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2012NitzkinHarmReduction Doc.pdf Presentation Introduction This document is adapted from a presentation I gave to a joint committee meeting of the Oklahoma House and Senate, October 3, 2012.
Eissenberg , et al. (2010), A Clinical Laboratory Model for Evaluating the Acute Effects of Electronic “Cigarettes”: Nicotine Delivery Profile and Cardiovascular and Subjective Effects,
Eissenberg , et al. (2010), A Clinical Laboratory Model for Evaluating the Acute Effects of Electronic “Cigarettes”: Nicotine Delivery Profile and Cardiovascular and Subjective Effects,
A fresh look at tobacco harm reduction: the case for the electronic cigarette Journal Article Abstract Smokers of any age can reap substantial health benefits by quitting. In fact, no other single public health effort is likely to achieve a benefit comparable to large-scale smoking cessation. Surveys document that most smokers would like to quit, and many have made repeated efforts to do so. However, conventional smoking cessation approaches require nicotine addicted smokers to abstain fro…
Alpert , et al. (2013), A prospective cohort study challenging the effectiveness of population-based medical intervention for smoking cessation,
A Systematic Review of Nicotine by Inhalation: Is There a Role for the Inhaled Route? Journal Article Introduction: A considerable minority of adults remain addicted to smoking cigarettes despite substantial education and public health efforts. Nicotine replacement therapies have only modest long-term quit rates. The pulmonary route of nicotine delivery has advantages over other routes. However, there are regulatory and technical barriers to the development of pulmonary nicotine delivery de…
AAPHP Statement re State Regulation of E-cigarettes Document The American Association of Public Health Physicians recommends the following State response to proposed legislation to ban or otherwise restrict the sale and use of nicotine vaporizers (commonly referred to as E-cigarettes or electronic cigarettes).
Acute effects of electronic and tobacco cigarette smoking on complete blood count Journal Article The World Health Organisation called for research assessing the safety of electronic cigarette (e-cigarette). We evaluated the acute effect of active and passive e-cigarette and tobacco cigarette smoking on complete blood count (
Flouris , et al. (2013), Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function, <http://informahealthcare.com/doi/abs/10.3109/08958378.2012.758197> accessed: 2014-02-20
Trehy , et al. (2011), Analysis of Electronic Cigarette Cartridges, Refill Solutions, and Smoke for Nicotine and Nicotine Related Impurities,
Analysis of refill liquids for electronic cigarettes Journal Article AIMS: To assess levels of nicotine, nicotine degradation products and some specific impurities in commercial refill liquids for electronic cigarettes.
ASH Fact Sheet 114- Nicotine and addiction Document What does the term addiction mean? Addiction is defined by the World Health Organization as “repeated use of a psychoactive substance or substances, to the extent that the user is:
ASH Fact Sheet 891- Use of e-cigarettes in Great Britain among adults and young people (2013) Document ASH has commissioned surveys on e-cigarette use starting in 2010 with a survey of smokers, followed in February 2012 and 2013 by surveys of all adults and in March 2013 with a survey of children aged 11 to 18.
ASSESSMENT OF THIRDHAND EXPOSURE TO NICOTINE FROM ELECTRONIC CIGARETTES Conference Paper Purpose: Electronic cigarettes (e-cigarettes) are new battery-powered devices that resemble tobacco cigarettes and convert nicotine solutions into inhalable vapors.
Awareness and Ever-Use of Electronic Cigarettes Among U.S. Adults, 2010–2011 Journal Article Introduction: Electronic cigarettes, or e-cigarettes, were introduced into the U.S. market in recent years. However, little is known about the health impact of the product or the extent of its use. This study assessed the prevalence and correlates of awareness and ever-use of e-cigarettes among U.S. adults during 2010–2011.
CAADE Board Resolution on Electronic Cigarettes Web Page CAADE SUPPORTS ELECTRONIC CIGARETTES FOR TOBACCO CESSATION: Watch Father Jack's Testimony at the SB 648 hearing on April 17, 2013
CASAA 2010 E-cigarette User Survey Results Web Page A Survey of over 200 users. ---------- answered question 2,217 skipped question What is your age group?
CDC (2013), CDC Online Newsroom | Press Release | E-cigarette use more than doubles among U.S. middle and high school students from 2011-2012,
G. Romagna MD , et al. (2012), Characterization of chemicals released to the environment by electronic cigarettes use (ClearStream-AIR project): is passive vaping a reality?,
Cigarette Smoke Toxins Deposited on Surfaces: Implications for Human Health Journal Article Cigarette smoking remains a significant health threat for smokers and nonsmokers alike. Secondhand smoke (
Foulds & Veldheer (2011), Commentary on Etter & Bullen (2011): Could E-cigs become the ultimate nicotine maintenance device?, <http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2011.03532.x/abstract> accessed: 2014-02-19
Farsalinos , et al. (2013), Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour Extract on Cultured Myocardial Cells,
Comparison of the effects of e-cigarette vapor and cigarette smoke on indoor air quality Journal Article CONTEXT: Electronic cigarettes (e-cigarettes) have earned considerable attention recently as an alternative to smoking tobacco, but uncertainties about their impact on health and indoor air quality have resulted in proposals for bans on indoor e-cigarette use. OBJECTIVE: To assess potential health impacts relating to the use of e-cigarettes, a series of studies were conducted using e-ci…
Phillips (2009), Debunking the claim that abstinence is usually healthier for smokers than switching to a low-risk alternative, and other observations about anti-tobacco-harm-reduction arguments,
Siegmund , et al. (1999), Determination of the Nicotine Content of Various Edible Nightshades (Solanaceae) and Their Products and Estimation of the Associated Dietary Nicotine Intake,
Kim & Shin (2013), Determination of tobacco-specific nitrosamines in replacement liquids of electronic cigarettes by liquid chromatography–tandem mass spectrometry,
Does e-cigarette consumption cause passive vaping? Journal Article Electronic cigarette consumption ('vaping') is marketed as an alternative to conventional tobacco smoking. Technically, a mixture of chemicals containing carrier liquids, flavors, and optionally nicotine is vaporized and inhaled. The present study aims at the determination of the release of volatile organic compounds (
Farsalinos & Voudris (no date), E-cigarette use and indoor air quality: methodological limitations Response to Schober W et al. Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases
Ecigarette mist harmless, inhaled or exhaled Report Background Electronic cigarettes, without tobacco, flame or smoke, claim to be cigarette substitutes and to deliver nicotine safely, without smoke toxicants. Are these claims justified?
Bullen , et al. (2010), Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial,
Polosa , et al. (2011), Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study,
Polosa , et al. (2014), Effect of Smoking Abstinence and Reduction in Asthmatic Smokers Switching to Electronic Cigarettes: Evidence for Harm Reversal,
Polosa , et al. (2013), Effectiveness and tolerability of electronic cigarette in real-life: a 24-month prospective observational study,
Borland , et al. (2012), Effects of a Fact Sheet on beliefs about the harmfulness of alternative nicotine delivery systems compared with cigarettes,
Caponnetto , et al. (2013), Efficiency and Safety of an electronic cigarette (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study,
Electronic cigarette: a possible substitute for cigarette dependence Journal Article ABSTRACT: Cigarette smoking is the leading cause of premature mortality in western countries and it is important for smokers to stop as early as possible. Electronic cigarettes are a popular phenomenon of global proportion. Recent uncontrolled studies, reported that a certain number of smokers have quit using electronic cigarettes. This could hint a role for electronic cigarettes to be used for smoking ce…
Foulds , et al. (2011), Electronic cigarettes (e-cigs): views of aficionados and clinical/public health perspectives, <http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2011.02751.x/abstract> accessed: 2014-02-19
Dutra LM & Glantz SA (2014), Electronic cigarettes and conventional cigarette use among us adolescents: A cross-sectional study, http://dx.doi.org/10.1001/jamapediatrics.2013.5488 accessed: 2014-03-06
Cahn & Siegel (2011), Electronic cigarettes as a harm reduction strategy for tobacco control: A step forward or a repeat of past mistakes?,
Electronic cigarettes as a method of tobacco control Journal Editorial Article Allow them, but research and monitoring are needed so that the risks can be regulated.
Electronic cigarettes for smoking cessation: a randomised controlled trial Journal Article Background: Electronic cigarettes (e-cigarettes) can deliver nicotine and mitigate tobacco withdrawal and are used by many smokers to assist quit attempts. We investigated whether e-cigarettes are more effective than nicotine patches at helping smokers to quit.
Electronic cigarettes: achieving a balanced perspective Journal Editorial Article Concerns have been raised that the advent of electronic cigarettes (e-cigarettes) may be harmful to public health, and smokers have been advised by important agencies such as the US Food and Drug Administration not to use them.
Pellegrino , et al. (2012), Electronic cigarettes: an evaluation of exposure to chemicals and fine particulate matter (PM), <http://europepmc.org/abstract/MED/22913171/> accessed: 2014-02-17
Electronic Cigarettes: Effective Nicotine Delivery After Acute Administration Journal Article Introduction: Electronic cigarettes (ECs) are marketed as nicotine delivery devices. Two studies with
Pepper & Brewer (2013), Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review,
Electronic Nicotine Delivery Systems: International Tobacco Control Four-country Survey Journal Article BACKGROUND: Electronic nicotine delivery systems (ENDS) initially emerged in 2003 and have since become widely available globally, particularly over the Internet. PURPOSE: Data on ENDS usage patterns are limited. The current paper examines patterns of ENDS awareness, use, and product-associated beliefs among current and former smokers in four countries.
Farsalinos , et al. (2013), Evaluating Nicotine Levels Selection and Patterns of Electronic Cigarette Use in a Group of
Evidence against a gateway from smokeless tobacco use to smoking Journal Article INTRODUCTION: It has been suggested that smokeless tobacco (ST) use by young people induces them to become smokers, but direct evidence is lacking.
Pirkle JL , et al. (1996), Exposure of the us population to environmental tobacco smoke: The third national health and nutrition examination survey, 1988 to 1991,
Free Market Solutions in Health: The case of nicotine Report Summary: Many campaigners working in the field of public health believe that good health and free market capitalism are irreconcilable. They regard advertising, competition and the pursuit of profit as major causes of unhealthy consumption and view disfavoured industries as ‘disease vectors’. Accordingly, they support political action which limits commercial speech and restricts product development.
Glaxo Memo Shows Drug Industry Lobbying on E-Cigarettes Newspaper Article GlaxoSmithKline Plc is pushing for more stringent regulation of electronic cigarettes, which compete with its Nicorette gum and other smoking cessation products, according to e-mails from a company executive.
Health effects of Theatrical Haze Document The major findings of this study are summarized below: • No evidence of serious health effects was found to be associated with exposure to any of the theatrical effects evaluated in this study.
How are the English Stop Smoking Services responding to growth in use of electronic cigarettes? Journal Article OBJECTIVE: To assess extent of electronic cigarette use by smokers attending Stop Smoking Services, the advice given about electronic cigarettes and whether this usage is recorded.
Mayer (2013), How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century - Springer,
Human Breath Emissions of VOCs Journal Article ABSTRACT The medical community has long recognized that humans exhale volatile organic compounds (VOCs). Several studies have quantified emissions of
IDENTIFICATION OF CYTOTOXIC CHEMICALS IN THIRDHAND SMOKE Conference Paper (See note attachment for extended abstract) IDENTIFICATION OF CYTOTOXIC CHEMICALS IN THIRDHAND SMOKE Vasundhra Bahl*
Farsalinos , et al. (2013), Immediate effects of electronic cigarette use on coronary circulation and blood carboxyhemoglobin levels: comparison with cigarette smoking,
Caponnetto , et al. (2013), Impact of an Electronic Cigarette on Smoking Reduction and Cessation in Schizophrenic Smokers: A Prospective 12-Month Pilot Study,
Interviews With “Vapers”: Implications for Future Research With Electronic Cigarettes Journal Article Introduction:
Dawkins , et al. (2013), Investigating the impact of nicotine on executive functions using a novel virtual reality assessment, <http://onlinelibrary.wiley.com/doi/10.1111/add.12082/abstract> accessed: 2013-11-11
Is Nicotine a Carcinogen? Report Nicotine itself has not been given a cancer rating, and it has not been analyzed as a carcinogen in its pure form. Although researchers call it the most biologically active ingredient in tobacco smoke and chewing tobacco, nicotine itself, according to research, does not cause the cell mutations.
Farsalinos & Stimson (no date), Is there any legal and scientific basis for classifying electronic cigarettes as medications?, <http://www.sciencedirect.com/science/article/pii/S0955395914000644> accessed: 2014-03-28
Key Issue: Glycerin | U.S. Pharmacopeial Convention Web Page Monograph Revisions At the request of the Food and Drug Administration (FDA), USP has revised and strengthened its Glycerin Monograph to prevent future diethylene glycol (DEG) and ethylene glycol (EG) adulteration.
USP (2009), Key Issue: Revision of Excipient Monographs Related to DEG & EG Adulteration | U.S. Pharmacopeial Convention, <http://www.usp.org/usp-nf/key-issues/revision-excipient-monographs-related-deg-eg-adulteration> accessed: 2014-01-29
Learning from Evidence in a Complex World Journal Article Policies to promote public health and welfare often fail or worsen the problems they are intended to solve. Evidence-based learning should prevent such policy resistance, but learning in complex systems is often weak and slow. Complexity hinders our ability to discover the delayed and distal impacts of interventions, generating unintended “side effects.”
Legislating abjection? Secondhand smoke, tobacco control policy and the public's health Journal Article Since the mid-1990s the position that “no amount of secondhand smoke is safe” has achieved hegemonic status in the field of public health. This has bolstered efforts in the tobacco control community to advocate for smoke-free legislation and a variety of countries around the world have implemented indoor smoking bans, with many others presently following suit. Increasingly, tobacco contro…
Letter re fatal flaws in Schober et al. paper on environmental vapor Blog Post by Carl V Phillips Below is a letter to the editor and Igor Burstyn and I will be submitting to the journal that published this article 
Long-term effects of inhaled nicotine Journal Article Tobacco smoking has been reported to be associated with increased risk of cardiovascular disease and cancer, particularly of the lungs.
Metabolism and Disposition Kinetics of Nicotine Journal Article Abstract Nicotine is of importance as the addictive chemical in tobacco, pharmacotherapy for smoking cessation, a potential medication for several diseases, and a useful probe drug for phenotyping cytochrome P450 2A6 (CYP2A6). We review current knowledge about the metabolism and disposition kinetics of nicotine, some other naturally occurring tobacco alkaloids, and nicotine analogs that are under development as potential thera…
Williams , et al. (2013), Metal and Silicate Particles Including Nanoparticles Are Present in Electronic Cigarette Cartomizer Fluid and Aerosol,
Guillem , et al. (2005), Monoamine Oxidase Inhibition Dramatically Increases the Motivation to Self-Administer Nicotine in Rats,
Kozlowski , et al. (2003), Most smokeless tobacco use is not a causal gateway to cigarettes: using order of product use to evaluate causation in a national US sample,
Farsalinos (2013), New study confirms that e-cigarettes have minimal quantities of nitrosamines – authors do not report it as a conclusion,
New Study of Passive Vaping Shows No Evidence of a Significant Public Health Hazard Blog Post A new study published online ahead of print in the International Journal of Hygiene and Environmental Health is one of the first to examine levels of chemicals in the ambient air of a real-life setting in the presence of electronic cigarette use.
Farsalinos , et al. (2014), Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices,
Nicotine Addiction Journal Article This review gives an account of the cigarette as a highly efficient nicotine delivery system. It explains how nicotine induces pleasure, reduces stress and anxiety, and causes addiction to tobacco smoking. The basis of nicotine addiction rests on its effects on the brain, but addiction is also influenced by learned or conditioned factors, genetics, and social and environmental conditions.
Nicotine and Health Blog Post This year, how about making a truly meaningful, life-altering New Year’s resolution? If you’re one of 44 million American smokers, we have one for you: Try separating the smoke from your nicotine fix. Doing so will save your life.
Nicotine Levels in Electronic Cigarettes Journal Article Introduction: The electronic cigarette (EC) is a plastic device that imitates conventional cigarettes and was developed to deliver nicotine in a toxin-free vapor. Nicotine in a solution is heated and
Nicotine treatment of mild cognitive impairment Journal Article Objective: To preliminarily assess the safety and efficacy of transdermal nicotine therapy on cognitive performance and clinical status in subjects with mild cognitive impairment (MCI).
Nicotine: Medication or Scourge? Book Section The majority of people in most cultures uses psychoactive drugs. In our society only three such substances are legal and freely available: caffeine, alcohol, and nicotine. One of these, nicotine, is an endangered species as the laws against its use multiply in the United States.
Richardson , et al. (2013), Noncombustible Tobacco Product Advertising: How Companies Are Selling the New Face of Tobacco, <http://ntr.oxfordjournals.org/content/early/2013/12/29/ntr.ntt200> accessed: 2014-01-30
Dawkins , et al. (2009), Patterns of change in withdrawal symptoms, desire to smoke, reward motivation and response inhibition across 3 months of smoking abstinence,
Goniewicz , et al. (2013), Patterns of electronic cigarette use and user beliefs about their safety and benefits: an Internet survey,
Callaghan , et al. (2013), Patterns of tobacco-related mortality among individuals diagnosed with schizophrenia, bipolar disorder, or depression,
RainMan's 2011-2012 CDC NYTS Survey Data Note: Data is preliminary, needs verification but believed to be accurate. Link to original CDC Datasets Related: CDC Online Newsroom - E-cigarette use more than doubles among U.S. middle and high school students from 2011-2012 category-youth cdc e-cigarette folder-e-cigs gateway incomplete_information-_bias leans-positive nicotine survey
Sofuoglu , et al. (2012), Rapid Nicotine Clearance is Associated with Greater Reward and Heart Rate Increases from Intravenous Nicotine,
Real–Time Measurement of Outdoor Tobacco Smoke Particles Journal Article Abstract The current lack of empirical data on outdoor tobacco smoke (OTS) levels impedes OTS exposure and risk assessments. We sought to measure peak and time-averaged OTS concentrations in common outdoor settings near smokers and to explore the determinants of time-varying OTS levels, including the effects of source proximity and wind. Using five types of real-time airborne particle monitoring devices, we obtained mo…
Farsalinos & Polosa (2014), Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review,
Vardavas , et al. (2012), Short-term pulmonary effects of using an electronic cigarette: Impact on respiratory flow resistance, impedance, and exhaled nitric oxide,
Technical Review and Analysis of FDA Report:“Evaluation of e-cigarettes” Journal Article Summary A recent report and press release issued by the Food and Drug Administration (FDA)
Teen smoking continues to decline in 2013 Journal Article Teen smoking continues to decline in 2013 ANN ARBOR—Smoking among teens in grades 8, 10 and 12 continued to decline in 2013—apositive trend since most smokers begin their habit in adolescence—according to the latest survey results from the nationwide Monitoring the Future study.
Robertson , et al. (1947), Tests for the Chronic Toxicity of Propylexe Glycol and Triethylene Glycol on Monkeys and Rats by Vapor Inhalation and Oral Administration,
Puck , et al. (1943), The Bactericidal Action of Propylene Glycol Vapor on Microorganisms Suspended in Air Ii. the Influence of Various Factors on the Activity of the Vapor,
The Bactericidal Action of Propylene Glycol Vapor on Microorganisms Suspended in Air. I Journal Article It has been found that propylene glycol vapor dispersed into the air of an enclosed space produces a marked and rapid bactericidal effect on microorganisms introduced into such an atmosphere in droplet form. Concentrations of 1 gm. of propylene glycol vapor in two to four million cc. of air produced immediate and complete sterilization of air into which pneumococci, streptococci, staphylo…
The effects of cigarette smoking and abstinence on auditory verbal learning Journal Article Smoking has been associated with both enhanced and impaired cognitive performance; across a variety of domains, but there is limited evidence demonstrating the effects on verbal learning.
The electronic-cigarette: Effects on desire to smoke, withdrawal symptoms and cognition Journal Article Electronic cigarettes (e-cigarettes) are battery operated devices that deliver nicotine via inhaled vapour. Few studies have evaluated acute effects on craving and mood, and none have explored effects on cognition.
THE MECHANISM OF AERIAL DISINFECTION BY GLYCOLS AND OTHER CHEMICAL AGENTS - 1 Journal Article Theoretical analysis of the mechanism of action of chemical aerial disinfectants reveals that the rapid killing action which is obtained cannot be accounted for by a collision process between germicidal aerosol particles and the air-borne bacteria. However, a mechanism involving condensation of germicide molecules in the vapor state on to the bacteria-containing droplets results in a theoretical ve…
THE MECHANISM OF AERIAL DISINFECTION BY GLYCOLS AND OTHER CHEMICAL AGENTS - 2 Journal Article The effectiveness of any compound as an aerial germicide depends upon the extent of condensation of its vapor on air-suspended bacteria, and on the rate at which the resulting concentration of germicide can produce death of the microorganisms. The properties of any compound conducive to production of the highest rate of kill of air-borne microorganisms by means of the smallest possible concentratio…
The regulatory challenge of electronic cigarettes Journal Article Electronic cigarettes (e-cigarettes or electronic nicotine delivery systems) heat a nicotine solution to generate vapor that is inhaled, without the combustion of tobacco and its toxic constituents. Use of e-cigarettes is increasing in the United States and around the world.
The scientific foundation for tobacco harm reduction, 2006-2011 Journal Article Over the past five years there has been exponential expansion of interest in tobacco harm reduction (THR), with aconcomitant increase in the number of published studies. The purpose of this manuscript is to review and analyze influential contributions to the scientific and medical literature relating to THR, and to discuss issues that continue to stimulate debate.
Tobacco harm reduction: How rational public policy could transform a pandemic Journal Article Nicotine, at the dosage levels smokers seek, is a relatively innocuous drug commonly delivered by a highly harmful device, cigarette smoke.
Sweanor, D., P. Alcabes, and E. Drucker (03-2007) 'Tobacco harm reduction: How rational public policy could transform a pandemic', International Journal of Drug Policy, 18: 70–74.
Toxins in E-Cig Vapor Also Found in Human Breath and Outdoor Air Manuscript Summary * Five of the volatile organic compounds detected by various studies in electronic cigarette vapor have also been found in human breath emissions (acetaldehyde, acetone, butanone, formaldehyde and isoprene).
Treatment of nicotine addiction: present therapeutic options and pipeline developments Journal Article Tobacco use is a global pandemic that poses a substantial and costly health burden.
Use of a liquid nicotine delivery product to promote smoking cessation Journal Article Despite access to various pharmacotherapies and counseling support to aid cessation, smokers typically demonstrate quit rates below 50%. This report describes the results of a Phase 2a study exploring the efficacy of a liquid nicotine delivery system as an aid to smoking cessation assessed after 12 weeks of therapy. PMID: 20334673
Schober , et al. (no date), Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases
‘Real-world’ effectiveness of smoking cessation treatments: a population study Journal Article Background and aims