Thursday, April 29, 2010

Email Message to Public Citizen

I am confused. Your web site states "Public Citizen serves as the people’s voice in the nation’s capital."

And yet, we see your organization's name on the Amicus Brief filed on behalf of FDA in Smoking Everywhere versus FDA. Either your organization cares nothing for the health and welfare of the people, or you have been snookered.

Perhaps you fell for one or more of the many half-truths, unsupported fears, or outright lies you have been told about electronic cigarettes. Here are the facts, with sources cited:

Purpose - Electronic cigarettes were invented as a way to provide smokers who can't or won't quit with a substitute that is less hazardous than inhaling tobacco smoke. [1]

They were not invented as a way to outfox indoor smoking bans. They were invented in China. China doesn't have such bans.

They were not invented to be an NRT "smoking cessation" product. NRTs are purposely low-dose with the ultimate aim of "curing" nicotine addiction.

Target Market - Adult, committed smokers.[2] Ask the people/organizations claiming that electronic cigarettes are being marketed to children, "What percent of customers are under age 18?" I'd be willing to bet they can't do this, because they haven't bothered to actually investigate it. You can check the results of a survey (n=303) conducted by the University of Alberta [3] to learn that 55% of customers are between 30 and 50, and 32% are 51 years or older. All were previous smokers. In an ongoing survey (currently over 1,100 responses) being conducted by CASAA [4], we find 53.2% between 30 and 50, with another 29% age 51 years or older, and 84.5% smoked for 10 years or more.

Success Rate as Smoking Alternative - The University of Alberta Survey [3] shows that 79% are using them for a complete replacement for traditional tobacco cigarettes. An additional 17% are using them as a partial replacement, and only 4% use them in addition to tobacco cigarettes. The CASAA survey [4] shows that only 17.9% of users continue to smoke (some) tobacco cigarettes and that 75.2% report that they now use no smoked or smokeless tobacco products at all.

Toxicity - Based on number and quantities of harmful chemicals, electronic cigarettes appear to be at least 1,000 times less dangerous than tobacco smoke.

The FDA's press release concerning lab tests conducted on 18 cartridges gleefully announced that the products contain carcinogens and "a chemical used in antifreeze". If you read the actual lab report [5] you will find that no quantities are specified for the carcinogens -- Tobacco-Specific Nitrosamines (TSNAs).

You can, however, find in a report issued by Health New Zealand that a 16 mg. electronic cigarette cartridge contains 8 nanograms of TSNAs -- "This amount is extremely small, equal for example, to the amount reported to be present in a nicotine medicinal patch. (8 ng in 1g = eight parts per trillion)." [6]

To put this quantity in perspective, consider the fact that a pack of Marlboros contains 11,190 ng/g of TSNAs. [7]

Tobacco cigarettes also contain the "ingredient used in antifreeze." However, in addition, tobacco cigarettes contain arsenic used in rat poison, hydrogen cyanide used in gas chambers, formaldehyde used to embalm dead bodies, polonium radiation dosage equal to 300 chest X-rays in one year, and many more harmful substances that you will not find in electronic cigarette liquid or vapor.

No smoke - Electronic cigarettes use the process of vaporization, rather than combustion. Thus, the user does not inhale tar, carbon monoxide, or particulates. As you might guess (see next item), the lack of these substances as well as the extreme reduction in toxins and carcinogens appears to have a beneficial effect on the health of the users. Consider the bystanders as well. A tobacco cigarette remains lit, producing sidestream smoke. An electronic cigarette does not produce vapor until the user inhales, and the vapor does not go into the surrounding air until the user exhales. The vapor was also tested by Health New Zealand and pronounced to be "harmless, inhaled or exhaled." [8]

Beneficial Health Effects - The majority of University of Alberta survey [3] respondents reported that their general health (91%), smoker’s cough (97%), ability to exercise (84%), and sense of smell (80%) and taste (73%) were better since using e-cigarettes and none reported that these were worse. In the CASAA survey [4] 91.3% report better lung function/easier breathing and 80% report increased lung capacity. Over half report reduced coughing, increased stamina, and sleeping better.

Adverse Health Effects - The CASAA survey [4] asked respondents about adverse effrects, rated by frequency. Dry/sore throat (3.3%), Dry Skin (1%), and Increased Phlegm (1%) were reported as being experienced frequently. These symptoms can be annoying, but are by no means life-threatening.

In contrast, two of the drugs approved by FDA for smoking cessation have resulted in serious adverse effects including seizures, major depression, suicidal ideation, and deaths, and now carry an FDA "Black Box" warning. [9]

In his 32-page opinion [10] accompanying the injunction against FDA in the aforementioned federal case, Judge Leon wrote:

"I am not convinced that the threat to the public interest in general or to third parties in particular is as great as FDA suggests. Together, both Smoking Everywhere and NJOY have already sold hundreds of thousands of electronic cigarettes, yet FDA cites no evidence that those electronic cigarettes have endangered anyone. Nor has FDA cited any evidence that electronic cigarettes are any more an immediate threat to public health and safety than traditional cigarettes, which are readily available to the public."

After considering the facts, I'm confident that you will agree that the public health dangers of electronic cigarettes have been greatly exaggerated by the FDA and the other organizations named in the Amicus Brief. As the surveys show, those who have switched to vaporized nicotine are enjoying the same kind of health benefits seen by those who quit all nicotine use. The real danger to public health lies with the possibility that FDA wins this case and immediately removes electronic cigarettes from the market. What will be the result?

In the CASAA survey [4], 72.2% indicate that it is likely or very likely that they will go back to smoking if electronic cigarettes become unavailable. Do you really want to be party to that end? Furthermore, consider the fact that the smoking prevalence rate has stagnated. Think of the over 40 million continuing smokers, who have tried over and over to quit, who might succeed at substituting vaporized nicotine for inhaling tobacco smoke--but not if the products are banned.

If you want to serve as "the people's voice," we are the people. We are being victimized by an overzealous government agency and non-profit organizations that claim they want to help people stop smoking. Instead, they are throwing all of their power and money into taking off the market the one product that finally worked for us. Look at both surveys. See how many products we tried in our attempts to quit. By insisting that "quit" means giving up all nicotine, these organizations are literally killing us with their "kindness."

Sincerely,

Elaine D. Keller, Board Member
The Consumer Advocates for Smoke-Free Alternatives Association (CASAA)
http://www.casaa.org

Sources:

[1] http://articles.latimes.com/2009/apr/25/world/fg-china-cigarettes25
[2]
http://www.ecassoc.org/eca-letter-to-congress/
[3]
http://tobaccoharmreduction.org/wpapers/011v1.pdf
[4]
https://www.surveymonkey.com/sr.aspx?sm=HrpzL8PN5cP366RWhWvCTjggiZM_2b8yQJHfwE9UXRNhE_3d
[5]
http://www.fda.gov/downloads/Drugs/ScienceResearch/UCM173250.pdf
[6]
http://www.healthnz.co.nz/RuyanCartridgeReport30-Oct-08.pdf
[7]
http://www.casaa.org/files/TSNA_Chart(1).pdf
[8]
http://www.healthnz.co.nz/ECigsExhaledSmoke.htm
[9]
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm170100.htm
[10]
http://www.casaa.org/files/SE-vs-FDA-Opinion.pdf

18 comments:

  1. Elaine, that is a superlative rebuttal. Just what on earth do these organisations think they are doing supporting the FDA's actions. Many thanks for taking the time to write such excellent exposes of their ignorance.

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  2. "As the surveys show, those who have switched to vaporized nicotine are enjoying the same kind of health benefits seen by those who quit all nicotine use. The real danger to public health lies with the possibility that FDA wins this case and immediately removes electronic cigarettes from the market. What will be the result?"

    I,(a former Cigarette Smoker of 27 yrs can answer this!), Thousands, if not hundreds of thousands will die NEEDLESSLY because they will more than likely have NO CHOICE but to return to the hazardous FDA approved/Big Tobacco endorsed carcinogen laden Cigarettes! This is both a travesty and shame to live in a Country so corrupt that Humanity takes a back seat because of Bureaucratic GREED!

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  3. Thank you for the time and effort you put into this outstanding post. Happily shared on my FB.

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  4. It is extremely disheartening to see organizations that supposedly "speak for the people" parroting the same tired negative propaganda against the e-cigarette. Apparently the millions of lives that could be dramatically improved by this device, and the many thousands that already have been, mean nothing to them.

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  5. Electronic cigarettes are saving my life.
    Why do they want me to die?

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  6. Very interesting take... electric cigarette has great potential, and are a great alternative for smokers and even for those who are not planning to quit the habit of smoking. They are rapidly gaining acceptance in US as well as other parts of the world too.

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  7. I was a 46 year smoker. Tried to quit with every option available, including cold turkey. I always picked the cigarette back up.

    Until the electronic cigarette. Within 6 days, I was vaping only. My cigarettes lay for weeks until I finally threw them out. It will be one year on June 23, 2010 since I switched to vaping.

    I have had pulmonary function tests done, and my lung function has improved by 80% already. I breathe better, sleep better, taste and smell so much better. The quality of my life has so greatly improved, I am still in awe of it!!

    How is that harmful?

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  8. this org like others are nothin but flaming assho-es,care nothing but there own gain,this just proves it

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  9. I speak for the people and the word is back the E-cig, not big Tobacco.!!!

    If you speak for the people get a set of Balls and stand up against Phillip Moris,
    R.J Renolds, and all the big tobacco companies that have been killing relentless numbers of people for hundreds of years now and back the Electronis Cigarette. Stop the big mighty dollar of the Big Tobacco companies from paying off people on the FDA and other groups and put the word out about these big payoffs and there Lobbing efforts to Ban the E-cig that save lives not destroys like the real cig's do, Big Tobacco is just paying off and buying who and what they want with there deep pockets and has a licence to Kill yet when it comes to a safer product like the E-cig they want to Ban this product cmon WAKE UP AND SMELL THE COFFEE PEOPLE AND GET WITH THE PROGRAM AND STOP BEING ON THE TAKE JUST LIKE SOME IF NOT MOST OF OUT GOV'T OFFICIALS. Bottom line is the E-Cig is hurting big tobacco so they are paying to try and crush it, but it's not going to happen the E-cig people are standing there ground, NOW BACK THE PEOPLE SINCE THATS A MISSION STATEMENT YOU MAKE.!!!!!

    mwa1024@aol.com

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  10. Estimations say that there are between 300,000 and 800,000 people now using e-cigarettes in the U.S. alone, and more people are finding them every day. As Elaine said, we ARE the people. We are the people that have tried the NRTs, (7% quit rate combined with 36% of gum and lozenge users being chronic users.) tried to quit cold turkey, (10% success rate)and finally resigned ourselves to being life long smokers. We are the people that are getting support from our doctors because our health has improved so greatly.

    It is no wonder the FDA has absolutely no reduced harm tobacco products listed. They try to ban everything that qualifies.

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  11. I'm a 30 year smoker. I quit 4 days after getting my e-cig in the mail. I haven't touched tobacco since. I feel great 4 months later.

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  12. I picked up an E Cigarette on December 6, 2009 and I haven't smoked a cigarette since; this after 40+ years of smoking two packs a day! I haven't felt this good in years; that’s the only proof that I need!

    Misled (through junk science) well meaning people are being hoodwinked into jumping on the Ban the E Cigarette Bandwagon! This is being encouraged by greedy BIG Tobacco and Pharmaceutical Barons who stand to lose fortunes from the threat of a safer alternative to smoking. Not to mention the lost revenues from tobacco taxes that state and federal governments have at stake.

    I fail to see how banning E Cigarettes and chasing me (and others like me) back to a known killer (cigarettes) is in the best interest of the public’s health? I inhale more toxic fumes during my daily commute than I do from an E Cigarette!

    I wish the FDA would conduct legitimate (scientific method) research on E Cigarettes, alongside others, and just report their results. But, that would mean adhering to time honored concepts like peer reviews.

    I’m an adult; I am capable of making reasonable choices when presented with accurate (unbiased) information! I don’t need or want the FDA (or anyone else) dictating what I should or should not put in my body (or head for that matter); just report the findings!

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  13. Public Citizen, the voice of the people? The “health” associations, organized to look out for our Health? Who are you the voice of? You certainly are not the voice for the 40 to 60 million smokers in this country. You certainly aren’t the voice for the friends and relatives of those smokers who would like to see their loved ones using a healthier alternative to deadly cigarettes. You certainly aren’t the voice for those non-smokers that have become knowledgeable about this new product that doesn’t effect them and they find as a much more favorable product than those cigarettes they dislike. So who do represent?

    Is it the Pharmaceutical industry and their use of nicotine to “cure” nicotine at outlandishly high profits and highly ineffective results? Maybe it’s their anti-depressant products, again at high profits with very dangerous consequences and poor results? Is it that you feel a sense of superiority in controlling those you have no right to control? Perhaps you like the fact that people will continue smoking real cigarettes? I can’t imagine any thinking logical person that can’t see that Electronic Cigarettes and other smokeless tobacco products are orders of magnitude safer for smokers, for people that come in contact with people that use these products and for the environment.

    I smoked for 43 years and tried like so many to quit using all these ineffective FDA approved methods only returning to cigarettes after they failed. I was smoking two to three packs a day at the end, and I do mean end, unless you get your way and I find no alternative that makes me comfortable except cigarettes. I don’t want that, those that have used these products to get off cigarettes don’t want that. Do you?

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  14. Rothenbj: You make some excellent points. Thanks for writing.

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  15. Anonymous: Interesting. Some citizen opponents of electronic cigarettes believe that Big Tobacco created and is promoting the products. Some members of the electronic cigarette community believe as you do that Big Tobacco is behind the push to ban the products. So far, the organizations that we have seen overtly stating they want the products banned are the ones I would have least expected to be opposed to something that helps people not to smoke: The 3-letter health organizations, along with anti-smoking organizations. Time will tell where BT stands on this issue.

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  16. Excellent rebuttle. Today marks my one year anniversary away from cigarettes using electronic cigarettes. I am totally, totally flabbergasted that our wonderful government, and groups like this "Public Citizen" who claims that they are the "voice of the people", don't really hear the voice of the people and jump on the band wagon to rid this nation of a groundbreaking device that will only end up saving thousands of lives each year, are so hell bent on removing them. It's no secret it's all about the money. Lets hope some positive response comes from this rebuttle.

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  17. Elaine, your letter actually underestimates the safety of e-cigarettes: "To put this quantity in perspective, consider the fact that a pack of Marlboros contains 11,190 ng/g of TSNAs."

    Although this is true, it could cause some confusion because the measurement of TSNA is in parts per billion, but there is more than one gram of tobacco in a pack of Marlboro--its actually closer to 20g. 20 x 11,190 = 223,800 nanograms of TSNA per pack.

    E-cigarettes and other products containing pharmaceutical grade nicotine like NRT's seem to have about 1ng of TSNA for every 2 milligrams of nicotine (ie. Njoy's 16mg/g cartridges have about 8ng TSNA). That means you'd need to vape nearly 28 liters of Njoy (or 27,975 1ml cartridges) e-liquid to have to have the same amount of TSNA as in one pack of cigarettes.

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  18. This is an informative and intelligent look at the Electronic Cigarette.I hope that they are not banned,DOOMING me to 3900+ chemicals as well as TAR! If the FDA were concerned about "people", they would be giving smokers free samples of e-cigarettes, which in turn would save or extend MANY lives!

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