Who

What are electronic cigarettes (e cigarettes)?

E cigarettes or ENDS (electronic nicotine delivery systems) are devices whose function is to vaporize and deliver to the lungs of the user a chemical mixture typically composed of nicotine, propylene glycol and other chemicals, although some products claim to contain no nicotine. A number of ENDS are offered in flavours that can be particularly attractive to adolescents. Electronic cigarettes (e cigs) are the most common prototype of ENDS.

Each device contains an electronic vaporization system, rechargeable batteries, electronic controls and cartridges of the liquid that is vaporized. The manufacturers report that the cartridges typically contain between 6 and 24 mg of nicotine, but sometimes can contain more than 100 mg. In the form of tobacco products, nicotine is an addictive chemical that in excessive amounts can be lethal (0.5 1.0 mg per kg of weight of the person).

Most ENDS are shaped to look like their conventional (tobacco) counterparts (e.g. cigarettes, cigars, cigarillos, pipes, hookahs or shishas). They are also sometimes made to look like everyday items such as pens and USB memory sticks, for people who wish to use the product without other people noticing.

Are electronic cigarettes (ENDS) safe?

The safety of ENDS has not been scientifically demonstrated.

The potential risks they pose for the health of users remain undetermined. Furthermore, scientific testing indicates that the products vary widely in the amount of nicotine and other chemicals they deliver and there is no way for consumers to find out what is actually delivered by the product they have purchased.

Most ENDS contain large concentrations of propylene glycol, which is a known irritant when inhaled. The testing of some of these products also suggests the presence of other toxic chemicals, aside from nicotine. In addition, use of these products when they contain nicotine can pose a risk for nicotine poisoning (i.e. if a child of 30 Kilos of weight swallows the contents of a nicotine cartridge of 24 mg this could cause acute nicotine poisoning that most likely would cause its death) and a risk for addiction to nonsmokers of tobacco products. Nicotine, either inhaled, ingested or in direct contact with the skin, can be particularly hazardous to the health and safety of certain segments of the population, such as children, young people, pregnant women, nursing mothers, people with heart conditions and the elderly. ENDS and their nicotine cartridges and refill accessories must be kept out of the reach of young children at all times in view of the risk of choking or nicotine poisoning.

As ENDS do not generate the smoke that is associated with the combustion of tobacco, their use is commonly believed by consumers to be safer than smoking tobacco. This illusive safety of ENDS can be enticing to consumers however, the chemicals used in electronic cigarettes have not been fully disclosed, and there are no adequate data on their emissions.

Is use of electronic cigarettes (ENDS) an effective method for quitting tobacco smoking?

The efficacy of ENDS for helping people to quit smoking has not been scientifically demonstrated.

ENDS are often touted as tobacco replacements, smoking alternatives or smoking cessation aids. But we know that for smoking cessation products to be most effectively and safely used, they need to be used according to instructions developed for each product through scientific testing. There are no scientifically proven instructions for using ENDS as replacements or to quit smoking. The implied health benefits associated with these claims are unsubstantiated or may be based on inaccurate or misleading information. When ENDS are used as cessations aids, they are intended to deliver nicotine directly to the lungs. None of the approved, regulated cessation aids, such as nicotine patches and chewing gum, delivers nicotine to the lungs. Therefore, the biological mechanism by which smoking cessation might be achieved by delivery of nicotine to the lungs and its effects are unknown. Delivery to the lung might be dangerous. Therefore, independently of the effects of nicotine, it is of global importance to study lung delivery scientifically.

The dose of delivered nicotine is also unknown. It is suspected that the delivered dose varies notably by product, which contain nicotine in various quantities and concentrations.

Conclusion

Until such time as a given ENDS is deemed safe and effective and of acceptable quality by a competent national regulatory body, consumers should be strongly advised not to use any of these products, including electronic cigarettes.

S.f. supes vote for same smoking laws for e-cigarettes — sfgate

Smoking electronic cigarettes in bars, restaurants and businesses will soon be illegal in San Francisco, after the Board of Supervisors voted unanimously Tuesday to treat the relatively new product like combustible cigarettes.

The legislation by Supervisor Eric Mar is intended to limit children’s use of the nicotine product, which he and other supporters contend has been marketed heavily toward young people, and to protect all members of the public from the secondhand aerosol emitted by the devices, he said.

Under the legislation, San Francisco would include e cigarettes in its strict antismoking laws, banning them in most public places besides curbside on city streets, requiring sellers to secure a special permit, and prohibiting their sale in pharmacies and other businesses where tobacco sales are banned. The board will vote on it once more next week, and it will become law in April after the mayor, a supporter, signs it.

It’s the latest step by local and state officials across the nation to limit use and sales of the devices, which the federal Food and Drug Administration has so far failed to regulate. Health advocates say use of e cigarettes is on the rise among high school students, in part because they are sold in flavors such as bubble gum that appeal to kids, and that little is known about their long term health effects.

Mar puffed on an e cigarette as he presented the legislation.

«Sorry for poisoning all of you, but it’s really important to show I have a banana flavored one and a peach flavored one … they are really targeted at young people and right now it’s not regulated,» he said, saying the product could create a new generation of nicotine addicts.

Manufacturers of electronic cigarettes some of which have marketed the products as a way for smokers to get their nicotine fix anywhere they want or as a way to quit smoking oppose San Francisco’s proposal. Cynthia Cabrera, executive director of the Smoke Free Alternatives Trade Association, said San Francisco’s legislation and limitations implemented elsewhere indicate a «fundamental misunderstanding» by policymakers of «what the product is.»

«It’s not a tobacco product, it’s a technology product … and this is stigmatizing people who use the product it sends the wrong message to the public,» she said. «It’s interesting that the city would rush to regulate something as if it’s tobacco when the FDA is still thoughtfully considering the issue. The city is deciding they have more information than the FDA, when the FDA has been looking at it for years.»

Medical marijuana advocates have also expressed concern. Dale Gieringer, director of the California chapter of the National Organization for the Reform of Marijuana Laws, said in a written statement that the legislation will hurt medical cannabis patients who «have no alternative but to vaporize because of the city’s stringent antismoking laws.» He said studies sponsored by NORML have «demonstrated that vaporizers are an effective harm reduction technology, effectively eliminating the respiratory toxins in marijuana smoke and posing zero secondhand smoke hazards.»

Stan Glantz, head of UCSF’s Center for Tobacco Control Research and Education, said the battery operated e cigarettes contain nicotine as well as dangerous chemicals and emit not just vapor but small particles and gases including metals. Just because they are safer than cigarettes doesn’t make them a healthier alternative, he said.

Also Tuesday, Supervisor London Breed introduced legislation she billed as a «comprehensive overhaul» of the city’s graffiti policies. The proposal is supported by a long list of city agencies, including the city attorney’s office, Police Department and Public Works Department.

Under the legislation, the city attorney will be able to pursue civil lawsuits against chronic graffiti offenders, and those repeat scofflaws will be barred from bringing graffiti and etching tools on Muni or into public parks. The proposal will also streamline the city’s evidence collecting system using the 311 phone app. Breed said it could save San Franciscans millions of dollars a year.

Marisa Lagos is a San Francisco Chronicle staff writer. E mail mlagos Twitter mlagos