Association for the Treatment of Tobacco Use and Dependence Supports the FDA Ban of 'Electronic' Cigarettes

[Wally]

Hi John.... welcome to the forum.

It appears, they want us to totally quit... or keep smoking tobacco. There is no middle ground whatsoever. We have had conversations with several groups and they all believe that if it isn't tobacco cigarettes, it should be FDA regulated smoking cessation device. Sad isn't it?

Lacey,

I'm really asking a question here, in hopes that it will help clarify ECA policy and approaches or help me clarify my misunderstandings.

I agree that there are many people in public health that want us to just quit both tobacco and nicotine (the abstinence people, who are in the mainstream of public health in the U.S.). Although the actual result of banning the e-cig might be that many of us would return to tobacco, I don't think that is their actual intent--even if they know that would happen. Their position would be that we always have the option of quitting and that is what they want. (Incidentally, I think that what will actually happen for many of us is that we will continue to import nicotine illegally and use it and that the FDA both knows that and tacitly condones it.) I make the distinction between what will happen and "what they want us" to do because the statement that they want us to smoke tobacco will seem ludicrous to them, to legislators and to the public at large.

The related question here, and I guess the real one, is what do we want them to do? If the e-cig is to be sold as a cessation device, it will obvious have to go throught a standard series of trials like anything else that makes a medical claim. If the e-cig is to be sold as a nicotine delivery device it will have to go through the same studies unless we feel it should somehow be grandfathered in with tobacco. All forms of nicotine other than tobacco are, in fact, regulated by the FDA. The e-cig seems novel enough to me that I can't imagine it being treated as tobacco.

So, my question is, what are we hoping for? I'd like to see the FDA just take a hike on this and leave us alone, but that isn't what's going to happen. So what do we want from them? As an example, one possibility would be special waivers as were granted for the early HIV anti-virals. They skipped over certain study requirements because the consequences of not using an antiviral were so dire and there were no other alternatives for infected people. That would require convincing the FDA that people who "cannot" stop smoking are comparable to people with HIV infection. But there are certainly other ideas like this, including claims for the e-cig as a special case because the tobacco cigarette is a special case and the basic science suggests that e-cig is very likely to be safer than the other.

Perhaps this is not quite the forum for this question, but I am trying to understand the conceptual issues. To put my questions in perspective, let me say that I have smoked tobacco for decades, very seriously tried to stop a number of times and am now, for the first time in my life, completely content without tobacco. I will use an e-cig if it is at all possible to do so and regardless of the law.

Thanks,
Wally

 

[RsL]

Realistically, there is nothing you or any average citizen could say to change their stance.

Face the fact that the e-cig is not going to have universal approval. Even with the general public. But with groups like this one, it has no chance at all. They are tied too closely to companies that would benefit from an e-cig ban. Words of praise are a waste -- like telling your enemy the war is unjust, so throw down the arms. Fat chance.

So are you suggesting that we vapors do nothing at all? I guess I just don't share your pessimism. You sure can't win a battle if you don't even choose to fight it. I don't agree that the general public won't accept them. I've already seen signs of the general public accepting it with my experience vaping in bars, etc. Also remember that part of that 'general public' are our wives/husbands/children/friends, and here again, everyone I know is thrilled that I'm not smoking analogs anymore and that I'm vaping instead.

Your are right that groups like this one are closely tied to companies that would benefit by an e-smoking ban. But these groups aren't going to have the final say in whether that ban happens...

 

[Oldnamenomore]

Glad you were able to stop smoking regardless of how. Keep up the good work and best of luck.
-Matt

their response

 

[gep]

Glad you were able to stop smoking regardless of how. Keep up the good work and best of luck.
-Matt

their response

Well, he's just a paid mouthpiece for them, so I'm not surprised at his response.

If you check their website you too can send out a press release for a mere $399!

 

[Bryn]

We are The Proof that e-cigarettes are working out well for us. Our health is improving.

Well, I for one am not going to back down.

Pffffffft!

 

[LaceyUnderall]

Wally -

Loaded question and I will do my best to answer. This is my opinion and the last I knew, I was on the same page as the ECA. Now, please keep in mind that Policy Impact may have to take an interesting route to get where we need to be based on the political playground in which they must play... However, with that said:

The first step is to lobby Congress to add amendments to the Kennedy bill. These amendments would help to keep the ecig from being pulled from the market. There is no way we can get them to wipe out the entire bill, so we have to focus on getting amendments made. That's the next step.

The ultimate goal for our ecigs is to be a self-regulated industry with the guidance and knowledge from the FDA to help us determine a: the third party who will be investigating possible manufacturers as "preferred manufacturers" so that suppliers can sell products from a wide list of manufacturers who uphold certain safety standards and b: what those safety standards should be.

From there, suppliers, depending on their specific countries laws, would be required not to make any health claims or cessation claims. Proper labeling and bottling will occur on the manufacturers level, so hopefully, that will reduce some of the stress on the suppliers.

Tobacco cigarettes are protected and any other form of nicotine delivery must go through this almost impossible process to gain a place in the market. Thus far, all other forms of nicotine have been presented by companies who wish to make certain health and cessation claims. The other issue is that for the first time, non-pharmaceutical companies have brought a nicotine product to the market. Now, NicoWater was brought to the market by a non-pharm but they did attempt to go through the proper channels, but the anti-smoking lobby ended that. (The failure here was also that it was put in the water cooler next to regular bottled water and frankly, that was a huge mistake. It should have been behind the counter.)

Now, you mentioned getting the ecig grandfathered in with tobacco and this is an option, and not as a tobacco product, but grandfathered in reference to time. One thing that has been noted is that this tobacco bill has made it's appearance on several occasions and until now, the date has changed, until this round. So it is possible that another avenue we could take if we cannot get amendments added is to request the Feb 2007 date be changed to the signing of the bill into law.

I would love to lay everything out on the table for everyone. Heck, I would love to have it all laid out for me, but the problem is that every day this changes. I know that one path was being looked at and then SE presented a lawsuit and that changed everything. The Waxman bill is now on the side lines while the Kennedy bill is presented. This changes everything. One good thing about the Kennedy bill is that there is supposedly a quick process allotted for less harmful tobacco products which the ecig may or may not fall into, but no-one knows for sure because the wording of the bill is not public yet. S.982 Search Results - THOMAS (Library of Congress)

This goes so deep. So deep. It crosses over an industry line, across the Atlantic, back again, through some very old and well established anti-smoking lobbies, through a few pharmaceutical waiting rooms and a lot of different groups are absolutely ...... about the ecig. There was almost a complete demonization of smoking and there was a hopeful but false perception that the habit of smoking would be eradicated shortly.

I don't know if I was able to answer your question, and I certainly apologize if I raised more . This is such a confusing time and there really is no crystal path to follow. The only thing I can tell you is that I have confidence that those who have been solicited to take our cause to the Hill are working hard for us. Anything we (as the small beings in this matter) can do is no matter how small we think a phone call is or the signing of a petition, it is all greatly needed and with all of the groups and propaganda that has built a nearly impossible wall to climb, we have to at least know in the final hour, we have done everything we possibly could.

 

[Wally]

Lacey,

Thank you for this response. I am digesting it. The phrase applied to HIV meds by the FDA was "fast track," as in "X is going to be fast tracked because of the need for it."

Wally

 

[iiimathman24iii]

thanks for all this info lacey really cleared up a few things that were very foggy for me on the ECA...

 

[Wally]

Realistically, there is nothing you or any average citizen could say to change their stance.

Face the fact that the e-cig is not going to have universal approval. Even with the general public. But with groups like this one, it has no chance at all. They are tied too closely to companies that would benefit from an e-cig ban. Words of praise are a waste -- like telling your enemy the war is unjust, so throw down the arms. Fat chance.

TBob-

I think you may be overestimating the unity of a group like ATTUD. I spoke with three members today and two were quite opposed to the PR on the e-cig and, I thought, fairly well informed about the issues. I left messages for another two. Whether the two dissenters from today are willing or able to put an effort into influencing the organizational policy is quite another thing. All three that I actually spoke to asked that I not use their names or quote our conversations because they "don't speak for the group." There are clinicians out there who really do have the patient's and public's welfare in mind. By in large they're not making policy though. ATTUD is a guild group, or an attempt at one. Pretty soon we'll have gastroenterologists and tobacologists and the latter will be getting insurance reimbursement too.

Wally

 

[Letzin Hale]

Anyone want to wager where this group gets funding? This PR crap smacks of Big Pharmaceutical. "Buy our 'proven' treatments." Your failures, you mean.

But that sure is an impressive title, don't you think? First I've ever heard of them.

No surprises Bob as they need their product to have a crappy success rate otherwise everyone would give up and stop buying. Now we have another prong with which to attack them, we can throw down the gauntlet in public and let the media know that Big T and Big P are running scared. If there is enough crap thrown in their direction then some will inevitably stick. I'm with gep and I think it is propaganda at the moment that will steer this argument.

They might believe that their 'respectable protests' will win the day but it's a gamble that could well backfire as there is greater freedom of information, demands for transparency and, of course, the media-fed public hunger for controversy, especially when it involves Government or big business.
In the Blue corner I give you the humble David and in the red corner, some big fat arrogant ba***rd who says you are all stupid!
We have to publicly acknowledge that tests are still ongoing and will take time, but we are determined that the people who need it most are not denied their basic right to choose. Big T&P are scared, not for the safety of the public, but for the safety of their profits from products that have a high fail rate or are known killers and they get angry when Mr Good Guy turns up with something that works and that, from tests so far, is far safer than the legalised killer that is condoned by the FDA and therefore the US Government.
If Big P really thinks that NRT works then let's have a head to head.
How many more must die from smoking Tobacco before the Government stops condoning it?
For us, this is about our health and our freedom, not about greed and profit.

Alan.

 

[Letzin Hale]

TBob-

I spoke with three members (of ATTUD) today and two were quite opposed to the (negative) PR on the e-cig and, I thought, fairly well informed about the issues. Whether the two dissenters from today are willing or able to put an effort into influencing the organizational policy is quite another thing. All three that I actually spoke to asked that I not use their names or quote our conversations because they "don't speak for the group."
Wally

Just the kind of fuel required:
"ATTUD dissenters scared to speak out".
Don't give up, go public!
Thanks Wally.

Alan.

 

[Letzin Hale]

I disagree with your approach there. Making accusations about funding and making comments about him thinking about health instead of money, is NOT going to help matters! You may be right about that and venting on this forum is fine. But when we write letters and send emails we should be telling them about the BENEFITS of vaping. IE: We should be talking about what vaping has done for us personally. How we don't hack our lungs up anymore each morning, how we sleep better, how we have more energy and how that extra energy is getting us up off our asses and exercising, etc.

That's the way to approach this. We need to talk about how e-cigs have improved our lives and health!

.....and ask searching questions that require (quotable) answers.
Alan.

 

[Smokingfreely]

While I certainly agree that official sounding groups chiming in in favor of the ban is bad for us, had anyone heard of this group before? Does anyone really care what they think? Now granted, some reporters start citing them as another group of "established experts" (whoops, excuse me) the "Premier group of established experts" that will be a problem. For now, I'd say the general public doesn't give a rat's ... what some group they've never heard of thinks... Just my two cents.

 

[prr2freya]

"As tobacco treatment professionals we are concerned that smokers desperate to quit will place their faith in unproven therapies," said John Hughes, MD, President-elect of ATTUD and professor of psychiatry at the University of Vermont College of Medicine. "Money spent on unproven treatments is money unavailable for proven, FDA-approved treatments,"

Money spent is MY money to spend as I see fit. Proven FDA-approved treatments?? 5% success rate... yeah...8-o

 

[prototype7]

Let's see... horrible chantix side effects... gum that tastes like you're sucking on pepper... patches that, lets be honest, do nothing but give you something to fidget with all day...
Why don't they go after chewing gum and candy manufacturers since people use those to try and quit all the time?!
Cause it's stealing money away from the death companies that's why!
I've used patches... made me nervous and angry after only 2 days... gum, got half a pack unchewed because it is SOOOO nasty!
I use the ecig and I'm down to half my cig intake after just one week... how can you argue with that?!
Oh I'm sure they're just worried about our well being!

 

[LaceyUnderall]

Lacey,

Thank you for this response. I am digesting it. The phrase applied to HIV meds by the FDA was "fast track," as in "X is going to be fast tracked because of the need for it."

Wally

Wally,

Very reasonable argument to be had on our side. I certainly would be affected if I had to go back to tobacco. I have forwarded that onto the ECA. (I forward every idea on... hey... at this point no stone left unturned).

And noticing in your discussion with TB you talked to the ATTUD and the clinicians don't see it the way these other reps did, this is appearing to be a not-uncommon thing happening. The FDA scientists went through this recently, stating that the managers were ignoring the science. This is interesting.

 

[LaceyUnderall]

While I certainly agree that official sounding groups chiming in in favor of the ban is bad for us, had anyone heard of this group before? Does anyone really care what they think? Now granted, some reporters start citing them as another group of "established experts" (whoops, excuse me) the "Premier group of established experts" that will be a problem. For now, I'd say the general public doesn't give a rat's ... what some group they've never heard of thinks... Just my two cents.

This is a great point. Another thing to consider is that even though Sen. Lautenburg's coming out party against the ecig seemed to be a bad thing, look at who it did bring out in favor! The American Physicians Dr. Nitkin, David Sweanor, the Congressman eSmokers...

If Wally can keep pressing these guys to step up and do right and speak out against the pharm naysayers... this could be very good. It will be a tough job for Wally... but I have a bottle or two of juice that says he can do it

 

[entropic]

oh yeah the awesome approved treatments which have about a 40% success rate. E-cigs have near 100%. Ignorant corrupt luddites.

 

[Angela]

oh yeah the awesome approved treatments which have about a 40% success rate. E-cigs have near 100%. Ignorant corrupt luddites.

Not intended as a dig, but plucking figures out from thin air won't help matters. Someone else will read that, take it as truth and quote it somewhere else, and they will...... etc etc etc

 

[sherid]

Smokers took a back seat and meekly accepted smoking bans and taxes without a whimper. E smokers cannot allow that to happen if they wish to continue vaping. It is time to stop playing nice nice and become ACTIVISTS. Look at the strategy guide developed by RWJF for anti smokers and use their methods to fight back.
Tobacco Control Strategy Planning - Guide 1