June 30, 2013
Here is the summary of the report, Electronic Cigarettes – An Overview, issued a couple months ago:
Electronic cigarettes are novel products emerging on the market just a couple of years ago. Consequently, there are only few scientific studies on the health implications of using electronic cigarettes.
Based on current data, the following statements can be made:
Product characteristics
■ E-cigarettes cannot be rated as safe at the present time.
■ Consumers do not have reliable information on product quality.
■ Electronic cigarettes have various technical flaws (leaking cartridges, accidental intake of nicotine when replacing cartridges, possibility of unintended overdose).
■ Some manufacturers provide insufficient and partly wrong information about their liquids.
Health effects
June 30, 2013
The Philippine FDA has issued an advisory on e-cigarettes, "Secondary exposure to e-cigarette emission might be harmful to health."
The Philippine FDA notes that "Electronic cigarettes are not emission-free. E-cigarettes contain volatile organic substances, including propylene glycol, flavors and nicotine, and are emitted as mist or aerosol into indoor air. Study showed that these ultrafine liquid particles ... may penetrate deeply into lungs." These ultrafine particles are an important cause of heart attacks with a nonlinear dose-response, i.e., low levels of exposure have big effects.
The advisory goes on to state, "four of the metals measures, namely sodium, iron, aluminum and nickel, were present at higher levels that those known in cigarette smoke. Five others, namely copper, magnesium, lead, chromium, manganese, were present in the same amount, while potassium and zinc were present at lower levels. Nickel and chromium are carcinogenic and lead is suspected to be carcinogenic. If several people are using e-cigarettes in a room at the same time, considerable indoor air pollution will accumulate and may result in harmful second-hand exposure." [emphasis added]
June 27, 2013
A paper entitled "EffiCiencyand Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study" was just published in PLoS One that is being interpreted as indicating that e-cigarettes lead to cessation of conventional cigarettes among people who are not planning to quit smoking regular cigarettes.
For the reasons discussed below, this is not an appropriate interpretation of the results in this study.
June 27, 2013
There has been a longstanding debate among advocates over whether it is better to accept a weak clean indoor air law to get your foot in the door with the idea of coming back later and strengthening it or whether it is better to hold out for a strong law from the beginning.
We just published a paper in American Journal of Public Health, "The Pattern of Indoor Smoking Restriction Law Transitions, 1970–2009: Laws Are Sticky," that examined the pattern of the passage of smoking laws across venues (government and private workplaces, restaurants, bars) and by strength (no law to 100% smoke-free) that were passed between 1970 and 2009 using data from the Americans for Nonsmokers' Rights Ordinance Database.
We found that each decade, more laws were enacted, from 18 passed in the 1970s to 3172 in the first decade of this century, when 91% of existing state laws were passed. Most laws passed took states and localities from no law to some level of smoking restriction, and most new local (77%; 5148/6648) and state (73%; 115/158) laws passed in the study period did not change strength.
June 22, 2013
Gary Fooks and Anna Gilmore just published a very important paper on how the pending Trans-Pacific Partnership (TPP) trade agreement could undermine tobacco control policies in countries including 40% of the world's population.
Their paper focuses on using the TPP to block plain packaging, but the concerns they raise apply to all tobacco control policies, all the way down to local clean indoor air laws and tobacco taxes. Indeed, the issues they raise apply to any health or environmental law that might make transnational corporations less profitable.
This paper is must reading for anyone interested to tobacco control or public and environmental health generally. It raises serious questions about the lack of transparency of the process by which the TPP is being negotiated and the preferential access to the negotiating process that multinational corporations, including multinational tobacco corporations, have. A logical conclusion of the information in this paper is that the negotiating process needs to be opened up to public scrutiny.
Given the tremendous impact that trade agreements like the TPP could have on all aspects of life, I do not understand why they are not considered treaties, which would require a 2/3 vote in the US Senate for ratification.