CASAA submits letter to Surgeons General of the Armed Forces

[Territoo]

In response to the anti-ecigarette ads being run by AFN, I submitted the following letter to the Surgeon General of each branch of the Armed Forces.

The Armed Forces Network (AFN) has been warning servicemen and women about the “dangers” of the electronic cigarette. As medical director for the Consumer Advocates for Smoke-Free Alternatives Association (CASAA), I am compelled to write this letter to inform you of the facts concerning the electronic cigarette. The AFN ads appear to be relying upon the FDA’s July 2009 press release, rather than the actual lab results.

E-Cigarettes Are Not Toxic

Regarding the non-vaporized liquid, the FDA’s lab report states: “tobacco specific nitrosamines and tobacco specific impurities were detected in both products at very low levels. Diethylene Glycol was detected in one sample (Smoking Everywhere 555 High cartridge) at approximately 1%.” (http://www.fda.gov/downloads/Drugs/ScienceResearch/UCM173250.pdf) A common use for DEG is as a humectant, to keep tobacco moist; therefore, given that the nicotine in the cartridges was extracted from tobacco, finding trace amounts of DEG would not be surprising. Characterizing non-toxic amount of diethylene glycol (DEG) as “antifreeze” in its press release was disingenuous on the part of the FDA.

CASAA has gathered a collection of lab reports on several brands of e-cigarettes. (CASAA.org) The FDA’s finding of trace amounts of DEG has not been repeated in any other testing. The FDA findings on the vaporized product are as follows: “Nicotine was detected in both products for all cartridges containing low, medium and high levels of nicotine but was not observed in cartridges identified as containing no nicotine. Screening for the possible tobacco specific impurities cotinine, nicotine-N-oxide, nornicotine, anabasine and myosmine was negative.”

In October 2008, Dr. Murray Laugesen of Health New Zealand tested the Ruyan brand of e-cigarette. His report concludes, “Ruyan® e-cigarette is designed to be a safe alternative to smoking. The various test results confirm this is the case. It is very safe relative to cigarettes, and also safe in absolute terms on all measurements we have applied.” http://www.healthnz.co.nz/RuyanCartr...t30-Oct-08.pdf

E-Cigarettes Are Not Carcinogenic

You will not find the phrase “cancer-causing” or “carcinogen” anywhere in the FDA’s official lab report. The reason for this is that the same tobacco specific nitrosamines (TSNAs) identified in some e-cigarette cartridges are also found in FDA-approved nicotine patches and nicotine gum, in roughly equivalent quantities (8 ng). [See “Comment 1” on page 7 of the Health New Zealand report cited above.] This quantity is too small to be considered carcinogenic, which is why the FDA nicotine products do not carry a health warning on their packages about cancer.

Sottera, Inc commissioned a study to determine the presence of TSNAs in the vapor of its NJOY product. The results of the study were further verified by an independent research lab. The report concludes, “There is no evidence that carcinogenic TSNAs are present in the aerosol from NJOY electronic



cigarettes. Thus, it is my conclusion that the TSNAs do not pose a health risk to the users of the electronic cigarettes distributed by NJOY.” http://www.casaa.org/files/Study_TSNAs_in_NJOY_Vapor.pdf

E-Cigarette Effect On Human Health

Switching from smoking to any smoke-free form of nicotine has positive effects on health. Gartner, et al found “There was little difference in health-adjusted life expectancy between smokers who quit all tobacco and smokers who switch to snus.” Assessment of Swedish snus for tobacco harm reduct... [Lancet. 2007] - PubMed result

It is estimated that there are at least a half million former smokers in the U.S. who became smoke-free by using an electronic cigarette. In one survey, 63% of respondents were former smokers thanks to electronic cigarettes, “Positive effects reported with e-cigarettes included their usefulness to quit smoking, and the benefits of abstinence from smoking (less coughing, improved breathing, and better physical fitness).” (PubMed home) In another survey, 79% were using an electronic cigarette as a complete replacement for all their smoked cigarettes. Over 90% of respondents stated their health had improved. http://tobaccoharmreduction.org/wpapers/011v1.pdf

E-Cigarette Vapor versus Tobacco Smoke

Although smoking accounts for only 80% of all tobacco use, it is responsible for 98% of the tobacco-related disease and death. Tobacco smoke contains tar, carbon monoxide, particles of ash, and thousands of other chemical compounds created by burning the tobacco and paper. E-cigarette vapor does not contain any of these harmful substances, because nothing is set on fire and burned.

Exposing Former Smokers to Smoke

There is no scientific evidence that the exhaled vapor could be harmful bystanders. Health New Zealand’s report (previously cited) stated, “Lacking any active ingredient or any gaseous products of combustion, the PG mist or ‘smoke’ is not harmful to bystanders. The ‘smoke’ or mist is not tobacco smoke, and not from combustion – no flame is lit – and is not defined as environmental tobacco smoke.”

There is no evidence that justifies sending former smokers to the smoking area whenever they want to use an electronic cigarette. People who are using Nicorette gum or lozenges, a Nicotrol inhaler, or Swedish snus to remain smoke-free are not banished to the smoking section to use their products.

Summary

There is a growing body of scientific evidence showing that switching from smoking to an e-cigarette results in improved health and does not endanger the health of either the user or bystanders. There is no scientific evidence supporting the contention that e-cigarettes present any danger to the health of users or bystanders. A press release does not constitute scientific evidence.

I leave you with this thought from Dr. Michael Siegel, Professor at Boston University School of Public Health:
“We in tobacco control should be trying to do everything we can to help smokers quit. Thus, we should be embracing electronic cigarettes rather than putting obstacles in the way of people using this product. The best way to reduce secondhand smoke exposure is to reduce cigarette smoking. Encouraging smokers to quit is the best thing we can do to reduce secondhand smoke, and the use of e-cigarettes to quit smoking seems to be a very effective and popular strategy.” The Rest of the Story: Tobacco News Analysis and Commentary

Please contact me if you need any further information.




Theresa Whitt, M.D. (twhitt@casaa.org)

 

[rons29445]

Thank You!

 

[GoodDog]

Great letter! Thank you so much for everything you do!

 

[Upinthehills]

Very well written. I'm impressed. Thank you!

 

[BCB]

Yes, thank you. Keep us informed if you get any responses. (Actually, keep us informed if you don't--that is also sending us a message, isn't it?)

 

[Rothman]

Rock on!! Thanks.

 

[laurel099]

Thank you!! Great letter and I appreciate your time in writing/sending it

 

[jj2]

Just another thank you.

 

[jtcaseyjr]

Great letter! Hope to see a positive response.

 

[Bustastew]

Well done Territoo!

 

[JerryRM]

Very nice Terri, let's hope that they don't ignore the facts and continue to rely on the FDA's report.

 

[Bustastew]

I just hope they each read this, more often then not they probably have people read and filter their mail for them...

 

[coralie]

This is a great letter. Thank you for taking the time to write and send it.

 

[thephoenix]

Great work! thanks for keeping the truth alive.

 

[clark8876]

Though far away, thank you for all you do. Your actions will have an effect on the international outcomes of this debate.

You have my support.

Oh...and Happy New Year to you all!!!!

 

[Rosco]

Outstandingly accurate and informative, that's what CASAA emulates.
I am grateful CASAA is fighting for our rights - worldwide. As individuals, we must also do all we can to educate humanity.

Thank you CASAA.