E-Cig Scaremongering

Watch out, e-cigarette smokers – you’re inhaling the unknown

Ooooo! Scary! Er, no, not really. Nicotine and water vapour. Not unknown at all.

Not only are these products not tested and regulated like proper medications – they are being targeted at the young

They are not medications, so don’t need any more regulation than current sale of goods act and I see no evidence that they are being targeted at the young. This is tobacco control scare mongering.

Electronic cigarettes sound fantastic. Rather than fill your lungs with tar, they deliver a vapour of nicotine to satisfy your craving, without the nasty side effects. They are popularly perceived as the safe alternative to cigarettes, a harmless way to get a nicotine hit.

Er, yeah, they are a safer alternative to smoking conventional cigarettes and people have taken to them without the consent of tobacco control and their big pharma backers. That smarts, doesn’t it? People doing their own thing without the consent of the puritans who elected themselves to tell us what to do. As a means of giving up, which is why some people have switched to them, they make obvious sense. What is not needed is more regulation and busybody interfering from the prodnoses on tobacco control.

Anything that could help smokers quit would be welcomed.

Well, yeah…

But e-cigarettes aren’t a medicine.

Didn’t I just say that?

There’s a reason you buy them from a newsagent rather than get them on prescription. E-cigarettes may look legitimate, but they haven’t been through the same stringent safety checks as medicated nicotine replacement therapies.

This, I would suggest, is a feature, not a bug. Has anyone died from inhaling vapour? Anyone?

I want to be certain I’m giving the right advice to patients when they ask about e-cigarettes, not unwittingly jeopardising their health. Hardened smokers trying to quit are using them like prescription drugs, but they don’t have any of the same safeguards. E-cigarettes are masquerading as medications – so let’s subject them to the same scrutiny.

They are not masquerading as medications, which is why you buy them from a newsagent not on prescription –  and, frankly, some of the prices I have seen are less than a prescription. So, no problem. If you want to give advice, you can always qualify it and let your patients –  who are adults, after all –  make up their own minds. Win, win.

A quick search of medical journal archives reveals about 200 references to electronic cigarettes over the past five years. These products are relatively new, so there are no long-term studies on the effects of using them regularly. Instead, research is focused on what is being delivered to smokers’ lungs in addition to nicotine.

Actually, they’ve been around for quite some time –  about a decade. Has anyone ever shown any ill-health as a consequence of inhaling vapour? Anyone?

Although concerning, this isn’t a huge surprise – similar levels are found in nicotine patches. But the FDA also found diethylene glycol, a component of antifreeze and brake fluids. Classed as a poison by the World Health Organisation, at high enough quantities it can cause kidney damage, nerve dysfunction and respiratory failure.

Ah… Right. One e-cig belonging to one brand at a level of 1%. And, as this is also in nicotine patches and no one is calling for them to be banned, we can treat this scare mongering with the well deserved contempt owing to it.

In March 2013, researchers from the University of California examined in detail the aerosol contents of e-cigarettes. They found particles of silver, iron, aluminium and silicate, and nanoparticles of tin, chromium and nickel. The researchers noted that concentrations of these elements “were higher than or equal to the corresponding concentrations in conventional cigarette smoke”, and that “many of the elements identified in [e-cigarette] aerosol are known to cause respiratory distress and disease”.

In minute amounts. We breath all sorts of toxins on a daily basis pouring out from the exhausts of motor vehicles and we don’t die. The trace amounts that may be in an e-cig really isn’t worth bothering with. No one has died as a result of vaping and it is unlikely that they will. They are clearly less toxic than conventional cigarettes and appear to be more effective than nicotine patches. And that is what this petulant demand for regulation is all about.

5 Comments

  1. Long, could you include the source you’re quoting from? Particularly if it has a comments section… }:>

    It said, “E-cigarettes are masquerading as medications – so let’s subject them to the same scrutiny.”

    … which led me to an interesting thought: If e-cigs turn out to be, say, less than 1% as “harmful” as tobacco cigarettes, and if they provide the same positive benefits of enjoyment, then there’s no real reason not to use them for any benefit OTHER than enjoyment.

    So what “medications” are out there that are approved and marketed simply for enjoyment? Are there any? Caffeine isn’t sold as a medication in regular coffee/cola drinks, but is it sold as a medication in pill form? What about in concentrated drinks like Five Hour Energy?

    In an ideal world the FDA (or whatever general food/drug regulatory body) would simply say, “OK, people are ‘ingesting’ them, so we should give them the same oversight we do to other products that could be harmful if over-consumed or contaminated. We’ll stick a warning on there saying ‘no children’ or ‘no pregnant moms’ or “no one for whom coffee has been contraindicated’; and we’ll inspect random lots to make sure they’re up to grade on whatever reasonable safety standards we set.”

    Unfortunately we’re NOT in an ideal world and the FDA simply can’t be trusted to do that job without politics screwing up the science. The current situation of no regulation is not ideal and it’s almost unavoidable that at some point there’ll be types of e-cigs or batches of e-liquids put out by some small manufacturer that are defective enough in some way that they’ll harm someone and a huge stink will be made. Just look at all the food recalls that are made every year by the highly regulated and safety-public-image-conscious food industry: of COURSE we’ll see some instances pop up of similar problems in the e-cig industry and it would be GOOD to have them properly regulated in some way… but how?

    I’d suggest some form of non-governmental self-taxing approach. Something along the lines of e-cig manufacturers, large and small, forming an organization that would self-tax their profits or their gross or whatever at a low rate, (perhaps just one or two percent) with that money going into a standards agency that would set reasonable standards for things like anti-freeze (i.e. perhaps, “no more antifreeze than the FDA currently allows in orange juice.” — you *DO* know there’s methanol allowed in your orange juice, right? Microgram levels perhaps, but it’s allowed.), and also allocated to random sampling testing of the products of participating manufacturers.

    Those participating manufacturers could then devise a “Good Housekeeping Seal Of Approval” type thing and eventually most, or even all, e-cig products and liquids would come under that oversight since consumers would not want to buy any that don’t. E.G. I could probably buy some pretty decent moonshine 90% grain alcohol in mason jars a lot cheaper than vodka… but I like the extra safety in buying a cheap brand that’s supposedly been checked for safety.

    (Another post following re that 1% with antifreeze claim…)

    – MJM

  2. The FDA examined two of the most popular brands of e-cigs, N-Joy and Smoking Everywhere, and 18 varieties of the e-liquids that were used in them. It is the FDA study that has been the basis for the widespread claim, mentioned in almost every news report I’ve ever heard discussing e-cigs, that they have been found to have antifreeze in them.

    In reality, the study found that one of the 18 varieties of e-liquid had small amounts of diethylene glycol, a chemical that is not toxic in the quantities measured – about 1/10th of a milliliter in a standard daily use of 10mL of the liquid used by an average vaper – but which is also used, just as water or salt is, in antifreeze. The actual toxic level would be about 100 times that amount, and since it would regularly be excreted far faster than absorbed, it would never build up to toxic levels in vapers even if it was indeed normally present at such quantities in their products.

    Unfortunately the researchers do not seem to have performed what a normal person might have considered the responsible action of extending their research a little by purchasing a few more samples of the type of e-liquid that they had found the contaminant in. It would seem to have been a pretty obvious and important question to examine in the course of their study. Was such a contaminant a unique one-time occurrence? Or was it something likely to be found on a regular basis? Personally, I cannot imagine why any responsible researchers in such a situation with such a potential for significant public impact would not have simply ordered/purchased a few more samples from different sources to see if the unusual result was repeated. Since they were only testing for a very few elements, and since they had specially picked Diethylene glycol to be one of those elements, it was obviously something that they expected they might find and which they must have been concerned about.

    So why would they avoid just a little bit more research into it while they were all set up and running? Could it be that they wanted to find something negative about the e-cigarettes and were simply frustrated that they were unable to? Could the DEG have actually been a deliberately created result that could not be shown to be common and therefore the researchers deliberately avoided testing further samples? Could it be that each run of such a test is so unusually and so enormously expensive that their research grant couldn’t pay for even a few extra tests on top of the hundreds that they’d already run, despite the importance of the question?

    I don’t know the answer, though from what I’ve seen in this field over the years and have examined so far in these Slabs I might have my suspicions. It’s been almost three years since the FDA study was done. E-Cig usage has grown by millions of consumers. And yet no one at the FDA or elsewhere seems to have replicated this result despite over a dozen further investigations by other researchers? My concerns would seem to be well-founded.

    Michael J. McFadden
    Author of “Dissecting Antismokers’ Brains”

  3. It’s an especially appalling article and sinister for two reasons.

    Firstly, he has cherry-picked only articles which rubbish e-cigs, all of which have now been thoroughly discredited.

    Secondly, it is written by a practicing NHS Doctor. These are the people who demand that we listen to their expert opinion cos they is brilliant, innit. On this evidence, I wouldn’t say the guy was qualified to prescribe me LemSip.

    The most shocking part in my opinion, was this:

    “I want to be certain I’m giving the right advice to patients when they ask about e-cigarettes, not unwittingly jeopardising their health.”

    So, instead, he has written an article to a massive audience when it is quite plain he knows little about the rapid evolving developments in e-cig studies. He just googled and pumped out a few bits of nonsense he found on the net.

    I wrote something about lethally irresponsible morons like him a while ago.

    He should be hauled in front of the GMC and given a thorough going over. The medical community loses any moral high ground it thinks it occupies over their own regular shrieking about tobacco deaths when balderdash like this is published which can only result in smokers continuing to smoke.

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