2014-03-24

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
MSN 3F5
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.

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
To: DIV28SUPER@LISTS.APA.ORG
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 _____________________
Div28m members may post here subscribers corner: http://lists.apa.org

___________________ div28SUPER@lists.apa.org _____________________
Div28m members may post here subscribers corner: http://lists.apa.org

___________________ div28SUPER@lists.apa.org _____________________
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Re: [DIV28SUPER] peril of e-cigarettes

These are household products not regulated by FDA (yet); therefore childhood poisoning risks are controlled under this CPSC statute:


Poison Prevention Packaging Act

Enacted in 1970, the PPPA (available in PDF), requires a number of household substances to be packaged in child-resistant packaging. The packaging required by the PPPA must be designed or constructed to be significantly difficult for children under five years of age to open within a reasonable time, and not difficult for normal adults to use properly. For the sake of the elderly and handicapped who might have difficulty opening such containers, the Act provides that a regulated product available for purchase on store shelves may be packaged in one non-complying size provided it carries a warning that it is not recommended for use in households with children, and provided that the product is also supplied in complying popular size packages. Regulated prescription drugs may be dispensed in non-child-resistant packaging upon the specific request of the prescribing doctor or the patient. The Environmental Protection Agency regulates economic poisons, such as pesticides. Since the regulation has been in effect, there have been remarkable declines in reported deaths from ingestions by children of toxic household products including medications.


and


Federal Hazardous Substances Act (FHSA)

The FHSA requires certain hazardous household products to have warning labels. It also gives CPSC the authority to regulate or ban a hazardous substance, and toys or other articles intended for use by children, under certain circumstances to protect the public.  Examples of products regulated under this law include electrically operated toys, cribs, rattles, pacifiers, bicycles, and children’s bunk beds. 


and


Consumer Product Safety Act (CPSA)

Enacted in 1972, CPSA is our umbrella statute. This law established the agency, defines CPSC’s basic authority and authorizes the agency to develop standards and bans. It also gives CPSC the authority to pursue recalls and to ban products under certain circumstances.


http://www.cpsc.gov/en/Regulations-Laws--Standards/Statutes/

#div28

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Re: [DIV28SUPER] peril of e-cigarettes

Yes, the risks of prenatal exposure must be taken into account, but these risks already exist with cigarettes and may also exist with medicinal nicotine products such as gum, patch, etc. The nicotine of e-cigarettes does not pose a novel risk to the fetus in that regard that is not already posed by medicinal nicotine products. And one doesn’t see the pharmaceutical companies’ barrels of nicotine that are used in manufacturing these products as being referred to as “barrels of poison”….

 

 

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

 

 

From: Weiss, Bernard [mailto:Bernard_Weiss@URMC.Rochester.edu]
Sent: Monday, March 24, 2014 1:34 PM
To: Jed Rose; DIV28SUPER@LISTS.APA.ORG
Subject: Re: [DIV28SUPER] peril of e-cigarettes

 

As  I noted in my previous note, you cannot  so easily dismiss the risks posed by gestational exposure. The scientific literature  contains hundreds of papers attesting to such risks. A developmental neurotoxicant is indeed a poison.

_______________________

 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: Jed Rose <jed.rose@DUKE.EDU>
Reply-To: Jed Rose <jed.rose@DUKE.EDU>
Date: Monday, March 24, 2014 1:06 PM
To: "DIV28SUPER@LISTS.APA.ORG" <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.

 

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 _____________________

 

Posted by at No comments:

Re: [DIV28SUPER] peril of e-cigarettes

As  I noted in my previous note, you cannot  so easily dismiss the risks posed by gestational exposure. The scientific literature  contains hundreds of papers attesting to such risks. A developmental neurotoxicant is indeed a poison.
_______________________
 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: Jed Rose <jed.rose@DUKE.EDU>
Reply-To: Jed Rose <jed.rose@DUKE.EDU>
Date: Monday, March 24, 2014 1:06 PM
To: "DIV28SUPER@LISTS.APA.ORG" <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.

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 _____________________
Posted by at No comments:

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
To: DIV28SUPER@LISTS.APA.ORG
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 _____________________
Div28m members may post here subscribers corner: http://lists.apa.org

___________________ div28SUPER@lists.apa.org _____________________
Div28m members may post here subscribers corner: http://lists.apa.org
Posted by at No comments:

Re: [DIV28SUPER] peril of e-cigarettes

Herb,

You are absolutely on target. What concerns me especially is that young women will find these to be attractive alternatives to tobacco, and will be unaware of the potential risks to the fetus once they become pregnant. Marijuana legalization poses the same kind of problems, of course. I wish more public attention were being paid to such risks. It took a long time for us to become sensitive to developmental neurotoxicants.

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: Herbert Barry III PhD <BARRYH@PITT.EDU>
Reply-To: "BARRYH@PITT.EDU" <BARRYH@PITT.EDU>
Date: Monday, March 24, 2014 10:37 AM
To: "DIV28SUPER@LISTS.APA.ORG" <DIV28SUPER@LISTS.APA.ORG>
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 _____________________
Posted by at No comments:

[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 _____________________
Div28m members may post here subscribers corner: http://lists.apa.org
Posted by at No comments:
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