AMA To Study E-cigs updated

[Krakkan]

AMNews: June 29, 2009. AMA meeting: More to do on tobacco control ... American Medical News

 

[eric]

Thanks for the post, Krakkan.

 

[Sun Vaporer]

"We have very little information on this new device," Dr. Annis said. "We know that nicotine can have adverse consequences, particularly cardiovascular disease. Does this [device] have more adverse effects than the nicotine patch? We don't know that. The big question is whether this is a way of surreptitiously getting people to continue their addiction to nicotine under the guise of being an aid to smoking cessation."

Strange--I thought the "Big Question" would be reversed---the "adverse health consequences" as opposed a "Surreptitiously getting people to continue their addiction"???????----Sun

 

[mmmvaping]

even if people still use e-cigs other than using tobacco cigs...will dramatically help the addict than keep smoking tobacco cigs. i would rather see people use this than reg cigs....its simple as that

 

[fresca]

"The FDA is concerned electronic cigarettes may introduce young people to nicotine and that their use could lead to the use of other nicotine products and other problems."

↑↑↑And there's the required "THINK OF THE CHILDREN!" sound bite. I swear, they're all reading from the same playbook.

Odd... it looks like they forgot to mention all the fun, fruity child-luring flavors...

 

[harmony gardens]

"We have very little information on this new device," Dr. Annis said. "We know that nicotine can have adverse consequences, particularly cardiovascular disease. Does this [device] have more adverse effects than the nicotine patch? We don't know that. The big question is whether this is a way of surreptitiously getting people to continue their addiction to nicotine under the guise of being an aid to smoking cessation."

Strange--I thought the "Big Question" would be reversed---the "adverse health consequences" as opposed a "Surreptitiously getting people to continue their addiction"???????----Sun

Yeah, strange, I thought they had studies that showed that nicotine was reletively safe when it wasn't delivered by a cigarette,,, at least that's what the studies I read about the safety of patches and nicotine gum say.

 

[SuperStack]

Ermm...

The AMA is yet another big-pharma funded shill group for those who don't know. The outcome of their "e-cig study" is going to be laughably obvious

The AMA, the BMA and the Nicotine Wars

The American Medical Association (AMA) is a key player in the nicotine wars. The Association receives many millions of dollars every year from the pharmaceutical industry, and some of those millions are specifically for anti-tobacco work. The Robert Wood Johnson Foundation alone gives the AMA millions for "administering" (i.e. lending its name to) the RWJF's SmokeLess States program.

The Journal of the American Medical Association (JAMA) also receives much of its budget from pharmaceutical advertising, as does the British Medical Association's BMJ. Both journals have dedicated entire issues to "tobacco control" in addition to publishing numerous editorials supporting tobacco control and the pharmaceuticals' "smoking-cessation" products. Both journals are also quick to print pharmaceutically funded studies on smoking-cessation drugs, done by researchers with stated financial ties to the pharmaceutical industry. It isn't as though the journals' editorial staffs aren't aware of the bias in many industry-funded drug studies. Indeed, they have even published articles on the subject of researchers' conflicts of interest.

"By 1999, almost 7.6% of faculty investigators [researchers] reported personal financial ties with sponsors of their research. Throughout the study period, 34% of disclosed relationships involved paid speaking engagements (range, <$1000-$20,000 per year), 33% involved consulting agreements between researcher and sponsor (range, <$1,000-$120,000 per year), and 32% involved the investigator holding a position on a scientific advisory board or board of directors. Fourteen percent involved equity ownership, and 12% involved multiple relationships." Boyd E, Bero L, "Assessing Faculty Financial Relationships With Industry: A Case Study," JAMA, 284(17), Nov. 1, 2000.


What they generally do not publicize are the medical associations' own conflicts of interest and their own financial ties to the pharmaceutical industry, vested interests that in some instances appear to take precedence over objective publishing standards and patient well-being. Nowhere is this more apparent than in the nicotine wars.

Editors at the BMJ and JAMA and officers of the British Medical Association and the American Medical Association, among others, seem not to consider fully the possible harm of some of the anti-tobacco information they disseminate and the some of policies they advocate. One example of this is their advocacy for lowering the nicotine content of cigarettes.

Former Surgeon General C. Everett Koop said the nicotine content of cigarettes should not be lowered because smokers would just smoke more, thereby getting twice as much cancer-causing substances. "I don't think the public health community would ever let FDA reduce nicotine remarkably in cigarettes," said Koop. "Report: Tobacco, FDA Rift Settled," AP, printed in The Washington Post, Aug. 24, 1997.


But the very next year both the AMA and the BMA urged their respective governments to force tobacco companies to lower the nicotine content in cigarettes, a position they justified by promoting the pharmaceutical companies' nicotine products.

Reed Tuckson, senior vice president for professional standards of the AMA said smokers could use pharmaceutical products to supplement nicotine. "These problems can be avoided by providing alternative forms of nicotine delivery with less or little risk to health as a part of expanded access to treatment (using) products such as nicotine gum, patches, oral inhalers and nasal sprays." "US, British doctors call for low-nicotine cigarette," Reuters, Oct. 28, 1998.


If that sounds like a ringing endorsement of the drug companies' products, consider this from a BMJ editorial:

"To meet the needs of the estimated 13 million current smokers in Britain, many of whom will never overcome their nicotine addiction, we also need legislation that explicitly encourages the development of alternative products that can deliver uncontaminated nicotine at a dose and rate comparable with cigarettes and in a way that is commercially and socially acceptable. If instead of nearly 13 million addicted smokers we have 13 million addicted to clean nicotine devices, so be it." Britton J, McNeill A, Editorial, "Why Britain needs a nicotine regulation authority," BMJ 2001; 322: 1077-1078, May 5, 2001. Both Britton and McNeill have been funded by the pharmaceutical companies which make and market smoking cessation products. In addition, McNeill participates in the pharmaceutically funded WHO partnership project on tobacco control.

The Pharms and Doctors: Corrupting Medicine

 

[Surf Monkey]

Yeah, strange, I thought they had studies that showed that nicotine was reletively safe when it wasn't delivered by a cigarette,,, at least that's what the studies I read about the safety of patches and nicotine gum say.

It still elevates your blood pressure and quickens your heart rate. The drug itself has the same consequences smoked as vaporized. The big benefit of PVs is more in the fact that they don't put a bunch of combustion byproducts into your system. Smoke = fine particulate. PVs represent a vastly lowered risk of ingesting cancer causing agents, but the nicotine still constricts your blood vessels and so forth.

That said, the early research suggests you get a lot less nicotine in your system from PVs, so even if it still has the same chemical action on your body, you're probably getting a lot less of it than before anyway.

 

[mmmvaping]

It still elevates your blood pressure and quickens your heart rate. The drug itself has the same consequences smoked as vaporized. The big benefit of PVs is more in the fact that they don't put a bunch of combustion byproducts into your system. Smoke = fine particulate. PVs represent a vastly lowered risk of ingesting cancer causing agents, but the nicotine still constricts your blood vessels and so forth.

That said, the early research suggests you get a lot less nicotine in your system from PVs, so even if it still has the same chemical action on your body, you're probably getting a lot less of it than before anyway.

my thoughts exactly. also the temp is also a factor as well. according to the new zeland testings the ecigs do not reach the temp as normal cigs which means no combustion. and we all know what that does. but i will say caffine is no different than nicotine as far as the side effects over years of abuse. and the with drawl of caffine can be almost identical with some folks even as long and as intense as nicotine. I know my dad went through 3 weeks of intence migranes, night sweats, wait gain, nausia, and had the same short term withdrawls as he did with 30 years of pipe smoking. now long term withdrawls are very different between both.

 

[TropicalBob]

If .. big "if" .. this study is properly done and reported, I welcome it. We need answers to many questions about e-smoking and its consequences. The tide is turning on nicotine for being a sizable cardiovascular threat, so that's no small matter. E-smokers might avoid lung cancer and emphysema only to die from clots breaking away from a clogged artery.

We need answers and the present void of accurate information is untenable.

 

[mmmvaping]

If .. big "if" .. this study is properly done and reported, I welcome it. We need answers to many questions about e-smoking and its consequences. The tide is turning on nicotine for being a sizable cardiovascular threat, so that's no small matter. E-smokers might avoid lung cancer and emphysema only to die from clots breaking away from a clogged artery.

We need answers and the present void of accurate information is untenable.

it would be great to have some good answers....but all studies have been tampered with one way or another....But we all know what the real out come of this is.....nicotine suppresses the nervice system. It can cause strokes if used in heavy dosages. It can clog arteries which lead to heart failure and heart disease. It also cause erection problems and other issues. But if used in less MG's it can be a good for you. All the these studies with altimers, ADHD, BI-poler disorders and even PDSD are coming back with some positive results...and of course there are negative results as well. Addiction to one of them. But with nicotine you cant really build up a tollarance thats what makes it so appealing.

 

[beckah54]

With all the money I've spent buying the e-smokes, the juice, the atomizers, batteries and cartridges, I'm wondering how all those "children" will be able to afford buying the strawberry, vanilla and grape flavors to use in their new e cigarettes. Do they all have charge cards to purchase their supplies with?

 

[Surf Monkey]

but all studies have been tampered with one way or another...

Let's not get ahead of ourselves, now. Scientific studies can be tampered with, and they can be manipulated for political purposes. But the assertion that "all studies have been tampered with" is going to far. It's possible to get clean research.

But with nicotine you cant really build up a tollarance thats what makes it so appealing.

What makes you think that? Your body can develop a tolerance for nicotine just as it can for practically any other substance you put in it.

 

[scintar]

Let's not get ahead of ourselves, now. Scientific studies can be tampered with, and they can be manipulated for political purposes. But the assertion that "all studies have been tampered with" is going to far. It's possible to get clean research.



What makes you think that? Your body can develop a tolerance for nicotine just as it can for practically any other substance you put in it.

Yes it is possible but we all know this won't happen. Possible is the perfect word to put a spin on things. To keep hope alive or even kill it.
Im with TB, I would love to know what the consequences are from inhailing nicotine in a vapor form but we may never know the truth just like we will never know the truth what is the trade secret ingredients in PM cigarettes. Is it possible that the FDA will make PM comply and state all the ingredients in thier cigarettes? Yes. Will it happen No. But the possibilities are endless.

 

[tikva]

"The FDA is concerned electronic cigarettes may introduce young people to nicotine and that their use could lead to the use of other nicotine products and other problems."

↑↑↑And there's the required "THINK OF THE CHILDREN!" sound bite. I swear, they're all reading from the same playbook.

Odd... it looks like they forgot to mention all the fun, fruity child-luring flavors...

With all the money I've spent buying the e-smokes, the juice, the atomizers, batteries and cartridges, I'm wondering how all those "children" will be able to afford buying the strawberry, vanilla and grape flavors to use in their new e cigarettes. Do they all have charge cards to purchase their supplies with?

You both posted what I was thinking. I don't know how they can keep trotting out this lame excuse with a straight face. I realise alot of the public is gullible, but in reading comments to online articles, I see many people still aren't buying the "for/think of, the children" crap.

If .. big "if" .. this study is properly done and reported, I welcome it. We need answers to many questions about e-smoking and its consequences. The tide is turning on nicotine for being a sizable cardiovascular threat, so that's no small matter. E-smokers might avoid lung cancer and emphysema only to die from clots breaking away from a clogged artery.

I think an honest study of nicotine affects in humans would need to separate nic use and dietary contributions to increased BP, CV problems etc.

I was born with a minor heart problem and had to take meds to slow my rapid heart beat. I don't eat red meats or any animal fats. I also don't eat plant fats that are not good (such as coconut). I have low BP, and since I quit analogs, nearly two months ago, I no longer need the heart meds. My heartbeat is normal now (first time in 37 years--which is how long I smoked) and I'm vaping 36mg-----

I realise that's just my experience, but just noting that I still think dietary habits should be taken into consideration in these studies to know which is actually contributing to vascular clotting-----nicotine, or an unhealthy diet? (I know nic is a vasoconstrictor).

 

[Tom09]

Just found the actual AMA Resolution in this handbook [file size 15 MB] on page 622.

AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES
Resolution: 420 (A-09)
Introduced by: American Association of Public Health Physicians
Subject: Study of Appropriate Use of Electronic Cigarettes in Smoking Cessation Programs
Referred to: Reference Committee D (James L. Milam, MD, Chair)


Whereas, There are over 40 million smokers in the US; and

Whereas, Tobacco use kills 500,000 Americans each year; and

Whereas, The medical community employs numerous protocols, techniques and tools to help
smokers quit tobacco with limited success; and

Whereas, The Electronic Cigarettes provide nicotine only with water vapors, but, do not contain
the approximately 4,000 other chemicals including several proven carcinogens isolated from a
burning cigarette; and

Whereas, The producers and supporters publicize the efficacy and safety of electronic
cigarettes, and are hard at work to convince the FDA and the congressional sponsors of the
FDA/Tobacco bill which is currently pending, to prevent a ban on the marketing and sale of their
product in the US; and

Whereas, Nicotine is addictive and has been implicated in the causation of vascular disease,
oral and gingival disease; and

Whereas, Helping patients quit tobacco use altogether is an ideal strategy that saves lives,
disease and money, it is not always easily accomplished, and harm reduction with smokeless
tobacco products (such as SNUS) and electronic cigarettes is being increasingly promoted,
causing some confusion among physicians who want to do what is best for their patients; and

Whereas, Our AMA has a unique opportunity to look at the available evidence and issue
appropriate guidance to the physicians and this endeavor would be consistent with the AMA's
mission and priorities previously articulated; be it therefore,

RESOLVED, That our American Medical Association Council on Science and Public Health
study the available evidence and develop recommendations for our profession on appropriate
use of electronic cigarettes in smoking cessation programs, with a report back at the 2010
Annual Meeting. (Directive to Take Action)

Fiscal Note: Implement accordingly at estimated staff cost of $3,813.

So, staff cost of $3,813 to collect available evidence and develop recommendations.
Not exactly the framework of an extensive scientific study.
However, AMA did not blindly join the ban waggon pushed by some vocal pressure groups.

 

[TropicalBob]

Thanks for posting the actual resolution. And it's a good one. All the AMA is pledging in the last paragraph is to study the available information and make a recommendation for doctors. No new studies are being initiated.

But this resolution might mean a thorough review of the Health New Zealand study, not yet peer reviewed. If the AMA found merit with that study, we could have an important friend.

As I've said before, doctors are going to be reluctant to recommend any new product like this that has not been studied and passed peer review. We need a group like AMA to lend its expertise. If e-smoking is bad, tell us. If e-smoking helps huge numbers of people quit tobacco products, tell us. If e-smoking can be done indefinitely without deadly consequneces, tell us. We'll take it from there.

I'm only sorry that this will take a year. Do we have a year?

 

[kinabaloo]

You both posted what I was thinking. I don't know how they can keep trotting out this lame excuse with a straight face. I realise alot of the public is gullible, but in reading comments to online articles, I see many people still aren't buying the "for/think of, the children" crap.


I think an honest study of nicotine affects in humans would need to separate nic use and dietary contributions to increased BP, CV problems etc.

I was born with a minor heart problem and had to take meds to slow my rapid heart beat. I don't eat red meats or any animal fats. I also don't eat plant fats that are not good (such as coconut). I have low BP, and since I quit analogs, nearly two months ago, I no longer need the heart meds. My heartbeat is normal now (first time in 37 years--which is how long I smoked) and I'm vaping 36mg-----

I realise that's just my experience, but just noting that I still think dietary habits should be taken into consideration in these studies to know which is actually contributing to vascular clotting-----nicotine, or an unhealthy diet? (I know nic is a vasoconstrictor).

Actually coconut oil is very healthy.

Bad oils are the polyunsaturate oils that have been extracted - extremely easily oxidised.

 

[robbiehatfield]

What makes you think that? Your body can develop a tolerance for nicotine just as it can for practically any other substance you put in it.

True. That's why there are warnings against non-smokers wearing a nicotine patch. (not that they'd want to I imagine..) They have no tolerance whatsoever to nicotine and could get sick, especially from the stronger ones.

Robbie

 

[Zrane]

I've investigated various smoking cessation methods for a while and there are really two factions. The older, more entrenched 'anything even vaguely like smoking is horrible' faction, which seems to have an almost insane 'punish the smokers that we pity' undertone definitely has the majority of power and access, right now.

On the plus side, the newer 'Look, it could be better, but smoking is worse. Doing less harm is better than nothing' camp seems to be gaining momentum and ground. The people shouting the loudest about e-cigs being bad isn't big tobacco, it's the American Lung Association, and the American Cancer association.