Tuesday, February 11, 2014

E-cigarettes: What is an electronic cigarette?

11:25 PM

E-cigarettes are NOT approved by Health Canada for sale or use in Canada. The safety, efficacy and quality of e-cigarettes are still unknown.
What is an electronic cigarette?
An electronic cigarette, also known as an e-cigarette, vapor cigarette or an e-cig, is a cylinder-shaped device made of stainless steel or plastic, that imitates a cigarette in terms of its appearance, use and sometimes taste. But with a critical distinction - it does not contain tobacco. E-cigarettes produce a vapour that resembles smoke and a glow that resembles the tip of a cigarette. They consist of a battery-powered delivery system that vapourizes and delivers a liquid chemical mixture that may be composed of various amounts of nicotine, propylene glycol, and other chemicals.
A typical electronic cigarette consists of three components:
  • A cartridge containing nicotine, water, and flavouring in a base of propylene glycol, vegetable glycerine, or polyethylene glycol 400 (Note: not all cartridges or solutions contain nicotine);
  • An atomizer containing a heating element which turns the liquid nicotine into a vapour; and
  • A battery to power the atomizer and the indicator light that glows like a lit cigarette when inhaled.
Are E-Cigarettes legal for use in Canada?
While e-cigarettes are marketed as a smoking cessation aid or tobacco replacement, they are not approved for use in Canada. In March 2009, Health Canada issued anAdvisory to Canadians NOT to use e-cigarettes as these products may pose health risks and have not been fully evaluated for safety, quality and efficacy by Health Canada.
Health Canada also issued a Notice to stakeholders indicating that all electronic products intended to administer inhaled doses of nicotine are considered new drugs and as such fall under the Food and Drugs Act. Under the Act, before any new drug can be imported, marketed, or sold in Canada, Health Canada must grant market authorization following a review of scientific evidence demonstrating the safety, quality, and efficacy of the product. The sale of these health products is currently not compliant with the Food and Drugs Act since no electronic smoking products have been granted a market authorization in Canada.
However, the Notice issued by Health Canada only applies to e-cigarettes “intended” to deliver nicotine, which has created a regulatory grey zone that has been widely exploited. E-cigarettes that do not make any health claim and do not contain nicotine may legally be sold in Canada. Thus, many vendors are openly selling the device with nicotine-free cartridges or with cartridges claiming to be nicotine-free. (Note: according to the article below written by the Non-Smokers Rights Association - some vendors are selling cartridges and e-liquid containing nicotine under the table or are referring customers elsewhere to obtain nicotine).
Are E-Cigarettes safe for use?
At present there is insufficient data to evaluate the health risks to users from short- or long-term use of e-cigarettes, leading many researchers to call for further research to be done as soon as possible. While e-cigarettes may be marketed as a safer alternative to conventional tobacco products and as an aid to quitting smoking, these products may pose risks such as nicotine poisoning and addiction. Nicotine is a highly addictive and toxic substance, and the inhalation of propylene glycol is a known irritant.
Warnings and precautions:
  • Toxicity of nicotine and other chemicals contained in these products
  • Exposure through skin during manipulation can pose serious risk
  • Route of exposure:
    • unknown - pulmonary route assumed because of vapour
    • addictive potential much greater with pulmonary route
  • lack of quality control in manufacturing the product (products labelled as being nicotine-free have been found to contain nicotine)
  • Replacement cartridges and E-liquid of inaccurate concentrations, poor quality and poor labeling
  • Leakage
  • Presence of toxic impurities
  • May attract and hook non-smokers
  • Flavoured products especially attractive to youth
  • May contribute to the “renormalization” of cigarette use
For more information, see the Position Statement developed by the Canadian Lung Association, based on the current scientific evidence and recommendations from the World Health Organization, Health Canada, the U.S. Federal Drug Administration.
Read also the various documents written by the Non-Smokers Rights Association: The Buzz on E-Cigarettes, Position Statement and E-cigarettes: Understand the Potential Risks & Benefits Oct 2013.
Check out this video which questions whether E-Cigarettes really are safer.
Source:
Nadeem Zia, B.Pharm, RPh. 
OpenDoor Team, www.OpenDoor.cc
Consulting Pharmacist, Vancouver, BC Canada
Vancouver, British Columbia, Canada

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