The use of e cigarettes has surged since smoking bans came into place.

In the UK, there are an estimated 1.3m users, compared with 9m smokers.

But what exactly are e cigarettes?

E cigarettes come in two parts in one end there is liquid nicotine, and in the other a rechargeable battery and an atomiser.

When the user sucks, the liquid nicotine is vaporised and absorbed through the mouth.

What looks like smoke is largely water vapour, hence smoking e cigarettes is often called vaping.

As the e cigarettes contain nicotine, the user gets the hit that makes smoking addictive, without being harmed by the toxins found in real cigarettes.

So are they safe, then?

The British Medical Association says the simple answer is that we don’t yet know, pointing out that only long term research can determine that.

The Medicines and Healthcare Products Regulatory Agency will regulate e cigarettes as medicines from 2016.

Part of the reasoning for this move was that there was concern the e cigarettes currently on the market did not meet appropriate standards of safety, quality and efficacy.

The regulator has said «levels of contamination» have been found in some products and others have been poorly manufactured.

However, there is a consensus that they are certainly less harmful than smoking tobacco, which is responsible for 100,000 deaths a year in the UK.

Should smokers use them to quit?

They are not recommended by the NHS yet, but there is some evidence they may help.

A team at the University of Auckland, in New Zealand, last year released the results of the first clinical trial comparing the devices with nicotine patches.

The results, published in the Lancet, showed 7.3% using e cigarettes had quit after six months compared with 5.8% using patches.

What is more, after six months, 57% of e cigarette users had halved the number of cigarettes smoked each day compared with 41% among those using patches.

However, the study did not involve enough people just 657 to prove definitively which is the better option.

There are also concerns that the increase in popularity of e cigarettes could act as a gateway to smoking, particularly for young people.

The Local Government Association has been critical of the way they appear to be marketed at children through social media and the sale of fruit flavoured versions.

Are they not covered by legislation?

Not a great deal. The UK like many countries is playing catch up.

Earlier this year ministers in England said they would ban the sale of e cigarettes to under 18s. Similar legislation is being considered elsewhere in the UK.

Wales is also considering a proposal to ban the use of them in public places to mirror the law covering real cigarettes. Some companies, including train firms, airlines and the pub chain JD Wetherspoon, have taken the step themselves.

Other countries have gone even further. Brazil, Singapore and Mexico have banned importing and selling the devices, even though tobacco is still on sale in all those countries.

Fda moves to ban sales of e-cigarettes to minors — chicagotribune.com

WASHINGTON (Reuters) The U.S. Food and Drug Administration proposed rules on Thursday that would ban the sale of e cigarettes to anyone under 18, but would not restrict flavored products, online sales or advertising, which public health advocates say attract children.

The long awaited proposal would subject the $2 billion e cigarette industry to federal regulation for the first time.

FDA Commissioner Margaret Hamburg said at a briefing that the proposal represented the first «foundational» step towards broader restrictions if scientific evidence shows they are needed to protect public health.

Critics of e cigarette advertising say it risks introducing a new generation of young people to conventional cigarettes when little is known about the long term health impact of the products. And they lamented the fact that limits were not included in the proposed rule.

«It’s very disappointing because they don’t do anything to rein in the wild west marketing that is targeting kids,» said Stanton Glantz, a professor at the Center of Tobacco Control Research and Education at the University of California San Francisco. «They should not have been so timid.»

Hamburg said the current proposal «lays the foundation for many more actions and activities.»

Vince Willmore, a spokesman for the Campaign for Tobacco Free Kids, said the proposal «by no means does everything we think needs to be done, but it starts the process. What is critical now is that they finalize this rule and then move quickly to fill the gaps.»

NO FREE SAMPLES

A law passed in 2009 gave the FDA authority to regulate cigarettes, smokeless tobacco and roll your own tobacco and stipulated the agency could extend its jurisdiction to other nicotine products after issuing a rule to that effect. E cigarettes use battery powered cartridges to produce a nicotine laced inhalable vapor.

In the short term, the rule would prohibit companies from distributing free e cigarette samples, forbid vending machine sales except in adult only venues and prohibit sales to minors. Companies would be required to warn that nicotine is addictive, but no other health warnings would be required. The addiction warning would have to be added no later than two years after the rule is set. The companies would not be allowed to make health claims in any advertising.

The proposal is subject to a public comment period of 75 days. Willmore said the FDA should aim to establish the rule within a year.

Some are skeptical that restrictions on marketing or flavors will come any time soon.

«The reality of these things is that every step takes years,» said Glantz. «By not addressing the youth directed marketing it means it won’t be addressed for a very long time.»

Some e cigarette companies that sell primarily through convenience stores were surprised at the lack of restrictions on online sales, since it can be difficult to verify a customer’s age over the internet.

«The internet thing is very surprising to me,» said Miguel Martin, president of Logic Technology, one of the biggest e cigarette manufacturers. «It reduces the visibility of the sales of the products and the type of products that the government has awareness of.»

The rules would require companies to submit new and existing products to the FDA for approval. They would have two years to submit applications from the time the rule goes into effect. Companies may continue selling their products and introducing new products pending the FDA’s review.

In the meantime, they would be required to register with the FDA and list the ingredients in their products. They would not be required to adhere immediately to specific product or quality control standards. That could come later, Hamburg said.

EVOLVING «VAPING» INDUSTRY

E cigarettes and other «vaping» devices generate roughly $2 billion a year in the United States, and some industry analysts expect their sales to outpace the $85 billion conventional cigarette industry within a decade.

Advocates of e cigarettes claim they are a safer alternative to conventional cigarettes, since they do not produce lung destroying tar. But there is little data about their long term safety.

The FDA’s proposal leaves many questions unanswered about how new products would be regulated over the long run. One key question relates to how products are approved.

Under current law, new tobacco products can be approved if they are «substantially equivalent» to a product that was on the market before February 15, 2007. It is unclear whether any e cigarettes were on sale before then, to be used as a benchmark.

Mitch Zeller, head of the FDA’s tobacco division, said at a briefing that the agency would be seeking more information during the public comment period on whether the «substantial equivalence» pathway is even valid for e cigarettes.

If it is not, e cigarette companies would have to use a different process, which would require them to prove their products are appropriate for public health, a higher hurdle to clear.

Also unclear is the fate of some cigars. The current proposal would include e vaping products and other tobacco products, but premium cigars may be excluded. The FDA said it would seek public comment on whether all cigars should be regulated equally. One option proposed by the agency is to regulate them all. The other is to define a category of premium cigars that would not be subject to the FDA’s authority.

Under the proposed rule, premium cigars are considered those wrapped in whole tobacco leaf, made manually by combining the wrapper, filler and binder, have no characterizing flavor, have no filter, tip, or non tobacco mouthpiece and are relatively expensive.

Tobacco company Lorillard Inc, owner of the blu e cigarette brand, is the dominant player in the field, followed by privately held NJOY and Logic. The three account for an estimated 80 percent of the market.

(Editing by Larry King)