Reply to post: Re: SMH

Re: SMH

Right, your first concern is regarding the release of TSNAs (Tobacco-specific nitrosamines) from the heating of nicotine, the exposure to which you suggested means that e-cigs should be banned.

You provided no source other than having worked with the materials in the past, no comparison to other methods of being exposed to TSNAs, no data at all, and advised me to 'put that in my pipe and smoke it'.

I responded to this with data from Public Health Englands study in to e-cigs showing that TSNA production from e-cigs was orders of magnitude lower than that in lit tobacco.and is in fact in line with that a subject recieves from nicotine patches.

Public Health Englands research concludes that on an overall level, e-cigs are at least 95% safer than lit tobacco, incidentally.

Your next statement was that vaping should be banned in public, based upon your personal preferences of the smell. This does not need to be debated or countered as it's a wholly facile point.

Your next un-sourced opinion is that PG could 'degrease the lungs'.

My response to this was a blog post that cites the US FDA and EPA recommending the use of atomised/vapourised PG for inhalation use in a variety of scenarios. This includes in nebulisers (as used by COPD patients to deliver medication directly to the lungs. This has been going on since the 1940s and no-one has had any problems with it in a medical setting. You are, quite simply, wrong on this point, and over seventy years of use in clinical settings proves it.

It was recently re-registered for use by the EPA and, I quote:

"General Toxicity Observations

Upon reviewing the available toxicity information, the Agency has concluded that there are no endpoints of concern for oral, dermal, or inhalation exposure to propylene glycol and dipropylene glycol. This conclusion is based on the results of toxicity testing of propylene glycol and dipropylene glycol in which dose levels near or above testing limits (as established in the OPPTS 870 series harmonized test guidelines) were employed in experimental animal studies and no significant toxicity observed.

Carcinogenicity Classification

A review of the available data has shown propylene glycol and dipropylene glycol to be negative for carcinogenicity in studies conducted up to the testing limit doses established by the Agency; therefore, no further carcinogenic analysis is required.

Mutagenicity Potential

Propylene glycol and dipropylene glycol were tested for mutagenic or genotoxic potential and found to be negative in a battery of studies: a bacterial gene mutation assay using Salmonella typhimurium, and in vitro Chinese hamster ovary (CHO) mutation assay, an in vitro Chinese hamster ovary (CHO) chromosomal aberration assay and an in vitro sister chromatid exchange assay. "

So in short, the concept of PG 'degreasing the lungs' has no basis in fact, whatsoever. It's approved for inhalation use without reservation.

Your last point is that lit tobacco (aka cigarettes) are being made less atrractive to kids, and that what is obviously happening is that they're turning to vapes.

I'm not going to copy and paste the entire part from the RCP report that utterly destroys that hypothesis by showing that use regular, non-experimental of these products in youth is very, very limited, and is almost exlusively limited to existing smokers. This data is backed up by ASH who produce a seperate study on youth use.

The main takeaway from this is, and again, I quote:

"Although children’s awareness of and experimentation with electronic cigarettes is increasing, regular use remains rare and is most common among those who currently smoke or have previously smoked. This indicates that it is unlikely that electronic cigarettes are currently acting as a gateway to smoking"

This is including when ASHs data is compared to other regional data.

These surveys are, I might add, YouGov, population level surveys - not self-selected internet surveys.

You have concerns about the use of these devices - that's understandable. However, the evidence we have does not show that your concerns are occuring, or even likely to occur.

That's the situation as it stands with regards to your specific concerns.

The real thing about e-cigarettes, that you seem to be missing, is the massive potential they have for harm reduction in existing smokers.

They have a wider penetration than any other smoking cessation product thanks to them being a consumer device, not a prescription service, and they have efficacy levels equivalent to or greater than that of existing stop smoking therapies, and this is because they were not regulated to death by people who are deliberately misinterpreting the scientific data to create laws that will almost certainly reduce the effectiveness of these devices in preventing harm in adults who cannot, or will not, stop smoking.

That is what this is all about. I want my brother to stop smoking, but he'll never do it on 18mg liquid, on a device that constantly needs refilling because it's 2ml capacity doesn't last long, having to carry around multiple 10ml bottles because he can't buy a 30ml one -it'd just be easier for him to go and get a packet of smokes than to deal with the inconvenience.

The most aggravating thing about it is that these restrictions that are being implemented are simply not evidence based.

That is why the Lords want to annul this SI - they, the DoH and MHRA know this set of regulations is backwards and won't do anyone any good, and will likely cause more problems than it solves (we haven't even talked about the cross-border sales registation site that crashed on day one, and which most EU countries haven't even implemented, meaning no-one can sell to them legally) and will likely be a detriment, not an improvement, to public health, not to mention costing thousands of jobs and a significant extra cost to users of these devices.

I don't disagree with regulations against lit tobacco, nor regulation on e-cigs, but given that these devices are not so much not in the same ball park as lit tobacco in terms of harm, but not even in the same county, to regulate them in a similar fashion is ludicrous and goes against all measure of common sense. They need to regulated for what they are, which are consumer devices used for delivering nicotine in a really rather, but not entirely (as nothing ever is) safe way.

Steven R