December 15, 2014

Stanton A. Glantz, PhD

New paper from UCSF: The importance of product definitions in US e-cigarette laws and regulations

Lauren Lempert, Rachel Grana, and I just published "The importance of product definitions in US e-cigarette laws and regulations" in Tobacco Control. 
This paper provides a detailed analysis of state e-cigarette legislation (including on online appendix with details on every law) that describes how the tobacco and e-cigarette companies (which are increasingly the same) are using laws that nominally restrict sales of e-cigarettes to kids as a Trojan Horse to enact changes to how e-cigarettes are defined that make it more difficult to regulate them, tex them, and include them in clean indoor air laws.
In the face of rapidly mounting evidence that e-cigarettes are prolonging and worsening the nicotine epidemic, including by supporting smoking of conventional cigarettes, it is important that health advocates understand and these technical details and ensure that the industy cannot continue to get these damaging laws passed.
Here is the abstract of the paper.

Background How electronic cigarettes and similar products (e-cigarettes) are defined affects how they are regulated, particularly whether existing laws for cigarettes apply, including sales and marketing, youth access, smoke-free and taxation laws.

Methods We examined the text of 46 bills that define e-cigarettes enacted in 40 states and characterised how e-cigarettes and similar products were defined.

Results States enact laws creating new product categories for e-cigarettes separate from the ‘tobacco product’ category (eg, ‘alternative nicotine product,’ vapour product,’ ‘electronic nicotine device’), with four states explicitly excluding e-cigarettes from ‘tobacco products.’ Twenty-eight states do not include e-cigarettes in their definitions of ‘tobacco products’ or ‘smoking,’ eight include e-cigarettes as ‘tobacco products,’ three include e-cigarettes in ‘smoking.’ Sixteen states’ definitions of e-cigarettes require nicotine, and five states pre-empt more stringent local laws. Tobacco and e-cigarette industry representatives tried to shape laws that benefit their interests.

Conclusions Definitions separating e-cigarettes from other tobacco products are common. Similar to past ‘Trojan horse’ policies, e-cigarette policies that initially appear to restrict sales (eg, limit youth access) may actually undermine regulation if they establish local pre-emption or create definitions that divide e-cigarettes from other tobacco products. Comparable issues are raised by the European Union Tobacco Products Directive and e-cigarette regulations in other countries. Policymakers should carefully draft legislation with definitions of e-cigarettes that broadly define the products, do not require nicotine or tobacco, do not pre-empt stronger regulations and explicitly include e-cigarettes in smoke-free and taxation laws.

The full paper is available here.
The CDC published a related paper in MMWR last week, "State Laws Prohibiting Sales to Minors and Indoor Use of Electronic Nicotine Delivery Systems — United States, November 2014," that also makes the point (consistent with our paper) that prohibiting sales of e-cigs to youth is a necessary, but not sufficient, step in controlling use and mentions industry interference.  (My blog post on the CDC study is here.)



<STRONG;because here: Robert West states:</strong;
<STRONG;“What’s in it? Obviously, the water vapour is fine. Then you’ve got propylene glycol, which is stage smoke. That’s been tested. It does have some irritant properties, but nothing like cigarette smoke, and it doesn’t have the high level of carcinogens. The nicotine is not totally harmless by any means.”</strong;
<STRONG;Curiously, here: however, Konstantinos Farsalinos et al state that, amongst other things:</strong;
<STRONG;“Although e-cigarettes do not combust any material, heat is necessary to generate the vapor (aerosol) which is subsequently inhaled by the users. This can result in thermal decomposition of some e-cigarette ingredients, releasing potentially toxic chemicals (most commonly aldehydes, such as formaldehyde, acetaldehyde and acrolein).”</strong;
<STRONG;Oh! So propylene glycol actually decomposes after a certain temperature, and we knew that in: 1947 here";http://jpet.aspe... but the researchers made sure the solvent did <EM;not</em; decompose. So, Robert’s comment about propylene glycol&nbsp; being “tested” isn’t correct after all . . . . not in the conditions found in an e-cigarette, anyway.</strong;
<STRONG;He also does not seem to mention what bibra state here :</strong;
<STRONG;“A wide array of flavouring substances are added to electronic cigarette formulations and these might be inhaled (along with nicotine and other excipients) by the consumer. The toxicological acceptability of such substances has historically been assessed for food and cosmetics applications, and their safety for use in electronic cigarettes (as inhaled flavourings) now needs to be substantiated.”</strong;
<STRONG;So, it sounds like: IF a current smoker can fully switch, that there might be a considerable reduction in harm. However, in youth, where the comparator is fresh air, and not tobacco, that children will be inhaling carcinogenic and toxic substance in devices that have not currently been fully tested for safety?</strong;
<STRONG;Sounds a bit like the end comment here:
<STRONG;“Technology is way ahead of the science,” Dr. Shihadeh concurred. “We’re creating this stuff, and we don’t understand the implications.”</strong;
<STRONG;Sounds like a good reason to: proceed with caution . . . .</strong;
<STRONG;This is good, on cessation data, also:
<STRONG;Where is this “mountain of evidence” that Bill Godshall keeps referring to?</strong;

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