11 May 2011 This file is about all types of e-cigarette not just Ruyan brand

“We’ve got to get people off the cigarette smoke” –

e-cigarettes “stuck in legal limbo”

Dr Marewa Glover director Auckland Centre for Tobacco Control Research discusses E-cigarettes on Breakfast with Petra Baguist

http://tvnz.co.nz/breakfast-news/wednesday-may-11-4164865/video

Petra: “The Ministry of Health is saying that e-cigarettes are far safer than a normal cigarette, and yet it is not possible to sell the nicotine that goes with them. What’s the crux of that situation?” Could it be classified as a tobacco product?

MG: “Possibly”…“People are using them to switch off from smoking and - why not? I would like see more smokers to have more access to things like this - alternatives that are safer. We’ve got to get people off the cigarette smoke.”

NZ Ministry of Health says E-cigarette ‘far safer’ than smoking

Ministry of Health advice to NZ Parliamentary Health Committee, April 2011 at pages 15-18.

The Parliamentary Health Select Committee recently asked the Ministry of Health to provide advice on electronic cigarettes:

“As the e-cigarette delivers only nicotine in a mist of propylene glycol, without the other 4,000 or so other chemicals in tobacco smoke, it is far safer than smoking.”

“The current safety data would therefore suggest that the e-cigarette poses few risks to people, and is safer than continuing to smoke. However, this should be confirmed with data from long-term outcome studies.

“The Ministry of Health believes there are research questions still to be answered around the e-cigarette before the Ministry would support its introduction and/or promotion in New Zealand. Trials to assess long term cessation outcome and safety are needed.”

End Smoking NZ congratulates the NZ Ministry of Health on possibly being the first ministry of health to concede e-cigarettes are safer than smoking. The Ministry, however, continues to use Medicines legislation to ban their sale to smokers, thus obviating the need to regulate ecigs so smokers could use them. The Ministry could, but is not classifying them for sale under tobacco products legislation. Not one death has occurred from e-cigarettes globally to our knowledge. Meantime cigarettes kill one in two persistent users.

If Ministry judges that ecigs are indeed “far safer than smoking”, let smokers decide which risk they wish to take.

Summary

Ministry of Health says the e-cigarette “ is far safer than smoking.” But the Ministry wants more research on safety and efficacy before introducing nicotine e-cigarettes for sale.

End Smoking NZ says the Ministry of Health should

1) Consider the real peril of smokers facing a 50% risk of dying from continued smoking.

2) Consider what smokers want. Smokers want a level playing field – they want freedom to buy nicotine cartridges just as they can buy cigarettes at any of 10.000 shops.

3) As long as Government permits sale of lethal tobacco cigarettes, Government has a duty to permit sale of a full range of safer cigarette substitutes for smokers to buy as of right.

4) E-cigarettes are not up to medicinal standards of purity. Rather than banning their sale as medicines they should be sold as cigarette substitutes under the Smokefree Environments Act. Medicinal purity standards required by the Medicines Act prevents nicotine e-cigarette cartridges being sold in NZ

5) The e-cigarette needs regulation, not by banning it under the Medicines Act, under the Smokefree Environments Act, as soon as possible.

6) Regulation. Approval for sale under Smokefree Environments Act means

a) Ministry can test for purity of ingredients

b) If ecigs are not completely safe, a health warning can be required as for tobacco products.

c) Doctors can monitor adverse effects.

d) Packet warnings can advise users to desist after 6 months, as soon as users are sure they won’t go back to smoking.

e) Licences to import can be withdrawn if new evidence comes to light.

Royal College of Physicians, London supports light regulation

released March 2011.

“In our view, nicotine products should be allowed on the market so long as

the nicotine meets acceptable purity standards, the dose and rate of absorption do not exceed that of a cigarette, and the product is shown to be tolerable and to

suppress the urge to smoke.”

- RCP to MHRA UK, 20 April, 2010 replying to consultation MLX 364 on The Regulation of nicotine containing products.

Sources and prices, New Zealand, December 2010

Distributors: please report updates to hnz@healthnz.co.nz

	Elusion & Hydro	Full Life	Intellicig
	www.Elusionec.co.nz	www.FullLife.co.nz	www.Intellicig.co.nz
Child access to nicotine liquid	Impossible	Impossible	Possible if bottled nicotine used
Nicotine leakage	Eliminated	Eliminated	If dismantled to fill
E-cigarette Starter kit, typically with spare charger, cartridges, battery.	84 mm length model no 1123, $99.90 recharging case and 6 cartridges	$86.99	$64.35
Non-nicotine cartridges $	$29.50 for 5	$14.98 for 5	$14.82 for 10
Nicotine* cartridges for e-cigarettes 16 mg**	www.elusion.co.uk *£9.99 for 5 www.elusion.com.au AUD19.99 for 5	Not on website	www.intellicig.co.uk NZ $14.72 for 10
e-cigarette, with cartomiser, 250 puffs with charger	$29.50 Hydro one cartomiser with battery and USB charger www.hydroelectroniccigarette.com	Not on website	Not available
Cartomisers to fit	5 Hydro cartomisers for $29.50 ##	Not available	Not available

*Nicotine can be personally imported for one’s own use. See website. **this is per ml. Most cartridges contain much less than 1 ml liquid. Cartomiser = cartridge with atomizer.

Postage and any discounts: check each website carefully. Listing here does not mean endorsement of the product by End Smoking NZ: none of the above are as yet approved for sale as medicines in NZ.

E-cigarette non-nicotine starter kits can be sold and advertised along with nicotine-free cartridges within NZ.

Nicotine e-cigarette cartridges, if sold within NZ as tobacco products, cannot be advertised.

Some websites offer flavours and various nicotine strengths. Switchers initially need maximum strength.

Getting started: Doctor Vapor's E-Cig 101

Class 1 - What Do I Order First? http://www.youtube.com/user/DoctorVapor#p/u/6/bGRoOfv6dnw

Class 2 - Attys, Refills and Dripping http://www.youtube.com/user/DoctorVapor#p/u/5/UxirXIHXysg

Class 3 - Cartomizers http://www.youtube.com/user/DoctorVapor#p/u/3/OXAwsqRI0E8

Class 4.1 - Big Battery http://www.youtube.com/user/DoctorVapor#p/u/0/uAIfkNkkmtQ

Class 4.2 - Big Battery http://www.youtube.com/user/DoctorVapor#p/u/1/62jbMV-ZJBU

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3 June 2009   Health warning:

Precautions required with e-cigarettes

Avoid bottled nicotine. Liquid nicotine (e-liquid) is small bottles of up to 30 mL or more, on the internet, or from stores in the USA, ARE often meant to last consumers one month; and often unlabelled as to nicotine dose. End Smoking NZ and Health New Zealand Ltd does not recommend sale or use of e-liquid unless Nicotine solution sold in child-proofed cartridges or un-openable disposable e-cigarettes or atomisers to avoid this risk.

Acute poisoning risk. For a child, the lethal dose is 10 mg nicotine. Bottles on sale can contain many times this amount. Even if the cap of a liquid nicotine bottle is child proofed, risk remains if someone else leaves it open. For adults, absorption of a fatal dose of 40-60 mg of nicotine could rapidly occur by spilling the liquid on one’s skin while using liquid nicotine to moisten the wick– a risk heightened by distraction, fatigue, alcohol, drugs. (Wash it off immediately). Wear gloves.

Avoid gravity feed. Old brand e-cigarettes should not be tipped up above mouth level, as the e-cigarette liquid can ooze out and drain nicotine on to the lips.

Avoid child-openable brands of e-cigarette and refill cartridges. Old long-length 3-piece e-cigarettes might allow young children to unscrew them giving access to a wick moist with nicotine solution, flavours in the liquid masking the bitter nicotine taste. Latest 2-piece brands (6 mg in 0.3 ml liquid), and 1-piece disposables, allow no access.

Safety results, April 2009:

E-cigarette Safety: Ruyan e-cigarette benchtop tests. Poster 5-11. See. www.healthnz.co.nz/DublinEcigBenchtopHandout.pdf  The poster itself is found in the following two Powerpoint files: http://www.healthnz.co.nz/DublinEcigPoster1.ppt and http://www.healthnz.co.nz/DublinEcigPoster2.ppt

The mist of the e-cigarette has been rigorously tested in the laboratory. Of over 60 priority-listed cigarette smoke toxicants tested, trace levels for some only were detected in the mist of the Ruyan® e-cigarette. The results are to be submitted for publication shortly in a peer-reviewed journal.  On the basis of findings to date, inhaling mist from the e-cigarette is rated some two orders of magnitude (100 times) less dangerous than smoking tobacco cigarettes. The nicotine dose per puff is comparable to that of a medicinal nicotine inhaler. E-cigarette nicotine is apparently not absorbed from the lung, but from the upper airways.

Update on the e-cigarette, October 2009

http://www.healthnz.co.nz/ElectronicCigsDarwinOct09.pdf

Efficacy results, April 2010

Health New Zealand Ltd sponsored this research on behalf of Ruyan, manufacturer of the Ruyan V8 e-cigarette, and it was carried it out in Auckland by researchers at the School of Population Health, University of Auckland. See http://www.healthnz.co.nz/2010%20Bullen%20ECig.pdf The study was published in Tobacco Control in April 2010.

TV3 2008 The Ruyan V8 Classic. An LED lights up the end. The white part is the battery. The nicotine is housed just upstream of the fingers. Recent models shorter (84 mm), and lighter.

Legal status (New Zealand)

E-cigarettes and non-nicotine cartridges can be sold in New Zealand, but not nicotine cartridges.

Nicotine when sold as a medicine comes under Medicines Act and approval for a new nicotine medicine is very expensive and takes several years. Import of e-cigarettes and nicotine cartridges for personal use is allowed.

About the device

The e-cigarette nicotine inhaler mimics the smoking experience more closely than any smokeless product to date and provides nicotine without causing smokers to cough.

It looks and acts like a cigarette, gives the pleasure of drawback, with a nicotine effect within 15 minutes. It is likely to be popular as a much cleaner and safer alternative to smoking, by eliminating the tar and the toxicant gases. More frequent puffs deliver more nicotine. Mouth holding longer may help. Use before coffee, coke, and fruit juice, not after.

Extended use, misuse of e-cig

The e-cigarette is an inhaler and the commercial brands do not appear to deliver nicotine deeply into the lung. Its ability with other drugs is untried. Nicotine by e-cigarette is probably absorbed from the throat and upper airways rather than from the lung.

People mixed tobacco with marijuana for smoking long before e-cigarettes, and smoking is the most dangerous way to consume cannabis or tobacco.

Devices for heating and vaporizing cannabis long preceded the e-cigarette. Whether or not e-cigarettes could be used for that purpose, no smoke will be inhaled.

It is not known whether the e-cigarette would facilitate absorption of THC, the active ingredient in cannabis. The e-cigarette vapourises liquid but does not burn plant material such as marijuana or tobacco. If cannabis is vaped by e-cigarette, rather than combusted and smoked in a joint, then no smoke is inhaled. Lung cancer is likely after many years of smoke inhalation, of either tobacco or marijuana smoke.

E-cigarette vaping of cannabis is likely to cause far lung damage than smoking.

For example, the illegality of cannabis makes adulteration possible, and prevents legal controls on its production. Also research safeguards are lacking. The effect of inhaling and vaporizing THC in the e-cigarette liquid has not been tested and researched by anyone to our knowledge.

Note: End Smoking NZ trust has no financial interests in any nicotine, tobacco or pharmaceutical company.

The e-cigarette provides a safer alternative for smokers. No deaths have yet been reported from e-cigarette use.

Dr Murray Laugesen chair; Prof Ross McCormick, Sir John Scott KBE, Trish Fraser MPH, Dr Marewa Glover, Trustees

Making it easier to quit smoking for good © 2010 End Smoking NZ