E-cigarettes are on everyone's lips this year
What is an electronic cigarette?
“Electronic cigarettes” also known as ecigs, e-cigs, e-cigarettes are an electronic device in the form of a traditional tobacco cigarette which is designed to deliver a dose of nicotine without the negative combustion effects associated with traditional tobacco products.The electronic cigarette is most often composed of a microprocessor, a vaporizing technology and a chamber containing a nicotine solution. This solution is vaporized by means of a heating element within the body of the chamber and activated when the user draws air through the device. A pressure sensor within the chamber detects air flow changes and activates the heating element or “atomizer” in accordance to that rate of change.
The nicotine solution is essentially comprised of the nicotine molecule dissolved within a water, alcohol, propylene glycol or vegetable glycerin mixture. Additionally, some manufacturers add aromas and flavors to the nicotine solution (also knows as “juice” or “e-juice”) to furhter emulate the cigarette smoking experience. Flavors often include a tobacco essence designed to emulate specific brands such as Marlboro or Camel as well as menthol flavors common in still other brands such as Kool. Some e-cigarette manufacturers have created more creative aromas such as popular perfumes as well as banana, vanilla, bubble gum, coffee, and caramel.
The term “cigarette” is a a misnomer in that there is nothing tobacco-related or nicotine-related to the product or its technology. As we mentioned above, this liquid solution (or juice or e-juice) may contain dissolved nicotine, but it isn’t a requirement. In other words, the electronic cigarette can vaporize pure water if the user so chooses. The vaporizing technology is simply engineered into a “form factor” that resembles a common tobacco cigarette because tobacco user understand and expect a similar form factor. Alternative form factors have been developed such as ballpoint pens which make the device more discrete and less obviously a tobacco-cigarette imitator. These alternative electronic cigarette form factors also have the added benefit of not calling undue attention to the e-cigarette consumer. E-cigarettes can be exceptionally convincing and can create confusion as to what the e-cigarette user is actually using.
No ifs, ands or — Butts!
Potential for confusion aside, tobacco cigarette smokers have turned to the electronic cigarette because it affords them an inexpensive and arguably less-harmful alternative to using tobacco products. Unlike traditional tobacco cigarettes, cigarette smokers can personally regulate the amount of nicotine they wish to consume (e.g. regular, light or ultra-light variety.) Another reason electronic cigarettes have become popular among smokers is that the devices afford them the ability to “smoke” in places currently prohibited to tobacco cigarette smokers (e.g. in public places, indoors, on planes, etc.) Lastly, electronic cigarettes are physically safer and more environmentally friendly. Since the electronic cigarette has no actual “coal” or burning ember, e-cigarette users cannot fall asleep with a lit cigarette in their hands like thousands of Americans do each year. Moreover, electronic cigarettes produce no butts. This means no more dirty ashtrays and ugly, stinky butts accumulating around the house or within the car. As a result these reasons and many others, tobacco cigarette smokers have found electronic cigarettes a convenient alternative to smoking when smoking traditional cigarettes is prohibited or unfeasible.
How do electronic cigarettes work?
When consumers inhale through the device, a sensor in the electronic cigarette detects a change in pressure.
When pressure sensor detects a “drag” it initiates the heating element that begins the vaporization process. The vapor is composed of a propylene glycol and water solution (also called an e-juice or juice) housed within the mouthpiece. An LED (colored light, in most cases red) on the tip of the device is also initiated during inhalation. The colored light ‘shines’ when the device is in use and imitates the burning coal (or hot tobacco ember) that tobacco cigarettes rely on for combustion of the tobacco and cigarette paper. The LED’s color is strictly cosmetic. Manufacturers can offer a wide variety of colors and shapes (e.g. diamonds, rubies, emeralds, etc.)
The “e-juice cartridge”
The mouthpiece or ‘cartridge’ is the portion that would be commonly referred to among tobacco cigarette smokers as the “cigarette butt.” Inside this resusable cartridge sits a small housing which can be filled with the nicotine solution to be vaporized. The cartridge is made such that air is able to flow through it and to enable the back flow of the nicotine-rich vapor to the consumer. When the liquid or e-juice has been consumed, the consumer can easily refill it again and again without having to throw anything away.
Battery
Most electronic cigarettes rely on a rechargeable lithium-ion battery to drive the atomizer. Many different electronic cigarette battery chargers are available, such as car chargers, wall mounted or USB chargers.
Nicotine solution or “e-Juice”
Nicotine solutions, or juices, are comprised of nicotine suspended within propylene glycol or glycerin. Both propylene glycol and glycerin are well known and highly used food additives in such things are shampoo, toothpaste, mouthwash, cake mix, and the like. The FDA classifies both propylene glycol and glycerin as “GRAS” or Generally Regarded As Safe. Some researchers believe that vegetable glycerin is a safer additive than propylene glycol, but there is no research to support that propylene glycol is unsafe given the wide variety of consumer products that it is used in and the nearly 30 years upon which the product has been observed in animals and humans.
The levels of nicotine dissolved within the juice can vary depending on the user’s choice. The levels commonly follow the traditional dosages found in tobacco cigarettes such as regular, light and ultra light. As described earlier, the juices can also contain aromas and flavors that mimic favorite brands of cigarettes such as Kool (menthol) or Marlboro or Camel cigarettes. Moreover, these juices can also contain flavors such as vanilla, coffee, caramel, mint, bubble gum, banana or cotton candy.
A recent FDA study claimed that a not-so-random sampling of e-juice turned up one manufacturer whose e-juice contained ethylene glycol. Ethylene glycol is the chemical used in anti-freeze and is a toxic substance. If this accusation is correct, this is a serious error. Calls for regulation and oversight have been put forward to ensure quality control and consistency and accountability. The industry is predominantly behind such efforts provided they are not subterfuges to eliminate consumers’ ability to choose to use such products should they be shown to be both safe and effective.
Electronic cigarette marketing controversy
Does bubblegum flavored cough syrup create cough syrup addiction?
Some critics of electronic cigarettes have argued that by adding flavors and aromas of candy that electronic cigarette will entice younger people to use the devices. Critics believe (although there is no definitive peer-reviewed longitudinal studies that create test/control groups to account for the effects of $13B in yearly tobacco marketing and influence in popular culture. Critics further argue that once young people – or anyone for that matter – try electronic cigarettes, they will find themselves invariably addicted to nicotine and that such addiction will lead to tobacco cigarette addiction. No such longitudinal study has been conducted and as of today such criticism is entirely conjecture. The same argument was levied against candy cigarettes. Unlike electronic cigarettes, those candy products were in fact marketed to children. However, there is no research to support that candy cigarettes were in fact the proximate cause that lead children to smoke real cigarettes. However, unlike candy, electronic cigarettes are not food products, do not contain sugar, do not market with cartoon characters, nor are electronic cigarettes marketed to or accessible to children. To the contrary, e-cigarettes are both costly and complex technology. Moreover, these are devices that are only used by current tobacco smokers in conjunction with and or as an alternative to smoking tobacco. There has been no research or data to support that by being initially introduced to nicotine via electronic cigarettes that users will then be more likely to use tobacco products than the general population. While this is not the goal of electronic cigarettes, it is nevertheless important to address this point that some adults might choose to use nicotine from an electronic means vs. a tobacco product. It is inconclusive at this point that someone who is first introduced to nicotine will become a tobacco user or will become addicted in the same manner in which tobacco products function. Curiously, it has been argued that the tobacco manufacturers have manipulated the chemicals within the tobacco cigarette in order to specifically make their product both desirable and exceptionally or uniquely addicting than tobacco products at large and/or nicotine by itself. With that in mind, it strikes us as disingenuous for state and federal regulators who receive billions of dollars in tobacco tax revenue that is supported by and reliant on tobacco addiction to call out nicotine addiction as potential cause for concern.
Could state reliance on increasing toabcco taxes actually encourage kids to smoke? When $25,000,000,000 per year is at stake, it isn't hard to imagine who's lining up against e-cigs and why. Without a growing customer base there can be no sustainable tax revenue base. That invariably means younger tax paying smokers need to take over for the older dying ones.
Joe finds new customers, States profits from tobacco tax
As states continue to raise tobacco taxes by as much as 1000% they come to rely more heavily on tobacco revenue. It can be said that State legislatures are addicted to tobacco in their own way and therefor their motives cannot be seen as entirely “objective.” Ostensibly, electronic cigarettes represent the greatest threat to tobacco tax revenue in the history of smoking cessation and this should righttfully give tax-and-spend politicians cause for concern. But it isn’t only the state treasurers that are outraged by e-cigs. Electronic cigarettes also threaten traditional operational profit systems sponsored by or supported by Big Tobacco itself. There are very large, entrenched interests ranging from major US law firms, state legislatures, federal regulators, research universities, Big Pharma and even Wall Street that all vested interests in maintaining the status quo if for no other reason than economic predictability. Therefore, arguing that electronic cigarettes might induce new people to consume nicotine appears on its face absurd given the system’s reliance on increasing tobacco revenues.
Electronic cigarettes vs. Tobacco Cigarettes
The electronic cigarette or e-cigarette is composed a microprocessor, a vaporizer or “atomizer”, an internal sensor that begins the vaporizing process and a “juice” or dissolved nicotine solution cartridge that contains the liquid being vaporized. The juice or e-juice is simply a mixture of water and propylene glycol or vegetable glycerin. Propylene glycol or vegetable glycerin is used for several reasons. First, it allows nicotine to be dissolved within it and is bateriacidal. Secondly and perhaps most importantly, when vaporized, it creates a visible, white smoke-like vapor that provides the user a feeling of actually smoking a tobacco cigarette product. However, there are important differences. First, the electronic cigarette’s vaporization process produces a liquid vapor – not smoke. In other words, vapor is composed of tiny liquid (water and propylene glycol or vegetable glycerin molecules) that behave like smoke but are not actual smoke. By contrast, tobacco cigarettes are burned and the smoke tobacco cigarettes produce is composed of both a very hot, dangerous gas (carbon monoxide, also found in automobile exhaust) as well as solid materials (e.g. ash and tar). The “ash” from tobacco cigarette smoke is caused by the incomplete combustion or burning of the cigarette paper (a highly-chemically treated wood product) and the tobacco leaf. However, within the tobacco leaf, cigarette manufacturers also include 4,000 other chemicals that, for their stated reasons, are “necessary” to help regulate the burning process and the nicotine delivery process. These chemicals can include: arsenic, lead, benzene, Polonium, formaldehyde, Freon, fungicides, herbicides, pesticides and many, many others. It is also worth noting that 400,000 cigarette smokers die each year due to tobacco-related consumption. While the research continues, many physicians and scientists point to the additives in tobacco as a major culprit to tobacco smokers’ death rates. Additionally, tobacco smoking is also associated with numerous other diseases such as heart disease and emphysema being just two.
History of electronic cigarettes
The electronic cigarette was invented in 2003 by Beijing head quartered, SBT Co. SBT, currently The Golden Dragon Group. Manufacturer, Ruyan, further developed the technology and by 2006, the electronic cigarette was introduced in Europe, and was officially launched at the “RUYAN” Overseas Promotion Conference in Austria. After its European launch, the electronic cigarette was adapted to the rest of the European market and marketed as the “Electro fag.” The “Electro Fag” was renamed when it was introduced to the American market for what should be obvious reasons.
Is Electronic Cigarette Manufacturers’ Association President, Matt Salmon swimming upstream?
Former Arizona Congressman and current President of the Electronic Cigarette Manufacturer’s Association, Matt Salmon (FYI: Salmon ran unsuccessfully for Arizona Governor against Janet Neopolitano) estimates that there are 300,000 current electronic cigarette / e-cigarette customers and that one million people have tried electronic cigarettes / e-cigarettes. A recent survey noted that e-cigarette substitution for tobacco cigarettes resulted in perceived health benefits by those who currently smoke tobacco cigarettes.
Health and Safety Issues
As noted earlier, there are numerous claims to the both the health benefits and the health concerns associated with electronic cigarettes. There are a couple important points to make about electronic cigarettes and tobacco smoking. First, let’s talk about traditional tobacco cigarettes:
According to Tobacco manufacturers themselves, tobacco manufacturers either actively or passively introduce over 50 well-known carcinogens and an additional 4,000 other chemicals into Tobacco. These chemicals are not limited to:
A ‘Harm Reduction’ Argument:
Research scientists and physicians who focus on public health policy concerning tobacco-deaths and tobacco-related injuries have argued that anything that reduces the harm inflicted on tobacco smokers would deliver a net-positive impact on public health. These scientists argue that offsetting the volume of cigarettes consumed in a day would have a benefit, even if the tobacco users remained tobacco users for the rest of their lives. They argue that when taken as a whole, reduction of worldwide tobacco consumption would have a net reduction in death and disease, prolonging life and increasing quality of life for the entire population of both smokers and those exposed to second hand and third hand tobacco smoke contaminants. Therefore, many of researchers have advocated for electronic cigarettes because, quite simply, electronic cigarettes slow the consumption of tobacco cigarettes.
Nicotine is not believed to be a carcinogen. However, could it actually be a health promoter?
Many researchers state and the medical community appears to concur that nicotine alone is not a carcinogen. Scientists, however, point to other elements within tobacco cigarettes as the primary drivers in cancer and disease, the most popular culprits being of course, tar, ash and carbon monoxide. Unbeknownst to many, nicotine has health promoting properties. Researchers have found many positive uses for nicotine. Nicotine is currently being studied as an important agent in fight against many autoimmune and inflammatory diseases. For example, researchers at University Hospital Cardiff Wales are exploring the use of nicotine as a healing agent in ulcerative colitis, Crohn’s Disease and irritable bowel syndrome (IBS.) Therefore, arguments that electronic cigarettes are dangerous simply because they contain nicotine have cannot on their face be true. For example, tobacco smokers do not seem to contract ulcerative colitis. Scientists posit that it is the nicotine that is actually preventing them from contracting the disease.
To-bacco or Not To-bacco. That is (no longer) the question.
Of all controversial substances known to man, nicotine sure must be one of the most researched. While it has been established that nicotine is an addictive substance, the question for tobacco smokers now is balancing the relative harms of continued nicotine use against the relative benefits. In the past, the only argument was to smoke tobacco or to not smoke tobacco. With the introduction of electronic cigarettes, there now is an alternative to tobacco-derived nicotine. Nicotine users, therefore, have and should continue to have the option as to how they consume this substance. As long as tobacco remains legal in the United States, and as long as states profit from its sale and use, smokers should retain the option as to how they receive that nicotine. Arguably, the state has a duty to its taxpaying citizens to enact and enforce beneficial public health policies. It also has the responsibility to not knowingly promote and / or rely on addicting its citizenry to nicotine for the purposes of revenue generation. As long as tobacco is legal, that process of addiction will continue. Therefore, it is argued that as long as the state profits from that process, the addicted citizens deserve the right to access to information and alternatives which might prolong their lives and or increase their quality of life without the undue interference and manipulation of special interest groups.
The argument is not whether one should or should not smoke. Rather, the argument is whether current smokers should be allowed to continue their nicotine usage via a less noxious and potentially less lethal method.
The FDA, Propylene Glycol and vegetable glycerin within e-cigarettes.
Propylene Glycol is what is called a “humectant” or moisture retaining substance. Propylene glycol has bee used as a food additive for decades because of its viscous, water retaining properties. Propylene glycol can be found in nearly every consumer product on the market today (e.g. soap, shampoo, conditioner, mouthwash, toothpaste, baby wipes, skin conditioner, make up, skin lotion, as well as food products such as cake mixes.) The FDA has stated that propylene glycol is GRAS or Generally Regarded As Safe for human use and consumption. There have been innumerable research projects studying the use and levels of propylene glycol in rats and humans and nearly all of them have been inconsequential. Therefore, propylene glycol (mixed with water) was chosen as the suspension fluid to dissolve the nicotine as well as the aromas and flavor. Questions have arisen as to whether vaporizing propylene glycol would be safe for the lungs. However, there are no definitive studies showing that absorption of propylene glycol in the lungs is significantly different than through the skin or digestive system. Moreover, the amount of propylene glycol consumed by electronic cigarette users is relatively small since nearly all of it is exhaled. Nevertheless, new forms of vegetable-based glycerin could alleviate complaints by some who say that propylene glycol is a petroleum derivative and therefore is inherently bad.
E-cigs, Smoking Cessation and Nicotine Replacement Therapies (NRT)
Electronic cigarette retailers and manufacturers are prohibited by law from marketing their products as a “smoking cessation” device. The phrase “Smoking Cessation” and “Nicotine Replacement Therapy” are the property of only a select group of companies producing products today such as: nicotine patches, nicotine gums, lozenges, nasal inhalers as well as drugs such as Zyban, Habitrol and Chantix. Some prominent public health professionals have argued that anything that reduces the aggregate number of tobacco cigarettes US smokers consume should be considered a ‘smoking cessation’ device. Nevertheless, electronic cigarettes resellers are not allowed to claim their products are designed to help users “quit smoking.” That said, were a tobacco smoker to quit smoking as the result of using an electronic cigarette, US regulators would still prevent electronic cigarette retailers and manufacturers from highlighting this point. It is a fact, however, that those tobacco smokers who use electronic cigarettes tend to consume less tobacco cigarettes if for no other reason than they are receiving a dose of nicotine from another, non-tobacco source. One thing is clear. Despite electronic cigarettes tobacco mitagation effects on smokers, e-cigarette manufacturers must and will continue to make no claims about their ability to assist consumers in smoking cessation or as a supplemental therapeutic nicotine replacement device.
Legal Challenges to electronic cigarettes
Perhaps one of the most interesting about faces the federal government, Congress, the Supreme Court, lobbyists and lawyers for Big Tobacco have ever made has come about with the past 8 years. Assuming that you haven’t been living under a rock for the past decade, tobacco companies have been settling the long-standing litigation concerning tobacco and health costs and burdens that the states have had to take on. During that period of time, the FDA under the Clinton Administration argued that cigarettes were Nicotine Deliver Devices and as such a drug and therefore subject to oversight of the FDA. It was a logical and clever argument. Prior to this point, the FDA wasn’t in the business of regulating tobacco and nicotine. But under this order, the FDA was claiming that it had the power to do so. This sent Big Tobacco into war mode and for 6 years it lobbied Congress the courts with the argument that had Congress wanted to grant the FDA such authority it would’ve done so 50 years earlier when the acts were written establishing the FDA’s authority. The US Supreme Court under Chief Justice Rehnquist and Justice Antonin Scalia argued that the FDA had no such authority. And the tobacco companies won their case. Three years later, however, a technology called the electronic cigarette emerged on the market that was truly a “nicotine delivery device.” However, the Supreme Court had decided that the FDA had no authority to act on this subject. The tobacco companies had spent the better part of the last decade fighting that authority. Now suddenly, it found it self in the odd position of arguing the exact opposite site of the case. Suddenly, tobacco companies were encouraging the FDA to prevent these products from proliferating claiming that it had the authority to act. Whoops!
Obama to the Rescue
In April of 2009 President Obama (ironically, a smoker himself) signed the Family Smoking Prevention and Tobacco Control Act of 2009 granting back to the FDA more authority to regulate nicotine delivery devices. And just in time too. According to the Electronic Cigarette Manufacturers’ Association, over 300,000 consumers claim to be currently using e-cigarettes with another 700,000 having already claimed to try them. Arguably these devices were finding great success and showed signs of rapidly proliferating and greatly offsetting profits and more importantly tobacco tax revenue.
Billions of Tobacco Tax Revenues at Stake
Tobacco taxes are big business
It is impossible to understand the electronic cigarette debate without understanding the State-by-state tobacco tax landscape. Some states such as California charge as much as $3.00 per pack. Other states such as South Carolina (a tobacco growing state) charge as little as $.07 per pack in taxes. We could get into the bizarre financial arrangements and how taxes are collected, who spends what and why – but suffice it to say, he who taxes the most doesn’t necessarily spend the most in smoking cessation programs. Moreover, he who taxes the least doesn’t necessarily have the highest death rates due to smoking related illness. Therefore, the relationship between what is taxed and what is actually spent and what is actually achieved is anything but linear. Arguably, electronic cigarettes pose to upset the balance of power struck between the states and the tobacco companies. And the battle will be one over market share, tax revenue and brand strategy. Health (and logic), as per usual, will most likely take a back seat to this ongoing regulatory, tax and morality play.
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