A Pharmacists Point of View

[LaceyUnderall]

One suggestion that was right on with Buyer/Hagan's bill I believe was a taxing system based on the "dirtiness" of the product. For instance, cigarettes, being the dirtiest would carry the highest taxation and down from there would be different levels. The ecig is definitely a "cleaner" approach to nicotine/tobacco use and should therefor carry much less of a tax for it's users than tobacco cigarettes. It also leans to the tobacco harm reduction philosophy, encouraging smokers to make choices for themselves.

IMHO I thought this was a very good suggestion.... leaving my business bias aside and looking at it from a public health perspective/freedom to choose perspective.

Minimike makes an excellent point here in that it will be up to BT to fight for equal standard taxation across the board... and that will be interesting to see what happens. (Hence the importance of an industry body to sit at the round table when those "decisions" are being discussed.)

[zero7starz]

Depending on how much it makes the price go up (I'd like to know, first, if that were possible lol) then I would be rather okay with it. At least (I'd hope) that the FDA standards would keep the strange stuff out of the liquid and give me POM to smoke it.

[Junebug]

Markarich- Do you remember the commercials for the inhaler NRT? This was about 7 years ago I think. When patches were going OTC. I can't remember the name or the MFR. I know that my HMO had decided it was non formulary and did not stock it. Then again anything new most HMOs won't approve and it's all out of pocket costs for the patient. I only saw the commercial a few times, then I never saw it again, or even heard about it via patients. Chantix, well when that came out many people were asking about it, then a year later the musician was killed in Texas because he used it in conjunction with alcohol.

[LaceyUnderall]

Depending on how much it makes the price go up (I'd like to know, first, if that were possible lol) then I would be rather okay with it. At least (I'd hope) that the FDA standards would keep the strange stuff out of the liquid and give me POM to smoke it.

Here's an interesting tidbit: Did you know that Aveda products would be 100% organic except for the fact that the FDA makes them put something in their formulations to keep it only 99% pure? Crazy isn't it? They have to add a chemical to it in order to publicly dispense it.

[markarich159]

Good calculations, but extracted nicotine, again in my opinion would not be taxed that agressively. Than would mean a 10 ml bottle of 16mg/g liquid(assuming density of liquid is 1g/ml) would contain 160 mg nicotine total. at $0.50/mg nicotine tax, that would be an $80 tax on $5.95 bottle of 16mg nicquid. There is No Way the Goverment would be able to square a tax like that. When I made my suggestion of comparison I said "usuable" nicotine in a cig. There is much more nicotine in a cigarette before being burned. So I guess comparing cigs to extracted nicotine for tax purposes, may be like comparing apples and oranges. Perhaps my initial cig to liquid comparison for tax purposes was not well thought out. The tax will be high but FAIR. As Lacey noted with Buyer/Hagans, consideration would definitely be given to "clean" extracted nicotine vs. "dirty" tobacco smoke derived nicotine.

[markarich159]

Markarich- Do you remember the commercials for the inhaler NRT? This was about 7 years ago I think. When patches were going OTC. I can't remember the name or the MFR. I know that my HMO had decided it was non formulary and did not stock it. Then again anything new most HMOs won't approve and it's all out of pocket costs for the patient. I only saw the commercial a few times, then I never saw it again, or even heard about it via patients. Chantix, well when that came out many people were asking about it, then a year later the musician was killed in Texas because he used it in conjunction with alcohol.

Yes the Nicorette inhaler, they are still around I think. We got one in stock and it never sold, had to reurn it to the distributor. The Pharmacy I work at is in a large MA(medical assistance) demographic and therefore, NRT's aren't paid for by MA. I beleive the price was like $50 for a box of cartridges. I haven't had one bit of good feedback about Chantix(Varenicline) yet. And most are scared to death of the black box suicide watch warning.

[Junebug]

I heard good reviews about Chantix from patients. Even though it was non formulary at the time, many patients were willing to swallow the costs as it helped them. I can't say that now with that black box warning now either. The HMO I have experience with is the CA based non profit HMO.

[markarich159]

I heard good reviews about Chantix from patients. Even though it was non formulary at the time, many patients were willing to swallow the costs as it helped them. I can't say that now with that black box warning now either. The HMO I have experience with is the CA based non profit HMO.

I guess it does help some, studies, of course, showed it to be effective, I've not personal known anybody. Again, though, in my experience, black box warnings are usually the death knell for marketed prescription drugs. I remeber SEVERAL years ago Seldane, I believe, got the black box warning for p450 interactions, and was recalled several months later. The same with the COX2 inhibitor Vioxx.

[Nix]

Great conversation, thanks for the perspective Markarich. I've been curious what a pharmacist might think on the topic. I always like to here the thoughts of a more experienced and educated person.

[Applejackson]

I used Chantix and had great results. Side effects were mild nausea and vivid dreams, but certainly no thoughts of suicide! I just couldn't break the urge when drinking. Enter e-cig. Voila! Cured.