Perhaps our failure to see eye-to-eye is rooted in the fact that we are asking different questions in our quest for knowledge. You are asking, "Have electronic cigarettes been proven safe?" My question is "Are electronic cigarettes likely to be less harmful to me than continued smoking?"
I missed the part of your take-home message that "e-cigarettes may well be an excellent product." Apparently, the popular press missed the message as well, since "E-cigarettes do more harm than good" is perpetuating across the web as a headline based on the BBC coverage of your article.
I agree with you that there is no evidence one way or another on the long-term effects on health of the e-cigarette. But we do have a lot more evidence than "unsubstantiated manufacturer's claims" regarding safety of e-cigarettes compared to the safety of continued smoking. And we also have more than manufacturers claims regarding the short-term health effects on users.
An obvious way to compare potential relative safety is to look at the number and quantities of known harmful substances in each of the two alternatives. You reviewed three testing reports. Did any of these reports mention finding tar or particles of ash in the vapor? I am guessing that none of the three labs would have wasted their time and money looking for substances that are created by the process of combustion, in view of the fact that e-cigarettes use the process of vaporization.
Regarding carbon monoxide, Dr. Laugesen actually tested the exhaled CO of human subjects who were inhaling vaporized nicotine from an e-cigarette and compared it to subjects exhaling after smoking tobacco. Apparently you do not have this report, because Dr. Laugesen tells me that the information in your article relies on the limited data from a poster that he presented before the complete report was available. I am attaching a copy of the complete report. You will find the CO information on page 19. Results. The tobacco cigarette boosted CO in exhaled breath by an average of 5 ppm, but did not increase it at all in the non-smoker inhaling from the Ruyan® e-cigarette.
So I stand by my statement regarding the lack of tar, CO, and particulates in e-cigarette vapor. If these are not present, it would be impossible for users or bystanders to be exposed to them, no? But if you fear these might be present, I would be happy to send you a box or two of cartridges so that you may conduct your own tests.
I am very surprised that you failed to mention shortcomings of the FDA test report in your article. You appeared to give it equal weight with the other two test reports. Did you not notice that there were no quantities reported for the "carcinogens" they found? Isn't a quantitative analysis something that should be in a lab report of this type? On page 6 of 8, the report reads, TSNA content is reported as weight of TSNA per weight of nicotine/flavorant cartridge (ng/g). Apparently FDA did conduct the quantitative analysis, but the results expressed as ng/g are nowhere to be found in their report.
Your article made a point of mentioning that HNZs analysis was funded by an e-cigarette manufacturer. If you take into account the fact that the FDA issued their report while they were in the midst of a lawsuit, then they have every bit as much of a vested interest in skewing the results as a manufacturer would, if the manufacturer conducted their own testing in-house, as the FDA did. As it stands, however, the manufacturers have hired qualified outside labs to do their testing.
You do Dr. Laugesen a great disservice when you hint that his scientific findings can be purchased. Dr. Laugesen is a greatly respected, award-winning anti-smoking advocate in New Zealand.
May I suggest that you contact Dr. Westenberger at the FDA and ask him to send you the data on TSNA quantities that were missing from his report. Also, he should be able to supply data on the TSNAs and quantities that are present in the FDA-approved NRT products. I have written and asked him for this information, and he never replied to my letter. Perhaps you will have better luck.
Here is his address:
Westenberger, B.J.
Food and Drug Administration
Division of Pharmaceutical Analysis
1114 Market Street, St. Louis , MO 63101
The Health New Zealand report provided the information for me that the FDA report lacked. Table 2.2 on page 7 specifies the quantities of TSNA's found in each of four levels of nicotine. The comment under the table reads as follows: "Tobacco-specific nitrosamines (TSNAs) were found, equal to 8 ng, in the 1 g of liquid of the 16 mg cartridge. This amount is extremely small, equal for example, to the amount reported to be present in a nicotine medicinal patch. (8 ng in 1g = eight parts per trillion)."
So, even though I do not have any clinical trials to back up my conclusion, logic tells me that if the type and quantity of carcinogens in both are equal, then it follows that there is no evidence the e-cigarette is any more likely to cause cancer than a nicotine patch. And again, with only logic as my guide, I have concluded that cigarette smoke, with 5,500 to 11,000 ng/g in a days supply, would be a lot more likely to cause cancer than either an e-cigarette or a nicotine patch. Im not saying this is absolute proof that smoking is more dangerous than inhaling vaporized nicotine, mind you. I am saying it gives most folks sufficient evidence to make a rational decision about which of the two alternatives might present a greater danger to their health.
Finally, we come to your assertion there is absolutely no knowledge of its health effects in animals or humans. I have very personal knowledge of its health effect on one humanme. I used to lie in bed at night, listening to myself wheeze. Sometimes the wheezing woke up me in the middle of the night. I used to pray that God would send me something that would allow me to stop smoking without requiring me to sacrifice my cognitive and emotional healthas happened when I went the nicotine abstinence route.
Guess what! No more wheezing. The productive cough is gone. I can actually laugh out loud now, without being interrupted by a coughing fit. My BP is improved (117/79), and my cholesterol numbers have changed: HDL is up by 4 points and LDL is down by 1. So where you see a potential menace, I see measurable evidence of a personal miracle.
I believe that it would be monumentally stupid on my part to go back to inhaling tobacco smoke while I wait around hoping that FDA will put its stamp of approval on the e-cigarette. And I also believe that it is monumentally stupid for smokers to continue inhaling smoke, when vaporized nicotine contains so many fewer toxic and carcinogenic substances and thousands and thousands of e-cigarette users who have stopped (or even just reduced) smoking are reporting improved health.
Smoking kills. Smokers dont have time to wait around for absolute proof that e-cigarettes are safer than smoking. Just as there is no convincing evidence yet that e-cigarettes are safe, there is no convincing evidence that they are as unsafe as tobacco smoking. Urging smokers to wait and see will prove to be a death sentence for many. It has been estimated that just one more month of continued smoking presents more danger to health than switching to Swedish snus and continuing to use it for the rest of ones life.
I would welcome clinical trials, but I believe, given what we do know about the subject, that it would be unethical and immoral to make completion of these trials a prerequisite for allowing smokers to choose e-cigarettes as an alternative.
I suspect that when all the evidence is in, we will find out that e-cigarettes are an alternative that reduces harm even more than Swedish snus. That is, if the evidence is ever allowed to be gathered. There are organizations that just want this product to go away.
"An electronic cigarette would have to be SO toxic to even come close to what cigarettes do to you ..." Dr. Dean Edell
