Re: [DIV28SUPER] peril of e-cigarettes

Feelings are CLEARLY running strong on this, and I feel everyone has some valid points, but I have to say I resonate most with Jed. No pregnant women, and no children/adolescents should have access to nicotine in any form, but adult smokers very substantially reduce their health risks by switching to e-cigarettes. Although not yet marketed/approved for smoking reduction, anecdotal evidence suggests that they may be the best stop-smoking aids yet developed, and switching to them clearly eliminates all risk associated with the carbon monoxide, particulates, and carcinogens found in tobacco smoke, as well as the second/third-hand risks of these. I've heard a quote attributed to a WHO official that the current uproar over e-cigarettes just diverts attention from the far greater hazards of smoking.

Bob Smith

Robert F. Smith, PhD
Professor of Psychology
4400 University Dr.
Fairfax, VA 22030
Phone: 703 993 4339
Email: bsmith@gmu.edu

From: div28super reaches div28 and div28m and its nested lists (e.g. div28s) <DIV28SUPER@lists.apa.org> on behalf of Jed Rose <jed.rose@DUKE.EDU>
Sent: Monday, March 24, 2014 1:06 PM
To: DIV28SUPER@lists.apa.org
Subject: Re: [DIV28SUPER] peril of e-cigarettes

I think it is important to distinguish between two quite distinct issues:

1) Acute toxicity of nicotine: it has long been known that nicotine in pure form is highly toxic, and even medicinal nicotine products are not without risk if they fall into the hands of children. It is therefore imperative that the FDA regulate all forms of nicotine to ensure that packaging is acceptably safe;

2) The chronic health risks of moderate doses of nicotine, which are far less than those of cigarettes, according to most experts. These experts include Mitch Zeller, Director of the FDA Center for Tobacco Products (he stated the conclusion about nicotine at a recent FDLI conference). Theoretical speculations about nicotinic/muscarinic balance must be viewed in the context of hard evidence, which thus far suggests that nicotine is indeed much less harmful than smoking. See also the findings of the Lung Health Study and other epidemiologic studies of the effects of nicotine when derived from non-combusted tobacco.

Dr. Neal Benowitz, quoted in the New York Time news article, has written:

"The development of a consumer-acceptable inhaled nicotine delivery system with absorption kinetics similar to those of a cigarette would be an important advancement in pursuing harm reduction through nicotine maintenance."
(Clinical Pharmacology & Therapeutics 83(4):531-41, 2008)

The recent Surgeon General's report estimated 480,000 premature deaths from smoking, largely due to the non-nicotine components of smoke produced by burning tobacco. E-cigarettes represent a promising approach to reducing this enormous death toll, and while FDA regulation is necessary to minimize the risk to children, to label the e-liquid "poison" is a bit of hyperbole that does not contribute to a sensible discussion of the topic.


Jed E. Rose, Ph.D.
Director, Center for Smoking Cessation
and Professor, Department of Psychiatry and Behavioral Sciences Duke University Medical Center
2424 Erwin Road, Suite 201
Durham, NC 27705
919-668-5055 (phone)
919-668-5088 (FAX)


-----Original Message-----
From: div28super reaches div28 and div28m and its nested lists (e.g. div28s) [mailto:DIV28SUPER@LISTS.APA.ORG] On Behalf Of Herbert Barry III PhD
Sent: Monday, March 24, 2014 10:38 AM
Subject: [DIV28SUPER] peril of e-cigarettes

When I initially heard about e-cigarettes, I doubted that they were safe alternatives to tobacco because of omitting components of tobacco that cause lung cancer and other maladies. Nicotine is a powerful endogenous substance, and overloding the system with exogenous nicotine might have adverse side effects, such as disrupting the balance between nicotinic and muscarinic stimulation.

The new information about toxic and even lethal effects of liquid nicotine indicates a very severe peril. I am reminded now about reports, many years ago, that swallowing a few cigarettes might be lethal because of overdose of nicotine. The effect is greatly diluted when nicotine is in a smoked cigarette.

An analogy is the dangerous and even lethal effects of overdose and chronic ue of morphine, heroin, ad other opiates. An important advance of our knowedge a few decades ago was the discovery of endorphins, which are endogenous sources of analgesia, miimicke by opiates.
--- Herb Barry

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