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Big Tobacco Attacks Sensible F.D.A. Rules on Vaping

As smokers turned to electronic cigarettes to reduce the health risks of smoking, big tobacco companies started buying e-cigarette makers and producing and selling their own. Now those companies are lobbying Congress to prevent the Food and Drug Administration from regulating electronic cigarettes and cigars, as it does conventional cigarettes. If they succeed, they will be able to sell and market addictive nicotine products to young people with few restrictions.

https://www.nytimes.com/2017/04/19/opinion/big-tobacco-attacks-sensible-fda-rules-on-vaping.html?_r=1

While promoters of e-cigarettes and e-cigars, which provide nicotine in vapor form, say they can help people quit conventional tobacco products containing harmful tar, there is not a lot of evidence for that claim. In addition, the devices are dangerous to young people because the nicotine they provide “can cause addiction and can harm the developing adolescent brain,” according to a 2016 report by the surgeon general, Vivek Murthy. Health experts also say that the vapor those devices produce can contain carcinogens and metal particles.

Another government report found that 16 percent of high-school students said they had used e-cigarettes in 2015, up from just 1.5 percent in 2011. The industry sells these products in a broad array of flavors, like gummy bear and cotton candy, designed to appeal to young people when they are more susceptible to becoming dependent or addicted to nicotine.

After years of deliberation, the F.D.A. said last May that it would begin regulating the manufacturing, sale, packaging and advertising of e-cigarettes, and all tobacco products, under a 2009 federal law that authorized it to do so. Specifically, the agency said it would begin reviewing the health risks of e-cigarettes introduced since early 2007, and potentially ban specific flavors and products that it deemed harmful. The tobacco lobby wants Republicans to amend a vital appropriations bill to exempt products that were introduced before May 2016 from F.D.A. review.

The push to undermine the F.D.A.’s authority began even before the agency had finished its rule. One Republican lawmaker, Representative Tom Cole of Oklahoma, introduced a bill in 2015 that was identical to a draft circulated by the Altria Group, the country’s biggest tobacco company and a marketer of vaping products. In addition to its legislative effort, the industry has also filed several lawsuits in federal courts challenging the rule.

Tobacco companies complain that the F.D.A.’s rule amounts to “retroactive” regulation because many of the e-cigarettes and e-cigars it will regulate have been on the market for years. But the industry has known for years that government officials were developing this rule. Large bipartisan majorities in Congress voted in 2009 to hand the agency the authority to evaluate and approve new tobacco products introduced on or after Feb. 15, 2007. The F.D.A. is simply doing its job by protecting public health.

California targets candy-flavored tobacco as teen ‘gateway’ to cigarette smoking

More teens are turning to fruit- and candy-flavored tobacco, raising concerns that sweetened e-cigarettes and cigarillos are a gateway to nicotine addiction. A California anti-tobacco campaign targeting teens has ramped up in high schools and at a recent state Capitol rally on Kick Butts Day. Claudia Buck cbuck@sacbee.com

http://www.sacbee.com/news/local/health-and-medicine/article140622513.html

At the checkout counter, the flavors are sweet and enticing: Banana Smash. Twisted Berry. Berry Honey. Cherry Dynamite.

They aren’t in the candy aisle but on the tobacco shelf, often sold in 99-cent two-pack mini-cigars or liquid cartridges for e-cigarettes.

While fewer young Americans are puffing on cigarettes, more teens are using flavored tobacco, typically by vaping with electronic cigarettes or smoking tiny cigars known as cigarillos.

This year, there’s a renewed push to banish flavored tobacco products, which health officials and others fear are luring the next generation of nicotine addicts by targeting teens and kids.

The sweetened flavors are “a gateway to traditional cigarette smoking,” said Scott Gerber, a wellness program director with the Alameda County Office of Education, who attended a recent anti-tobacco state Capitol rally with a handful of high school students from Berkeley and Fremont. Tobacco companies, he said, “are targeting young people with cherry, strawberry, piña colada flavors. … Gummi bears? That’s a youth-friendly flavor, not an adult-friendly flavor.”

Gerber was among about 250 high school students and chaperones who attended the anti-tobacco rally, chanting slogans and carrying signs with messages such as “We want to see a new light, not a lighter” and “We want 7,700 flavors of ice cream, not tobacco!” The rally was part of national Kick Butts Day, co-sponsored by the California Youth Advocacy Network and the Campaign for Tobacco-Free Kids.

In 2014, 73 percent of high school students and 56 percent of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product, according to the federal Centers for Disease Control and Prevention.

Wheatland High School student Angelina Hom, 15, who belongs to a campus group called SOWHAT (Students Of Wheatland High Against Tobacco), said she’s seen the negative impacts of tobacco firsthand in family members and hopes more of her peers get the message to avoid tobacco.

Convenience stores near her Northern California school have prominent displays of brightly colored, fruity-flavored tobacco products positioned close to the checkout counter, she said. “You go to pay for your food and there’s a wall full of of tobacco and cigarettes. It targets kids into thinking it’s cool.”

E-cigarettes are the most commonly used tobacco product among middle and high school teens in California. An estimated 217,000 Californians between the ages of 12 and 17 currently smoke traditional cigarettes or e-cigarettes, according to state health officials.

In stores, although tobacco products by law must be behind glass, it’s not unusual to find Swisher Sweets, candy-flavored cigarillos sold in two-packs for less than a dollar, sitting near candy bars and snacks, at eye level of young customers.

“Having it advertised as candy unlocks the door to the world of addiction,” said shopper Jenni Richardson, 24, in a midtown Sacramento convenience store where Swisher Sweets sit directly above the ice cream freezer case. A self-described recovering heroin addict, Richardson said tobacco products are dangerously addictive, noting it was far easier for her to quit narcotics than nicotine.

Last summer, the growth in e-cigarette use helped prompt California to toughen state tobacco laws, raising the minimum age for legally buying cigarettes and cigars from 18 to 21, the first change since tobacco control laws went into effect 144 years ago. Also for the first time, those laws now apply to e-cigarettes, which have become hugely popular for their myriad fruit and candy-scented flavors, with names such as Watermelon Krush, Apple Pie a la Mode and Blueberry Cotton Candy.

Some counties have banned all sales of flavored tobacco, including Yolo County, which prohibits sales in the county’s unincorporated areas, starting May 1. The intent was to deter use by youths, said Keri Hess, the county’s tobacco prevention youth coordinator.

“Lots of kids who use e-cigarettes would never dream of trying a regular cigarette because they say it tastes gross. They know the hazards of regular cigarettes and tobacco, but they don’t recognize the health hazards of e-cigarettes,” Hess said.

In Yolo County, 73 percent of stores carried e-cigarettes last year compared with 46 percent in 2013.

The state’s crackdown came as illegal sales of tobacco to minors were up last year by more than a third from 2015, according to the state Department of Public Health’s annual survey, which took place before the legal age was changed. Using teenage decoys trying to buy smokes, the annual survey found that 10.3 percent of 793 stores sold tobacco to underage buyers, the highest rate in eight years.

Citing research that shows brain development continues until around age 25, state health officials say nicotine is a “highly addictive neurotoxin” that can permanently damage adolescent and young adult brains.

“The younger people are when they start smoking or using nicotine, the more likely they are to become addicted,” said State Public Health Officer Dr. Karen Smith during a news conference last summer. Every year in California, she noted, 34,000 people die of tobacco-related diseases.

She said the surge of teens vaping with e-cigarettes is no accident, given the “aggressive marketing” and the proliferation of gadgets and flavors by tobacco companies. Calling them “enticing gateway products,” Smith said e-cigarettes are “fueling the addiction” to nicotine.

Since 2009, the U.S. Food and Drug Administration has banned the sale of cigarettes with fruit and candy flavors, part of federal efforts to reduce tobacco addiction among youths. More recently, the FDA is focusing on cigars and cigarillos (mini-cigars). In December, it issued warning letters to four tobacco companies, including Swisher International Inc., maker of Swisher Sweets, for selling cigars in “youth-appealing” flavors, such as grape, wild cherry and strawberry.

If the companies don’t take action, they could face civil penalties, criminal prosecution and seizure of products, according to the FDA.

“Flavored cigarettes appeal to kids and disguise the bad taste of tobacco, but they are just as addictive as regular tobacco products and have the same harmful health effects,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, in a statement. He said continued bans on flavored tobacco are essential to “protect future generations from a lifetime of addiction.”

To students at the recent state Capitol rally, the brightly colored packaging and sweetened flavors are “like candy,” enticing teens and kids to get hooked on nicotine at an early age, said Naphatsorn Kaewwanna, 18, a high school senior with the Asian American Drug Abuse Program in Los Angeles County.

“We should put a stop to it,” she said.

 

Cancer Activists Push Bill to Hike Legal Age to Buy Tobacco

Over 100 cancer patients, survivors and their families from across Massachusetts are planning to gather at the Statehouse to press lawmakers to support efforts to protect young people from nicotine addiction.

http://www.capecod.com/newscenter/cancer-activists-push-bill-to-hike-legal-age-to-buy-tobacco/

At the top of the agenda is a bill that would increase the legal age to buy tobacco products from 18 to 21.

The legislation would also include e-cigarettes in the smoke-free workplace law and ban the sale of tobacco products in facilities that provide health care, such as pharmacies.

About 95 percent of adults who smoke started by age 21.

More than 140 communities in the Commonwealth have passed regulations raising the purchase age from 18 to 21, including Falmouth, Mashpee, Yarmouth, Brewster, Orleans, Eastham and Provincetown.

The Board of Health in Harwich will hold a public hearing April 11 to discuss a proposed regulation change to increase the legal age to 21. The board could vote on the measure that night.

Wednesday’s visit to Beacon Hill is part of the American Cancer Society Cancer Action Network’s annual lobby day.

This year, an estimated 37,000 Massachusetts residents will be diagnosed with cancer. An estimated 12,600 will die from the disease.

AAP, public health organizations call for FDA ban of all flavored tobacco products

Five health care organizations have urged the FDA to prohibit all candy- and fruit-flavored tobacco products, including e-cigarettes, cigars and hookah tobacco, asserting that these products are undermining national efforts to reduce youth tobacco use and placing children at health risks from tobacco use and nicotine addiction.

http://www.healio.com/pediatrics/school-health/news/online/%7Baf2b3993-2fb7-48e8-afee-325363abd6d4%7D/aap-public-health-organizations-call-for-fda-ban-of-all-flavored-tobacco-products

The joint report released by the AAP, American Lung Association, the American Heart Association, the American Cancer Society’s Cancer Action Network and Campaign for Tobacco-Free Kids also criticized recent legislation introduced in Congress that could limit FDA oversight of e-cigarettes and cigars, as well as the growing market of flavored products.

“Despite the FDA’s ban on flavored cigarettes, the overall market for flavored tobacco products is growing. Continuing a long tradition of designing products that appeal explicitly to new users, tobacco companies in recent years have significantly stepped up the introduction and marketing of flavored other tobacco products — OTPs — particularly e-cigarettes and cigars, as well as smokeless tobacco and hookah,” the organizations wrote. “Although tobacco companies claim to be responding to adult tobacco users’ demand for variety, flavored tobacco products play a key role in enticing new users, particularly kids, to a lifetime of addiction.”

The report highlights data from the 2013-2014 Population Assessment of Tobacco and Health (PATH) demonstrating the prevalence of flavored OTP use in youth demographics.

According to this study, two-thirds of children who currently use tobacco products claim enticing flavors, including gummy bear, cotton candy, peanut butter cup and cookies ‘n cream, as their reason for use.

Additionally, 80.8% of children aged between 12 and 17 years who have ever used a tobacco product began using with flavored products.

In May 2016, the FDA issued a deeming rule in which its authority on tobacco products would stretch to include all previously unregulated OTPs, including e-cigarettes, cigars and water pipes. This rule included several additional provisions, including refusal of sale to those under 18 in the U.S., vending machine sales in adult-only facilities, required addiction and health warnings, and disclosure of ingredients.

The deeming rule also allows the FDA to control the contents of tobacco products and forbids introducing OTPs without FDA review and additional scientific support of public health benefits. However, the White House Office of Management and Budget deleted a suggested provision that prohibited characterizing flavors.

E-cigarette use involves inhaling nicotine, a solvent (such as glycerin) and other additives. Although there are limited studies on the long-term effects of their use, studies have revealed that toxins such as formaldehyde, acrolein, toluene, tobacco-specific nitrosamines, and metals like lead and nickel are found in their make-up.

OTP use can lead to cancer of the oral cavity, larynx, esophagus and lung; aortic aneurysms; COPD; and increased risk of poisoning due to varying levels of nicotine. The effects of inhaling the flavoring in these products is unknown, according to the 2016 Surgeon General’s report.

“Congress must reject any proposals to weaken FDA oversight of these products. In fact, the FDA should strengthen its new rule by prohibiting all flavored tobacco products, including menthol products,” the organizations wrote. “As the FDA itself has demonstrated and as this report documents, there is more than sufficient scientific evidence to support such a prohibition. Eliminating all flavored tobacco products is a critical step in preventing tobacco companies from addicting another generation of kids and reversing our nation’s progress in the fight against tobacco.” — by Katherine Bortz

Health groups ask FDA to ban candy-flavoured e-liquids

Candy- and fruit-flavoured tobacco products including e-cigarettes and cigars are luring youth into nicotine addiction, according to a report sponsored by leading health organisations that asks they be banned.

http://www.tobaccojournal.com/Health_groups_ask_FDA_to_ban_candy-flavoured_e-liquids.54145.0.html

Food and Drug Administration (FDA) authorities should ban all flavoured tobacco products, says the report issued by the Campaign for Tobacco-Free Kids, American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Heart Association and American Lung Association.

“Gummy bear, cotton candy, peanut butter cup, cookies ‘n cream and pop rocks for e-cigarettes and chocolate, wild berry, watermelon, lemonade and cherry dynamite for cigars,” are some of the flavours targeted in the report.

Letter from New Zealand Associate Minister of Health on e-cigarette Regulations

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When Public Health and Big Tobacco Align

Nobody trusts the tobacco industry, and it’s easy to understand why. For decades, industry executives knew that smoking caused cancer and heart disease yet publicly denied the dangers of cigarettes. It relentlessly attacked its critics. Documents that emerged in the 1990s showed that the industry targeted teenagers, knowing that the earlier someone became addicted to cigarettes, the more likely they would be lifelong smokers. And so on.

https://www.bloomberg.com/view/articles/2017-03-09/when-public-health-and-big-tobacco-align

In the 1980s and 1990s, the public health community went to war with the tobacco industry. Though the war largely ended in 1998 with Big Tobacco agreeing to a multi-billion-dollar settlement with the states, it remains a powerful memory for public health.

To this day, most tobacco-control advocates view the cigarette companies as being every bit as duplicitous and evil as they were in the bad old days. Some years ago, I asked Stanton Glantz, perhaps the leading anti-tobacco scientist in the U.S., what his ultimate goal was. He didn’t say it was to eliminate the scourge of smoking. He said: “To destroy the tobacco industry.”

What brings this to mind is an excellent cover story in the upcoming issue of Bloomberg Businessweek about the efforts of the tobacco industry to devise and market so-called reduced risk products like electronic cigarettes — products that give users their nicotine fix without most of the attendant carcinogens that come with combustible tobacco.

Although the tobacco companies have done decades of R&D on smokeless products, the business was dominated early on by startups like NJOY, which is today the largest independent e-cigarette company in America. From the start NJOY has said that a big part of its mission was “to end smoking-related death and disease.” And from the start, messages like that have been scorned by the public health community.

Ingesting nicotine in some smokeless fashion is vastly safer than smoking a combustible cigarette. (In the words of the late South African tobacco scientist Michael Russell, “People smoke for the nicotine but die from the tar.”) Last year, the Royal College of Medicine issued a report saying that e-cigarettes were some 95 percent safer than cigarettes.

Even so, the public health community in the U.S., led by the Centers for Disease Control and Prevention, has done everything it can to demonize smokeless products. Some of this has been with good reason: to try to keep kids from picking up an addictive habit. But this effort has also helped to create the impression that smokeless products are as dangerous as cigarettes. One result, sadly, is that many long time smokers have refused to try them, even though they could save their lives.

My sense in talking to tobacco-control officials over the years is that too many of them simply don’t believe in a reduced-harm approach. We give heroin addicts methadone not because methadone is good but because it is better than heroin. With cigarettes, however, the public health mindset appears to be all or nothing — that the only “right” thing for smokers to do is to go cold turkey.

But the lingering distrust of the tobacco industry has also had a lot to do with public health’s unwillingness to acknowledge the potential benefits of alternative products. Matt Myers, the president of the Campaign for Tobacco Free Kids, has often complained, for instance, about the marketing of e-cigarettes, saying that companies are using the same tactics to hook teenagers that Big Tobacco once used.

With the e-cigarette market clearly established, the four big tobacco companies — BAT, Reynolds American, Altria (formerly Philip Morris) and Philip Morris International (spun off from Altria) — have proclaimed themselves all in.

Philip Morris International is an especially interesting case: Not only does it have an array of e-cigarettes and other smokeless products, but as the Bloomberg Businessweek story points out, it has publicly proclaimed that its goal is to lead the world into “a smoke-free future.” The home page of its website asks, “How long will the world’s leading cigarette company be in the cigarette business?”

As astonishing as it is that a company with $26 billion in tobacco revenue last year would be calling for the end of cigarettes, I believe Philip Morris is sincere. It has spent around $3 billion in research. Its new flagship product, called IQOS, heats tobacco but doesn’t burn it — which the company believes will be more satisfying to smokers than vaping. IQOS already has 7 percent of the tobacco market in Japan, and is being rolled out in other countries.

Philip Morris recently asked the British government that tobacco products “be taxed according to their risk profile.” In other words, it wants the government to impose higher taxes on cigarettes to encourage smokers to move to reduced-risk products. What tobacco company has ever done that before?

In the U.S., Philip Morris has done something extraordinary: It has made a submission to the Food and Drug Administration to get the right to market IQOS as a reduced risk product. The expensive submission consumed 2.3 million pages and is backed by a great deal of research, including several clinical trials. So far, none of the U.S. e-cigarette companies have attempted to get such a designation, and it is a big problem. How do you sell a reduced risk product when you can’t tell anybody it reduces risk?

The business case for diving into this market is that it’s a product category that’s growing, while the cigarette market is shrinking. Philip Morris doesn’t want to be left behind. But there is no particular need for the company to set out such a transformative agenda, at least not yet. The small smokeless companies are not much of a threat. NJOY filed for bankruptcy last fall. And under a 2009 law, every company in the e-cigarette industry will have to file something called a premarket tobacco application with the FDA by August 2018. The submissions will cost, on average, over $450,000, and the companies will have to show that their products have some public health benefit. There is a legitimate chance that some small companies won’t be able to clear the hurdle.

No, Philip Morris is pushing as hard as it is, I believe, because it wants to get on the right side of the issue, finally — to be viewed as a good corporate citizen. When I spoke to Glantz the other day about the company’s new anti-smoking agenda, he said, “I don’t believe them.” (He added, “If they were serious, they would stop marketing cigarettes right now.”)

No doubt many others in the tobacco-control community feel the same way. They still loathe Big Tobacco, and view Philip Morris’s new strategy as just another deception. But the truth is, if there is ever going to be a serious move from cigarettes to less dangerous products, it will have to come from Big Tobacco. They have the R&D resources, they have the marketing apparatus — and, it appears, they have the will.

Public-health advocates don’t have to trust Philip Morris, or any other tobacco company. They don’t have to believe what I believe in order to arrive at the same conclusion: that the advocates should be rooting for the companies’ innovations — pushing them, double-checking their data, making sure regulations are in place to prevent their products from being marketed to kids. The advocates should also be spreading the word that there is an alternative to cigarettes. Who really cares whether it’s Big Tobacco or some other entity that reduces smoking deaths? What matters is that it happens.

The tobacco wars are long over. Continuing to fight the cigarette companies may bring a certain satisfaction to the veterans on the public-health side. But joining forces is the way to save lives.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Joe Nocera at jnocera3@bloomberg.net

To contact the editor responsible for this story:
Philip Gray at philipgray@bloomberg.net

Cole-Bishop Bill Reintroduced in Congress

http://tobaccobusiness.com/cole-bishop-bill-reintroduced-congress/

By Tobacco Business –

FDA Congress

U.S. Representatives Tom Cole (R-Oklahoma) and Cole Bishop (D-Georgia) reintroduced legislation in Congress in an effort to change the FDA predicate date under the FDA tobacco regulations. Known as the FDA Deeming Clarification Act of 2017 (HR 1136), this legislation would also adopt new regulations relating to e-cigarette and vapor products. HR 1136 is an updated version of HR 2058 and the Cole/Bishop amendment.

The re-introduced bill would change the predicate date from Feb. 15, 2007 to Aug. 8, 2016, the date when the FDA deeming regulations took effect.

This move would allow newly deemed tobacco products that were on the market as of Aug. 8, 2016-including e-cigarettes, vapor, cigars, pipe tobacco, hookah tobacco, nicotine gels and dissolvable nicotine products-would not need a special Substantial Equivalency Application or Pre-Market Tobacco Application to be filed with the FDA in order to remain on store shelves and in the market. These products would still be required to comply with the other FDA tobacco regulations, however.

Specifically for vapor products, the bill would also establish a product standard for vapor product batteries. The product standard would include technical characteristics that batteries for vapor products would need to meet in order to be used in an e-cigarette or vapor product. Vapor product manufacturers, wholesalers, and retailers would not be allowed to advertise a vapor product in a newspaper, magazine, periodical or other publication except an adult publication whose readers younger than 18 years old constitute no more than 15 percent of the total readership and fewer than 2 million people younger than 18 years older.

This bill would have a major impact on various part of the tobacco industry. First, it would relieve some of the burden placed on manufacturers of varying ages and sizes. Companies founded after Feb. 15, 2007 would be able to continue operating with their products readily available in the market. As is, compliance costs could drive many newer manufacturers out of business. Second, changing the predicate date would give many manufacturers more product on the market. This also could drastically change the course of the vapor industry, much of which was established long after 2007. The vapor industry is also greatly founded in technology and the ongoing improvement and development of said technology. Anything that was on the market prior to the 2007 predicate date, which is very little, would likely not be promoted or used by vapor consumers today. There are also a great deal of questions and concerns regarding the FDA approval process for tobacco products like cigars, pipe tobacco and vapor products, which is likely to be a very long, costly and confusing process.

Many in the vapor industry view HR 1136 as the first necessary step in developing appropriate regulation for the vapor industry. On its website, the Consumer Advocates for Smoke Free Alternative Association (CASAA) commented, “Different efforts and strategies are required to keep moving the ball forward. Looking to the future, fair regulatory treatment of vapor products is part of the larger campaign to change the tobacco control culture int he United States. Ultimately, policy makers, regulators, and public health advocates must change their abstinence-only approach to one of the comprehensive harm reduction in order to humanely reduce the morbidity and mortality associated with smoking cigarettes.”

The passing of HR 1136 would be a major breakthrough for those hit by the FDA deeming ruling. You are encouraged to reach out to your state representatives and voice your support for the bill, either through email, phone or attending a town hall meeting.

Clean Indoor Air Act – Use of Electronic Cigarette Devices – Prohibition

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Alert: Just 10 Puffs Of an E-Cigarette As Deadly As a Regular Fag

“Quitting smoking is the easiest thing in the world. I know it because I’ve done it thousands of times. Mark Twain

https://www.thequint.com/fitness/2016/12/21/just-10-puffs-of-e-cigarette-are-as-deadly-as-regular-cigarette-vaping-is-not-safer-than-smoking-quit-smoking-2017

Bang on! Science says that 9 out of 10 people who try to kick the butt fail miserably. Perhaps that is why, practically overnight, e-cigarettes have come into their own as the new in thing.

And now an independent study done by USA’s biggest child health body, the American Academy of Pediatrics, finds that e-cigarettes could be the gateway to lifelong nicotine addiction, hinder brain development, give you ‘popcorn lungs’ (an irreversible and fatal condition where the airways are narrowed and weakened) – and all this combined can threaten decades of anti-smoking gains.

If you think that e-cigarettes are an American phenomenon, smoke on this: In the last 3 years, the e-cigarette market has shot up to a $3-4 billion industry and the US contributes to only a quarter of it. In 2014, ITC started manufacturing e-cigarettes in India when most of the Chinese e-cigarette brands were readily available, and obviously, the cigarette giant will not invest millions in a tobacco cessation tool.

Before You Start Vaping, Here’s What You Need To Know

An alarming new study by Swedish scientists found that just 10 puffs of an e-fag can set the heart disease ball rolling, just like a regular cigarette.

It increases the risk of high blood pressure, hardens arteries and makes it harder for people to quit smoking. All this for the popular perception that e-cigarettes are a smoking cessation tool, but contrary to popular perception, it does contain nicotine.

Nicotine is as addictive as heroin, precisely why these vaping devices will never help anyone wean themselves off smoking.

An e-cigarette is a terrible alternative to smoking. In fact, they are much more sinister than tobacco cigarettes – even the World Health Organisation doesn’t buy it.

Nicotine poses several health hazards of varying severity and promotes the growth of tumours.

Dr Pankaj Chaturvedi, Senior Oncologist Surgeon, Head and Neck Cancer Surgery, Tata Memorial Hospital

According to Dr Chaturvedi, e-cigarettes also pose the threat of nicotine poisoning – if you inhale three cartridges in a row, you can die. One cartridge has roughly 11 milligrams of nicotine, three would be over 30, which is a fatal dose. The World Health Organisation says reports of nicotine poisoning have increased manyfold in the US and UK where the popularity of e-cigarettes is soaring.

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Where Does India Stand On E-Cigarette Regulations?

Like with most subjects to do with ‘health’, India does not have a national policy on e-cigarettes yet.

The problem is that e-cigarettes are not mandated by law, and they don’t come under the jurisdiction of the Drugs and Cosmetics Act or fall in the Cigarette and Other Tobacco Products Act. Companies can openly flout the tobacco control provisions, which means they can sell it to kids under the age of 18, skip the gory pictorial warnings on packaging, and openly advertise it.

In 2013, the then Union Health Minister Dr Harsh Vardhan called a closed door meeting of public health activists and FDA officials to completely ban the sale and supply of e-cigarettes in the country.

He was motivated by the news that 13 of the 59 countries that regulate e-cigarettes banned them after compelling scientific evidence that these sticks do more harm than good. But since then, the Health Minister changed and the issue has been put on the back-burner.

A new drug is being freely and openly being sold to people and that drug is nicotine. We don’t know how healthy or unhealthy these are over the long term. But the question is this: if in the next 5 years, we find out these are as deadly as cigarettes for your health, what happens then?

Dr Pankaj Chaturvedi, Senior Oncologist Surgeon, Head and Neck Cancer Surgery, Tata Memorial Hospital

The problem is that Big Tobacco has not revealed exactly what kinds of chemicals there are in the vapour liquid.

And that is concerning.

Health experts don’t trust them. Nobody should trust them. Their only motive is profit. Will you be naive enough to think that big tobacco firms want to help smokers quit?