2014-01-22 CC Packet - Laserfiche WebLink

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The BMA has noted literature finding electronic cigarettes as safer than tobacco smoking, but also is concerned by the lack of high quality peer- reviewed studies about safety. They have noted that the amount of nicotine delivered can be highly variable between devices due to differences in how well the nicotine is vaporized. They have also raised concerns that the delivered dose may be inconsistent or misleading compared to the nicotine level stated on the liquid container, with identically labelled cartridges emitting "markedly different" levels of nicotine. Issues around proper labeling, child -proof packaging, and electrical safety have also been raised .L A preliminary analysis of e- cigarette cartridges by the US Food and Drug Administration (FDA) in 2009 identified that some contain tobacco - specific nitrosamines (TSNAs), known cancer - causing agents. r 151[161 The amounts of TSNAs present were on par with existing NRT products like nicotine gum and inhalers. The FDA's analysis also detected diethylene glycol, a poisonous and hygroscopic liquid, in a single cartridge manufactured by Smoking Everywhere and nicotine in oneU G cartridge claimed to be nicotine -free. Diethylene glycol was found in a cartridge tested in 2009 by the FDA, but in 2011 researchers reviewed the data and noted that 15 other studies had failed to find any evidence of this chemical in e- cigarettes. Further concerns were raised over inconsistent amounts of nicotine delivered when drawing on the device. In some e- cigarettes, "Tobacco- specific impurities suspected of being harmful to humans — anabasine, myosmine, and 0- nicotyrine — were detected in a majority of the samples tested." It is not clear if these chemicals were detectable in exhaled vapor. 19 The UK National Health Service noted that the toxic chemicals found by the FDA were at levels one - thousandth that of cigarette smoke, and that while there is no certainty that these small traces are harmless, initial test results are reassuring. 20 Addiction A number of organizations including the Centers for Disease Control and Prevention, the International Union Against Tuberculosis and Lung Disease, the American Academy of Pediatrics [22) and the Food and Drug Administration have concerns that a -cigs might increase addiction to and use of nicotine and tobacco products in children. [241[251 The World Health Organization raises the concern of addiction from their use. 26 A 2013 report by the CDC analysing the 2012 National Youth Tobacco Survey (NYTS), a survey including 24,658 US students, found that while electronic cigarette use among middle and high school students almost doubled from 2011 to 2012, use of certain tobacco products (bidis and krekets) were shown to have fallen over the same period. Usage Electronic cigarette sales increased from 50,000 in 2008 to 3.5 million in 2012. As of 2011, in the United States, one in five adults who smoke have tried electronic cigarettes. 39 In a UK survey conducted in 2013 of more than 12,000 adults, 11% of regular smokers in the sample identified themselves as using electronic cigarettes and 24% stated that they had used them in the past. Amongst non - smokers in the same sample, 1 % said they had tried them and 0% stated that they were currently using them. [401 19