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Could FDA E-Cigarette Regulations Help More People Quit Smoking?
#1
夸奖 
Could FDA E-Cigarette Regulations Help More People Quit Smoking?

Here's a look at the policy challenges should the Food and Drug Administration get the authority to regulate e-cigarettes.
By Michael P. Eriksen

E-cigarettes are smoking hot. They are the most popular nicotine-delivery products used by kids and the majority of adult smokers have tried them. E-cigarettes are a multi-billion dollar industry, with the website Yelp tallying more than 10,000 vape shops across the country. Wall Street analysts are predicting that revenue from e-cigarettes will surpass traditional cigarettes in a decade.

Given the size of the enterprise, you would think there would be policies and rules in place that would assure e-cigarettes' safe use and promote them as a tool to quit smoking. After all, the vast majority of long-time adult smokers desperately want to quit the habit. While vaping is not risk-free, nearly everyone agrees that e-cigarettes are almost certainly better than smoking, if for no other reason than the fact that smoking is so harmful due to the tars and toxins in smoke that are created from burning the tobacco in traditional cigarettes.

Surprisingly, despite the size of the market and the millions of smokers (and some nonsmoking kids and former smokers) who have tried e-cigarettes, there are virtually no federal rules or regulations that govern any aspect of the industry.

That could change soon. Federal officials are expected to come out with a decision any day now that could give the Food and Drug Administration (FDA) authority to develop regulations. But figuring out how to regulate e-cigarettes to maximize their benefits and minimize their risks is harder than it looks.

What's at Stake for Cigarette Smokers

Cigarette smoking is the leading preventable cause of death in the world, killing nearly 500,000 Americans and six million people around the world each year. The causes of death and chronic illness include, of course, lung cancer, but also heart disease, diabetes mellitus, colorectal and pancreatic cancer and a range of medical conditions that fall under the umbrella of chronic obstructive pulmonary disease (COPD).

Most adult smokers took their first puff of a cigarette as a teenager. And most wish they had never started, and consider it one of the worst decisions they have ever made.

More than half of middle-age smokers have quit. Quitting can be extraordinarily hard. The average 40-year-old smoker who started in his teens will have made more than 20 failed attempts to quit. While there are aids to help people quit smoking, such as Nicotine Replacement Therapy (NRT) and prescription medications Chantix and Zyban, they vary widely in how well they work. There is certainly room for a more effective method. But it's unclear whether e-cigarettes are the answer.

Some research suggests that e-cigarettes are as effective as other smoking cessation approaches. But the research is limited, and the major health and medical organizations currently do not recommend e-cigarettes for cessation. A noteworthy exception is the United Kingdom, where an e-cigarette became part of the National Health Service smoking cessation program in January.

Meanwhile, U.S. smokers are being barraged by mixed messages. Vaping advocates promote e-cigarettes as a potentially life-saving product, but the industry can't make health claims without going through an FDA review process. (And the FDA doesn't currently have the authority to conduct such a review.) Right now we are waiting for Office of Management and Budget to approve FDA's request to extend their current authority to cover e-cigs and other novel products.

For the first time in generations, there are glamorous ads on TV for what appears to be smoking (but is actually vaping). One e-cigarette company even ran a "Welcome Back" marketing campaign that appeared designed to entice former smokers to start vaping, a move that could get them readdicted to nicotine and possibly on the road to smoking traditional cigarettes again.

How Are E-Cigarettes Regulated Right Now?

The federal government has been slow to regulate the fast-evolving e-cigarette industry, but it has been trying. In 2009 the FDA attempted to have e-cigarettes regulated as a drug-device combination, which would require FDA oversight. But the courts didn't see it that way, and in 2010 ruled that e-cigarettes were tobacco products and had to be regulated as such. When President Obama signed the Family Smoking Prevention and Tobacco Control Act, it complicated things in that it allowed the FDA to regulate some tobacco products, but it did not explicitly include e-cigarettes (or hookah, cigars and cigarillos and other novel tobacco products).

That meant that for the FDA to regulate e-cigarettes, they had to extend or "deem" their authority to include these novel products. FDA indicated their intent to do so in early 2014 and received over 100,000 public comments on their proposed rules, which today are awaiting final action from the Office of Management and Budget.

The net effect is that there are currently no federal rules, and the e-cigarette industry is basically unfettered. The one exception is a new law signed by President Obama in January to require childproof caps for the containers of liquid nicotine used in e-cigs. The containers had been blamed for more than 3,700 calls to poison control centers in 2014, with more than half of the cases involving children under 6.

Some state and local jurisdictions have stepped in to pass laws and policies within their authority. For example, most states have passed minimum age of purchase laws, many jurisdictions call for e-cigarettes to follow the same restrictions as tobacco products in terms of where they can be used, and some states are imposing excise taxes on e-cigarettes as well.

Are E-cigarettes Tobacco Products?

The burning question (pun intended) is whether e-cigarettes should be treated the same as tobacco products (as the courts have ruled and as the e-cig industry fears) or if they should benefit from preferential policies because they are less harmful than traditional cigarettes.

Creating a regulatory framework that varies by the risk of the product makes sense, but is fraught with challenges, mainly because e-cigarettes are relatively new and the science is mixed. Decisions will need to be made about whether e-cigarettes should benefit from differential tax policy, marketing regulations and, perhaps most knotty, where they can be used. Rep. Duncan Hunter, a Republican from California, tried to argue that vaping should be allowed on airplanes, dramatically blowing a cloud of vapor while speaking at a Congressional hearing last week. (He lost that debate.)

The Conversation Some argue that e-cigarettes should be used to nudge smokers away from traditional cigarettes, and that this could be achieved by having public policies differ based on the harm caused by the product. For example, e-cigarettes and other noncombustible tobacco products could be taxed at a lower level and be allowed to advertise commensurate with the harm they cause. Advertising for combustible cigarettes would still be severely restricted, but e-cigarettes could be marketed like nicotine replacement therapy.

Some have even made the dubious suggestion that rather than increasing the minimum age of buying tobacco products to 21 (as many jurisdictions are doing), having a different minimum age of e-cigarette sales of 16 years of age so that young people who crave nicotine can start with a less "harmful" product.

We don't know all the answers, but we do know that smokers urgently need (and want) to quit smoking. The policy challenge for FDA is to have the wisdom to put in place the rules and regulations that will achieve the greatest population health benefit and result in the beginning of the end of smoking as we know it.

This article was written by Michael P. Eriksen, professor and dean, School of Public Health, Georgia State University, for The Conversation. It is republished here with permission.

http://bit.ly/1qavgxB
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#2
Nicotine delivery products?

If e-cigarettes are markted as nicotine delivery and smoking cessation devices, then it is only logical they are put under tobacco rules and laws. In shortest time big corperates will rule the game. And that will not help, no.
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#3
I'm really happy that I enjoy the vape, and love the taste and vapors of ejuice. Can't imagine one day I returned back to tabacco.
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#4
Me too. But if they were smoking cessation devices then most of us would stop vaping after we dropped cigs.
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#5
People quit smoking to vaping, that's the difference. They're totally different. How could it be sorted as the so called Nicotine delivery products.
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#6
i would like to know if there was zero nicotine in e-juice would the FDA still try to regulate it? the one thing i have noticed is that when someone decides to switch to vaping that the amount of Nicotine is dropped. i know i started out with 24 mg of of nic and over time i have gone down to no nicotine. now there are times i get 3mg cus i like the throat hit with certain flavors. the things i experienced during the transition to 24mg to no nicotine.

1. [24mg nic] my taste and smelling got better (2-3 months with pen like device)
2. [12mg nic] started to breath better and no longer had toothaches ( 3-7 months upgraded to bigger tank with more air flow and option for tight draws)
3. [6mg nic] started to sleep better and didn't like the tight draws as much (7-12 months got in to RDAs and high powered device)
4. [0-3mg nic] within a year of vaping i have noticed that a cyst i have no longer gets inflamed or has come back. now i don't know for sure if vaping was what helped but is funny when i quit smoking it's gone 微笑

now i vape for flavor and clouds 舌 and vaping is not smoking it is something i choose to do and not a addition 微笑 now having to buy as many mods and tanks............... is a whole other story舌 舌
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#7
(03-30-2016, 11:39 AM)bey1012 Wrote:  i would like to know if there was zero nicotine in e-juice would the FDA still try to regulate it? the one thing i have noticed is that when someone decides to switch to vaping that the amount of Nicotine is dropped.
... snip

That's because nicotine is actually only a mild addictive, similar to Coffeine. The addition of ammonia compounds into the cigarette amplify the effect of nicotine.

It was long denied by the tobacco giants they add chemicals to increase addiction, but that is the fact. The cigarettes nowadays contain only about 50 % real tobacco, the rest are fillers and other chemicals designed to make us to the perfect junkies.
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#8
(03-30-2016, 02:08 PM)peter-k Wrote:  
(03-30-2016, 11:39 AM)bey1012 Wrote:  i would like to know if there was zero nicotine in e-juice would the FDA still try to regulate it? the one thing i have noticed is that when someone decides to switch to vaping that the amount of Nicotine is dropped.
... snip

That's because nicotine is actually only a mild addictive, similar to Coffeine. The addition of ammonia compounds into the cigarette amplify the effect of nicotine.

It was long denied by the tobacco giants they add chemicals to increase addiction, but that is the fact. The cigarettes nowadays contain only about 50 % real tobacco, the rest are fillers and other chemicals designed to make us to the perfect junkies.

yes that is right but the main reason i started to use less nic is due to the device i was using and the more air i was drawing in. 24mg of nic in a pen like device with a tight daw is less harsh than a RDA or tank with a lot of air flow. my brother still uses 18mg of nic in his HERAKLES tank at 60w with full air flow and don't know how he can stand it lol
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#9
Sure it was the high level of nic that helped us overcome the artifically created nicotine junkie phase. Now I like sometimes the mild stimulant effect of a 3 mg e-liquid. But I am not addicted. If I don't add nic to my self made e-liquid I am not craving for any. I don't really need it.


IF vaping was mostly helping the "strong addiction to nicotine", then politics and experts would ask rightfully: Well then why don't you take another method of nicotine delivery? One that is proven harmless? Which is what they do ask at least here in Singapore. Or they ask: Why then don't you stop vaping after you got the nicotine from your system? Isn't that a valid question?

It was a mistake from the beginning to market vaping devices as nicotine delivery device.

Other nicotine delivery methods, like patches, gums, tablets, why do these have a high failure rate? Because someone wants most of us to fail with these methods. Or they would add as well ammonia compounds, at least in the beginning.


I think the worst part of the artificially created nicotine addiction is overcome in 4 - 6 weeks, mostly, or at least to a point that many could manage with will power and a well meaning support by partner + family. But we stick with vaping.

So, no, the nic addiction can not be the real picture. I think it is a certain oral fixation, it is the activity itself that relaxes us, it tastes damn good without giving us calories.

Stop market vaping as nicotine delivery, or putting it in any way close to smoking. Stop restricting vaping. Vaping is not smoking, therefore it is couterproductive having tobacco laws applied to it.
Aim the laws and regulations to make vaping and the materials used as safe as possible.
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