E-cigarettes

E-cigarettes impair immune responses more than tobacco

As evidence emerges that e-cigarettes are not as safe as advertisers claim, a new study shows that flavorings classed as “Generally Recognized as Safe” by the US Food and Drug Administration are best avoided in smoking. The findings are presented at the American Association for the Advancement of Science annual meeting in Washington, DC.

Cigarettes kill more than 480,000 people annually in the US. Since e-cigarettes appeared on the scene, many assume them to be a safer alternative, because smokers are not inhaling known carcinogens.

But as researchers analyze the contents of e-cigarettes, they are finding that some of them could be as risky as tobacco.

Ilona Jaspers, PhD, professor of pediatrics and director of the curriculum in toxicology at the University of North Carolina (UNC) School of Medicine has been researching new and emerging tobacco products, including e-cigarettes.

Having already found that cigarette smoking significantly impairs the immune responses of mucosal cells in the respiratory system, Jaspers’ lab is now looking at how e-cigarette chemicals affect immune responses in smokers’ airways.

E-cigarette flavorings not ‘recognized as safe’ for inhalation

While the Food and Drug Administration (FDA) may class e-cigarette flavorings “Generally Recognized as Safe,” Jaspers points out that this classification means they are safe for oral consumption.

But people do not consume e-cigarette flavorings orally, they inhale them. And the potential for toxic effects of inhalation have not been assessed, in most cases.

Researchers studied the effects on smokers of cinnamon-flavored e-liquids and cinnamaldehyde, the chemical that gives cinnamon flavor to an e-cigarette.

Results showed that the cinnamaldehyde e-liquids had a significant negative impact on epithelial cells that could set off a chain of cellular mechanisms potentially leading to impaired immune responses in the lung.

Jaspers elaborates: “The chemicals compromise the immune function of key respiratory immune cells, such as macrophages, natural killer cells and neutrophils.”

Source: medical news today

E-cigarettes won’t help cancer patients kick the butt’

E-cigarettes may do more harm than good to cancer patients as researchers have found that those using e-cigarettes (in addition to traditional cigarettes) are equally or less likely to quit smoking traditional cigarettes than non-users. Cancer patients using e-cigarettes are more nicotine-dependent, the findings showed.

E-cigarettes won't help cancer patients kick the butt'

“Consistent with recent observations of increased e-cigarette use in the general population, our findings illustrate that e-cigarette use among tobacco-dependent cancer patients has increased within the past two years,” said co-researcher Jamie Ostroff from the Memorial Sloan Kettering Cancer Center in the US.

To examine available clinical data about e-cigarette use and cessation among cancer patients, the researchers studied 1,074 cancer patients who smoked and were enrolled between 2012 and 2013 in a tobacco treatment programme within a comprehensive cancer centre in the US. The researchers observed a three-fold increase in e-cigarette use from 2012 to 2013.

At enrolment stage, e-cigarette users were more nicotine dependent than non-users, had more prior quit attempts, and were more likely to be diagnosed with lung or head and neck cancers. At follow-up stage, e-cigarette users were just as likely as non-users to be smoking. Seven day abstinence rates were 44.4 percent versus 43.1 percent for e-cigarette users and non-users, respectively.

The study appeared online in the journal Cancer

Source: business standard

‘Ban E-cigarette use indoors,’ says WHO

The World Health Organization says there should be a ban on the use of e-cigarettes indoors and that sales to children should stop. In a report the health body says there must be no more claims that the devices can help smokers quit – until there is firm evidence to support this.

WHO experts warn the products might pose a threat to adolescents and the foetuses of pregnant women. But campaigners say regulations must be proportionate.

'Ban E-cigarette use indoors,' says WHO

Tempting flavours
According to the WHO legal steps need to be taken to end the use of e-cigarettes indoors – both in public spaces and in work places. And the report focuses on the potential for products to spark wider cigarette use in children. The health experts call for a ban on advertisements that could encourage children and non-smokers to use the devices.

And they say fruit, candy or alcoholic-drink style flavours should be prohibited too, while the sales of electronic cigarettes from vending machines should be heavily restricted.

1. On some e-cigarettes, inhalation activates the battery-powered atomiser. Other types are manually switched on

2. A heating coil inside the atomiser heats liquid nicotine contained in a cartridge

3. Liquid nicotine becomes vapour and is inhaled. The ‘smoke’ produced is largely water vapour. Many e-cigarettes have an LED light as a cosmetic feature to simulate traditional cigarette glow.

‘Health threats’
The WHO warns exhaled e-cigarette vapour could increase the background air levels of some toxicants and nicotine. According to the team while e-cigarettes are likely to be less harmful than traditional cigarettes, they may pose threats to adolescents and the foetuses of pregnant women who use these devices.

But some researchers suggest tough regulations may prevent smokers having access to products that are potentially less harmful than conventional cigarettes. A spokesman for the British American Tobacco company said: “We have always said that given nicotine is addictive, minimum age laws of 18 for the sale of e-cigarettes should be introduced.

“However, if overly restrictive regulations are introduced hampering innovation or adult usage, then this could simply stifle the growth of new products and prevent smokers from being aware of and having access to them – this can only be bad thing for public health.”

‘Proportionate regulation’
Hazel Cheeseman, at the charity Action on Smoking and Health, said there was no evidence of any harm to bystanders and warned regulation needed to be proportionate.

She added: “Smoking kills 100,000 people in the UK alone. “Smokers who switch to using electronic cigarettes in whole or in part are likely to substantially reduce their health risks.

“Although we cannot be sure that electronic cigarettes are completely safe, as the WHO acknowledges, they are considerably less harmful than smoking tobacco and research suggests that they are already helping smokers to quit.”

Global guidelines
A UK Department of Health spokeswoman said: “More and more people are using e-cigarettes and we want to make sure they are properly regulated so we can be sure of their safety.

“We have already set out our intention to change the law to ban the sale of e-cigarettes to children under 18. “The UK has an existing licensing system for higher strength products and those that claim to help people quit.

“We are also bringing in new European rules to cover lower strength products which will ban most advertising, limit nicotine levels and set standards for ingredients, labelling and packaging.” The WHO’s recommendations were published ahead of a meeting involving all countries that have signed up to an international convention on tobacco control.

New global guidelines could be agreed during the October meeting.

Source: bbc news

Many Doctors Recommend E-Cigs as Anti-Smoking Aid

E-cigarettes seem to be everywhere these days, and a new study finds many U.S. doctors recommending them to smokers as a way to kick the tobacco habit.

“Even in the absence of evidence regarding the health impact of e-cigarettes and other vaping devices, a third of physicians we surveyed are recommending e-cigarettes to their patients to help quit smoking,” study co-author Leah Ranney, associate director of the Tobacco Prevention and Evaluation Program at the University of North Carolina, said in a university news release.

Many Doctors Recommend E-Cigs as Anti-Smoking Aid

The researchers cautioned, however, that more research is needed to determine if e-cigarettes are safe and if they actually help people to stop smoking.

E-cigarettes work by turning various concentrations of nicotine, flavorings and other chemicals into a vapor that can be inhaled — a process also known as “vaping.” Most of the nicotine in e-cigarettes enters the bloodstream through the soft tissue in users’ cheeks, not their lungs. The safety and effectiveness of e-cigarettes, however, remains unclear.

In conducting the study, published online July 29 in the journal PLOS ONE, Ranney and her colleagues randomly selected 128 doctors in North Carolina and asked them about their attitudes towards e-cigarettes.

The researchers found that two-thirds of the doctors believed the devices could be a useful tool to help people quit smoking. In fact, 35 percent said they had recommended e-cigarettes to their patients.

However, “e-cigarettes are not approved by the [U.S. Food and Drug Administration] for smoking cessation,” Ranney said. She suggested that “physicians should refrain from recommending e-cigarettes until more is known about their safety.”

Doctors were more likely to recommend e-cigarettes if their patients asked about them or if they believed these products were safer than smoking regular cigarettes.

The study authors cautioned that some doctors may have conflicting information about the safety of e-cigarettes. Among those polled, 13 percent were unaware that e-cigarettes are not FDA-approved.

Study co-author Dr. Adam Goldstein, a University of North Carolina family medicine physician, noted in the news release that “physicians may choose to use FDA-approved medications rather than devices and products not approved by FDA.”

The study was funded by the U.S. National Cancer Institute and the North Carolina Department of Health and Human Services.

Source: webmd

WHO urged to stop controlling and suppressing use of e-cigarettes

ecigarette

A letter signed by more than 50 researchers and public health specialists has urged the World Health Organization (WHO) to “resist the urge to control and suppress e-cigarettes”.

The letter says that the devices – which deliver nicotine in a vapour – could be a “significant health innovation”. But the UK’s Faculty of Public Health says it is too early to know whether benefits outweigh potential risks. The WHO said it was still deciding what recommendations to make to governments.

The open letter has been organised in the run-up to significant international negotiations on tobacco policy this year. Supporters of e-cigarettes, who argue the products are a low-risk substitute for smoking, fear they might become subject to reduction targets and advertising bans.

There has been a big growth in the market for e-cigarettes, but the Department of Health says they are not risk-free. Critics said that not enough is known about their long-term health effects. A recent report commissioned by Public Health England said e-cigarettes required “appropriate regulation, careful monitoring and risk management” if their benefits were to be maximised.

The letter has been signed by 53 researchers – including specialists in public health policy and experts such as Prof Robert West, who published research last week suggesting that e-cigarettes are more likely to help people give up smoking than some conventional methods.

Source: business standard

E-cigarettes may have unknown health risks: Study

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Despite our growing knowledge that smoking tobacco is bad for us more than 40 million Americans are cigarette smokers. Smoking cigarettes is known to cause damage to every organ in your body, and smoking-related illnesses are responsible for one out of every five deaths in the U.S. But nearly 70 percent of smokers report they want to quit, and a little more than 42 percent say they’ve tried to quit during the past year

In 2009 there was a 10 percent decrease in cigarette sales in the U.S., and while that directly followed an increase in the federal cigarette tax, it’s not only price that’s changing the habits of American smokers. Electronic cigarettes (known also as e-cigarettes) have also contributed.

Global sales of smokeless tobacco products, including smokeless inhalers, has grown to nearly $3 billion — and continues to grow. In an attempt to quit the tobacco habit as many as one-fifth of smokers have tried e-cigarettes [source: Ross].

E-cigarettes were first developed in China and were introduced to the U.S. market in 2007. Many are similar enough in appearance to be mistaken for regular tobacco cigarettes. But one look inside and you’ll see the main difference: This is a tobacco-free product. E-cigs are actually vaporizers; instead of burning tobacco, the mechanism heats up a liquid.

The liquid turns into vapor, which is then inhaled, or “vaped.” While some argue that vapor offers health advantages over traditional cigarette smoke, regulatory agencies and some health experts aren’t so sure that’s true. Before you consider taking up the e-cigarette habit, read on to get the facts.

Source: how stuff works

E-cigarettes next big smoking poison, warns study

The fast spreading e-cigarettes are undoing the anti-smoking efforts of the last three decades, health experts warn.

Also, the number of people being poisoned by e-cigarettes in the US has gone up manifold in the last few years, according to official reports.

The number of calls to poison centres in the US relating to e-cigarettes has risen from one per month in September 2010 to 215 per month in February 2014.

The figures, from the Centres for Disease Control and Prevention (CDC), also show the number of calls per month relating to conventional cigarettes did not increase in the same way.

The CDC statistics show that more than half of the calls relate to children under the age of five.

Poisoning related to e-cigarettes involves the liquid containing nicotine used in the devices.

“This report raises another red flag about e-cigarettes — the liquid nicotine used in e-cigarettes can be hazardous,” CDC director Tom Frieden said in a statement.

E-cigarette liquids come in candy and fruit flavours that are appealing to children.

“The most recent National Youth Tobacco Survey showed e-cigarette use is growing fast, and now this report shows e-cigarette related poisonings are also increasing rapidly,” Tim McAfee, director of CDC’s office on smoking and health, was quoted as saying.

The study comes close on the heels of news that the Welsh government might include e-cigarettes under the smoking ban.

Source: daily news and analysis

E-Cigarettes Won’t Help You Quit, Study Finds

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Contrary to some advertising claims, electronic cigarettes don’t help people quit or cut down on smoking, a new study says.

Users of e-cigarettes inhale vaporized nicotine but not tobacco smoke. The unregulated devices have been marketed as smoking-cessation tools, but studies to date have been inconclusive on that score, the study noted.

“When used by a broad sample of smokers under ‘real world’ conditions, e-cigarette use did not significantly increase the chances of successfully quitting cigarette smoking,” said lead researcher Dr. Pamela Ling, an associate professor at the Center for Tobacco Control Research and Education at University of California, San Francisco.

These findings — based on nearly 1,000 smokers — are consistent with other studies and contradict the claims frequently found in e-cigarette advertising, she said.

“Advertising suggesting that e-cigarettes are effective for smoking cessation should be prohibited until such claims are supported by scientific evidence,” Ling said.

For the study, Ling’s team analyzed data reported by 949 smokers, 88 of whom used e-cigarettes at the start of the study. One year later, 14 percent of the smokers had quit overall, with similar rates in both groups.

“We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not,” Ling said. There was no relationship between e-cigarette use and quitting, even after taking into account the number of cigarettes smoked per day, how early in the day a smoker had a first cigarette and intention to quit smoking, Ling added.

However, the researchers noted that the small number of e-cigarette users may have limited the ability to find an association between e-cigarette use and quitting.

The report, published online March 24 in JAMA Internal Medicine, also found that women, younger adults and people with less education were most likely to use e-cigarettes.

One expert said the study is flawed and shouldn’t be taken seriously. “It’s an example of bogus or junk science,” said Dr. Michael Siegel, a professor of community health sciences at Boston University School of Public Health.

“That’s because the study does not examine the rate of successful smoking cessation among e-cigarette users who want to quit smoking or cut down substantially on the amount that they smoke, and who are using e-cigarettes in an attempt to accomplish this,” Siegel said. “Instead, the study examines the percentage of quitting among all smokers who have ever tried e-cigarettes for any reason.”

Many of the smokers who tried e-cigarettes may have done so out of curiosity, Siegel said. “It is plausible, in fact, probable, that many of these 88 smokers were not actually interested in quitting or trying to quit with electronic cigarettes,” he said. “These products have become very popular and have gained widespread media attention, and it is entirely possible that many of these smokers simply wanted to see what the big fuss is all about.”

Calling that a “fatal flaw” in the research, Siegel said it “destroys the validity of the authors’ conclusion.” It would be a tragedy, he said, if policy makers use the study to draw conclusions about the effectiveness of e-cigarettes for smoking cessation purposes.

Erika Ford, assistant vice president for national advocacy at the American Lung Association, said the study confirms what is already clear — “e-cigarettes are not associated with quitting among smokers.”

Ford noted that most e-cigarette companies no longer make claims that their products help smokers quit. “But there is a need for the FDA [U.S. Food and Drug Administration] to begin their oversight of these products. It’s time for the FDA to find out which products are making no smoking claims and which ones might be in violation of current law,” she said.

The FDA plans to introduce regulations for e-cigarettes, but hasn’t yet. In the past, the agency has warned companies about making false claims and for poor manufacturing practices.

Source: webmd

Helping Smokers Quit, or Not Start in the First Place

“Even 50 years after the first surgeon general’s report on smoking and health, we’re still finding out new ways that tobacco kills and maims people,” Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, recently told me. “It’s astonishing how bad it is.”

Dr. Frieden and public health specialists everywhere are seeking better ways to help the 44 million Americans who still smoke to quit and to keep young people from getting hooked on cigarettes. “Fewer than 2 percent of doctors smoke. Why can’t we get to that rate in society as a whole?” he wondered.

One reason: Smoking rates are highest among the poor, poorly educated and people with mental illness, populations hard to reach with educational messages and quit-smoking aids.

But when I mentioned to Dr. Frieden, a former New York City health commissioner, that the city’s streets are filled with young adult smokers who appear to be well educated and well dressed, he said television seems to have had an outsize influence.

Focus groups of white girls in New York private schools have suggested a “Sex in the City” effect, he said: Girls think smoking makes them look sexy. In the last two years, middle-aged men, too, have begun smoking in increasing numbers after a half-century decline. Dr. Frieden cited “Mad Men,” the popular TV series featuring admen in the early 1960s, when well over half of American men smoked.

Dr. Frieden said that an antismoking effort begun in 2008 by the World Health Organization “can make a huge difference in curbing smoking, and we should fully implement what we know works.” The program is called Mpower:

M stands for monitoring tobacco use and the effectiveness of prevention programs like antismoking videos on YouTube.

P for protecting people from secondhand smoke. Half the country still lacks laws mandating smoke-free public places. The latest national health survey found that about half of children from nonsmoking households have metabolites of tobacco in their blood, Dr. Frieden said.

O for offering help to the 70 percent of smokers who say they would like to quit. “Tobacco use remains egregiously undertreated in health care settings,” Dr. Helene M. Cole, associate editor of JAMA, The Journal of the American Medical Association, and Dr. Michael C. Fiore, a professor of medicine at the University of Wisconsin, wrote this month in the journal.

Medical aids for quitting smoking, which can triple the likelihood of success, should become available, without a co-pay, to many more people under the Affordable Care Act, Dr. Frieden said.

W for warning about smoking hazards through larger and more graphic messages on cigarette packs and paid advertising on radio and television.

E for enforcing bans on tobacco marketing, advertising, promotion and sponsorships. In bodegas throughout the country, Dr. Frieden said, “tobacco ads are used as wallpaper.” Smoking is freely depicted in movies and popular TV shows.

R for raising taxes, which studies have shown is the single most effective way to reduce smoking in the population, especially among teens.

“A higher cigarette tax is not a regressive tax, because it would help poor people even more than the well-to-do,” Dr. Frieden noted. President Obama has proposed an additional 94-cent-per-pack tax on cigarettes, which would yield $80 billion to fund universal prekindergarten.

Smokers ready to quit can choose from among a cornucopia of aids as wide-ranging as nicotine substitutes, low-dose antidepressants, hypnosis and acupuncture. While none by itself has a high rate of success, different methods have proved effective for different people. Many former smokers required several attempts before they managed to quit for good.

But quitting smoking does not necessarily require assistance. As two public health specialists, Andrea L. Smith and Simon Chapman at the University of Sydney in Australia, have pointed out, “The vast majority of quitters do so unaided.” A Gallup Poll conducted last year in the United States found that “only 8 percent of ex-smokers attributed their success to [nicotine replacement therapy] patches, gum or prescribed drugs,” these experts noted. “In contrast, 48 percent attributed their success to quitting ‘cold turkey’ and 8 percent to willpower, commitment or ‘mind over matter’.”

They added, “For many smokers, having a reason to quit (a why) was more important than having a method to quit (a how).”

For my husband, who smoked a pack a day for 50 years, the “why” was his distress at seeing two beautiful young nieces smoking; he made a pact with them to quit if they would, and he followed through.

Techniques that can help people trying to quit when troubled by the urge to smoke include waiting 10 minutes and distracting yourself; avoiding situations you associate with smoking, at least until you have become a committed ex-smoker; using stress reducers like physical activity, yoga, deep breathing, muscle relaxation and self-hypnosis; seeking moral support from a nonsmoking friend, family member or online stop-smoking program; and oral distractions like chewing sugarless gum or raw vegetables.

Electronic cigarettes are being promoted by some as a way to resist the real thing. E-cigarettes, invented in 2003 by a Chinese pharmacist, contain liquid nicotine that is heated to produce a vapor, not smoke. More than 200 brands are now on the market; they combine nicotine with flavorings like chocolate and tobacco.

But their contents are not regulated, and their long-term safety has not been established. In one study, 30 percent were found to produce known carcinogens. Dr. Frieden said that while e-cigarettes “have the potential to help some people quit,” the method would backfire “if it gets kids to start smoking, gets smokers who would have quit to continue to smoke, gets ex-smokers to go back to smoking, or re-glamorizes smoking.”

Nearly two million children in American middle and high schools have already used e-cigarettes, Dr. Frieden said. In an editorial in the Canadian Medical Association Journal last year, Dr. Matthew B. Stanbrook, an assistant professor of medicine at the University of Toronto, suggested that fruit-flavored e-cigarettes and endorsements by movie stars could lure teens who would not otherwise smoke into acquiring a nicotine habit.

A survey in 2011 of 75,643 South Korean youths in grades 7 through 12 by researchers at the University of California, San Francisco, revealed that four of five e-cigarette users also smoked tobacco. It could happen here: Stanton A. Glantz, the study’s senior author and a professor of medicine at the university, described e-cigarettes as “a new route to nicotine addiction for kids.”

Source: New York Times

E-cigarettes: a burning question for U.S. regulators

At the Henley Vaporium, one of a growing number of e-cigarette lounges sprouting up in New York and other United States cities, patrons can indulge in their choice of more than 90 flavours of nicotine-infused vapour, ranging from bacon to bubble gum.

The lounge, located in Manhattan’s trendy Lower East Side, features plush seating, blaring rock music, and fresh juice and coffee. A sprawling sign on one wall lists all the carcinogens that e-cigarette users avoid by kicking their smoking habits and using the devices instead.

But the growing popularity of e-cigarettes has not escaped the notice of the industry’s critics, who have stepped up calls for new regulations, including bans on their use in public places, even though the scientific evidence about exposure to their vapours remains inconclusive.

Selling for about US$30 to US$50 (S$37.60 to S$62.66) each, e-cigarettes are slim, reusable, metal tubes containing nicotine-laced liquids that come in exotic flavours. When users puff on the device, the nicotine is heated and releases a vapour that, unlike cigarette smoke, contains no tar, which causes cancer and other diseases.

The product, introduced in China in 2006, has become a worldwide trend at least in part because it may help smokers of regular cigarettes break the habit.

“It’s an addiction — not everyone can quit cold turkey,” Mr Nick Edwards, 34, a Henley employee who says he kicked a 15-year cigarette habit the day he tried his first e-cigarette, said yesterday (Nov 11). “E-cigarettes give you a harm-reduction option.”

That’s one reason why the market for e-cigarettes is expected to surge, reaching US$2 billion by the end of this year and US$10 billion by 2017, according to Ms Bonnie Herzog, an analyst at Wells Fargo Bank in New York.

Ms Herzog said the US market alone could top US$1 billion this year. She predicts that by 2017 e-cigarettes sales will overtake sales of regular cigarettes. That estimate does not take into account the impact of potential government regulations on sales.

E-cigarettes may help smokers save money too. Mr Edwards, for one, says he cut his US$60 monthly cigarette bill in half when he switched. On top of the cost of the device, the smoking liquids cost around US$10 per refill.

Despite the perceived benefits, critics worry that the addictive nicotine found in e-cigarettes could lure more people into smoking and discourage others from quitting all together.

SOurce: today online