February 16, 2012

Stanton A. Glantz, PhD

e-cigarette blows up in smoker's mouth, creating severe burns: is that enough to provoke action?

There was a horrific incident yesterday when an e-cigarette exploded in a user's mouth, creating severe burns.  (The ABC news story is available here.)

This is the starkest evidence yet that these products have poor quality control and need to be regulated.

Meanwhile, the FDA dithers along.  Maybe the Consumer Product Safety Commission could issue an emergency order.  Or state AGs could sue for fraud based on all the unsubstantiated claims the e-cig companies make on their web sites. 

This is certainly all the evidence that the Department of Transportation needs to issue an emergency order banning e-cigs on airplanes.  (We needs an underwear bomber when you can explode an  e-cig?) 

It is yet another reason why e-cigs should be included in clean indoor air laws, so that they are not used indoors.

To learn more about the unsubstantiated claims being made about e-cigs, check out Rachel Grana's presentation at our "It's About a Billion Lives" symposium available here.



It is important to remember that what happened, while tragic, is extremely rare. Lithium-ion batteries are used in many products, including laptop computers, cell phones, flashlights, electric toothbrushes, and even electric automobiles. Accidental fires or explosions in any of these products are rare, but not unheard of.
Nobody has called for all laptop computers or all cell phones to be pulled off the market or prohibited on planes. There is no information available at this time regarding exactly what brand and model was being used or whether the product had been modified. Therefore it is premature to conclude that all smoke-free electronic vaporizers (“e-cigarettes”) are more dangerous than any other type of electronic device that uses lithium-ion batteries.
According to the CDC, approximately 2.5 million smokers tried an e-cigarette in 2010, and it is very likely that more than 1 million former smokers currently use e-cigarettes as a complete replacement for their combustible cigarettes. These former smokers have reduced their risks of lung disease, heart disease, and cancers because they no longer inhale tar, carbon monoxide, particulates, and thousands of chemicals of combustion along with their nicotine.
All current smoking cessation products and programs are based on complete nicotine abstinence, which may explain why the cold turkey quitting rate is 3% and, according to GlaxoSmithKline, NRTs can only double that number. The Royal College of Physicians pointed out in their report, Harm reduction in nicotine addiction: helping people who can't quit, that some smokers may never be able to give up all use of nicotine.
A growing body of research is showing that smoking abstinence is being achieved at rates above 70% among e-cigarette consumers who want to escape from smoking. What's more, a recent pilot study showed a 22% smoking cessation rate at 6 months among a group of smokers who had no intentions of completely quitting, but were only looking for a way to reduce their cigarette consumption.
We do not force laptop computer users outdoors or prohibit indoor use of cell phones to guard against accidental injury of bystanders by explosions. Clean indoor air laws were enacted to protect bystanders from the harmful elements in smoke. These elements are not found in vapor. We now know that the "carcinogens" the FDA detected in e-cigarette liquid do not exceed the level found in a 4 mg nicotine patch. No carcinogens at all and no toxic chemicals were found in the vapor. Toxicology tests of e-cigarette liquid and vapor from around the world have never measured anything higher than harmless trace levels of chemicals in the vapor. Including e-cigarettes in clean indoor air laws protects no one, and works to discourage current smokers from trying a product that might help them avoid smoking-related lung disease, heart disease, and cancer.
So let's all take a deep breath and wait for more definitive information to become available.
Disclaimer: I do not sell or profit in any way from smoke-free e- cigarettes. I smoked for 45 years and could not stay quit, no matter what cessation method I used. Nicotine abstinence triggered intractable cognitive and mood impairments that only partially responded to medication. I have been smoke-free since March 27, 2009, thanks to a combination of long-term use of nicotine gum and daily use of an e-cigarette.

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