German report form DR Bernd Mayer

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Appraisal over the pharmacology and toxicology one Electrical cigarette to the smoker curing O. Univ. - Professor Dr. Bernd Mayer Institut for pharmaceutical sciences Pharmacology and toxicology Karl Franzens university Graz, university University of 2 A-8010 Graz, Austria Assigned of: Renatus Derler Utschgraben 79 A-8600 Oberaich Austria Background Mr. Renatus Derler plans the introduction of one " Electrical cigarette to Raucherentwöhnung" (Patent specification EP1618803) in the European market and has , an appraisal asks me over the healthwise relevant aspects of this To provide product. In the context of my technical authority I become in the following companies who can be expected and toxicological effects the product judge. Free market and juridische aspects withdraw themselves and remain unconsidered for my authority from there. Operational principle The substantial components " Electrical Zigarette" are with nicotine solution of soaked filters and an electrical atomizer to the electricalthermal Evaporation of the nicotine solution. Condensed steam becomes over a mouthpiece inhaliert, whereby the process of smoking is simulated. The technical details and the structure of the electrical cigarette are in the godfather writing EP1618803 described in detail. B. Mayer - appraisal electrical Zigarette/2 Composition of the nicotine solutions According to patent specification EP1618803 four with differently concentrated become Nicotine solutions soaked filters offered. In the highest dosage those contains electricalthermally solution evaporated 6% nicotine, in the lowest dosage 0,1%. As additive the solutions 80 contain - 90% propylene glycol (1,2-Propandiol). In addition the solutions/toxicological negligible contain companies Quantities (! 5%) at taste materials and Antioxidantien. As quantitatively relevant inhalierte ingredients therefore is nicotine and To rate propylene glycol. Nicotine Nicotine is the main alkaloid in the sheets of the tobacco plant (Nicotina tabacum). Pure nicotine is, a water-soluble liquid colorless at room temperature. The company effect of nicotine is based on stimulation more nikotinischer Acetyl choline receptors in vegetative ganglia (vegetative effects like e.g. Increase of blood pressure and gastrointestinal Motilität), in suprarenal body Marks (Promotion of the adrenalin payment) and in the brain (central exciting Effect). While the central exciting effect too more psychologically and physically Nicotine dependence leads, is based the substantial effect injurious to health caused of nicotine on by stimulation of sympathetic ganglia Narrowing of blood vessels and from this resulting arterial hypertonia, Thrombosen and significantly increased risk for myocardial infarction and ischemic Insult (apoplexy). Propylene glycol The bivalent alcohol propylene glycol (1,2-Propandiol) is a colorless, usual use innocuous liquid. The substance is in numerous Food, Kosmetika, drugs and tobacco goods as auxiliary material contain. Canned goods fodder for small animals enthät up to 13% propylene glycol. With the mentioned Applications propylene glycol serves solution mediators as preservative, Emulsifying agent or damp retaining means. As food additive it carries the designation E 1520. Apart from allergischen reactions, those by almost all materials released will can, and easy irritations of the Konjunktiva is propylene glycol toxicological without heistation. At the rat the LD50 20 - 25 amounts to accordingly g/kg, 1,5 - 1.9 kg/75 kg, thus several orders of magnitude over the propylene glycol content " Electrical Zigarette". The additive of propylene glycol is from there to rate present level of knowledge as toxicological irrelevant. B. Mayer - appraisal electrical Zigarette/3 Quantitative comparison with conventional cigarettes Cigarettes contain nicotine per piece up to 1 mg. With on the average 15 courses per cigarette maximally 0,067 mg nicotine per course are thus inhaliert. Typical one Substitution preparations contain 2 to 4 mg (chewing rubber) or 25 - 100 mg (depot Plaster with continuous release over 16 to 24 hours). " Electrical Zigarette" contains per tube (according to 20 cigarettes and/or 300 courses) 1.05 - 1,1 g solution, whereby after use a remainder volume of 0.15 - 0,2 g remains (Renatus Derler, personal report), so that per tube about 0,9 g Solution for the inhalation are available, the 0,9 mg (0,1%) to 54 mg (6%) Nicotine contain. With 300 courses per tube thus 180 (6%) becomes, 120 (4! %) inhaliert, 60 (2%) and 3 μg (0,1%) nicotine per course. The more highly proportioned Solutions (6 - 2%) therefore contain compared with commercial Cigarettes larger and/or comparable nicotine quantities, whereas with consumption the 0,1% - igen solution only 1/20 (5%) of the nicotine quantity contained in cigarettes one inhhaliert. " Electrical Zigarette" should from there on the one hand strong Sufficiently nicotine to smokers at the disposal put, on the other hand however through gradual reduction of the nicotine content an almost complete curing make possible. Toxicological evaluation " Electrical Zigarette" Due to the nicotine content must as with all forms of the therapeutic Nicotine substitution also with " Electrical Zigarettte" the toxic effects stated above of nicotine to be considered. As other nicotine substitution preparations is " Electrical Zigarette" from there with young people, Pregnant one, nonsmokers and persons with cardiovascular illnesses contraindicated. , This information appears essential to the consumer in generally more understandably and easily accessible form to mediate (on one Enclosing note and/or as text on the packing). Foreseen of the nicotine content is " Electrical Zigarette" to evaluate but as toxicological harmless. Comparison with the consumption of tobacco goods Of 58328 male cancer deaths in Germany in the year 1995 50 became - 70% by the cigarette smoking cause, whereby the rate with laryngeal cancer 80% and with cancer of the lungs 75 - 90% amounted to (Becker, N.J. Cancer Res. Clin. Oncol. 127, 9-19, 2001). Main cause for the increased cancer risk in addition, for others Subsequent illnesses of smokers (e.g. bronchitis and Emphyseme) is one difficult-to-understand number of foreign matter, those with the burn of Tobacco smoke (developing temperature 850 - 950 °C) and by pyrolysis of B. Mayer - appraisal electrical Zigarette/4 Zigarettenpapier to be formed. In the gaseous phase of tobacco smoke became so far more than 500 chemical compounds identify, in the particle phase (condensate) more 69 carcinogenic materials and a multiplicity recognized than 4000, under it more toxically, partially highly reactive substances (Marquardt & Shepherd, text book that Toxicology, Stuttgart, 2004). In " Electrical Zigarette" the nicotine solution is electricalthermally evaporated, so that no active burn takes place. In the difference to the tobacco smoke contains inhalierte steam from there neither tar, nor condensate or Carbon monoxide. How with other nicotine substitution preparations from there no increased risk for those is to expect mentioned above illnesses. In the comparison to the consumption of tobacco goods the health risk is " Electrical Zigarette" from there substantially lower. From medical view one " Electrical Zigarette" to the smoker curing seriously recommended. Comparison with other forms of the nicotine substitution Compared with other forms of the nicotine substitution " Electrical one Zigarette" several substantial advantages. Particularly to emphasize is the better To be dosedness and thus adjustment to the need of the smoker. The rate that Nicotine release from depot preparations (plasters) is not controllable, chewing of nicotine chewing rubbers leads frequently to unwanted points of the nicotine plasma concentration and appropriate side effects (among other things more violently, very more unpleasantly Sip on). " Electrical Zigarette" made possible however the accurate Adjustment of the nicotine dose to the current need. A further advantage is those Availability of four filters with removing nicotine content. This makes that possible Concerned one in the course of curing a gradated reduction of the nicotine dose. Finally also the psychological advantage should be mentioned, of which I me personally to convince could do. " Electrical Zigarette" simulate the process of smoking extremely " lebensecht": one holds one (something oversized) Cigarette in the hand, one can pull on it, it develops a smoke-similar steam and at the point simulate a red light the glow. With consideration of the Craze behavior of smokers and their motor Bedürnisse (" something into that Hands halten" and " at something nuckeln"), this simulation of smoking appears as substantial advantage opposite other nicotine substitution preparations. It is only to fear that flight attendants and other surpervisors in nonsmoker zones of it will be heavy to convince that but one does not smoke this only simulates. Summary B. Mayer - appraisal electrical Zigarette/5 As is the case for other nicotine substitution preparations the toxicity that is limited " Electrical Zigarette" on the effects of nicotine. Since no burn process takes place, the load with other in the tobacco smoke contained is void toxic and above all carcinogenic foreign matter. The health risk is from there substantially lower than with the consumption of tobacco goods. Foreseen of Nicotine content is " Electrical Zigarette" to evaluate as toxicological harmless. In the difference to other forms permits the nicotine substitution " Electrical one Zigarette" the accurate adjustment of the nicotine dose to the need. The availability of four filters with removing nicotine content a gradated makes possible Reduction of the nicotine dose in the course of curing. The simulation of smoking curing should support also psychologically better than chewing rubbers or Plaster. To the smoker curing can " Electrical Zigarette" unreservedly recommended become. However is the product - like all other forms of the nicotine substitution - with young people, pregnant women, nonsmokers and persons with cardiovascular Illnesses contraindicates. Over it the consumers in general must more understandably and easily accessible form to be informed. Graz, on 6 March 2006 O. Univ. - Professor Dr. Bernd Mayer
 
A slightly easier to read version??

Opinions on the pharmacology and toxicology
a Electric cigarette for smoking cessation
O. Univ. Dr. Bernd Mayer

Institute for Pharmaceutical Sciences Pharmacology and Toxicology
Karl-Franzens University Graz, University Place 2
A-8010 Graz, Austria
Instructed by:
Renatus Derler
Utschgraben 79
A-8600 Oberaich
Austria

Background

Mr Renatus Derler plans to introduce an "electric cigarette to
Stop Smoking "(patent EP1618803) in the European market and has
I asked an opinion on the health aspects of this
Product to create. As part of my expertise in, I will
following the expected pharmacological and toxicological effects
assess the product. Economic and juridical aspects elude
my competence and therefore remain ignored.

Operating principle

The main components of the "electric cigarette" with a nicotine solution coated filter and an electric nebulizer to electrothermal
Evaporation of the nicotine solution. The steam is condensed through a mouthpiece inhaled, making the process of smoking is simulated. The technical details and the structure of the electric cigarette in the font Pate EP1618803 described in detail.

B. Mayer - Opinion Electrical cigarette / 2
Composition of nicotine solutions

According to patent EP1618803 are four different concentrated
Nicotine impregnated filter solutions offered. At the highest dose contains the Electrothermal vaporized nicotine solution 6%, the lowest dosage 0.1%. As an additive to solutions containing 80 - 90% propylene glycol (1.2-propanediol). Moreover, the solutions containing pharmacologically / toxicological negligible Quantities (! 5%) to taste substances and antioxidants. When inhaled quantitatively relevant ingredients and nicotine are consequently
Propylene glycol to evaluate.

Nicotine

Nicotine is the Hauptalkaloid in the leaves of the tobacco Plant (Nicotina tabacum). Pure nicotine is a colorless at room temperature, water-soluble liquid. The pharmacological effects of nicotine based on stimulation of nicotinic Acetylcholine receptors in vegetative ganglia (vegetative effects such as Increase of blood pressure and gastrointestinal motility) in the adrenal Mark
(Promotion of adrenaline) and in the brain (central disturbing
Effect). While the central disturbing effect on mental and physical
Nicotine addiction leads, based on the significant adverse health effect of nicotine on a sympathetic ganglia by stimulating effect
Constriction of blood vessels and resulting in arterial hypertension,
Thrombosis and significantly increased risk for myocardial infarction and Insult ischemic (stroke).

Propylene glycol

The binary alcohol propylene glycol (1.2-propanediol) is a colorless, with normal use non-toxic liquid. The substance is in many Foodstuffs, cosmetics, drugs and tobacco as an auxiliary substance. Canned food for small animals contains up to 13% propylene glycol. At the mentioned Applications propylene glycol is used as a preservative solution intermediary, Emulsifier or humectants. As a food additive it bears the name E 1520. Apart from allergic reactions caused by virtually all substances triggered may be slight irritation and the conjunctiva is propylene glycol toxicologically harmless. At the rat, the LD50 20-25 g / kg, according 1.5 - 1.9 kg/75 kg, so several orders of magnitude above the propylene glycol content
the "electric cigarette." The addition of propylene glycol is therefore current knowledge of toxicological as irrelevant to evaluate.

B. Mayer - Opinion Electrical cigarette / 3
Quantitative comparison with conventional cigarettes

Cigarettes contain up to 1 mg of nicotine per piece. At an average of 15 trains per cigarette are more than 0,067 mg of nicotine inhaled per train. Typical Substitution preparations containing 2 to 4 mg (chewing gum) or 25 - 100 mg (depot Pavement with continuous release of about 16 to 24 hours). The "Electrical Cigarette contains per tube (equivalent to 20 cigarettes or 300 trains) 1.05 - 1.1 g solution, but after use a residual volume of 0.15 - 0.2 g remains (Renatus Derler, personal communication), so that each tube about 0.9 grams Solution for inhalation available, the 0.9 mg (0.1%) to 54 mg (6%) Contain nicotine. At 300 trains per tubes are therefore 180 (6%), 120 (4!%), 60 (2%) and 3 g (0.1%) per train inhaled nicotine. The higher dose Solutions (6-2%) contain respectively as compared to commercially Cigarette nicotine comparable or greater quantities, whereas consumption the 0.1%-owned solution only 1 / 20 (5%) of nicotine in cigarettes contained quantity inhhaliert will. The "electric cigarette" should be the one strong Nicotine smokers sufficiently available, but by gradual reduction of nicotine yield an almost complete cessation possible.

Toxicological assessment of the "electric cigarette"

Due to the nicotine content must be like all forms of therapeutic
Nicotine substitution at the "Electric Zigarettte" the above
toxic effects of nicotine are taken into account. Like other nicotine replacement products is the "electric cigarette" thus youths,
Pregnant women, non-smokers and people with cardiovascular disease contraindicated. It seems essential that this information to the consumer in generally understandable and easily accessible form to convey (on a Leaflets and / or as text on the packaging). Apart from the nicotine content is the "electric cigarette" but as safely of toxicological assessed. Compared with the consumption of tobacco products Of 58,328 male cancer deaths in Germany in 1995 were 50 — 70% by cigarette smoking causes, with the rate of larynx cancer
80% of lung cancer and 75 - was 90% (Becker, NJ Cancer Res Clin. Oncol. 127, 9-19, 2001). The main reason for the increased risk of cancer but also for other Sequelae of smokers (eg bronchitis and emphysema) is a unmanageable number of foreign substances used in the incineration of Tobacco Smoke (formation temperature of 850 - 950 掳 C) and by pyrolysis of

B. Mayer - Opinion Electrical cigarette / 4

Cigarette paper can be formed. In the gas phase of tobacco smoke have been More than 500 chemical compounds identified in the particulate phase (condensate) more than 4000, including 69 carcinogenic substances and accepted a large number toxic, z.T. highly reactive substances (Marquardt & Schaefer, the textbook
Toxicology, Stuttgart, 2004). In the "electric cigarette is the nicotine solution Electrothermal evaporated, so that no active combustion takes place. In contrast to tobacco smoke contains
The inhaled steam therefore neither tar nor condensate or carbon monoxide. As with other nicotine replacement products is therefore no increased risk for above-mentioned diseases can be expected. In comparison to the consumption of tobacco products is the health risk of "electric cigarette" so much lower. From a medical perspective, the "electric cigarette" for smoking cessation
strongly recommended. Compared with other forms of nicotine replacement In comparison to other forms of nicotine replacement, the "Electric Cigarette "Several significant advantages. Particularly noteworthy is the better Dosed and thus adapt to the needs of the smoker. The rate of Nicotine release from custody preparations (patches) is not controllable, which chew of nicotine chewing gums often leads to unwanted peak nicotine plasma concentration
and related side effects (including violent, very unpleasant
Hiccup). The "electric cigarette", however, allows the exact
Adaptation of the nicotine dose to the current needs. Another advantage is the Availability of four filters with decreasing nicotine content. This allows Affected in the course of weaning a graduated reduction of nicotine dose. Finally, should also be mentioned psychological advantage, which I personally could convince. The "electric cigarette" simulates the process Smoking extremely "lifelike": it holds a (slightly oversized) Cigarette in hand, you can drag it creates a smoke-like steam and at the top of a red light to simulate the glow. Taking into account the Addiction behavior of smokers and their motorized needs ( "something in the Hands "and" something nuckeln "), this simulation of smoking as a major advantage over other nicotine replacement products. It is only
to fear that flight attendants and other caregivers in Non-Smoking
difficult to convince be that you do not smoke but this is only simulated.

Abstract
B. Mayer - Opinion Electrical cigarette / 5

Like other nicotine replacement products is limited to the toxicity of
"Electric cigarette" on the effects of nicotine. Because no combustion process takes place, eliminates the burden with other tobacco smoke contained especially toxic and carcinogenic contaminants. The health risk is therefore significantly lower than the consumption of tobacco products. Apart from Nicotine content is the "electric cigarette" as safe to toxicologically evaluate. In contrast to other forms of nicotine substitution allows the "Electric Cigarette "the exact adaptation of the nicotine dose to the demand. Availability four filters with decreasing nicotine content allows for a tiered Reduction of nicotine dose during weaning. The simulation of smoking Weaning should also psychologically better support than chewing gum or Plaster. For smoking cessation, the "electric cigarette" unreservedly recommended will. However, the product - like all other forms of nicotine substitution — in adolescents, pregnant women, non-smokers and people with cardiovascular Diseases contraindicated. Moreover, the consumers in general understandable and easily accessible form to be informed.
Graz, 6 March 2006 O. Univ. Dr. Bernd Mayer
 
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