What Are Second and Third-Hand Smoke and Vaping Aerosols?
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Electronic (E-) Cigarettes and Secondhand Aerosol
Defending your right to breathe smokefree air since 1976 Electronic (e-) Cigarettes and Secondhand Aerosol “If you are around somebody who is using e-cigarettes, you are breathing an aerosol of exhaled nicotine, ultra-fine particles, volatile organic compounds, and other toxins,” Dr. Stanton Glantz, Director for the Center for Tobacco Control Research and Education at the University of California, San Francisco. Current Legislative Landscape As of January 2, 2014, 108 municipalities and three states include e-cigarettes as products that are prohibited from use in smokefree environments. Constituents of Secondhand Aerosol E-cigarettes do not just emit “harmless water vapor.” Secondhand e-cigarette aerosol (incorrectly called vapor by the industry) contains nicotine, ultrafine particles and low levels of toxins that are known to cause cancer. E-cigarette aerosol is made up of a high concentration of ultrafine particles, and the particle concentration is higher than in conventional tobacco cigarette smoke.1 Exposure to fine and ultrafine particles may exacerbate respiratory ailments like asthma, and constrict arteries which could trigger a heart attack.2 At least 10 chemicals identified in e-cigarette aerosol are on California’s Proposition 65 list of carcinogens and reproductive toxins, also known as the Safe Drinking Water and Toxic Enforcement Act of 1986. The compounds that have already been identified in mainstream (MS) or secondhand (SS) e-cigarette aerosol include: Acetaldehyde (MS), Benzene (SS), Cadmium (MS), Formaldehyde (MS,SS), Isoprene (SS), Lead (MS), Nickel (MS), Nicotine (MS, SS), N-Nitrosonornicotine (MS, SS), Toluene (MS, SS).3,4 E-cigarettes contain and emit propylene glycol, a chemical that is used as a base in e- cigarette solution and is one of the primary components in the aerosol emitted by e-cigarettes. -
BRFSS Brief Electronic Cigarette
BRFSS Brief Number 2020-01 The Behavioral Risk Factor Surveillance System (BRFSS) is an annual statewide telephone survey of adults developed by the Centers for Disease Control and Prevention (CDC) and administered by the New York State Department of Health. The BRFSS is designed to provide information on behaviors, risk factors, and utilization of preventive services related to the leading causes of chronic and infectious diseases, disability, injury, and death among the noninstitutionalized, civilian population aged 18 years and older. Electronic Cigarette Use New York State Adults, 2017 Introduction and Key Findings Electronic cigarettes (e-cigarettes) are battery-powered devices that heat a solution of liquid nicotine, flavorings, and other chemicals creating an aerosol that is inhaled by the user. E-cigarettes are known by many different names including e-cigs, vapes, vape pens, e-hookahs, and electronic nicotine delivery systems (ENDS). Using an e-cigarette is called vaping. E-cigarettes are not a United States (US) Food and Drug Administration (FDA) approved smoking cessation aid and their usefulness as a cessation aid is unproven. With or without nicotine, e-cigarettes are not hazard-free and e- cigarette aerosol is not simply water vapor; the aerosol may contain heavy metals, volatile organic compounds, ultrafine particles, and other toxins.1 In addition, e-cigarette use can undermine social norms about tobacco, delay cessation among cigarette smokers, and increase the risk of ever using combustible tobacco cigarettes among youth and young adults.1 The long-term health risks of e-cigarettes will not be known for decades. The FDA has extended regulatory authority to all tobacco products including e-cigarettes.2 But the FDA approach to regulation of e-cigarettes is being phased in over time, may be delayed by litigation, and effective regulation may be years away. -
Other Tobacco Products (OTP) Are Products Including Smokeless and “Non-Cigarette” Materials
Other tobacco products (OTP) are products including smokeless and “non-cigarette” materials. For more information on smoking and how to quit using tobacco products, check out our page on tobacco. A tobacco user may actually absorb more nicotine from chewing tobacco or snuff than they do from a cigarette (Mayo Clinic). The health consequences of smokeless tobacco use include oral, throat and pancreatic cancer, tooth loss, gum disease and increased risk of heart disease, heart attack and stroke. (American Cancer Society, “Smokeless Tobacco” 2010) Smokeless tobacco products contain at least 28 cancer-causing agents. The risk of certain types of cancer increases with smokeless tobacco: Esophageal cancer, oral cancer (cancer of the mouth, throat, cheek, gums, lips, tongue). Other Tobacco Products (OTP) Include: Chewing/Spit Tobacco A smokeless tobacco product consumed by placing a portion of the tobacco between the cheek and gum or upper lip teeth and chewing. Must be manually crushed with the teeth to release flavor and nicotine. Spitting is required to get rid of the unwanted juices. Loose Tobacco Loose (pipe) tobacco is made of cured and dried leaves; often a mix of various types of leaves (including spiced leaves), with sweeteners and flavorings added to create an "aromatic" flavor. The tobacco used resembles cigarette tobacco, but is more moist and cut more coarsely. Pipe smoke is usually held in the mouth and then exhaled without inhaling into the lungs. Blunt Wraps Blunt wraps are hollowed out tobacco leaf to be filled by the consumer with tobacco (or other drugs) and comes in different flavors. Flavors are added to create aromas and flavors. -
Electronic Cigarettes (E-Cigarettes)
Electronic Cigarettes (e-cigarettes) Electronic cigarettes (also called -e cigarettes or electronic nicotine delivery systems) are battery-operated devices designed to deliver nicotine with flavorings and other chemicals to users in vapor instead of smoke. They can be manufactured to resemble traditional tobacco cigarettes, cigars or pipes, or even everyday items like pens or USB memory sticks; newer devices, such as those with fillable tanks, may look different. More than 250 different e-cigarette brands are currently on the market. While e-cigarettes are often promoted as safer alternatives to traditional cigarettes, which deliver nicotine by burning tobacco, little is actually known yet about the health risks of using these devices. How do e-cigarettes work? Electronic cigarettes are Most e-cigarettes consist of three different components, including: battery-operated devices a cartridge, which holds a liquid solution containing varying amounts of designed to deliver nicotine nicotine, flavorings, and other chemicals with flavorings and other a heating device (vaporizer) chemicals to users in vapor a power source (usually a battery) instead of smoke. In many e-cigarettes, puffing activates the battery-powered heating device, Although they do not which vaporizes the liquid in the cartridge. The resulting aerosol or vapor is produce tobacco smoke, then inhaled (called "vaping"). e-cigarettes still contain nicotine and other Are e-cigarettes safer than conventional cigarettes? potentially harmful Unfortunately, this question is difficult to answer because insufficient information chemicals. is available on these new products. Early evidence suggest that Cigarette smoking remains the leading preventable cause of sickness and e-cigarette use may serve as mortality, responsible for over 400,000 deaths in the United States each year. -
"I Always Thought They Were All Pure Tobacco'': American
“I always thought they were all pure tobacco”: American smokers’ perceptions of “natural” cigarettes and tobacco industry advertising strategies Patricia A. McDaniel* Department of Social and Behavioural Sciences, School of Nursing University of California, San Francisco 3333 California Street, Suite 455 San Francisco, CA 94118 USA work: (415) 514-9342 fax: (415) 476-6552 [email protected] Ruth E. Malone Department of Social and Behavioral Sciences, School of Nursing University of California, San Francisco, USA *Corresponding author The Corresponding Author has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive licence (or non exclusive for government employees) on a worldwide basis to the BMJ Publishing Group Ltd and its Licensees to permit this article (if accepted) to be published in Tobacco Control editions and any other BMJPGL products to exploit all subsidiary rights, as set out in our licence (http://tc.bmj.com/misc/ifora/licence.pdf). keywords: natural cigarettes, additive-free cigarettes, tobacco industry market research, cigarette descriptors Word count: 223 abstract; 6009 text 1 table, 3 figures 1 ABSTRACT Objective: To examine how the U.S. tobacco industry markets cigarettes as “natural” and American smokers’ views of the “naturalness” (or unnaturalness) of cigarettes. Methods: We reviewed internal tobacco industry documents, the Pollay 20th Century Tobacco Ad Collection, and newspaper sources, categorized themes and strategies, and summarized findings. Results: Cigarette advertisements have used the term “natural” since at least 1910, but it was not until the 1950s that “natural” referred to a core element of brand identity, used to describe specific product attributes (filter, menthol, tobacco leaf). -
Banning Flavored E-Cigarettes
CONTENTS Executive Summary 1 Introduction 2 The Potential for Unintended Harms 3 Predicting Response to a Flavor Ban 3 Impacts of a Flavor Ban on Harm Reduction 5 Other Impacts of a Flavor Ban 7 Lost Revenue and the Potential Public Health Tradeoff 8 Conclusion 8 About the Author 9 sation efforts and the growth of counterfeit and contraband products; and harm to communities via lost funding for broader health resources. A limited number of studies have looked at people’s actual and presumptive responses to flavor bans. This small body of research suggests that the policy could reduce vaping in R STREET POLICY STUDY NO. 222 general, but that it may drive some current vapers to resume March 2021 or increase their use of combustible cigarettes and others to seek out their preferred e-cigarette flavors through illicit markets and hard-to-regulate online retailers. As such, both potential sets of behavior changes could tip the net public health impact of flavor bans toward harmful. BANNING FLAVORED Because ENDS users inhale a nicotine-infused vapor rath- E-CIGARETTES COULD HAVE er than toxin-laden tobacco smoke, vaping is considered a safer alternative to smoking combustible cigarettes. In fact, UNINTENDED PUBLIC HEALTH both the U.S. Centers for Disease and Prevention and Public CONSEQUENCES Health England have stated (albeit to varying degrees) that smokers would benefit from switching to e-cigarettes, and By Stacey A. McKenna the devices are gaining traction as cessation tools. Further- more, research shows that flavors may aid individuals who are using e-cigarettes to quit or reduce smoking. -
Juul and Other High Nicotine E-Cigarettes Are Addicting a New Generation of Youth
JUUL AND OTHER HIGH NICOTINE E-CIGARETTES ARE ADDICTING A NEW GENERATION OF YOUTH Launched in 2015, JUUL quickly disrupted the e-cigarette marketplace, popularizing e-cigarette devices that are sleek, discreet and have sweet flavors and a powerful nicotine hit. Nicotine is highly addictive, can negatively impact the development of the adolescent brain, and can harm the cardiovascular system.1 Youth e-cigarette use in the United States has skyrocketed to what the U.S. Surgeon General and the FDA have called “epidemic” levels, with 3.6 million middle and high school students using e- cigarettes. 2 Former FDA Commissioner Scott Gottlieb has stated, “There’s no question the Juul product drove a lot of the youth use.”3 The Surgeon General has called for “aggressive steps to protect our children from these highly potent products that risk exposing a new generation of young people to nicotine.”4 Use of Nicotine Salts Makes it Easier for New Users to Try E-Cigarettes Just like the tobacco industry has used additives and design changes to make cigarettes more addictive and appealing to new users (particularly youth),5 JUUL pioneered a new e-liquid formulation that delivers nicotine more effectively and with less irritation than earlier e-cigarette models. According to the company, the nicotine in JUUL is made from “nicotine salts found in leaf tobacco, rather than free-base nicotine,” in order to “accommodate cigarette-like strength nicotine levels.”6 JUUL’s original patent stated that, “certain nicotine salt formulations provide satisfaction in an individual superior to that of free base nicotine, and more comparable to the satisfaction in an individual smoking a traditional cigarette. -
Use of Non Cigarette Tobacco Products (NCTP) Smokeless
Non Cigarette Tobacco Products (NCTP) and Electronic cigarettes (e-cigs) Michael V. Burke EdD Asst: Professor of Medicine Nicotine Dependence Center Mayo Clinic, Rochester, MN Email: [email protected] ©2011 MFMER | slide-1 Goals & Objectives • Review NCTP definitions & products • Discuss prevalence/trends of NCTP • Discuss NCTP and addiction • Review recommended treatments for NCTP ©2011 MFMER | slide-2 NCTP Definitions & Products ©2011 MFMER | slide-3 Pipes ©2011 MFMER | slide-4 Cigars Images from www.trinketsandtrash.org ©2011 MFMER | slide-5 Cigar Definition U.S. Department of Treasury (1996): Cigar “Any roll of tobacco wrapped in leaf tobacco or any substance containing tobacco.” vs. Cigarette “Any roll of tobacco wrapped in paper or in any substance not containing tobacco.” ©2011 MFMER | slide-6 NCI Monograph 9. Cigars: Health Effects and Trends. ©2011 MFMER | slide-7 ©2011 MFMER | slide-8 Smokeless Tobacco Chewing tobacco • Loose leaf (i.e., Redman) • Plugs • Twists Snuff • Moist (i.e., Copenhagen, Skoal) • Dry (i.e., Honest, Honey bee, Navy, Square) ©2011 MFMER | slide-9 “Chewing Tobacco” = Cut tobacco leaves ©2011 MFMER | slide-10 “Snuff” = Moist ground tobacco ©2011 MFMER | slide-11 Type of ST Used in U.S. Chewing Tobacco Snuff National Survey on Drug Use and Health (NSDUH) ©2011 MFMER | slide-12 “Spitless Tobacco” – Star Scientific ©2011 MFMER | slide-13 RJ Reynold’s ©2011 MFMER | slide-14 “Swedish Style” ST ©2011 MFMER | slide-15 Phillip Morris (Altria) ©2011 MFMER | slide-16 New Product: “Fully Dissolvables” ©2011 MFMER -
Indianapolis Air Monitoring Study
INDIANAPOLIS, INDIANA INDOOR AIR QUALITY MONITORING STUDY Mark J. Travers, PhD, MS Lisa Vogl, MPH Department of Health Behavior and Aerosol Pollution Exposure Research Laboratory (APERL) December 2012 EXECUTIVE SUMMARY In May, August and November 2012, indoor air quality was assessed in 10 restaurants and bars in Indianapolis, Indiana. Effective June 1st, 2012, the new Indianapolis law prohibits smoking in most public places and places of employment with exemptions for nonprofit clubs, retail tobacco shops and a horse race betting parlor. Prior to the smoke-free air law, all 10 bar and restaurant locations permitted indoor smoking. After the smoke-free air law took effect all bars and restaurants were reassessed to observe the effect of the new smoke-free air law; no smoking was observed in 7 locations, while 3 locations met requirements to be exempt from the smoke-free air law. The concentration of fine particle air pollution, PM2.5, was measured with a TSI SidePak AM510 Personal Aerosol Monitor. PM2.5 is particulate matter in the air smaller than 2.5 microns in diameter. Particles of this size are released in significant amounts from burning cigarettes, are easily inhaled deep into the lungs, and cause a variety of adverse health effects including cardiovascular and respiratory morbidity and death. Key findings of the study include: In all 10 locations with observed indoor smoking before the law, the level of fine particle air pollution 3 was “very unhealthy” (PM2.5 = 229 µg/m ). In the 7 locations that went smoke-free after the law, the 3 level of fine particle air pollutions was “hazardous” prior to the law (PM2.5 = 273 µg/m ). -
Regulating E-Cigarettes Regulating E-Cigarettes
Regulating E-cigarettes Regulating E-Cigarettes The introduction of electronic cigarettes (or e-cigarettes) in countries around the world poses new challenges to governments wanting to protect youth and reduce tobacco use. Policies governing e-cigarettes must be guided by an assessment of the impact of these products on the pace of progress in reducing the death and disease caused by tobacco use. The evidence around the health harms from e-cigarettes and their impact on young people is evolving. Any assessment of the evidence has to consider the impact on both individual smokers and the population as a whole. While e-cigarettes may have health benefits to individual smokers if they are proven to help smokers quit completely, they are nevertheless harmful to public health if they lead to more young people starting, if they renormalize tobacco use, and/or if they discourage smokers from quitting. The World Health Organization has concluded that e-cigarettes are “undoubtedly harmful” and that countries “that have not banned [e-cigarettes] should consider regulating them as harmful products.” 1 This is consistent with the general obligations of the WHO Framework Convention on Tobacco Control, which require Parties to the Convention to implement measures for preventing and reducing nicotine addiction. 2 In the absence of effective government regulation, e-cigarettes could create a new generation of nicotine and tobacco users and undermine the progress made in combatting the tobacco epidemic. This policy brief uses a three-step process to assist government officials in determining how to regulate e-cigarettes to fit their country circumstances while balancing competing public health considerations: 1. -
Submission of Plans for Cigarette Packages and Cigarette Advertisements (Revised)*
Contains Nonbinding Recommendations Submission of Plans for Cigarette Packages and Cigarette Advertisements (Revised)* Guidance for Industry Comments may be submitted at any time for Agency consideration. Electronic comments may be submitted to https://www.regulations.gov. Alternatively, submit written comments to the Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Room 1061, Rockville, MD, 20852. All comments should be identified with the docket number listed in the notice of availability that publishes in the Federal Register. For questions regarding this guidance, contact the Center for Tobacco Products at (Tel) 1-877- CTP-1373 (1-877-287-1373) Monday-Friday, 9 a.m. – 4 p.m. EDT. Additional copies are available online at https://www.fda.gov/tobacco-products/products- guidance-regulations/rules-regulations-and-guidance. You may send an e-mail request to [email protected] to receive an electronic copy of this guidance. You may send a request for hard copies to U.S. Food and Drug Administration, Center for Tobacco Products, Attn: Office of Small Business Assistance, Document Control Center, Bldg. 71, Rm. G335, 10903 New Hampshire Ave., Silver Spring, MD 20993-0002. U.S. Department of Health and Human Services Food and Drug Administration Center for Tobacco Products July 2021 OMB Control Number: 0910-0877 Expiration Date: 4/30/2023 See additional PRA statement in Section IV of the guidance *This is a revision to the third edition of this final guidance, which issued in February 2021. A summary of the revisions is at the end of the guidance. Contains Nonbinding Recommendations Table of Contents I. -
Vape Shops' in the San Francisco Bay Area
UCSF UC San Francisco Previously Published Works Title A Pilot Study of Retail 'Vape Shops' in the San Francisco Bay Area. Permalink https://escholarship.org/uc/item/9nv2x6r0 Journal Tobacco prevention & cessation, 2(Suppl) ISSN 2459-3087 Authors Burbank, Andrea D Thrul, Johannes Ling, Pamela M Publication Date 2016 DOI 10.18332/tpc/65229 Peer reviewed eScholarship.org Powered by the California Digital Library University of California HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Tob Prev Manuscript Author Cessat. Author Manuscript Author manuscript; available in PMC 2017 April 06. Published in final edited form as: Tob Prev Cessat. 2016 ; 2(Suppl): . doi:10.18332/tpc/65229. A Pilot Study of Retail ‘Vape Shops’ in the San Francisco Bay Area Andrea D Burbanka,*, Johannes Thrula,*, and Pamela M Linga aUniversity of California, San Francisco, United States Abstract INTRODUCTION—The use of electronic cigarettes or vape devices is increasing, and products are evolving rapidly. This study assessed retail vape shops in the San Francisco Bay Area to describe store characteristics, products offered, advertisements and health claims, as well as employees’ perceptions of their customers’ demographics, and practices to support smoking cessation. METHODS—We conducted store audits of shops that exclusively sell vape devices with physical addresses in San Francisco and Alameda counties (n=23, response rate 72%) and interviewed vape shop owners/employees. RESULTS—While all stores carried second and third generation vape devices, 83% of stores did not carry first generation devices. Employees estimated the majority of their customers bought devices for smoking cessation or to replace tobacco, and a small minority purchased for first-time recreational use.