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From the BMJ (formerly the British Medical Journal)
http://www.bmj.com/content/344/bmj.e3
Hanover bans e-cigarette use in civic offices amid calls for better safety data - BMJ
January 5, 2012
Ned Stafford
Health authorities in Germany are warning of potential risks to health from electronic cigarettes (e-cigarettes), with a top official at the German Cancer Research Centre in Heidelberg calling it one of the major new health issues currently facing Germany and the rest of Europe.
Martina Pötschke-Langer, head of the centres cancer prevention unit, told the BMJ that e-cigarettes usually contain nicotine and other potentially harmful substances. But unlike medical products that contain nicotine, such as chewing gum and patches used to help cigarette smokers quit, which can be bought only in pharmacies, e-cigarettes can be sold over the internet or in tobacco kiosks and other shops. Current information on the health effects of e-cigarettes is dangerously meagre for a product already on the market, she said, adding that research efforts need to be greatly intensified to provide a foundation on which to base regulatory decisions.
E-cigarettes are one of the most burning health issues at the moment because dozens of companies are trying to develop the nicotine market outside of pharmacies in Germany and other European Union countries, said Dr Pötschke-Langer, who is also head of the World Health Organizations Collaborating Centre for tobacco Control in Heidelberg.
The most important ingredient in e-cigarettes is nicotine, which is a drug produced by the pharmaceutical industry and also for e-cigarettes. There is no rational reason why the application of nicotine in the form of an e-cigarette should not be regulated, like nicotine patches, gums, inhalers, or tablets.
E-cigarettes are often shaped in a cylindrical form like a ballpoint pen, sometimes designed to resemble traditional tobacco cigarettes. Inside is a battery and a replaceable cartridge of propylene glycol or glycerin based liquid solution that contains nicotine, flavourings such as menthol or cola, and other substances. When the user inhales, the device heats the liquid solution to produce a smoke free vapour that can be visible when exhaled.
E-cigarettes are being marketed for tobacco smokers to use in places where smoking is not allowed, such as smoke free pubs or restaurants, or as an aid similar to pharmaceutical nicotine products to help cigarette smokers quit tobacco use.
An increase in the popularity of e-cigarettes in Germany and their widening availability is setting off alarm bells among German health authorities, and several regional and federal officials in recent weeks have issued warnings about the potential risks to health. In the last week of December the city of Hanover banned the use of e-cigarettes by civil servants in city offices and city vehicles, making it one of the first cities in Germany to enact an e-cigarette ban. The city is considering banning the use of e-cigarettes in restaurants and other enclosed public areas pending additional studies to determine the potential effects of passive smoking of e-cigarettes.
Hanover based its decision in part on a warning about the health risks of e-cigarettes issued on 19 December by Elisabeth Pott, director of the Federal Centre for Health Education in Cologne, which is administered by the German Ministry of Health (BZgA : Pressemitteilungen 2011). In addition to the warning, Dr Pott also disputed the claim that e-cigarettes can help smokers successfully quit.
Whoever believes that quitting smoking is easier with e-cigarettes is wrong, Dr Pott said, adding that successfully quitting smoking requires behaviour modification.
She said that propylene glycol, which accounts for up to 90% of the content of some cartridges, can cause acute respiratory system irritation. She noted that the US Food and Drug Administration in 2009 analysed e-cigarette cartridges and found traces of the carcinogen nitrosamine and other potentially harmful substances in products from several manufacturers, in addition to ethanol, glycerin, and aroma substances (Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted By FDA).
The health minister of the state of North Rhine-Westphalia, Barbara Steffens, added to the chorus of warnings. On 16 December she announced that the state government had determined that e-cigarettes and their cartridges fall under regulations concerning medicines and medical products. She said that the state government is planning to adopt regulations to ban their sale unless approved for sale in pharmacies.
Dr Pötschke-Langer said that independent research into the effects on health of propylene glycol, nicotine, and other substances found in e-cigarettes is urgently needed.
She said, Before a consumer product is placed on the market and advertised as a new healthy lifestyle product, there must be complete transparency about this product and basic data on many issues, such as composition of the liquids and the vapour . .. We also need animal studies on toxicology and carcinogenicity and effects of long term exposure.
http://www.bmj.com/content/344/bmj.e3
Hanover bans e-cigarette use in civic offices amid calls for better safety data - BMJ
January 5, 2012
Ned Stafford
Health authorities in Germany are warning of potential risks to health from electronic cigarettes (e-cigarettes), with a top official at the German Cancer Research Centre in Heidelberg calling it one of the major new health issues currently facing Germany and the rest of Europe.
Martina Pötschke-Langer, head of the centres cancer prevention unit, told the BMJ that e-cigarettes usually contain nicotine and other potentially harmful substances. But unlike medical products that contain nicotine, such as chewing gum and patches used to help cigarette smokers quit, which can be bought only in pharmacies, e-cigarettes can be sold over the internet or in tobacco kiosks and other shops. Current information on the health effects of e-cigarettes is dangerously meagre for a product already on the market, she said, adding that research efforts need to be greatly intensified to provide a foundation on which to base regulatory decisions.
E-cigarettes are one of the most burning health issues at the moment because dozens of companies are trying to develop the nicotine market outside of pharmacies in Germany and other European Union countries, said Dr Pötschke-Langer, who is also head of the World Health Organizations Collaborating Centre for tobacco Control in Heidelberg.
The most important ingredient in e-cigarettes is nicotine, which is a drug produced by the pharmaceutical industry and also for e-cigarettes. There is no rational reason why the application of nicotine in the form of an e-cigarette should not be regulated, like nicotine patches, gums, inhalers, or tablets.
E-cigarettes are often shaped in a cylindrical form like a ballpoint pen, sometimes designed to resemble traditional tobacco cigarettes. Inside is a battery and a replaceable cartridge of propylene glycol or glycerin based liquid solution that contains nicotine, flavourings such as menthol or cola, and other substances. When the user inhales, the device heats the liquid solution to produce a smoke free vapour that can be visible when exhaled.
E-cigarettes are being marketed for tobacco smokers to use in places where smoking is not allowed, such as smoke free pubs or restaurants, or as an aid similar to pharmaceutical nicotine products to help cigarette smokers quit tobacco use.
An increase in the popularity of e-cigarettes in Germany and their widening availability is setting off alarm bells among German health authorities, and several regional and federal officials in recent weeks have issued warnings about the potential risks to health. In the last week of December the city of Hanover banned the use of e-cigarettes by civil servants in city offices and city vehicles, making it one of the first cities in Germany to enact an e-cigarette ban. The city is considering banning the use of e-cigarettes in restaurants and other enclosed public areas pending additional studies to determine the potential effects of passive smoking of e-cigarettes.
Hanover based its decision in part on a warning about the health risks of e-cigarettes issued on 19 December by Elisabeth Pott, director of the Federal Centre for Health Education in Cologne, which is administered by the German Ministry of Health (BZgA : Pressemitteilungen 2011). In addition to the warning, Dr Pott also disputed the claim that e-cigarettes can help smokers successfully quit.
Whoever believes that quitting smoking is easier with e-cigarettes is wrong, Dr Pott said, adding that successfully quitting smoking requires behaviour modification.
She said that propylene glycol, which accounts for up to 90% of the content of some cartridges, can cause acute respiratory system irritation. She noted that the US Food and Drug Administration in 2009 analysed e-cigarette cartridges and found traces of the carcinogen nitrosamine and other potentially harmful substances in products from several manufacturers, in addition to ethanol, glycerin, and aroma substances (Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted By FDA).
The health minister of the state of North Rhine-Westphalia, Barbara Steffens, added to the chorus of warnings. On 16 December she announced that the state government had determined that e-cigarettes and their cartridges fall under regulations concerning medicines and medical products. She said that the state government is planning to adopt regulations to ban their sale unless approved for sale in pharmacies.
Dr Pötschke-Langer said that independent research into the effects on health of propylene glycol, nicotine, and other substances found in e-cigarettes is urgently needed.
She said, Before a consumer product is placed on the market and advertised as a new healthy lifestyle product, there must be complete transparency about this product and basic data on many issues, such as composition of the liquids and the vapour . .. We also need animal studies on toxicology and carcinogenicity and effects of long term exposure.
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