit can lead to heart disease, stroke, diabetes, lung diseases, and certain types of cancer. If you’re looking for an explanation as to why cigarette smoke results in more than 480,000 deaths each year in the United States, look no further than its ingredients. The average cigarette contains upward of 600 different ingredients on top of over 7,000 chemicals produced by cigarette smoke. Where these ingredients and chemicals also show up may shock some smokers into quitting once and for all.

Cigarette Ingredients

“One of the issues with cigarettes is that they have hundreds of added ingredients, not just what is naturally in the tobacco plant,” environmental health scientist with Mount Sinai School of Medicine, Dr. Luz Claudio told Medical Daily in an email. “What complicates this even more is that when these chemicals burn, they form other chemicals that may have additional effects on health.”

While tobacco companies like R.J. Reynolds insist that a lot of the ingredients found in cigarettes are also found in Food and Drug Administration-approved foods and beverages, a few of these ingredients are also found in products that you would never think to put in your body otherwise. Take for example arsenic, an inorganic substance found in wood preservatives and rat poison. On the FDA’s Established List of Harmful and Potentially Harmful Constituents in Tobacco Products and Tobacco Smoke, arsenic’s dangers include: carcinogen, cardiovascular toxicant, and reproductive or developmental toxicant.

Some of cigarettes’ harmful ingredients and chemicals are more familiar, such as carbon monoxide, which can be found in car exhaust fumes, and nicotine, also found in insecticides. There’s also formaldehyde, a cancer-causing ingredient of embalming fluid. Others may not seem so dangerous by name alone like cadmium, an active ingredient in batteries, or hexamine, sometimes found in barbecue lighters. Approximately 70 of the chemicals and ingredients found in a cigarette are considered carcinogenic, meaning they have the potential to cause cancer. Almost all of these ingredients can lead to death in some way or another.

“Cigarette smoke can affect the flow of oxygen within our bodies in two ways,” pulmonologist specializing in pulmonary rehab with City of Hope, Dr. Brian Tiep told Medical Daily. “First, carbon monoxide grabs on to the hemoglobin molecule, which prevents the transport of oxygen through red blood cells. Secondly, cyanide hinders tissue’s ability to take up and utilize oxygen. Tissue cannot function without this steady flow of oxygen.”

According to the American Cancer Society, cigarette smoke accounts for at least 30 percent of all cancer-related deaths in the U.S. This includes 87 percent of lung cancer deaths among men and 70 percent of among women. Cigarette smoke can also lead to certain lung diseases including emphysema, bronchitis, and chronic airway obstruction. There are currently more than 16 million Americans suffering from a disease that was caused by smoking. If appropriate prevention strategies are not put in place to curb the number of young Americans who pick up smoking, an estimated 5.4 million people under the age of 18 will die prematurely due to a smoking-related illness.

Electronic Cigarettes Contain Higher Levels of Toxic Metal.

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Electronic Cigarettes Found To Contain Dangerous Metal Nanopartices

A concerning new study found that the aerosol from electronic cigarettes contains higher levels of measurable nanoparticle heavy metals than conventional tobacco smoke.

A new study published in the journal PLoS One has uncovered a concerning fact about electronic cigarettes (EC): toxic metal and silicate particles including nanoparticles are present in both the cigarette fluid and aerosol.1

Researchers at the Department of Cell Biology and Neuroscience, University of California Riverside, tested the hypothesis that electronic cigarettes (EC) contain metals from various components in EC.  They employed a variety of testing methods to ascertain the level of contamination, including light and electron microscopy, cytotoxicity testing, and x-ray microanalysis. Their results were reported as follows:

The filament, a nickel-chromium wire, was coupled to a thicker copper wire coated with silver. The silver coating was sometimes missing. Four tin solder joints attached the wires to each other and coupled the copper/silver wire to the air tube and mouthpiece. All cartomizers had evidence of use before packaging (burn spots on the fibers and electrophoretic movement of fluid in the fibers). Fibers in two cartomizers had green deposits that contained copper. Centrifugation of the fibers produced large pellets containing tin. Tin particles and tin whiskers were identified in cartridge fluid and outer fibers. Cartomizer fluid with tin particles was cytotoxic in assays using human pulmonary fibroblasts. The aerosol contained particles >1 µm comprised of tin, silver, iron, nickel, aluminum, and silicate and nanoparticles (<100 nm) of tin, chromium and nickel. The concentrations of nine of eleven elements in EC aerosol were higher than or equal to the corresponding concentrations in conventional cigarette smoke. Many of the elements identified in EC aerosol are known to cause respiratory distress and disease.

The study authors concluded that “The presence of metal and silicate particles in cartomizer [atomizer/cartridge connecting to the battery] aerosol demonstrates the need for improved quality control in EC design and manufacture and studies on how EC aerosol impacts the health of users and bystanders.”

Cartomizer Anatomy

Discussion

While e-cigarettes are rightly marketed as safer than conventional tobacco cigarettes, which contain thousands of known toxic compounds including highly carcinogenic radioactive isotopes, they have not been without controversy.  In May 2009, the US Food and Drug Administration Division of Pharmaceutical Analysis found diethylene glycol, a poisonous liquid used in explosives and antifreeze, in one of the cartridges they sampled. They also discovered the cancer-causing agent, tobacco-specific nitrosamines, in a number of commonly used brands.2

The findings of this latest PLoS One study refutes proponents of e-cigarettes who claim that the health risks of smoking are eliminated with their use. Heavy metals like tin, aluminum, cadmium, lead and selenite are increasingly being recognized as carrying significant endocrine disrupting potential and belong to a class of metals known as ‘metalloestrogens.’

One of the unintended, adverse consequences of nanotechnology in general is that by making a substance substantially smaller in size than would occur naturally, or though pre-nanotech production processes, the substance may exhibit significantly higher toxicity when in nanoparticle form. Contrary to older toxicological risk models, less is more: by reducing a particle’s size the technology has now made that substance capable of evading the body’s natural defenses more easily, i.e. passing through pores in the skin or mucous membranes, evading immune and detoxification mechanisms that evolved millions of years before the nanotech era.

For example, when nickel particles are reduced in size to the nanometer range (one billionth of a meter wide) they may actually become more toxic to the endocrine system as now they are capable of direct molecular interaction with estrogen receptors in the body, disrupting their normal structure and function.3 4 5 Moreover, breathing these particles into the lungs, along with other metals, ethylene glycol and nicotine produces a chemical concoction exhibiting synergistic toxicity, i.e. the toxicity of the whole is higher than the sum of their parts. These sorts of “chemical soups” are exceedingly difficult to study, as they embody a complexity that analytical and theoretical models within toxicology are not equipped to readily handle. Nonetheless, it is likely that when taken together the harms done by e-cigarettes are significant, and will likely manifest only after chronic use when identifying ‘singular causes’ of disease is nearly impossible. Regulators will have a hard time, therefore, identifying a “smoking” gun even after a broad range of health issues do emerge in exposed populations.

Ultimately, finding a less harmful alternative to tobacco smoking is justified, but let buyer (and user) beware, the products are not without possible harm as some marketers falsely advertise.

 

E-Cigarette Smoking Could be Banned at L.A. Restaurants, Beaches

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Thumbnail image for e_cigarette_Michael_Dorausch_Flickr_ok.JPG
Michael Dorausch/Flickr

Hold onto to your e-cigarettes while you can, people, because using them might soon be banned in the same places that prohibit lighting up regular smokes.

The L.A. City Council today will consider a new motion to be introduced by Councilman Mitch O’Farrell that would treat electronic devices the same way that cigarette smoking is regulated in town.

And means no puffing, electronic or otherwise, in or on:

-elevators
-supermarkets
–offices
-restaurants
-city beaches, or
-within 25 feet of playground equipment, bleachers, backstops, sports courts and fields, and picnic areas.

Yep. O’Farrell’s spokesman, Tony Arranaga, confirmed to the Weekly the gist of today’s proposal.

According to a statement put out by the offices of O’Farrell and the City Attorney:

The motion directs the City Attorney’s office to draft an ordinance to regulate the usage of electronic smoking devices where smoking is prohibited by law.

But wait, there’s more:

The council today will also weigh Councilman Paul Koretz‘s motion to raise the age limit on e-cigarette purchases to those 18 or older. As it stands, electronic tobacco retailing has no age limit for customers.

There have also been efforts on the state level to treat the battery-operated “vapes” (for nicotine vaporizers or atomizers) the same as regular cigs.

Proponents of e-cigarettes have been enjoying loopholes in the law, often smoking at bars and restaurants without reprisal. They argue that the water vapor emitted by the devices is not smoke and that it is not harmful.

However, some critics say that scientific testing has yet to catch up with the devices. The jury is still out about whether they are the source of second-hand smoke danger.

E-cigarettes ‘could save millions’

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Scientists say that if all smokers in the world switched from cigarettes to electronic cigarettes, it could save millions of lives.

Woman smoking an electronic cigarette

In the UK there are currently about 100,000 deaths per year attributable to smoking, worldwide it is estimated to be more than five million.

Now researchers are hopeful that an increasing use of e-cigarettes could prevent some of these deaths.

But some groups warn that e-cigarettes could normalise smoking.

An estimated 700,000 users smoke e-cigarettes in the UK, according to Action on Smoking and Health. Some users combine “vaping”, as it is often called, with traditional cigarettes while others substitute it for smoking completely.

E-cigarettes have also recently be found to be just as effective as nicotine patches in helping smokers quit.

Future hope

Rather than inhaling the toxic substances found in tobacco, e-cigarette users inhale vaporised liquid nicotine.

Robert West, professor of health psychology at University College London, told delegates at the 2013 E-Cigarette Summit at London’s Royal Society that “literally millions of lives” could be saved.

“Start Quote

Every adolescent tries something new, many try smoking. I would prefer they try e-cigarettes to regular cigarettes”

Dr Jacques Le Houezec Tobacco and nicotine researcher

“The big question, and why we’re here, is whether that goal can be realised and how best to do it… and what kind of cultural, regulatory environment can be put in place to make sure that’s achieved.

“I think it can be achieved but that’s a hope, a promise, not a reality,” he said.

A revolution

This view was echoed by Dr Jacques Le Houezec, a private consultant who has been researching the effects of nicotine and tobacco.

He said that because the harmful effects of its main comparator, tobacco, e-cigarette use should not be over-regulated.

“We’ve been in the field for very long, this for us is a revolution.

E-cigarettes
There is concern over the lack of regulation of e-cigarettes

“Every adolescent tries something new, many try smoking. I would prefer they try e-cigarettes to regular cigarettes.” Dr Le Houezec added.

Many are now calling for the industry to be regulated. An EU proposal to regulate e-cigarettes as a medicine was recently rejected, but in the UK e-cigarettes will be licensed as a medicine from 2016.

Konstantinos Farsalinos, from the University Hospital Gathuisberg, Belgium, said it was important for light regulation to be put in place “as soon as possible”.

“Companies are all hiding behind the lack of regulation and are not performing any tests on their products, this is a big problem.”

Prof Farsalinos studies the health impacts of e-cigarette vapour. Despite the lack of regulation, he remained positive about the health risks associated with inhaling it.

Healthy rats

E-cigarettes are still relatively new, so there is little in the way of long-term studies looking at their overall health impacts.

In order to have valid clinical data, a large group of e-cigarette users would need to be followed for many years.

Seeing as many users aim to stop smoking, following a large group of e-smokers for a long period could be difficult.

But in rats at least, a study showed that after they inhaled nicotine for two years, there were no harmful effects. This was found in a 1996 study before e-cigarettes were on the market, a study Dr Le Houezec said was reassuring.

Concern about the increase in e-cigarette use remains.

The World Health Organization advised that consumers should not use e-cigarettes until they are deemed safe. They said the potential risks “remain undetermined” and that the contents of the vapour emissions had not been thoroughly studied

Woman smoking electronic cigarette
E-cigarettes still divide opinion

The British Medical Association has called for a ban on public vaping in the same way that public smoking was banned.

They stated that a strong regulatory framework was needed to “restrict their marketing, sale and promotion so that it is only targeted at smokers as a way of cutting down and quitting, and does not appeal to non-smokers, in particular children and young people”.

Ram Moorthy, from the British Medical Association, said that their use normalises smoking behaviour.

“We don’t want that behaviour to be considered normal again and that e-cigarettes are used as an alternative for the areas that people cannot smoke,” he told BBC News.

But Lynne Dawkins, from the University of East London, said that while light-touch regulation was important, it must be treated with caution.

She said that e-cigarettes presented a “viable safer alternative” to offer to smokers.

“We don’t want to spoil this great opportunity we have for overseeing this unprecedented growth and evolving technology that has not been seen before, We have to be careful not to stump that.”

Menthol cigarettes: Stub out these seductive smokes.

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Menthol cigarettes make it easier to start smoking and harder to quit. It’s time to stub them out for good

SMOKING may be under siege, but it is still the world’s second biggest cause of preventable death. Tobacco kills nearly 6 million people every year, approximately 10 per cent of all deaths. Smoking also results in hundreds of billions of dollars in economic costs from increased healthcare expenditure and lost productivity.

<i>(Image: Andrzej Krauze)</i>

In the West, anti-smoking campaigns seem to have stalled. Around 1 in 5 US adults smokes, about the same as 10 years ago. Now those who seek to further reduce the harm from smoking have proposed a new measure: a ban on menthol in cigarettes.

Last week, after months of intense debate, the European Parliament voted for a ban on menthol cigarettes, which will come into force in 2022. Similar moves are afoot in the US, again surrounded by intense debate.

Menthol cigarettes were invented in the 1920s by Lloyd “Spud” Hughes of Mingo Junction, Ohio, who reportedly stored his cigarettes in a tin with menthol crystals that he used to treat a persistent cold. The tobacco absorbed the mint flavour and made the cigarettes easier to smoke. Hughes began selling mentholated cigarettes, and by 1932 his Spud brand was the fifth bestselling cigarette in the country.

Today, about a quarter of cigarettes sold in the US are menthol; 30 per cent of adult smokers and more than 40 per cent of youth smokers report smoking them.

In 2009, the US passed a law that for the first time gave the Food and Drug Administration (FDA) the authority to regulate tobacco products. Among other things, the agency now has the power to regulate the levels of “harmful components” they contain.

The FDA quickly acted to ban flavourings such as chocolate and vanilla, which are thought to be particularly attractive to children and teenagers. But it stopped short of banning menthol – the most popular additive – pending further studies.

Menthol is not simply a flavour additive: it can also have drug-like effects. In addition to its fresh taste and aroma, it can produce cooling, soothing sensations, which is why it is an ingredient in a number of medicinal products, such as throat lozenges. Menthol produces these effects by binding to receptors on sensory neurons which mediate signals related to pain, temperature and irritation. Low doses of menthol in cigarette smoke can therefore reduce the painful and irritating effects on the lining of the nose, mouth and airways, thereby allowing smokers to inhale more easily.

An analysis of internal tobacco industry documents from 1965 to 2000 identifies two types of menthol smoker. The first are people for whom menthol primarily serves to reduce the harsh effects of smoke. These people tend to be occasional smokers or young smokers. The second are people for whom it provides a stronger flavour and physical sensation. In the US, they tend to be African American men.

Data from numerous surveys and research projects confirm these findings. Adolescents aged between 12 and 17, for example, smoke menthol cigarettes at a higher rate than older age groups. The same is true for young adults aged 18 to 24.

The fact that menthol cigarettes are favoured by adolescents and young smokers leads to the suspicion that their availability encourages people to smoke, and this, too, is supported by research. In 2011, a report from the FDA’s Tobacco Products Scientific Advisory Committee concluded that “there is strong evidence indicating that adolescent menthol cigarette smokers are more dependent on nicotine than adolescent non-menthol cigarette smokers”.

The increased use of menthol cigarettes among African Americans, meanwhile, suggests that their availability results in disproportionate harm to that section of society.

In July the FDA said it was “likely” that menthol cigarettes posed a greater health risk than normal cigarettes, because they encourage young people to take up smoking, make it more difficult to quit and increase addiction. The agency opened a public consultation period, due to end on 22 November, with a view to an eventual ban.

The primary counterargument put forward by the tobacco industry is that a ban would create a black market for menthol cigarettes. However, the evidence for this is weak. One study directly asked smokers of menthol cigarettes how they would respond if the product was no longer sold. Thirty nine per cent said they would quit and 36 per cent said they would switch to non-menthol cigarettes.

In another study that included the response “seek out illicit products”, only 25 per cent indicated that they might consider purchasing black market products. These findings do not suggest that there would be an explosion of illicit activity if menthol cigarettes were banned.

In light of the tremendous threat that tobacco use poses to health and the minimal risk that would be expected from banning menthol cigarettes, the risk/benefit calculation appears to favour a ban. This opinion is shared by several leading health organisations, including the American Cancer Society, American Heart Association, American Lung Association, American Academy of Pediatrics, African American Tobacco Control Leadership Council and American Public Health Association. These organisations recently submitted a petition to the commissioner of the FDA to request the prohibition of the use of menthol.

We will only know how a ban on menthol cigarettes will pan out when we actually test it outside the laboratory. There is a growing consensus that the science is telling us it is time to conduct the experiment.

This article appeared in print under the headline “Not smooth, not cool”

Hormone removes the pleasure of smoking.

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The hormone GLP-1 is released when we eat and makes us feel full or sated toward the end of the meal.

 GLP-1 receptors are also activated in parts of the brain that are linked to satisfaction or a sense of reward. This indicates the hormone is directly involved in our experience of gratification.

Scientists reason that by blocking these receptors they can prevent smokers from feeling satisfied after a cigarette.

“Without this kind of reward, a smoker will not keep smoking. It can reduce addiction and the risk of a relapse,” says Elisabet Jerlhag, a researcher at the Sahlgrenska Academy of the University of Gothenburg.

Jerlhag and colleagues have investigated this new potential weapon in the battle against smoking.

Smokers require treatment

The ranks of daily, habitual smokers are on the decline but tobacco smoke remains a substantial public health challenge. One in four Norwegians smoke on occasion and the numbers of such “party smokers” are fairly stable.

Even those who are not heavy, daily smokers can find it hard to stub their cigs for good.

“Nicotine is remarkably habit-forming, and many people find it terribly hard to quit smoking. We need to start accepting dependency as a disorder that requires treatment,” says Jerlhag.

Tested on nicotine mice

To test whether GLP-1 regulates gratification, the researchers experimented with another chemical substance, Exendin-4 (Ex4), which imitates GLP-1’s effect on receptors. The substance was administered to a group of lab mice who had been given doses of nicotine.

The researchers then observed the mice’s movement patterns as well as the dopamine releases in their brains.

They found that nicotine made the mice more active, but the addition of Ex4 reduced that activity. However, mice that had not been given nicotine to start with did not experience the mitigating effect of Ex4. Nicotine increased the release of dopamine in their brains, but this was reduced when Ex4 had been given earlier.

The researchers concluded that GLP-1 receptors regulated the effect of nicotine on the reward functions in the brains of mice, and that Ex4 diminished the effect of nicotine.

Same effect on alcohol, amphetamines and cocaine

The researchers point out that other experiments have shown the same mitigating effect of Ex4 with other habit-forming substances such as alcohol, amphetamines and cocaine.

“Because Ex4 also reduced the motivation for consuming sucrose, this could indicate that GLP-1 receptors play a key role in the gratification created by addictive substances and the rewards of natural activities,” they add.

The researchers believe that substances that mimic the GLP-1 hormone should be considered for new prospective treatment regimens to help battle smoking and nicotine addiction.

Developing new medications

This method, which prevents smoking from soothing the nicotine cravings, is different from existing methods for treating habitual tobacco use, such as nicotine patches, or drugs such as bupropion or varenicline.

The hope is that the findings can lead to the development of new medications that mimic GLP-1. These kind of drugs have already been approved for diabetes, so that it should be relatively easy to get the green light to use them to help smokers kick their habit.

“Rewards are a prime reason why we become addicts. So we think medications that work in the same way as GLP-1 can have a positive impact on nicotine dependency. This is a whole new approach,”  Jerlhag says.

If you think the timing is wrong for quitting cigarettes, you are wrong – Now is the time.

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I bet you didn’t know that nicotine in commercial cigarettes is up to 35 times stronger than it was in the 1950’s and early 1960’s, before Big Tobacco (Marlboro and Kool) started using ammonia to free-base it. That is the number one reason why 95% of smokers who try to quit without help will return to smoking within 6 months. Nicotine is artificial chemical control of your emotions. Some people are switching to e-cigs (electronic cigarettes), so they can keep their nicotine addiction going strong while eliminating “some” of the chemicals found in the commercial cancer sticks. Other people quit cold turkey, usually after finding out they have cancer, or after a close friend or relative winds up six feet under from the nicotine nightmare. Talk about bad timing.

Old-Cigarettes-Trash-Ashtray

Quitting “cold turkey” is very difficult. Most people who quit smoking “cave in” and start back up again within half a year, but why? That’s because most programs give little to zero advice about nutrition and building back up the nutrients and the gut “flora” (good bacteria), which is destroyed by the 4,000 chemicals in every cigarette. Also, behavior rituals like breathing patterns and hand to mouth habits must be replaced with positive ones, or they will be missed and might cause a relapse. (http://www.naturalnews.com)

Plus, on top of everything else that sends smokers back to the well, toxic food and high blood acidity can cause nicotine withdrawal symptoms to flare up and the “urge to smoke” seem more “necessary,” leading to temporary relief from cravings and stressful moments, only to drag the person back into the undertow of chemical addiction and artificial emotion control. (http://www.naturalnews.com)

On top of the big “hooks” that keep smokers addicted, the cigarette industry spends about $23,000,000 a day on advertising and promotions. The statistics are all consuming, and cigarettes cause about 5 million deaths annually worldwide. Still, people smoke and wonder why they don’t quit. Want to know why? They can’t quit because they don’t know how. Even though “Big Tobacco” got busted for fraud and settled in the billions, they’re still up to no good, free-basing nicotine and brainwashing people into the habit from which they just can’t seem to “escape.”
(http://www.cdc.gov)

23 million smokers in U.S. wish they could QUIT today

There are 46,000,000 smokers in the U.S. alone and half want to quit, but only 5% will succeed. Scary ads don’t work, and commercial cigarettes are STILL JUICED UP WITH AMMONIA, despite settling with Blue Cross Blue Shield to the tune of $6.5 billion in the 1990’s for doing just that and also marketing to children and teens. “More than 15 years has passed since the conclusion of the Minnesota tobacco trial and the signing of the Master Settlement Agreement (MSA) by 46 U.S. State Attorney Generals and the US tobacco industry. The Minnesota settlement exposed the tobacco industry’s long history of deceptive marketing, advertising, and research and ultimately forced the industry to change its business practices. It has also been more than 15 years since the tobacco industry’s individual settlements with the states of Mississippi (1997), Florida (1997), and Texas (1998) … These agreements are the 5 largest settlements in the history of litigation.” (http://www.ncbi.nlm.nih.gov)

The CDC scary advertising campaign is also a dismal failure, only helping about 4% of the people who see it quit smoking, half of whom go back to smoking within 6 months, so what’s the use? Although the CDC brags that 1.6 million people TRIED to quit thanks to their scary ad campaign, how many really did quit? You can’t just scare people out of the third strongest addictive drug on the planet (nicotine); people need guidance and nutritional help.
(http://www.examiner.com)

The Number One Excuse is “Bad Timing”

The single most popular excuse that people use for not quitting is that the timing is wrong. They will say that times are TOO stressful, so they’ll have to wait, but the last thing the body needs while it’s under stress is ammonia, bleach, pesticide and plastic fumes entering the lungs, attached to chemical tar and glass fibers that cut the epithelial tissue. This breaks down the person’s immunity and makes them more susceptible to common colds, flu, viruses, bacterial infections, nasal congestion, allergies, sinus infections, bronchial infections, bladder infections, depression, sleep disorders and more. So go figure. Who needs all of that when times are stressful? Some people turn to electronic cigarettes to filter out some of the chemicals contained in commercial cigarettes (except for diethylene glycol – antifreeze – which causes leukemia!), but many of those people learn a hard lesson: nicotine damages the central cleansing organs and causes a host of its own problems, short term and long term, so bragging rights there are few and far between. (http://www.naturalnews.com)

One way out of the nicotine “prison” is to combine chemical knowledge with behavior modification and nutritional guidance. These three factors and skill bases, when taught and used correctly, have the highest success rate for helping smokers quit and stay smoke-free for life. There is a natural method that incorporates all three of these phases and is receiving excellent reviews. Studies show that smokers who seek help and follow the “yellow brick road” to a smoke-free life have an easier time “sticking to their guns.” The 14AndOut one hour program (video of the class) teaches smokers how to wean themselves off commercial cigarettes in 14 days or less and is recommended by Mike Adams, the Health Ranger and Editor of Natural News. The program has been a sensation for the past two years and there is nothing else like it on the market right now. Give 14AndOut a try and share the natural method with your friends, co-workers, relatives and/or neighbors who smoke cigarettes and speak of quitting. Stop smoking before 2014 and bring in the New Year with style and good health. Where there is a will, there is a way!

The Regulatory Challenge of Electronic Cigarettes.

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Electronic cigarettes (e-cigarettes or electronic nicotine delivery systems) heat a nicotine solution to generate vapor that is inhaled, without the combustion of tobacco and its toxic constituents. Use of e-cigarettes is increasing in the United States and around the world. Current smokers in the United States report an 11.4% prevalence of ever use of e-cigarettes and 4.1% use in past 30 days.1 They likely pose less direct hazard to the individual smoker than tobacco cigarettes and might help smokers quit smoking or reduce harm by smoking fewer tobacco cigarettes. On the other hand, there are potential harms, including promoting continued smoking of cigarettes and renormalizing cigarette smoking behaviors. The Food and Drug Administration (FDA) is authorized to regulate tobacco products, and in 2011 the agency announced plans to regulate e-cigarettes as tobacco products.2 The FDA will need to make a number of regulatory decisions about product safety that could have major effects on public health and will face many challenges.

THE E-CIGARETTE AS A NICOTINE DELIVERY SYSTEM

The delivery of nicotine to the lungs via inhalation, with rapid absorption into the circulation, is critical to the addictiveness of cigarette smoking.3 The adverse health consequences of cigarette smoking are caused primarily by inhalation of toxic tobacco constituents and organic combustion products. Nicotine per se contributes to some smoking-related diseases, but its contribution is considered to be much smaller than that of combustion products.3 The provision of clean nicotine (without combustion products or other tobacco plant toxins) in the form of nicotine replacement therapies (NRTs) has been in use for nearly 30 years and has proven to be a safe way to facilitate smoking cessation. Currently available NRT products are not as satisfying and are less acceptable to smokers compared with inhaling and absorbing nicotine from cigarette smoke. The possibility of an inhaled clean nicotine device has been discussed by health researchers for many years as a potentially more effective way to promote smoking cessation. Although not yet proven safe or effective for smoking cessation, the e-cigarette has been positioned as such an inhaled nicotine delivery device and has gained popularity through this perception.4

PRODUCT EVOLUTION

More than 250 e-cigarette brands are on the market currently, and products have evolved rapidly in recent years. Different e-cigarette brands are engineered differently, affecting the character and potential toxicity of the vapor. Thus, it is difficult to generalize about e-cigarettes as a single device. The FDA will need to consider the engineering of e-cigarettes with respect to different types of nicotine solutions, the capacity of the cartridges containing the solution, the nature of the heating element and battery, the types of additives and flavorings, and the potential toxicants released in the vapor.

ASSESSING POTENTIAL TOXICITY AND HEALTH EFFECTS

Liquids used in e-cigarettes vary with respect to concentrations of toxicants, and the quality control in e-cigarette manufacturing is questionable.5 Although a number of toxicants have been identified in e-cigarette vapors, the levels of these toxicants are orders of magnitude lower than those found in cigarette smoke, although higher than those found in NRT.6 Although it cannot be said that currently marketed e-cigarettes are safe, e-cigarette vapor is likely to be much less toxic than cigarette smoke. Among the questions that should be considered by the FDA are (1) Do low levels of contaminants in e-cigarette vapor pose a health risk? (2) What are the thresholds for toxicity of contaminants in vapor? (3) What should be the basis for product standards for e-cigarettes? (4) Could the risks be ameliorated by changes in engineering?

POTENTIAL HEALTH BENEFITS FOR INDIVIDUAL SMOKERS

Testimonials, surveys, and one uncontrolled clinical trial report that e-cigarettes facilitate the quitting of cigarette smoking and allow smokers to smoke fewer cigarettes per day if they continue to smoke.7– 8However, longitudinal analysis using population-level data found no difference in quit rates between e-cigarette users and nonusers.9 Controlled clinical trials and population-level observational cohort studies are needed to establish the utility of these cigarettes to facilitate smoking cessation. Research is also needed regarding the role of e-cigarettes in harm reduction, including reduced cigarette smoking and associated reduction of tobacco toxicant exposure. The FDA will need to determine the magnitude of potential health benefits from e-cigarettes for individual smokers.

POTENTIAL POPULATION HARM

Several potential sources of population harm require research and subsequent weighing of individual benefit vs population risk. These include uptake of e-cigarette use by nonsmokers, who may later become cigarette smokers or long-term nicotine addicts; promotion of dual use of e-cigarettes and regular cigarettes, such that use of e-cigarettes undermines quitting cigarette smoking; undermining the denormalization of cigarette smoking, because e-cigarettes look like regular cigarettes and their use in public would give the appearance that cigarette smoking behavior is more acceptable; and exposure to a new source of air pollution in places covered by smoke-free policies.

ADVERTISING AND MARKETING

Advertising and marketing can be considered in the context of both manufacturer and consumer. Industry has been aggressively marketing e-cigarettes with claims of health benefit compared with smoking tobacco cigarettes, for reducing and quitting smoking, for smoking without generating irritating and harmful secondhand smoke, and for using when a person cannot smoke cigarettes.10 Marketing also uses young models and celebrities to convey images of the product as glamorous and modern. The net result of industry marketing and consumer advocacy has been a substantial increase in the use of the product. Effective promotion of e-cigarettes could be advantageous if it was determined there was individual health benefit and a low level of total population harm—for example, if e-cigarette use was found to facilitate smoking cessation and not encourage dual use or appeal to youth as a novel nicotine product.

The FDA needs to decide how marketing should be regulated in the context of potential benefits and population risks. This includes deciding the legal age at which minors can purchase the products and other possible access restrictions, as well as evaluating the appeal of the marketing to youth. Determining the effect of e-cigarettes on the entire population will be challenging.

BROADER REGULATORY ISSUES

Assuming that e-cigarettes of high quality could be safe and could offer net public health benefit (including high consumer acceptability, more effective nicotine delivery, low levels of contaminants, not undermining existing tobacco control efforts), and that product improvement is occurring in an environment of marketplace competition, a critical question is when the FDA should begin to require product licensing. A disadvantage of requiring licensing is that regulatory requirements are likely to slow product innovation. The advantage of licensing would be to ensure the quality and consistency of products.

Medications to promote smoking cessation are regulated by the FDA Center for Drug Evaluation and Research (CDER). Tobacco products are regulated by the FDA Center for Tobacco Products (CTP). According to current FDA regulations, in the event that e-cigarettes are found to be helpful in facilitating smoking cessation, the same product could be regulated simultaneously, both by CDER as a medication and by CTP as a tobacco product. This makes little practical sense. A comprehensive regulatory approach to nicotine-containing products is needed. Regulation needs to include the full spectrum of products, from the most hazardous to the least hazardous, with consideration of the potential of less harmful products to reduce exposure to the most harmful combustion products from smoked tobacco, while simultaneously evaluating the total public health effects of the policies.

Source: JAMA

Should electronic cigarettes be as freely available as tobacco cigarettes? No.

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The Medicines and Healthcare Products Regulatory Agency has decided to license electronic cigarettes as medicines from 2016. Simon Chapman agrees with regulation, seeing e-cigarettes as another way for big tobacco to try to make nicotine addiction socially acceptable again, but Jean-François Etter (doi:10.1136/bmj.f3845) says restrictions will result in more harm to smokers

Amid the feverish embrace of electronic cigarettes, come several statements by the tobacco industry that should cause public health proponents of such products to get a grip. For example, the chief executive of Reynolds America told shareholders in November 2012, just six months before entering the e-cigarette market, “We have a little mantra inside of the company . . . which we call the 80-90-90 . . . We spend about 80% of our resources in the combustible space. The combustible space is still 80%, 80+% of our operating income . . . [and] 90% of the organizational focus . . . And despite a lot of these new innovations that you see coming out, 90% of our R&D [research and development] budgets are actually directed at the combustible category . . . That is the category that’s still going to deliver a lot of growth into the future.”1

Misconceptions

Big tobacco is not investing in e-cigarettes to wean itself off cigarette sales. Its recent

oleaginous rhetoric about them saving lives is utter duplicity. None of the big companies now in the e-cigarettes market have desisted from virulent opposition to policies that are known to reduce smoking. None has declared accelerated targets for reducing cigarette sales. As with other forms of smokeless tobacco, big tobacco wants smokers to use e-cigarettes as well as cigarettes, not instead of them. Its five goals are widespread dual use; retarding smoking cessation; resocialising public smoking back into fashion from its forlorn exile outside buildings; conveying to young, apprehensive would-be smokers that nicotine is a benign drug; and welcoming back lapsed smokers.

If big tobacco succeeds with any of these ambitions, e-cigarettes may cause a net increase in population harm. Urged on by myopic health professionals who seem to have lost any population health focus they might have had, this may become one of the biggest blunders of modern public health.

Public health enthusiasts for e-cigarettes see their promise as a way to get smokers to quit or reduce toxic exposure, but they seem blasé about the other possible effects described above. There are many impassioned, vocal testimonies that e-cigarettes have helped many thousands to quit or cut down smoking. But the first prospective study found that although smoking cessation and harm reduction motivated many e-cigarette users, there were no differences in smoking quit rates between e-cigarette users and non-users.2 And importantly, cutting down cigarettes rather than quitting confers little if any health benefit,3 so dual use may be as bad as continued smoking in terms of health outcomes.

Regulation is required

So how should we respond to e-cigarettes? The first step must be to move beyond anecdotal testimony and naive optimism and study large populations to build the evidence about whether e-cigarettes do accelerate quitting and to quantify behaviours indicative of the important industry goals above.

Tobacco use may kill a billion people this century,4 largely because of tobacco’s historic treatment as an unexceptional item of commerce and, later, decades of glacial action by governments failing to regulate this dangerous consumer product. But in the past 50 years, we have learnt much about how to reduce tobacco use—for example, only 15.7% of Australians aged 15 or over now smoke daily,5 and youth smoking has never been lower.6 We are finally pulling access to tobacco products back to where it should have started: expensive, highly regulated, non-advertised, plain packaged, and out of retail sight.

We should make none of the many disastrous mistakes made with cigarettes in the name of allowing e-cigarettes to compete better with cigarettes. We should start by not assuming they are benign items of commerce. Drug companies have long been able to sell nicotine in small doses as a quitting aid but have never tried to register high dose products. Their awareness of the role of nicotine in apoptosis, angiogenesis, inflammation, and cell proliferation7 8 9 has always put the brakes on any temptation to have regulatory agencies allow them to sell products with doses that genuinely compete with cigarettes. So why should e-cigarettes, for which users can create their own e-juice, escape such regulation?

Many smokers want to access e-cigarettes to quit or reduce risk, and they should not be denied this opportunity. But the needs of often desperate smokers must not become the tail that wags the dog of tobacco control policy, putting at risk the massive gains we have achieved. The advent of e-cigarettes provides a perfect pretext to introduce a form of user licence for nicotine products in the same way that access to potent drugs has long required a temporary licence (a prescription) for those who need them.10 This would balance the right to use e-cigarettes with all the constraints and disincentives that are now, and should be further, applied to cigarettes. For countries where e-cigarettes are virtually “off the leash” this will probably be impossible. But for most nations that have acted cautiously, e-cigarettes may in fact turn out to be a Trojan horse, stimulating regulators to take more seriously the regulation of all tobacco and nicotine products—not just pharmaceutical nicotine—regardless of the motive of the individual user or the stated and unstated motives of the manufacturer.

Notes

Cite this as: BMJ 2013;346:f3840

Footnotes

  • Competing interests: I have read and understood the BMJ Group policy on declaration of interests and have no relevant interests to declare.
  • Read Jean-François Etter’s side of the debate at doi:10.1136/bmj.f3845.
  • Provenance and peer review: Commissioned; not externally peer reviewed.

References

  1. ↵

Moore M. Reynolds American’s CEO hosts investor day [transcript]. 2012. seekingalpha.com/article/1001691-reynolds-american-s-ceo-hosts-investor-day-transcript.

  1. ↵

Adkison SE, O’Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong H-H, et al. Electronic nicotine delivery systems. International tobacco control four-country survey. Am J Prev Med2013;44:207–15.

CrossRefMedline

  1. ↵

Tverdal A, Bjartveit K. Health consequences of reduced daily cigarette consumption. Tobacco Control2007;15:472-80.

Web of Science

  1. ↵

Proctor RN. Tobacco and the global lung cancer epidemic. Nature2001;1:82-7.

Web of Science

  1. ↵

Australian Bureau of Statistics. Australian health survey: first results, 2011-12.www.abs.gov.au/ausstats/abs@.nsf/Lookup/73963BA1EA6D6221CA257AA30014BE3E?opendocument.

  1. ↵

Tobacco in Australia. Facts and issues. www.tobaccoinaustralia.org.au/chapter-1-prevalence/1-6-prevalence-of-smoking-secondary-students.

  1. ↵

Zeidler R, Albermann K, Lang S. Nicotine and apoptosis. Apoptosis2007;12:1927-43.

CrossRefMedlineWeb of Science

  1. ↵

Chen RJ, Ho YS, Guo HR, Wang YJ. Rapid activation of Stat3 and ERK1/2 by nicotine modulates cell proliferation in human bladder cancer cells. Toxicol Sci2008;104:283-93.

Abstract/FREE Full Text

  1. ↵

Vassallo R, Kroening PR, Parambil J, Kita H. Nicotine and oxidative cigarette smoke constituents induce immune-modulatory and pro-inflammatory dendritic cell responses. Mol Immunol2008;45:3321-9.

CrossRefMedlineWeb of Science

  1. ↵

Chapman S. The case for a smoker’s license. PLoS Med2012;9:e1001342.

CrossRefMedline

 

Source: BMJ