PERSONAL VAPORIZERS REDUCE HARM

December 9, 2013 Mr. John Schell Southwestern Community College 447 College Drive Sylva, NC 28779 Mr. Schell, I have included a copy of the requested report, Personal Vaporizers Reduce Harm Inherent to Tobacco Products. The enclosed document is intended to contextualize media reports and popular culture regarding personal vaporizers, to draw some evidence and logic-based conclusions from them, and to lightly examine anecdotal evidence in the form of a 118 participant survey. The content should sufficiently summarize the health effects of PV use, and examine the potential impact of a movement by the US Food and Drug Administration to halt their distribution. If you have any questions, please feel free to contact me with the information provided above. Sincerely,

Taylor Rodes

PERSONAL VAPORIZERS REDUCE HARM

Personal Vaporizers Reduce Harm Inherent to Traditional Tobacco Products Taylor S. Rodes Southwestern Community College Professor John Schell 12/08/2013

PERSONAL VAPORIZERS REDUCE HARM

TABLE OF CONTENTS LETTER OF TRANSMITTAL .......................................................................................................1 TITLE PAGE ...................................................................................................................................2 LIST OF ILLUSTRATIONS ...........................................................................................................4 ABSTRACT (Optional) ...................................................................................................................5 CHAPTERS CHAPTER 1 Introduction.............................................................................................................6 CHAPTER 2 Discussion ...............................................................................................................7 CHAPTER 3 Summary, Conclusion ..........................................................................................11 REFERENCES ..............................................................................................................................12

PERSONAL VAPORIZERS REDUCE HARM

List of Illustrations Figure 1. Simple visual aid for the function of a common electronic cigarette.

PERSONAL VAPORIZERS REDUCE HARM

Abstract This research paper provides information on the health risks, regulatory conditions and mechanical function of PVs, or personal vaporizers. It will demonstrate the history, function and social appeal of electronic cigarettes, while contextualizing the media storm encircling the tobacco-replacement products. The sources for this paper are collected from scholarly journals like the American Journal of Preventive Medicine and the Tobacco Harm Reduction Journal. For explorative purposes, this document will also outline the results of a survey conducted on a popular discussion board and examine the many myths and pieces of propaganda in the world of electronic cigarettes.

PERSONAL VAPORIZERS REDUCE HARM Personal Vaporizers Reduce Harm Inherent to Traditional Tobacco Products INTRODUCTION Its hard to deny that electronic cigarettes have exploded in popularity over the last few

years. Their sales numbers have climbed at an exponential rate, expected to reach a mark as high as $1 billion by the end of 2013 (DeNoon). Media reports and government press releases on the subject have increased accordingly. Because these relatively new devices use a simple feat of electrical engineering and strategic design to produce a puff of vapor, they are objects of public awe and, especially, suspicion. Adopters of the personal vaporizer frequently report being gawked at while using their devices.. Its not uncommon for people near to express disapproval of PVs, as news stories constantly report on the toxic chemical used in electronic cigarettes. (Winograd). Even the U.S. Food and Drug Administration has demanded that nicotine vaporizers be sold only under its regulation. The intent of this paper is to dissect the foreseeable health effects of electronic cigarettes, and examine the implications of the potential FDA ban. History The electronic cigarette was developed and popularized by a pharmacist in China. In a geographic area reporting very high smoking rates, the young pharmacists father had recently died of lung cancer. The Pharmacist, Hon Lik, smoked three packs per day and was faced with his own mortality. His solution was to develop a product that closely simulates the sensation of smoking and provides nicotine in a safer context. His creation resulted in his parent company electing to change their name to Ruyan, which is Chinese for like smoke. Electronic cigarettes have vastly increased in popularity since their invention in 2003 (Gray), and today there exists a wide variety of personal vaporizers, along with countless nicotine solutions for consumption.

PERSONAL VAPORIZERS REDUCE HARM Problem If the FDA governs the sale of electronic cigarettes, sales of required materials to vaporize nicotine will be halted in the United States until the products are extensively studied, which would likely take years (Hemphill). Because many former smokers and smokers attempting to quit use electronic cigarettes to consume nicotine, it is likely that many would resort to smoking in the absence of their PVs. While this might result in the collection of a few more tax dollars

and a born-again RJ Reynolds customer, the smoker himself is back to a much higher health risk. Because electronic cigarettes only contain nicotine, glycol and flavoring, we can infer their approximate harm to humansnicotine releases neurotransmitters that enhance concentration and memory due to increased levels of acetylcholine, It also increases beta-endorphin levels, which is chemically known to alleviate anxiety. Nicotine is not regarded as a carcinogen, and is a drug that is comparable in terms of lethal dose to caffeine. Just as one person enjoys a dose of caffeine in the morning, another person may enjoy their preferred dose of nicotine. We are a culture that uses drugs, but harshly discriminates between them. Because the majority of carcinogens detected in cigarettes are present in tar, a material created by the process of combustion, electronic cigarettes can provide users the positive sensations associated with nicotine use while they avoid the carcinogenic nature of their analog counterparts (Polosa). Electronic cigarette users find the transition process to be easy, if not accidental. (Rodes.) DISCUSSION How it works All electronic cigarettes work on the same basis. A small battery energizes an atomizer, which consists of a positive and negative contact that are linked by a heating coil, which

PERSONAL VAPORIZERS REDUCE HARM

surrounds a wicking material. When the battery is activated, it energizes the coil, which heats up to vaporization temperature and converts the nicotine solution in the wick into the fog that the consumer exhales. The principle and ingredients are all very similar to the function of any fog machine.

Fig. 1. The function of a common type of personal vaporizer (Veppo).

Electronic cigarette users most frequently use either e-liquid or cartridge refills that consist of glycol or glycogen, desired flavorings and measured nicotine. The effects of glycol and glycogen (the primary ingredients in refill materials) have been rigorously documented for decades, and prove to be harmless on rats in context of long-term exposure (Polosa). Users can specify the proportion of nicotine present in their devices, or purchase a solution that is nicotinefree. The customer can also specify amount of vapor and throat hit through adjustments to the atomizing element and battery. There are endless possibilities available for purchase; electronic cigarettes and personal vaporizers come in all shapes and sizes. Some look just like cigarettes, while others are in the shape of a box with an LCD screen that operates much like a cell phonedisplaying battery life, voltage settings and more. Atomizers can be bought to replace with refills, or in the form of

PERSONAL VAPORIZERS REDUCE HARM rebuildable atomizers. With a rebuildable atomizer, the user is required to create their own

heating element and wick from wire and cotton, but does not have to purchase refills. The ability to tailor every aspect of this electronic device and its refill product could result in a more enjoyable and safer alternative to smoking. Myths and Misconceptions While many consider the electronic cigarette to be a brilliant or even life-saving innovation, there are also plenty of sensationalist news outlets that perpetuate almost absurd misconceptions in order to draw attention to their works. For the purpose of this research paper, I will focus on the content of a Huffington Post article, entitled 9 Terribly Disturbing Things About Electronic Cigarettes. (Winograd.) Mr. Winograd writes that a 2009 FDA analysis of e-cigarettes foundglycol, which is found in antifreeze. The truth is, brands like Prestone use propylene glycol in antifreeze to provide an added margin of safety for pets and children. The article also laughs, people think e-cigarettes can help them quit smoking. In this section, it is revealed that half of smokers surveyed believed an electronic cigarette could help them quit. The poor journalism in this article includes no refuting data to establish his jest at the participants stupidity, but insists that it must be incorrect because there is little evidence to support the effectiveness of electronic cigarettes as smoking cessation devices. Survey results in the American Journal of Preventative Medicine (Electronic Nicotine Delivery Systems) revealed that respondents using e-cigarettes more than 20 puffs per day had a quit rate of 70%. The same researchers studied how effective nicotine patches and nicotine gums crave-curbing abilities and noted that only 7.7-8.2% of respondents effectively quit using those cessation devices.

PERSONAL VAPORIZERS REDUCE HARM

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With such malicious journalism tactics surrounding a potentially groundbreaking tool in reducing the harm inherent to nicotine addiction, there isnt much hope that consumers will ever be presented with an accurate understanding of a statistical superior option that is available to help them reduce the harm inherent to tobacco products, or, better yet, break their addiction altogether. Survey For the purpose of this report, I have executed an informal survey of PV consumers on reddit.com. Reddit is an online message board that users organize into specific categories, or, sub-reddits. One of these sub-reddits is dedicated to personal vaporizer use, and 118 users were kind enough to provide me with information regarding their quitting processes, preferred equipment, health statuses, and side effects. While the bias for this sample is undeniable, the purpose of this report is not to be published in a scholarly journal. I intend to clearly and articulately present evidence that the common citizen is capable of evaluating on merit of logic, reason and evidence. Results of the survey revealed that the average e-cigarette user smoked 21.8 cigarettes per day; just over one pack. 95% of those respondents were successful in using a personal vaporizer to quit. However, 7% of total respondents occasionally use non-cigarette tobacco products (these participants all indicated a cultural value of hookah). 94% of the surveyed Reddit users said that their transitions were easy. The remaining 6% reported using unpreferred products, like a small-battery Blu or similar. Participants indicated being most satisfied by devices that sport variable voltage, a feature that allows the user to quickly change the devices output.

PERSONAL VAPORIZERS REDUCE HARM No significant health detriment was reported, although several respondents mentioned burning their fingers on hot coils during DIY projects. 91% of those surveyed reported better breathing and decreased difficulty with exercising.

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CONCLUSIONS Electronic cigarettes are devices that boast extremely high quit-rates compared to any other smoking cessation device. They reduce the risk of bodily harm once thought necessary to enjoy the effects of nicotine. While all electronics containing batteries have the propensity to catch fire, electronic cigarettes are mostly safe and have never been proven toxic to anyone. With so many American citizens suffering the lifelong consequences of smoking habits, its important that we embrace a new, innovative alternative and respect the rights of any person who wishes to choose what he or she sees as a safer alternative to tobacco products. Electronic cigarette users are expected by retailers to treat vaporizers as caveat emptor, or buyer beware products. Its not that users deny the possibility of some health effects, but more practically estimate the health effects and cost of vaporizers to be minimal in comparison to other nicotine products. Evidence would suggest that personal vaporizers can be used to reduce the harm a tobacco user can expect to incur through traditional use of tobacco products. Limiting access to a viable tobacco alternative with toxicity tests comparable to Nicorette and Nicoderm would remove an invaluable option from all United States citizens, and legal opposition to do so will likely be met with great opposition by the outspoken PV community.

PERSONAL VAPORIZERS REDUCE HARM References Adkison, S., OConnor, R.,Bansal-Travers, M., Hyland, A., Borland, R., Cummings, M. & Hammond. (2013). Electronic Nicotine Delivery Systems. American Journal of Preventive Medicine, 44(3), 207-15. DeNoon, D. (2011, April 13). "E-Cigarettes Under Fire." WebMD. Retrieved November 08, 2013, from http://www.WebMD.com. Gray, E. (2013). This Is Not a Cigarette. Time, 182(14), 38-45.

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Hemphill, T. (2013). Electronic Cigarettes at a Regulatory Crossroads. Regulation, 36(3) 10-12. Ricardo, P., Rodu, B. (2013). A Fresh Look at Tobacco Harm Reduction: The Case for the Electronic Cigarette. Harm Reduction Journal 10(1), 1-11. Rodes, T. (2013, November 15). Electronic Cigarettes. Survey. Reddit. Retrieved November 15, 2013 from http://www.reddit.com. Winograd, D. (2013, September 03). 9 Terribly Disturbing Things About Electronic Cigarettes." The Huffington Post. Retrieved November 6, 2013 from http://www.huffingtonpost.com/2013/09/03/electronic-cigarettes_n_3818941.html How an Electronic Cigarette Works. Photograph. Retrieved November 06, 2013 from http://www.e-cigarettedirect.com/product_images/uploaded_images/ecigwork.jpg.