FDA may soon propose regulation that could ban many/most e-cigarette products, eliminate many/most companies

[Lisa Belle]

I meant to also add: Medical insurance Companies...... You know, they raise rates for smokers, and they don't want to lower them for vapers? We are fighting corporate greed and it's intrinsically linked to every fiber of this economy and government, forget big BIG government. It's BIG corporations. I agree we need less government in the wrong place and not in the right places, it's a crazy mixed up world, except in the balance sheets of investors and share holders. The fact that what we do when we vape and how we vocally love it so much, the fact that we seem to be growing and businesses are everywhere opening vaping stores, and TV ads, with cigarette sales declining, these are the red flags to the money markets. Plus, healthcare professionals, pulmonary specialists, respiratory specialists, more people have found work in these fields than any others and without sick patients, it could really upset an economy based on America's health issues. Think of all those student loans, people need to pay off, should they go back to school and get out of healthcare, what could they do in this economy instead of healthcare??? I will pray for a miracle and for every wink of approval, there are many who take pleasure in ridiculing, ostracizing and pigeon holing, just plain knocking nicotine addicts. It's the new designer drug don't we all know?

 

[kristin]

This is my first time in this section of the forum. I"ve been vaping since the beginning of May and this is my new addiction. I've got several thoughts of what actually might happen and what we should be doing. First, I'm not sure that the FDA has the legal authority to ban personal vaping devices (note I'm not saying "e-cigarettes". This is because the devices don't require nicotine to work. All of the other components of e-juice (PG, VG and flavorings) aren't drugs per se, and as such the FDA probably can't outlaw them. Consider the fact that we've had a war on drugs for over 30 years now, but you can still go into certain shops and buy bongs, water pipes, hookahs, etc. I'm more concerned on them locking down access to nicotine. What we need to be doing as a community is distancing outselves from the whole idea of cigarettes in general. I don't "smoke" an e-cigarette; I don't use "e-cigs" at all. I have a PVD (personal vaping device), which produces water vapor, not smoke. Comparing that to smoking is like comparing coffee to 5-hour energy drinks; they both contain caffeine, but the similarities end there. I try to make this point clear to anybody I can talk to about this; what I do has nothing to do with smoking, tobacco, or any related products. My device looks nothing like a cigarette, cigar or any other smoking product. We need to get this message out to our lawmakers and other powers that be. Every body in the medical community that I've talked to is thrilled with the idea of a viable alternative to smoking; we should attempt to get the AMA on board as well.

First point - you can't "distance" e-cigarette from smoking, because they LOOK like you are smoking. The ANTZ want to continue the de-normalization of smoking. So, unless you eliminate the vapor, the nicotine, tasty flavors and any resemblance to smoking, AND prove that even nicotine-free vapor is 100% harmless, there will continue be HUGE opposition from the ANTZ. It doesn't matter one iota WHAT you call them. In their mind, if it looks like a duck (even if it's really a rare goose) then it's a duck. Besides, if the market is going to continue to attract smokers, they will never call them "personal vaping devices" or make starter kits look or taste too different from cigarettes. The vast majority of smokers who try e-cigarettes for the first time are looking for something that "looks and tastes" like their brand.

Second - the AMA has already come out firmly AGAINST e-cigarettes: AMA: Electronic Cigarettes Are Drug Delivery Devices and Should Be Subject to FDA Regulations

"American Medical Association (AMA) recommends that electronic cigarettes (e-cigarettes) be classified as drug delivery devices, subject to the same FDA regulations as all other drug delivery devices. Additional policy adopted supports prohibiting the sale of e-cigarettes that are not FDA approved."

 

[DC2]

Simply this isn't about right and wrong it's only about profits. I am writing letters anyway, as CASAA.ORG asks us all to do. In my heart of hearts, I hope it might do some good.

It HAS been doing some good.
In fact it has been doing a LOT of good.

We have won far more battles than we have lost, and nobody is doing it for us.
It is our letters, phone calls, and personal appearances that have made huge differences around the country.

Of course, what we really need is a lot more vapers doing what you are doing.

 

[Vocalek]

DC is correct. See: Successful CASAA Campaigns

 

[DaveP]

Fat and sugar probably contribute to personal harm much more than the products being attacked. There will come a time when fast food outlets will find it difficult to continue selling comfort foods under the new regulations. A good steak may be too costly to consider in the future if we continue to legislate personal preference.

I favor legislation across the board for all harmful substances. Get rid of fast food, sugar laced products, and autos that emit harmful gases. Outlaw natural gas, electricity, and burning of carbon based fuels. Once America comes to a complete standstill, the people will change the administration and be extremely careful about who they elect and life will be reasonably comfortable again. We get what we allow from our elected officials.

I'd love to see people in the streets with signs that say, "Give me back my Big Mac and my chocolate shake!!!" and "I hate my tiny electric car!!!".

Outlaw limousines and you'll get the attention of lawmakers.

 

[JD4x4]

The good news is that health care providers who have a stake in healthy insurance plan members (HMO's) may be more receptive to harm reduction.

For example Kaiser Permanente in the U.S. is taking a cautious but positive view (ref:here).

 

[TennDave]

The good news is that health care providers who have a stake in healthy insurance plan members (HMO's) may be more receptive to harm reduction.

For example Kaiser Permanente in the U.S. is taking a cautious but positive view (ref:here).

"The cartridges contain different levels of nicotine. So in theory, you could lower the nicotine levels over time until you no longer crave nicotine. This is why some people use them as aids to quitting smoking."

Yes, more positive, but from the above, they still don't see that e-cig use is not smoking...

 

[Lisa Belle]

Thanks for the good news. We need some hope.

 

[JD4x4]

"The cartridges contain different levels of nicotine. So in theory, you could lower the nicotine levels over time until you no longer crave nicotine. This is why some people use them as aids to quitting smoking."

Yes, more positive, but from the above, they still don't see that e-cig use is not smoking...

On the contrary, imo. From the same page:
"Since most of the harm from smoking is not from nicotine but from other things in tobacco, e-cigarettes may be safer than real cigarettes. But more research is needed before experts can say for sure."

A fair position and one I would expect from a health professional. NOT the same position as I've seen from the FDA, many other health organizations, or legislators. I'll take what I can get and try to build upon it for the better.

 

[Vocalek]

I had to log in to the Kaiser site to get to the document. Here are the salient points in print format.

Topic Overview

Electronic cigarettes are battery-powered devices that turn liquid nicotine into a vapor that you inhale. Many of them are made to look like real cigarettes. Some even have a light at the end that glows when you inhale.

For smokers, electronic cigarettes may satisfy nicotine cravings. They can be used in nonsmoking areas. And they may have less of the harmful chemicals that are in cigarette smoke. These cigarettes are often called e-cigarettes.

[snipped part that describes what an electronic cigarette is]

Are e-cigarettes safe?

Since most of the harm from smoking is not from nicotine but from other things in tobacco, e-cigarettes may be safer than real cigarettes. But more research is needed before experts can say for sure.

The cartridges contain different levels of nicotine. So in theory, you could lower the nicotine levels over time until you no longer crave nicotine. This is why some people use them as aids to quitting smoking.

If you are thinking about using e-cigarettes to help you quit smoking, talk to your doctor first.

[snip]

References

Other Works Consulted

Flouris AD, Oikonomou DN (2010). Electronic cigarettes: Miracle or menace? BMJ, 340: c311.

Yamin CK, et al. (2010). E-cigarettes: A rapidly growing Internet phenomenon. Annals of Internal Medicine, 153(9): 607–609.

Credits for Electronic Cigarettes

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD, MD - Family Medicine
Specialist Medical Reviewer John Hughes, MD - Psychiatry
Last Revised July 6, 2011

I'll have to see if I can send Kaiser more references. Their list of references is quite limited, given the growing volume of scientific research on the topic.

I wondered whether this "Specialist Medical Reviewer, John Hughes" is the same one that I met at the SRNT conference. It turns out that he is.

John R. Hughes, MD - Addiction Psychiatry

Dr. John R. Hughes reviews medical content for Healthwise, a nonprofit organization with a mission to help people make better health decisions. His major clinical research focuses include nicotine dependence, human behavioral pharmacology of drug abuse, and alcohol and drug abuse. Dr. Hughes received the Ove Ferno Award for research in nicotine dependence and the Alton Ochsner Award Relating Smoking and Health. He is a cofounder and past president of the Society for Research on Nicotine and Tobacco and the Association for the Treatment of Tobacco Use and Dependence. He has written over 350 publications on nicotine and other drug dependencies and is one of the 25 most-cited tobacco scientists. Dr. Hughes has been a consultant on tobacco policy to the World Health Organization, the U.S. Food and Drug Administration, and the White House.

Nicotine withdrawal versus other drug withdrawal syndromes: similarities and dissimilarities - HUGHES - 2006 - Addiction - Wiley Online Library
Smoking and Dependence
Faculty and Staff : Department of Psychology : University of Vermont

 

[DC2]

I wondered whether this John Hughes is the same one that I met at the SRNT conference. It turns out that he is.

So what was your impression of him?

 

[Lisa Belle]

It would be great if Dr. Hughes would confirm that e-cigarettes are a proven to be safer alternative, and join with us in trying to sway the FDA away from removing our choice of products and how we use them.

 

[Lisa Belle]

It would be great if Dr. Hughes would confirm that e-cigarettes are already proven to be safer and preferred alternative, and join with us in trying to sway the FDA away from removing our choice of products and how we use them. Would he be willing to go that far?

 

[Vocalek]

It would be great if Dr. Hughes would confirm that e-cigarettes are already proven to be safer and preferred alternative, and join with us in trying to sway the FDA away from removing our choice of products and how we use them. Would he be willing to go that far?

I doubt that he would be willing to go that far at this point. He would probably want to see more studies that test this hypothesis. The strongest evidence we have at this point are the surveys of users, but RCTs (randomized placebo-controlled trials) carry a lot more weight in the medical community. So far, we only have Dr. Riccardo Polosa's one pilot study that used 40 subjects. Dr. Polosa has completed a larger study, but the results won't be published for a few more months.

I see as hopeful signs the fact that he understands that nicotine dependence is not just like addiction to mind-bending drugs and the fact that he kept the Kaiser discussion objective without bringing in the usual accusations about carcinogens and toxins. However, in the past he has not been at all supportive.

Bill Godshall had this to say about him:

Hughes fully understood that e-cigarettes were being used as a replacement for cigarettes when he (and many other drug industry funded smoking cessation researchers, programs and promoters) urged the FDA to ban sales of e-cigarettes several years ago.

For the past 20 years, drug companies have paid John Hughes to research and promote NRT as the most effective way to quit smoking.

In this recent article, however, his view of NRT seems to be that effectiveness is an open issue and could go either way.
Effectiveness of over-the-counter nicotine ... [Nicotine Tob Res. 2011] - PubMed - NCBI

He may be moving in our direction, but I would not say that he is definitely there yet.

 

[Lisa Belle]

virstasch (.......ized Yiddish for I understand)

 

[JD4x4]

..
I see as hopeful signs the fact that he understands that nicotine dependence is not just like addiction to mind-bending drugs and the fact that he kept the Kaiser discussion objective without bringing in the usual accusations about carcinogens and toxins. However, in the past he has not been at all supportive.

Bill Godshall had this to say about him:

Hughes fully understood that e-cigarettes were being used as a replacement for cigarettes when he (and many other drug industry funded smoking cessation researchers, programs and promoters) urged the FDA to ban sales of e-cigarettes several years ago.

For the past 20 years, drug companies have paid John Hughes to research and promote NRT as the most effective way to quit smoking.

In this recent article, however, his view of NRT seems to be that effectiveness is an open issue and could go either way.
Effectiveness of over-the-counter nicotine ... [Nicotine Tob Res. 2011] - PubMed - NCBI

He may be moving in our direction, but I would not say that he is definitely there yet.

All I'd ask to see/hear from anyone is unbiased truth as they understand it, and a strong leaning toward the principle of individual liberties.

 

[Lisa Belle]

ME TWO AND ME THREE! JD4x4

 

[Bill Godshall]

Since drug companies have provided most of John Hughes' pay for the past 15 years (to promote NRT products as the only effective way to quit smoking), I don't expect Hughes to endorse e-cigarettes.

And as I recall, Hughes was/is very actively involved with a drug industry funded smoking cessation program provider trade association that urged the FDA to ban e-cigarettes in 2009.

 

[sandybeach]

Bill, so where are we at on this? I'm confused by everything I am reading.
Sandy

 

[Lisa Belle]

We all are wondering. The posts previous, are still correct too, especially about, our need to be vocal and pro-active in regards to our experiences with vaping. We can write to legislatures, even if it seems futile. What else can we do. The cards of money and power are stacked against this new freedom. Unless, some miracle happens our days of usage with affordability, and DYI-ing our mixtures are numbered.