2014-03-24

Re: [DIV28SUPER] peril of e-cigarettes

John,

I think you've missed my point. Jed Rose and others whose diligence has made even the most self-involved teenager aware of the health hazards of tobacco smoking, may inadvertently make it seem, to the scientifically naïve, as if e-cigarettes are free of risks. They exist, however. To me, the most serious are those arising from gestational exposure to nicotine and its effects on brain development. To some young women who would not dream of smoking or drinking while pregnant, the allure of the more 'benign" e-cigarette may be hard to resist. I come from a different perspective. Who would have thought, a few years ago, that feeding infant formula in plastic bottles hardened by Bisphenol A presented a threat to brain development and planted the seeds of prostate cancer? Or that shampoos and perfumes containing phthalates could demasculinize the male fetus in pregnant women using those products?  I concede the advantages of e-cigarettes over tobacco products, but they are not free of health costs, especially subtle ones.

Bernie
_______________________
 Bernard Weiss, Ph.D.
Professor of Environmental Medicine
University of Rochester
School of Medicine and Dentistry
Rochester, NY 14642

tel:         585-275-1736
fax:        585-256-2591




From: John Grabowski <grabo040@UMN.EDU>
Reply-To: "grabo040@UMN.EDU" <grabo040@UMN.EDU>
Date: Monday, March 24, 2014 3:42 PM
To: "DIV28SUPER@LISTS.APA.ORG" <DIV28SUPER@LISTS.APA.ORG>
Subject: Re: [DIV28SUPER] peril of e-cigarettes

A thought: Is the quibble here between the need/demand for Abstinence (and
perfection--Calvin would be pleased) and the Harm Reduction perspective, a
pill hard to swallow in the US but widely recognized in many countries as
having important benefits?

As for the comment that "no women should have access to
nicotine"--silliness for two reasons. Prohibition has never been effective
for its intended purpose. And for a woman who would otherwise continue to
smoke cigarettes, nicotine preparations do indeed provide the Harm
Reduction possibility--ooops there he goes again.

Oh, and yep, if you jump in a vat of nicotine it will likely have adverse
consequences. We agree on that do we not? Recall the disorders of those who
worked in the tobacco fields and sheds? Sad to say that, as with the
Malaysian flight event, and in this case nicotine, even the NYT has found
it necessary to pander to the "reality TV" crowd.

Be well, enjoy the dialogue.

John Grabowski PhD
Professor
Director, Ambulatory Research Center
Department of Psychiatry
Medical School
University of Minnesota






On Mar 24 2014, Robert F Smith wrote:

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
MSN 3F5
4400 University Dr.
Fairfax, VA 22030
Phone: 703 993 4339

________________________________________
From: div28super reaches div28 and div28m and its nested lists (e.g.
div28s) <DIV28SUPER@lists.apa.org> on behalf of Jed Rose
Sent: Monday, March 24, 2014 1:06 PM
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.

Sincerely,

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)

Dukesmoking.com


-----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

___________________ div28SUPER@lists.apa.org _____________________

___________________ div28SUPER@lists.apa.org _____________________

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--
John Grabowski PhD
Professor
Director, Ambulatory Research Center
Department of Psychiatry
Medical School
University of Minnesota

___________________ div28SUPER@lists.apa.org _____________________
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