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By James Thalman

Deseret News

Electronic cigarettes, or e-cigarettes, were first made in China and are sold mostly on the internet.

They are battery-powered devices which emit a "puff" or fine mist of nicotine into the lungs and are intended to replace normal cigarettes and help smokers quit.

The products are at the centre of a legal battle in the United States between manufacturers and the Food and Drug Administration (FDA), which regulates drugs and which wants to stop e-cigarettes from being imported into the US.

The FDA, which conducted research into e-cigarettes, has expressed concerns about their safety, and teams from Greece and New Zealand have also carried out studies into them.

But interpretations of the three reports vary, with the New Zealand study saying e-cigarettes should be recommended because they are safer than tobacco cigarettes, and the Greek study taking a broadly neutral stance.

"The limited information given in these three reports represents all the knowledge we currently have about e-cigarettes," Andreas Flouris and Dimitris Oikonomou, of the Institute of Human Performance and Rehabilitation in Greece, wrote in the British Medical Journal.

"This may be one reason why the battle...between the FDA and e-cigarette manufacturers has been so heated."

A US judge last week granted an injunction barring the Obama administration from trying to ban imports of e-cigarettes, saying the move was part of "aggressive efforts" by the FDA to regulate "recreational tobacco products".

Tobacco is the leading preventable cause of death in the world, killing more than 5 million people a year. A report by the World Lung Foundation last August said smoking could kill a billion people this century if trends hold.

Flouris and Oikonomou said that while "alternative smoking strategies are always welcome in an effort to reduce the threat to public health" caused by tobacco, safety was also vital.

"More rigorous chemical analyses are needed, followed by extensive research involving animal studies and, finally, clinical trials in humans," they wrote.

THE ELECTRONIC cigarette or E-cigarette has reached the shores of Trinidad and Tobago, ironically at a time when the Tobacco Control Act comes into effect to ban smoking in enclosed public spaces and reduce the effects of smoking on the public.

The Act was passed in December 2009 and took effect from February 15. The prohibitions in this phase include the designation of no smoking areas and prohibition against smoking therein; prohibition of the sale of tobacco products to and by minors; prohibition against tobacco advertising; prohibition against incentive promotions; and free supply of tobacco products and prohibition against tobacco sponsorship.

The legislation also states that vendors selling single cigarettes can face a $12,000 fine and six months imprisonment.

The E-cigarette is a new product available, as many would say, “thanks” to recent technology and can be used in the public or in any business or home.

This E-cigarette is a revolutionary device that acts much the same way as an ordinary tobacco cigarette would, but rather than producing smoke from combustion, it produces vapour from vaporisation of the E-liquid.

An electronic cigarette usually takes the form of some manner of elongated tube, though many are designed to resemble the outward appearance of real smoking products, like cigarettes, cigars, and pipes. A common design is also the “pen-style”, so named for its visual resemblance to a ballpoint pen. Most electronic cigarettes are reusable devices with replaceable and refillable parts. A number of disposable electronic cigarettes have also been developed.

E-cigarettes have no fire, no tar, no carbon monoxide, no ash, no stub. It lets the smoker or the quitter of smoking tobacco, enjoy and satisfy those tactile taste sensations without any risk from smoking or tobacco.

Actually, you can smoke E-cigarettes anywhere healthily without environmental pollution. Indulging in smoking E-cigarette can help you to reduce or quit smoking habits.

A kit of two E-cigarettes, two catridges and rechargable batteries costs an estimated $500 locally.

One of its importers, who wished not to be identified described it as “a great ultimatum” to individuals who desperately want to quit tobacco smoking for various reasons including own health, health of loved ones or for just “quitting sake.”

“This E-cigarette is a device that provides inhaled doses of nicotine by way of a vaporised solution. It is an alternative to smoked tobacco products, such as cigarettes, cigars, or pipes. In addition to nicotine delivery, this vapour also provides a flavour and physical sensation similar to that of inhaled tobacco smoke, while no tobacco, smoke, or combustion is actually involved in its operation,” the importer said. The importer revealed that late last year he brought several kits to sell for selected customers “just to feel out the market for it” and added that he has gotten “great response.”

He, however, added that one of his shipment was “stuck” on the TT Port of Port-of-Spain due to complications arising in having to clear the container because of the Food and Drug Act.

“Apparently what we are hearing was that the product has to be cleared under the food and Drug Act and the custom officers are presently viewing the Act, not until that is completed then we can get our goods cleared. So as soon as that is done one can easily access the product,” the importer said.

“E-cigarettes have become the world’s number one choice and so far number one in TT. Electronic cigarette products are the most comprehensive product lines in the world, which is guaranteed to always meet your own needs,” the importer added.

Local user of the product Dave Parmassar, 36, of Carapichaima said he was introduced to the E-cigarette two months ago and finds it very “satisfying” compared to other procedures he followed in a bid to quit smoking.

Parmassar has been smoking for the past 17 years at an average rate of one and a half packs of cigarettes equivalent to 30 sticks per day.

He said he made countless attempts to stop smoking but said that he successfully did it with the E-cigarette, “I was introduced to the E-cigarette about two months ago and when I started it I immediately quit tobacco smoking. It is a bit costly to start but very cost effective once you have started.

“I don’t have to worry no more about my mouth having a lingering bad odour or my wife complaining. I can smoke it in the car with the windows rolled up, in the house, almost anywhere imaginable, even around children because it is harmless to them, there is nothing like secondary smoking when you use the E-cigarette,” Parmassar said.

The products come in the most unique e-cigarette kits that one can ever find in the market. The sets come in a water resistant tin with everything an e-smoker may need: two batteries (blue LEDs), two atomizers, one USB charger with a USB to AC adapter, five empty cartridges and a bottle of E-liquid (approximately equivalent to 300 tobacco cigarettes) to fill and refill those cartridges. In some kits, there is also a velvet carrying pouch for electronic smoking on the go provided.

Electronic cigarettes — battery-powered devices that deliver a fine spray of nicotine without any flame or smoke — have been sold in this country for about three years now. Some people use them as a way to quit smoking real cigarettes. Unlike gum or patches, the devices mimic the sensation of smoking while providing the nicotine rush. Other people use them to get their cigarette fix in places where smoking is not allowed.

The Food and Drug Administration hasn't approved electronic cigarettes as an aid to quit smoking or for anything else. The agency has tried to stop the products from entering the country, but its authority over e-cigarettes is still being hashed out in courts. Meanwhile, the gadgets have developed a devoted fan base. On message boards and blogs, e-cigarette users have loudly and clearly proclaimed their allegiance to the devices.

E-cigarettes — sold without age restrictions online, in some bars and clubs, and at the occasional mall kiosk — come with replaceable cartridges containing various levels of nicotine. The regular cartridges for NPRO cigarettes from NJOY, for example, contain 18 milligrams of nicotine, but you can also get a light version with 12 mg., an ultralight version with 6 mg. and even a nicotine-free version. The company says that, for a typical smoker, each cartridge would last about as long as a pack or pack-and-a-half of cigarettes. For comparison, a smoker would get about 20 mg. of nicotine from a single pack of regular cigarettes. Each cartridge also contains water and propylene glycol, a chemical that helps disperse the nicotine. (Propylene glycol also is a key component of fog made by fog machines, should you be curious.)

The cartridges come with a variety of flavors. Users of the No. 7 cigarette from SS Choice, for example, can choose from tobacco, menthol, blueberry, vanilla and other options — as well as a range of colors. The Hydro Imperial from Crown7 comes in white and black.
August 02, 2010|By Chris Woolston, Special to the Los Angeles Times
(Page 2 of 3)
A starter pack of NPRO cigarettes containing 10 cartridges costs about $80. A starter pack of No. 7 cigarettes with five cartridges containing 16 mg. of nicotine each costs about $70. A starter pack of Hydro Imperial containing two cartridges with 18 mg. of nicotine each costs a little less than $40. All brands offer replacement cartridges of various strengths and flavors.

Claims: The FDA does not allow e-cigarette companies to market the devices as aids to quit smoking. But both Ron MacDonald, president of Crown7, and Jonas Joiner, marketing director of SS Choice, say they know of plenty of ex-smokers who used e-cigarettes to wean themselves off the real thing. (A spokesperson for NJOY declined to comment because the company is currently in litigation with the FDA.) Some users manage to give up nicotine completely, but others just switch from one source of nicotine to another, MacDonald says. "A lot of people continue to use our product instead of regular cigarettes, and they feel better," he says.
The NJOY website says that an e-cigarette provides "all the pleasure and sensation of smoking without all the health, social and economic problems." The SS Choice site says that its cigarette is more convenient and cost-effective than a regular cigarette and doesn't contain "the thousands of additives and chemicals" found in cigarettes. The Crown7 site says that its cigarettes are "the latest way to get a nicotine fix without most of the harmful effects associated with smoking."

The bottom line: Electronic cigarettes certainly have their appeal in a gadget-centric world, but many questions remain, says Thomas Eissenberg, director of the clinical behavioral pharmacology laboratory at Virginia Commonwealth University in Richmond. For one thing, he says, e-cigarettes have never been studied for smoking cessation, so nobody knows if they are any more or less effective than other nicotine replacement products such as gums or patches.

August 02, 2010|By Chris Woolston, Special to the Los Angeles Times
(Page 3 of 3)
Also, Eissenberg says, it's not very clear what smokers are getting when they take a drag on an e-cigarette. In a study published in July, Eissenberg and colleagues had 32 smokers take puffs on two brands of e-cigarettes, the NPRO with 18 mg. of nicotine and a model from Crown7 with 16 mg. Each smoker took 20 normal puffs, with a short break after the first 10. The study found that electronic cigarettes did reduce the urge to smoke, but, importantly, neither brand delivered measurable amounts of nicotine to the users' bloodstreams. Eissenberg suspects that the devices are so similar to cigarettes that they can help fill the psychological urge to smoke even if they don't provide much nicotine.
"I've been told that you can get nicotine from these things if you really work at it," Eissenberg adds. He believes it's possible that real-life users can get all the nicotine they need by drawing hard, inhaling deeply and taking many puffs. He's considering running a study under more realistic conditions with smokers who are already familiar with e-cigarettes.

In another study published in July, researchers at UC Riverside used a smoking machine to show that it takes more suction to get nicotine from an electronic cigarette than from a regular cigarette.

Eissenberg believes that electronic cigarettes may be worth a try for someone who wants to quit smoking. "Using it for six to eight weeks could be good," he says. But long-term use is another matter, he adds. Although propylene glycol is generally considered to be safe for humans, he warns that nobody knows the effects of deeply inhaling the compound for hours at a time on a daily basis. "I don't know that that's safer than cigarettes," he says.

Adam Leventhal, director of USC's health, emotion and addiction laboratory, says that electronic cigarettes are almost certainly safer than cigarettes. Still, he believes that nicotine patches and gums would probably be better options for anyone looking to quit smoking. Such products are regulated by the FDA, and users can be confident that they're getting the amount of nicotine that they expect. And because e-cigarettes are so much like regular cigarettes, he's concerned that they won't do much to break the actual habit of smoking. "We always tell people who are trying to quit smoking that they should get rid of anything that reminds them of smoking, including ashtrays and cigarettes," he says. "Electronic cigarettes could be a trigger."

Experts and policymakers who criticize electronic cigarettes are missing a great chance to improve public health, says Carl Phillips, a former associate professor of public health at the University of Alberta in Edmonton and creator of tobaccoharmreduction.org, an academic website that promotes alternatives to smoking.

He says the effects of propylene glycol should be studied, but he's confident that e-cigarettes are at least 95% safer than actual cigarettes. "If users are engaging in something that feels the same as smoking but doesn't involve any smoke, that's great," he says.

Curious about a consumer health product? Send an e-mail to health@latimes.com.

Read more at latimes.com/skeptic.

Electronic cigarettes — battery-powered devices that deliver a fine spray of nicotine without any flame or smoke — have been sold in this country for about three years now. Some people use them as a way to quit smoking real cigarettes. Unlike gum or patches, the devices mimic the sensation of smoking while providing the nicotine rush. Other people use them to get their cigarette fix in places where smoking is not allowed.

The Food and Drug Administration hasn't approved electronic cigarettes as an aid to quit smoking or for anything else. The agency has tried to stop the products from entering the country, but its authority over e-cigarettes is still being hashed out in courts. Meanwhile, the gadgets have developed a devoted fan base. On message boards and blogs, e-cigarette users have loudly and clearly proclaimed their allegiance to the devices.

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E-cigarettes — sold without age restrictions online, in some bars and clubs, and at the occasional mall kiosk — come with replaceable cartridges containing various levels of nicotine. The regular cartridges for NPRO cigarettes from NJOY, for example, contain 18 milligrams of nicotine, but you can also get a light version with 12 mg., an ultralight version with 6 mg. and even a nicotine-free version. The company says that, for a typical smoker, each cartridge would last about as long as a pack or pack-and-a-half of cigarettes. For comparison, a smoker would get about 20 mg. of nicotine from a single pack of regular cigarettes. Each cartridge also contains water and propylene glycol, a chemical that helps disperse the nicotine. (Propylene glycol also is a key component of fog made by fog machines, should you be curious.)

The cartridges come with a variety of flavors. Users of the No. 7 cigarette from SS Choice, for example, can choose from tobacco, menthol, blueberry, vanilla and other options — as well as a range of colors. The Hydro Imperial from Crown7 comes in white and black.

A starter pack of NPRO cigarettes containing 10 cartridges costs about $80. A starter pack of No. 7 cigarettes with five cartridges containing 16 mg. of nicotine each costs about $70. A starter pack of Hydro Imperial containing two cartridges with 18 mg. of nicotine each costs a little less than $40. All brands offer replacement cartridges of various strengths and flavors.

Claims: The FDA does not allow e-cigarette companies to market the devices as aids to quit smoking. But both Ron MacDonald, president of Crown7, and Jonas Joiner, marketing director of SS Choice, say they know of plenty of ex-smokers who used e-cigarettes to wean themselves off the real thing. (A spokesperson for NJOY declined to comment because the company is currently in litigation with the FDA.) Some users manage to give up nicotine completely, but others just switch from one source of nicotine to another, MacDonald says. "A lot of people continue to use our product instead of regular cigarettes, and they feel better," he says.

The NJOY website says that an e-cigarette provides "all the pleasure and sensation of smoking without all the health, social and economic problems." The SS Choice site says that its cigarette is more convenient and cost-effective than a regular cigarette and doesn't contain "the thousands of additives and chemicals" found in cigarettes. The Crown7 site says that its cigarettes are "the latest way to get a nicotine fix without most of the harmful effects associated with smoking."

The bottom line: Electronic cigarettes certainly have their appeal in a gadget-centric world, but many questions remain, says Thomas Eissenberg, director of the clinical behavioral pharmacology laboratory at Virginia Commonwealth University in Richmond. For one thing, he says, e-cigarettes have never been studied for smoking cessation, so nobody knows if they are any more or less effective than other nicotine replacement products such as gums or patches.

Also, Eissenberg says, it's not very clear what smokers are getting when they take a drag on an e-cigarette. In a study published in July, Eissenberg and colleagues had 32 smokers take puffs on two brands of e-cigarettes, the NPRO with 18 mg. of nicotine and a model from Crown7 with 16 mg. Each smoker took 20 normal puffs, with a short break after the first 10. The study found that electronic cigarettes did reduce the urge to smoke, but, importantly, neither brand delivered measurable amounts of nicotine to the users' bloodstreams. Eissenberg suspects that the devices are so similar to cigarettes that they can help fill the psychological urge to smoke even if they don't provide much nicotine.

"I've been told that you can get nicotine from these things if you really work at it," Eissenberg adds. He believes it's possible that real-life users can get all the nicotine they need by drawing hard, inhaling deeply and taking many puffs. He's considering running a study under more realistic conditions with smokers who are already familiar with e-cigarettes.

In another study published in July, researchers at UC Riverside used a smoking machine to show that it takes more suction to get nicotine from an electronic cigarette than from a regular cigarette.

Eissenberg believes that electronic cigarettes may be worth a try for someone who wants to quit smoking. "Using it for six to eight weeks could be good," he says. But long-term use is another matter, he adds. Although propylene glycol is generally considered to be safe for humans, he warns that nobody knows the effects of deeply inhaling the compound for hours at a time on a daily basis. "I don't know that that's safer than cigarettes," he says.

Adam Leventhal, director of USC's health, emotion and addiction laboratory, says that electronic cigarettes are almost certainly safer than cigarettes. Still, he believes that nicotine patches and gums would probably be better options for anyone looking to quit smoking. Such products are regulated by the FDA, and users can be confident that they're getting the amount of nicotine that they expect. And because e-cigarettes are so much like regular cigarettes, he's concerned that they won't do much to break the actual habit of smoking. "We always tell people who are trying to quit smoking that they should get rid of anything that reminds them of smoking, including ashtrays and cigarettes," he says. "Electronic cigarettes could be a trigger."

Experts and policymakers who criticize electronic cigarettes are missing a great chance to improve public health, says Carl Phillips, a former associate professor of public health at the University of Alberta in Edmonton and creator of tobaccoharmreduction.org, an academic website that promotes alternatives to smoking.

He says the effects of propylene glycol should be studied, but he's confident that e-cigarettes are at least 95% safer than actual cigarettes. "If users are engaging in something that feels the same as smoking but doesn't involve any smoke, that's great," he says.
Copyright © 2010, The Los Angeles Times

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Do respect that the quitter is in charge. This is their lifestyle change and their challenge, not yours.

Do ask the person whether he or she wants you to ask regularly how he or she is doing. Let the person know that it's OK to talk to you whenever he or she needs to hear encouraging words.

Do help the quitter get what she or he needs, such as hard candy to suck on, straws to chew on, and fresh veggies cut up and kept in the refrigerator.

Do spend time doing things with the quitter to keep his or her mind off smoking -- go to the movies, take a walk to get past a craving (what many call a "nicotine fit"), or take a bike ride together.

Do try to see it from the smoker's point of view -- a smoker's habit may feel like an old friend that has always been there when times were tough. It's hard to give that up.

Do help the quitter with a few chores, some child care, cooking -- whatever will help lighten the stress of quitting.

Do celebrate along the way. Quitting smoking is a BIG DEAL!

Don't judge, nag, preach, or scold. This may make the smoker feel worse about him or herself. You don't want your loved one to turn to a cigarette to soothe hurt feelings.

Don't take the quitter's grumpiness personally during his or her nicotine withdrawal. The symptoms usually pass in about 2 weeks.

Don't offer advice. Just ask how you can help with the plan or program they are using.

If your ex-smoker "slips"

Don't assume that he or she will start back smoking like before. A "slip" (taking a puff or smoking a cigarette or two) is pretty common when a person is quitting.

Do remind the quitter how long he or she went without a cigarette before the slip.

Do help the quitter remember all the reasons he or she wanted to quit, and forget about the slip as soon as possible.

Don't scold, nag, or make the quitter feel guilty. Be sure the quitter knows that you care about him or her whether or not he or she smokes.

If your quitter relapses

Research shows that most people try to quit smoking several times before they succeed. (It's called a relapse when smokers go back to smoking like they were before they tried to quit.) If a relapse happens, think of it as practice for the time he or she will succeed. Don't give up your efforts to encourage and support your loved one. If the person you care about fails to quit or starts smoking again:

Do praise him or her for trying to quit, and for whatever length of time (days, weeks, or months) of not smoking.

Do encourage him or her to try again. Don't say, "If you try again..." Say, "When you try again..." Studies show that most people who don't succeed in quitting are ready to try again in the near future.

Do encourage him or her to learn from the attempt. Things a person learns from a failed attempt to quit may help him or her quit for good next time. It takes time and skills to learn to be a non-smoker.

Do say, "It's normal to not succeed the first few times you try to quit. Most people understand this, and know that they have to try to quit again. You didn't smoke for (length of time) this time. Now you know you can do that much. You can get even further next time."

If you are a smoker

Do smoke outside and always away from the quitter.

Do keep your cigarettes, lighters, and matches out of sight. They might be triggers for your loved one to smoke.

Don't ever offer the quitter a smoke, even as a joke!

Do join your loved one in his or her effort to quit. It's better for your health and might be easier to do with someone else that is trying to quit, too!

Call the American Cancer Society at 1-800-227-2345 to find out what resources might be available to you for your quit attempt

[Smoking reduction and temporary abstinence: new approaches for smoking cessation&91;

[Article in French&91;

Le Houezec J, Säwe U.

Pharmacia, R & D Consumer Healthcare, Helsingborg, Suède. jacques.lehouezec@pharmacia.com

PMID: 14978435 [PubMed - indexed for MEDLINE&91;