blog.bioethics.net

"At least these aren't as dangerous as candy cigarettes."

What's dangerous about candy cigarettes? Dang, now you tell me. I probably ate my weight in those things when I was a kid.

- by Laura(southernxyl) on Sep 21, 2008 at 6:43 PM | link

so what is so "dangerous" about these "fake cigarettss"? so far all you've said is o no! their bad noone should smoke them because their bad, boo-hoo get some definative data, cite it and present it otherwise you just sound like a little kid arguing to his uncle that cigaretts are bad without knowing anything at all.

- by joe cool on Oct 16, 2008 at 1:21 PM | link

Dr. Johnson has obviously misrepresented the facts in this case. According to WHO, they do not know how safe or effective these devices are. Therefore, they will not endorse them. That in no way means they condemn them.
There is no evidence so far that e-cigs are harmful and they have been used in China for over a year now.
Dr. Johnson, as one Ph.D. to another, please use facts rather than your own emotional bias.
Please reference for more information: http://www.timesonline.co.uk/tol/news/uk/health/article4907645.ece

- by Another Phd on Oct 27, 2008 at 9:59 AM | link

There are so many people out there, especially this Summer Johnson (PhD) character that obviously don't have a clue about anything. This person is probably some puritan that has never had to deal with the struggles of nicotine addiction. The electronic cigarette, for many hardcore smokers, is the only means for them to separate themselves from the ture evils of tobacco. Get off of you high horse, Summer Johnson.

- by Shawn Tribble on Jan 6, 2009 at 5:29 PM | link

I would suggest that this article is nothing but unresearched self opinionated codswallop.

It is just such mutterings that give science a bad name.

Do everybody a favour Summer and live up to your PhD - DO SOME RESEARCH.

You never know you might just find that these 'fake cancer sticks' could very well save more premature deaths than any other device yet invented.

- by Ray on Jan 7, 2009 at 12:36 PM | link

Wow. That's really sad, since PhD implies you are somebody we should trust with health issues. Obviously, you don't research, and like to state your (incorrect) option as fact.
These devices contain nicotine, same as prescribed inhalers, and propylene glycol, which is safe, as many studies have shown.

Compared to the 1000 odd carcinogens and chemicals in cigarettes that WILL kill you, this is an entirely acceptable substitute for an addicted smoker.

Shame on you. I'm glad you're not MY doctor.

- by Randy on Jan 7, 2009 at 7:54 PM | link

Thank you to all the people who have commented so far. To be clear, I do not support e-cigarettes as an alternative to real cigarettes due to their demonstrated dangers. Although I do not write about this topic normally, I felt it was important to voice an opinion, when the WHO made a statement about it, because they represent an important threat to public health. I feel that companies who market products as "safer" or "healthier" alternatives--like "light" cigarettes--are pushing an ethical boundary. I make such a claim by pointing to data or other authoritative sources, not by claiming any authority myself. I note that I am a PhD in public health and ethics only to clarify the claims made by previous respondents who have said I am a "doctor", not because I have any moral authority to make such a claim at all. If I can persuade you, then you should read on. My fear, with any product that masquerades as a nicotine delivery device (including candy cigarettes), is that e-cigarettes give the appearance that smoking is a morally acceptable behavior. Perhaps that is why the WHO has, in addition to their toxic effects, turned away from e-cigarettes, as would any ethicist.

- by Summer Johnson, PhD on Jan 9, 2009 at 12:38 PM | link

"Thank you to all the people who have commented so far. To be clear, I do not support e-cigarettes as an alternative to real cigarettes due to their demonstrated dangers. "
Several people have asked for your authoritative citations for said dangers, and so far you are 0 and 2 on that..

The Wikipedia article you site (remember, the encyclopedia that ANYONE can edit, and therefore clearly NOT any kind of authority) actually states "Toxicological studies of the electronic cigarettes have been conducted, with some reporting that electronic cigarettes are less harmful than traditional tobacco cigarettes.[1][6]" Wouldn't it be better to say more research and hard data are needed before we close the book?

That's in fact what the WHO is saying.

Here's the WHO's position:
http://www.who.int/mediacentre/news/releases/2008/pr34/en/index.html
"The electronic cigarette is not a proven nicotine replacement therapy....WHO has no scientific evidence to confirm the product's safety and efficacy. Its marketers should immediately remove from their web sites and other informational materials any suggestion that WHO considers it to be a safe and effective smoking cessation aid.
{and here is the punchline}
"WHO does not discount the possibility that the electronic cigarette could be useful as a smoking cessation aid. The only way to know is to test."

So there you go. More evidence is needed before we can declare that these devices are Satan in a steel tube. However, we do know one thing. Nicotine can actually be GOOD for you:
http://health.howstuffworks.com/nicotine-health-benefits.htm

- by Captin Obvious on Jan 9, 2009 at 11:42 PM | link

Mr. Summer, it is refreshing that you actually read your readers comments. But you are ignoring one major piece of this issue. I am a smoker. I have tried to quit many times. It is not the Nicotine that brings me back. I use e-cigs with no Nicotine. It is the "Act" of smoking that i enjoy. You can't smoke a patch or a piece of gum anyway. I enjoy taking a few minutes and separating myself from people, and puffing. This gives me that enjoyment, that frankly I am not willing to give up. And I believe there are thousands that have no desire to quit smoking. So if this isn't a "good alternative" then why not encourage companies to design a good alternative that allows people to smoke, but safely. Whether it violates your ethics, which in your ethical opinion is worse. Letting thousands die because of real cigarettes? Or saving thousands by giving them a healthier alternative. People have been smoking stuff since the dawn of time, your not going to stop it now.

- by K4ot1K on Jan 11, 2009 at 7:18 AM | link

Dr Johnson, you imply that electronic cigarettes have a toxic effect, could you elaborate please? Also are these effects more dangerous than smoking a normal cigarette?
I would appreciate your reply.

- by Dayo on Jan 11, 2009 at 9:59 AM | link

So basically what you're implying is that current smokers should be screwed because the illusion of of smoking is morally harmful? That's ridiculous. So you're telling people to go cold turkey even though smoking is a very psychologically addicting habit? So what should all those people that are seriously addicted to smoking do? I'm a smoke and I feel that I'm not in the wrong place to say that myself along with MANY other smokers enjoy the feeling of that smoke going down our throats. E cigarettes seems to be the only alternative that's available that can satisfy that crucial aspect of smoking. It's ridiculous that the illusion of smoking is so morally wrong that yourself and other are trying to discourage it by stating untested claims of dangers associated with e cigarettes. This is the same argument we've heard countless times before about the microwave, cellular phones, and sitting in front of the television too close.

- by Steve on Jan 12, 2009 at 11:13 AM | link

"......give the appearance that smoking is a morally acceptable behavior"

So now we're bad people because we smoke?

- by Steve on Jan 13, 2009 at 3:29 PM | link

This article is ridiculous. It does not cite any factual data and misrepresents what the WHO has said about electronic cigarettes. "Captain Obvious" has properly represented the WHO's statements about them.

In reality, no controlled studies have been done with these devices, and no health problems, other than the rare occurrence of nicotine overdose (headaches, heart palpitations...spawned from overuse aka abuse) as a result of their use have been reported thus far.

The writer of this article just hates smoking and smokers, and judges people that use e-cigarettes in the same way. Judge not, so-called Summer Johnson, MD...lest ye be judged....and judged you will be.

- by Troy on Jan 14, 2009 at 1:16 AM | link

they know the chemicals that are used in E-Cigarettes and they have extensive data on the chemicals found in regular cigarettes. I unfortunatley have been a smoker for years and just common sense tells me that the chemicals I inhale through an e cigarette are safer or "less dangerous" than the "real deal" , some of the most well known chemicals in "real" cigarettes are arsenic, co2, and tar just to name a few. In my opinion these appear to be much more dangerous than vaporized non carcinogenic chemicals that are "FDA approved" to be used in foods and MEDICINES Please feel free to look for yourself. Are they 100% proven no but, how many newly created medicines guarantee no side effects and are 100% safe. Also, Can they be used as a cessation device probably the method of delivery is different from a patch or gum but the concepts the same, overtime reduce the amount of nicotine intake untill your no longer dependent on the nicotine. Does it depend on the person and their will to quit, show me a smoking cessation method that doesnt for example, cold turkey or the patch. I have tried the patch and the e cig is the first thing that has actually kept me from lighting up a real cigarette. hey its a step in the right direction if you ask me. I started smoking at 14 and have been smoking for 16 years.

- by john doe on Jan 15, 2009 at 7:40 AM | link

The main reasons for the upswell of anti e cigarettes in the who or other institutions fda etc etc, is that there not getting there piece of this pie. It has blown past them and their regulations. They're in a panic because here is something that works and you can't have something that works without their approval. It just can't be allowed to exist. Where is the FDA when I've got to breathe welding smoke at work all day? and yet a millions of square feet shop with over 400 welding machines going all day forces employees to take a smoke break outside in subzero temps, its the law, made by stupid people just like this Dr Johnson.

- by drew on Jan 15, 2009 at 1:48 PM | link

The Nicotrol Inhaler has been around for years and is an FDA approved nicotine delivery system. It also releases exhaled nicotine into the air. You just can't see it. If every smoker switched to the E-Cig the tobacco industry would collapse and the anti-smoking advocates would be out of work too.

- by Devon on Jan 17, 2009 at 8:53 AM | link

Here is what the WHO actually said:

http://www.who.int/mediacentre/news/releases/2008/pr34/en/index.html

Just read it, their case is very clear. Make up your own mind.
Of particular interest to this article is the paragraph:

"WHO does not discount the possibility that the electronic cigarette could be useful as a smoking cessation aid. The only way to know is to test."

- by Steve on Jan 18, 2009 at 10:50 AM | link

Summer Johnson i hope you have learnt from this that posting poorly constructed mis informing articles on the internet is not a good idea... ive seen better arguments in A level classes than that load of bull crap you just tried to force feed smokers.

the e-cig helped me cut down my habbit from 20 fags a day to 0 fags and 0 e-cig after about a 2 months its a great gadget that saved me from the grave.

a little bit of advice go to a real university and get a real PHD i mean sure the mail order ones let you look important but they give you shit all knowledge and make you look like a jack ass when you pos articles like this

- by chris on Jan 21, 2009 at 9:26 AM | link

A PhD and you have no common sense. Also i would like to know exactly what "Noxious chemicals" you are talking about.

Tell you what, why don't you research it and then comment. untill then do like my mum always said "if you cant say anytinhg nice, don't say anything at all" or you could do like my dad said, "if you don't know about something ask, dont just bluff your way through because you wil just look stupid"

Smart guy my dad, god rest his soul!

- by Paul on Jan 25, 2009 at 10:24 AM | link

I am of the belief that Dr Summers speaks from the standpoint that because e-cigarettes are not affiliated with any big pharma. and therfore Dr Summer (or any other Dr) will not get any "kickbacks" as they do by prescribing Nicatrol, Chantix, or any other prescribed cessation drugs, and that automatically makes them "bad"!!

I have been a heavy smoker (3 packs a day) for over 30 yrs and have tried every quit-smoking device prescribed and otc. With e-cigarettes I have been smoke free for a month. For the first time in my life I've found something that actually works. How dare someone come along and put out a biased, un-informed, personal opinion (and claim it to be "professional")

You should expect such feedback and I personally hope there's more to come!

- by jane doe on Jan 25, 2009 at 4:13 PM | link

Wow. Did you do ANY research before writing this article at all? There are three different labs, world wide, who have done testing on this product. There has also been a clinical trial and we are just waiting for the data to be analyzed.
Why does it appear that FDA and the WHO are so against getting people to remove tobacco from their lives? I find it extremely interesting that the electronic cigarette is a viable option for people to change their habit, yet both the FDA and the WHO want to draw a line in the sand.
My question to Dr. Johnson? Are you an ex-smoker who is angry that she cannot have a smoke? And frankly, your anti-smoking agenda is quite dangerous. It is persons like yourself who lead the US into communistic philosophies like bans and ratting on your neighbor.
Here... a much better article than the crap you have written: http://www.e-cig.org/2009/01/16/clinical-trials-and-testing-of-the-electronic-cigarette/

- by LaceyUnderall on Jan 25, 2009 at 5:11 PM | link

I have some moral failing becuase I smoke in public places? I am less moral than you because I choose to try any method of quitting including electronic cigarettes?

My opinion is that you are the one lacking moral clarity. Deliberately spreading misinformation and fueling the moral panic that will help ban devices that have helped hundreds of people quit tobacco puts you in the same moral category as the tobacco companies themselves.

After 20 years of smoking tobacco and countless attempts to quit, I am now tobacco free. I can breath better, I can smell things again, I can walk up the stairs without being out of breath. I don't stink, I don't create ashes or cigarette butts. But according to you electronic cigarettes are "just plain dangerous".

Summer Johnson, you are a douchebag.

- by xpdx on Jan 25, 2009 at 6:26 PM | link

Its intuitively obvious to the most casual observer that vaping via e-cigs is the lesser of two evils. It is equally obvious that lights and ultra light cigs was/is a step in the right direction as is the use of free standing cig filters.

It sounds like you are stuck in a black/white world. Often we must vote for grey and then ammend laws towards improvement. Nothing is perfect the first time around. I believe we should always support the step in the right direction then work for refinement rather than saying nay.

You also project a lack of understanding, compassion, and empathy of addicted individuals. These are traits that don't automatically come with a college education.

Like any product, people need to use common sense. The more I read about e-cig smokers playing with the cartridges to get a few extra days (by pulling out the wool, re-use, etc) the more it makes me cringe. Its unsanitary and they are introducing the potential of bacterial infection each time. Saving $1.50 vice an infection from hell should be a no brainer.

Bottom line: its a step in the right direction; ensure cartridge modifications are done under sanitary conditions; and last, but not least, know that nicotine overdose is a very real condition so vape wisely.

- by Profoundly on Jan 28, 2009 at 3:54 PM | link

Where did you get your doctorate degree and what in? Did you actually READ the WHO blurb on e-cigarettes? Nobody has said (outside of marketing companies of the product) that e-cigarettes are more harmful or less harmful. The WHO is warning people not to buy them because they haven't been extensively tested yet.

This statement you made is rather scary "are supposed to deliver a fine nicotine mist to those who need a fix but instead deliver a noxious mix of toxic chemical additives" ...wait what? Is there a peer-reviewed study that you are privy to and the rest of the world is not? I haven't seen an independent study yet that says if the e-cigarette mist is unsafe OR safe.

The closest one done so far was done by Dr. Laugesen of NZ who was hired by Ruyan (an e-cig company) to independently test the chemicals. He reported that they are safe for the most part. One must of course take his study with a grain of salt and it needs to be replicated many more times and in many different labs before one comes to a conclusion as to the safety of e-cigarettes.

I agree that companies should not market the device as a safe alternative to smoking yet, because it has not been proven, but neither have the statements you made about it being "toxic."

As a "Doctor" one would think you would actually research things before posting information that hasn't been proven either way yet. I too am glad you aren't MY doctor nor one of my professors.

- by Golden on Feb 11, 2009 at 3:48 AM | link

The FDA has determined that the vapor from the electronic cigarette is not harmful. In my opinion, any doctor that actually had "ethics" would take this stance Dr. Johnson, not yours:

http://www.youtube.com/watch?v=5rERRdftB7E&NR=1

- by jbbishop on Feb 16, 2009 at 6:57 PM | link

Ive been using one for about8 months now. My doctor has noticed definite improvements in both my blood pressure which is now back under control WITHOUT any more drugs. As well as better lung functionality.

I have yet to find any Ill effects from using my E-cig and reccomend it to all my friends and family. I hope all smokers have the opportunity to get their hands on these and puff away!

- by Chris on Feb 17, 2009 at 7:24 PM | link

Again, a dissenting viewpoint. If the electronic cigarette is shown to be much safer than smoking, it seems more ethical to me to keep an open mind concerning the beneficial uses it has rather than to demonize it which is how your review reads to me, and the position statements of WHO appears to me to amount to an attack. Warfarin killed my mother, but doctors who pledge to do no harm endorse it. The same "potentially toxic" additives that are referred to by the WHO in the US News report are found in nicotine patches, and the only other additives are propylene glycol and a little flavoring which are non-toxic. That's it. And safety studies have been done. Certainly WHO needed to make a response if false claims of endorsement were made. But it thus appears to me that their response is retaliatory and slanted against the entire industry because of an isolated incident, which would certainly be unethical on their part. I have not heard claims of these being marketed as a nicotine replacement therapy and yes, another battery of studies would need to be done to make that claim. False claims is the basis for two thirds of the complaints by WHO and seems to be nothing more than a smoke screen. Now I've covered all of the points they make against them. But again, about safety. The electronic cigarette does not contain any of the 4000 plus carcinogens found in tobacco products. They contain no carcinogens, there is no second-hand smoke and they do not cause cancer. The vapor produced by the product, as determined by laboratory tests has been deemed non-harmful by the FDA.

- by jbbishop on Feb 21, 2009 at 2:22 AM | link

Hello Summer,

From what I gather your principal arguments against e-cigarettes are as follows:

1. In the same way that "light" cigarettes are marketed as healthier products, the marketers of e-cigarettes are culpable for making spurious claims on health grounds.

2. From an ethical position, anything that resembles smoking should be discounted. Therefore, candy cigarettes, joke shop cigarettes, e-cigarettes all fall foul of this (arbitrary) ethical distinction. Presumably this is derived from (uncited) research that shows a link between the sale and usage of these products and actual smoking?

Starting with the first point, you have your facts plain wrong. E-cigarettes are clearly safer than cigarettes. "light" cigarettes, as you may already know, are as harmful as "regular" strength cigarettes because the smoker ends up inhaling, on average, the same amount of chemicals in either case. Additionally, it is not yet known the quantity of these chemicals actually needed to create disease in the user. In other words, one or two cigarettes per day may be as lethal for some smokers as a whole pack.

E-cigarettes, on the other hand, typically contain nicotine, water, propylene glycol and flavorings. Nicotine is mildly cardiotoxic, neurotoxic and there is some evidence that it promulgates the spread of existing cancers, although there is none that it is carcinogenic in its own right. The other chemicals are all found in food products and their health effects have been extensively researched. What e-cigarettes do lack, unlike "light" cigarettes, is the presence of the 60 odd known carcinogens and 4000+ other chemicals that have a clear detrimental effect on human health.

Granted, there are unscruplulous marketers out there who use the WHO's name to promote their products, and some who claim that e-cigarettes are smoking-cessation devices; there may well be issues with the quality control of the composition of the liquid that is vaporised in the devices, and these are issues that need to be sorted out. The trouble is that since the devices occupy a regulatory grey area, no-one has thus far been prepared to bring them within the regulatory framework necessary. Many e-smokers are resistant to the idea of regulation due to the perception, right or wrong, that as soon as health authorities do take action, it will be to outlaw them.

Posts like yours only serve to confirm this fear.

Referring to point 2, it seems to be the case that your ethical position extends only as far as protecting those who have not yet succumbed to nicotine addiction, a position that doesn't seem very ethical to me at all. Consider the following thought experiment:

A smoker decides to quit smoking by using a joke-shop cigarette as a substitute. They do so successfully, managing to stop smoking entirely by the technique, possibly adding extra years to their life. During the course of this, many children and adult non-smokers witness the smoker sucking on the fake-cigarette.

Would you discourage a smoker from attempting to break their nicotine addiction by sucking on a joke-shop cigarette? Would you view this as "unethical" on the grounds stipulated above, or does the ethical position only pertain to those involved in selling the aforementioned goods?

Additionally, you give no consideration whatsoever in your post to the concept of harm-reduction; a concept that is absolutely key to e-smoking, or "vaping" as, increasingly, it is becoming termed by the users.

I'm not sure that you can really say you take any ethical position of any merit without having first considered harm-reduction, but when you say of e-cigarettes "they represent an important threat to public health", you appear to have prejudged this. It seems extraordinary that you make the claim that e-cigarettes are dangerous without considering what the alternative might be.

I realize that this is not your particular field of expertise and that this is just a blog piece, but must say I am pretty shocked that an academic of your status should be prepared to write such an ill-considered article.

If you would like to find out more about the real issues surrounding e-smoking, may I invite you to e-cigarette-forum.com to discuss these matters further?

- by SmokeyJoe on Feb 21, 2009 at 12:26 PM | link

If the electronic cigarette is shown to be much safer than smoking, it seems more ethical to me to keep an open mind concerning the beneficial uses it has rather than to demonize it which is how your review reads to me, and the position statements of WHO appears to me to amount to an attack. Warfarin killed my mother, but doctors who pledge to do no harm endorse it. The same "potentially toxic" additives that are referred to by the WHO in the US News report are found in nicotine patches, and the only other additives are propylene glycol and a little flavoring which are non-toxic. That's it. And safety studies have been done. Certainly WHO needed to make a response if a false claim of endorsement were made. But it thus appears to me that their response is retaliatory and slanted against the entire industry because of an isolated incident, which would certainly be unethical on their part. I have not personally heard of these being marketed as a smoking cessation product and yes, another battery of studies would need to be done to make that claim. False claims are the basis for two thirds of the complaints by WHO and seems to be nothing more than a smoke screen. Now I've covered all of the points they make against them. But again, about safety. The electronic cigarette does not contain any of the 4000 plus carcinogens found in regular cigarettes. They contain no carcinogens, there is no second-hand smoke and they do not cause cancer. The vapor produced by the product, as determined by laboratory tests, contains 99% water, 1% nicotine and trace elements that have been deemed non-harmful by the FDA.

- by jbbishop on Feb 22, 2009 at 1:13 AM | link

Dr. Johnson,

I'm afraid that I'll have to agree with everyone else on this topic. You have shown no evidence to suggest your hypotheses (which, in fact, discounts them as hypotheses). Others here have even provided data that suggest the opposite of what you claim.

There are indeed studies of long-term potentiation in the hippocampal formation that suggest that nicotine may have some beneficial effects in modulating LTP in rats (see almost any study by Yoshihiko Yamizaki), which - admittedly, at a stretch - may be generalizable to humans.

Please do your profession (whatever that may be) and Ph.D.'s everywhere a favor and either (a) cite sources for your claims or (b) state your opinions as such, not as tested hypotheses.

- by A Brain Guy on Feb 22, 2009 at 11:53 PM | link

PhD in what?

Not in any science, I'll bet.

Otherwise, he would have actually investigated what is in the cartridges.

From puresmoker.com

"2. What is in the cartridge and this Vapor you inhale?
Three main ingredients make up this liquid (what some like to call ELiquid). They consist of:
Water: Cant survive without it. Its that substance you see covering 70+ percent of the earth
PG (Propylene Glycol): Considered generally food safe by the FDA (Food and Drug Administration) Its mainly used in flavoring extracts but can also be found in medicines, cosmetics, hand soap, etc…
Some Include Nicotine: Need I say more? I could go on for hours. The fact remains, NICOTINE IS ADDICTIVE. "

Where's the "...noxious mix of toxic chemical additives. ", "doc"?

- by Tom Spafford on Mar 3, 2009 at 6:21 PM | link

Clearly a blog post by someone that hasn't wrestled with nicotine addiction and all the ineffective NRT (patches, gum, etc.)

Summer Johnson, PhD, writes this:

"...they are not for cessation, they are not nicotine alternatives, they are just plain dangerous...."

Dangerous, compared to what... cigarettes?

How can you claim this is "not an alternative?" I have been smoke free for over a month thanks to these vaporization devices. I have never lasted more than a week on a patch or gum. I hope to stop altogether, eventually.

That being said, this is not at all a "cessation device" -- it is a device that allows a person, as they see fit, to address their nicotine addiction. If a person can wean themselves from the horrible addiction to tobacco products with this type of device, then I say that is great news. If they can use such a device to wean themselves of nicotine addiction eventually, then even better.

I think I missed the motivation of the blog post, Summer. Was it a well-thought out diatribe that just seriously lacked substance and supporting facts, or just something you posted whilst you were bored?

Here's something to get you started:
http://www.healthnz.co.nz/aboutus.htm

Dr Murray Laugesen , of New Zealand, would like to eventually outlaw tobacco cigarettes. However, as a form of "harm reduction" he supports the devices you just flippantly dismissed.

Here's a shortcut to his findings to this point: http://www.healthnz.co.nz/Portland2008ECIG.pdf

Since he didn't compare to candy cigarettes, you may not be in the same realm. If not, please don't post such drivel on subjects you clearly know nothing about.

- by Mouser on Mar 4, 2009 at 12:52 AM | link

"is that e-cigarettes give the appearance that smoking is a morally acceptable behavior"
Are you kidding me? you take away all the carcinogens and all that is left is nicotine and vapor. Do you also argue that drinking coffee is morally unacceptable? Do your research. This product could potentially save millions of lives and you just passed a summary judgment on it. How's that for morally unacceptable?

- by sartre on Mar 6, 2009 at 9:57 AM | link

Seriously this is what the truth is. E-cig are not FDA approved, cigarettes sadly are. The problem this Johnson and the govt have is, they can tax analogs and ahve for god knows how long. Now that e-cigs hit the market they don't have their greedy little hands in it yet. Would I choose e-cig's over analogs even if the govt got involved and taxed them? Sure, I can now breath better, I have tons more energy, I've also lost 60 lbs in the time I started using the e-cig. The govt makes too much money off analogs to just simply allow e-cigs to be widely known. God think of how much money they would lose if every smoker turned around and started vaping and stopped buying those little state taxed sealed boxes of junk we used to puff on?

- by MeMyself&I on Mar 9, 2009 at 10:48 PM | link

Your diatribe is very annoying Dr. Johnson. I certainly hope you don't teach classes or actually treat people with your attitude. Your license and diploma should be revoked. Try citing some facts instead of baseless acusations.

- by John Smoker on Mar 9, 2009 at 10:58 PM | link

"My fear, with any product that masquerades as a nicotine delivery device (including candy cigarettes), is that e-cigarettes give the appearance that smoking is a morally acceptable behavior."

Madam, candy cigarettes are not a "nicotine delivery system" in any fashion. People who use e-cigarettes quite probably use them for various reasons-cost (tobacco is exorbitantly taxed), the ability to indulge where they otherwise might not be able to, and even with the intent of using them as smoking cessation devices.

Rather than inhale tobacco smoke (which contains various toxins wholly separate from nicotine), users of the e-cigs get some water vapor, nicotine and propylene glycol or glycerine (PG and glycerine are used in quite a few consumer products, including toothpaste-go check for yourself, I'll wait...) and some flavor.

Not a health food, but not tar, arsenic, carbon monoxide, carbon dioxide and cyanide either.

That said, the real sticking point in the bit of your comment I quoted is your desire to legislate morality. Rape, murder, robbery and assault are acts that are not morally acceptable. Smoking is unhealthy at the most. Using an electronic cigarette is in no way comparable to murder, at least not to a rational and well adjusted individual. It is not the job of government to create legislation against actions taken by mature adults.

I would never advocate underage smoking, and I support education programs in an attempt to curb it. That said, what I, as a responsible adult, ingest is my own business. If there is immorality involved in this subject, it is the desire of some to exert control over others, simply because what they are doing (smoking/e-cigs/smokeless tobacco/Red Bull/alcohol/firearms ownership-pick your busybody poison) is, simply put, "icky".

- by Mike T on Mar 10, 2009 at 3:17 AM | link

I have stopped smoking using a dse901. I have since switched to 0 nicotine fluid, which I make myself, using nothing but Propylene Glycol and water based candy flavoring. In my workplace, no less than 12 people have already QUIT smoking, 4 of them stopped using the vaporizer as well.

First of all, thanks for deciding on behalf of myself and other supporters of this device that your opinion is the correct one. I guess all the research and studies I've read must be wrong, since without any evidence at all you've declared them "bad." That's a fine scientific hypothesis, doc.

What I decide to put into my body is MY business, not yours. I'm not sure what kind of moral trip people must be on to try to control every facet of human existence, citing moral superiority and half researched nonsense. Don't like them? No problem. As a doctor, you're free to have an opinion on the health aspects of these devices, but I'd suggest you back it up with some real facts. Would you tell your patients to keep smoking real cigs? No, you'd likely just sit on a high horse and claim that smoking anything is stupid, and you'd be right. You'd be a poor doctor, but you'd be right. For generations, parents and teachers have used the same, "Drugs are bad." logic to utter failure. Like most impressionable youth, they'd like to know why. When you don't know enough to have that answer ready, you undermine your argument, valid as it may be.

I hope to have kept a cooler head than many respondents before me, but it wasn't easy. You might want to post a follow up article detailing what "noxious chemicals" are released with the nicotine and propylene glycol.

- by Faron on Mar 10, 2009 at 6:29 AM | link

The ingredients of e-cigarettes are known. There are companies that are printing the ingredients and the amounts on the packaging. Not to mention there are users of the e-cigarettes that are making their own liquids for re-filling the cartridges. Not only do they know what they are smoking, they know where the ingredients came from and who created it.

- by andreo on Mar 10, 2009 at 5:17 PM | link

You use the WHO as a reference, I could go and quote, but will paraphrase from memory, you can look it up yourself. It states that there is no evidence that supports that they are safe, now that also means that there is no evidence that they are not since all ingredients are all FDA approved and all are less volume than the acceptable levels from the FDA.

The next thing is that China gains 64 Billion in tax revenues, if half get on the e cigs, then they stand to lose half of their tax revenue. And this is just from tax revenue on sales, what about income tax on the people who work the tobacco fields, shipping, packaging etc...?

The US stands to lose 32 billion in tax revenue, and guess who pushes the buttons of the FDA? the Gov and Lobbyist.

For a PHD, you do not practise criticle thinking and stated as an absolute that "but instead deliver a noxious mix of toxic chemical additives."

You must be a cancer doctor!

- by Jim on Mar 11, 2009 at 3:58 PM | link

quote: is that e-cigarettes give the appearance that smoking is a morally acceptable behavior.

Morally acceptable behavior? For many people it is and nose in the air pompous attitudes is not. If you are going to base an article against morally acceptable, then why not also post an article on gay rights since most states seem to ban marriage, but the fight to force it on people continues, yet by the vote it would seem to not be morally acceptable, why not pick any topic then and deem it unhealthy because your perceptions are moral perceptions and not actual facts.

- by Tom on Mar 25, 2009 at 11:12 AM | link

You write that "these fake "cancer sticks" are supposed to deliver a fine nicotine mist to those who need a fix but instead deliver a noxious mix of toxic chemical additives."

Source please? I have not read anything which remotely validates your statement. What toxic chemical additives are you referring to? Please state your source and/or research or else stop being a "chicken little". Thank you.

- by Nate on Mar 28, 2009 at 1:56 AM | link

This is very dissapointing post considering its associateion with the Journal of Bioethics. Readers have pointed out the lack of facts and misrepresentations, yet the reply is "it's my opinion but any ethicist would have to agree with me"? That's absurd. While it does make sense to wait until more health information is available (a position you apparently spurn), if the ethical imperative is to reduce deaths from smoking, we should do everything we can to encourage electronic cigarettes as an alternative to smoking... not a cessation aid, but alternative. The dangers from fire are essentially eliminated, the environmental effects would appear to be significantly lower, there is almost no way for "second hand smoke" effects to be felt, and 99.9% of known carcinogens have been removed. With the combined effects of taxes, smoking bans, and health problems on persoanl choice to smoke, using a vaporizer seems to offer a superior alternative which is rapidly gaining in acceptance. The only objection I can see is that "people shouldn't ingest nicotine." This seems to be your underlying position, but with thousands of years of documented ethical debate ragarding alcohol consumption, I don't think it is fair to assume that every ethicist will agree with you on that stance.

- by Unwind on Mar 29, 2009 at 1:34 PM | link

I believe the last contributor was essentially correct..almost.....

This is all about $$$$......What happens if this works and "cig" smoking is reduced world wide by say....75%??

Forget about Phillip Morris....think "government".....

How much $$$ in taxes do the tobaco companies pay?

Forget everything else...its all about the millions, if not billions of dollars the governments would lose in tax revenues.

Common sense dictates...what can possibly be "bad" about a ecig, that produces no nicotine, vs. any real cig on the market???

Seriously?....only tax revenues....

- by makeitso on Mar 30, 2009 at 2:25 PM | link

So, Doc, a question, what do you consider more immoral,

1) lying for the purpose of curbing use of a product that could very well save the life of many, or........

2) an immoral smoker that's pretty much harming no one but themselves?

Being a Doctor as you are, you scare me.

"Now we just have to make sure that adults just say no, too."

We who?

- by Immoral Smoker on Apr 2, 2009 at 12:20 AM | link

The ONLY reason why people are trying to ban these ecigarettes, is because they are either affected by the import/export sales of tobacco. OR have chose to believe what those who are affected have told them about their lies on the evils of ecigarettes.

- by leah on Apr 2, 2009 at 3:46 AM | link

This whole article is a load of bull and just peddling misinformation and fear. If people don't understand something they fear it. If they fear it it's much easier to HATE it. I have been a smoker over 25 years and from day one of getting my e-cig I quite regular (analog) cigarettes entirely. I feel better and I know I'm not putting anyone else in harms way with second hand smoke. Not only is their no second hand smoke, there is no first hand smoke.. THERE IS NO SMOKE. It's water vapor + nicotine + flavor. Sure, the jury is still out on the exact level of safety vs regular cigarettes but this will be decided by organizations around the world who are doing testing as we speak. Several countries who initially banned the e-cig have now unbanned them after their own testing. This should be a pretty good indicator of their safety and ability to help people stop smoking analogs.

I'm just surprised a purported "learned" person would become a parrot of misinformation. Rather than stating things as fact, why not make sure people understand it's your own opinion and move on. Don't trust the credentials, trust the research. I could have a PhD in cat litter, but that does not give me the right to comment on things as an expert outside of that area.

- by Mike Goodridge on Apr 5, 2009 at 1:04 PM | link

You're not very well educated on the e-cigatette. The dangerous mix of chemicals (water and nicotine) can't be taxed, and that's the real problem. But nictine gum, lozenges and patches are safe? If I die, or someone I know dies from smoking real cigarettes when a safe alternative was available the blood is on your hands. Not that you'd care, that's obvious.

- by hipmonkey on Apr 5, 2009 at 1:49 PM | link

I would first like to address Summer Johnson’s assumption that the e-cigarette creates the appearance that smoking is morally acceptable. This does not make sense on a number of levels. Although smoking is unhealthy, it is in no way unethical or immoral. I would also assume that someone who begins the use of the e-cigarette was probably using regular cigarettes prior to beginning and did not see an e-cigarette user and think, “Hey, I want to start doing that.”

My second point is that the CDC estimated smoking-caused healthcare cost per pack of cigarettes sold was $10.28. That was approximately $194 billion last year. Little if any of this cost was due to nicotine, but rather the other ingredients of cigarettes. So until there is definitive proof that e-cigarettes are harmful, which I have not seen yet, I propose we help drive down the ever increasing cost of healthcare.

- by Health Conscious on Apr 14, 2009 at 3:47 PM | link

Plainly put, the removal of tobacco from society can only be seen as a good thing.

The problem is that you can not un-invent things.

If there was a blanket ban tomorrow on all tobacco products it would, on paper at least, appear to be a great move.

It would make criminals of the population and a fortune for those dealing in the contraband.

And what ever standards imposed upon the industry would disappear leading to wildly dangerous practices.

Basically what happened under prohibition in the US.

Removing tobacco from society will be a MULTI generational under taking.

All of my grand parents smoked, of my parents generation far fewer were smokers, and now in my generation the smokers are a large minority.
The idea being that subsequent generations will have even fewer smokers.

The E Cigarette, the E Cigar and the E Pipe are all nicotine delivery systems, not TOBACCO delivery systems.

I do not think we will ever be rid of NICOTINE, but we need tobacco like an extra hole in the head.

I agree that E Smoking, or Vaping as it seems to be being called, needs more study and quite possibly a lot more regulation as to vapour potency and chemical composition.

If Vaping is kept a very cheap but regulated nicotine system while the tax on tobacco products rise again and again you will make millions of vapers out of smokers.

The brass tacks of this are a huge saving in health care costs, personal financial costs, the costs of cleaning up tobacco litter, the cost to others who lose their jobs, health, and lives to second hand smoke as well as re socialising public places, the removal of stigma.

Take the long view.

Summer Johnson Phd's article seems to be a puritanical reaction to smokers rather than a reasoned plan for what to do.

Oh I was a smoker of 20 plus years, I have been smoke free for 6 years. And support the current status quo AND further research.

Am also buying a Ba Da Bing E Cigar.

- by polsigerson on Apr 16, 2009 at 11:31 AM | link

How can anyone trust anything American anymore? How can anyone even trust the government if they were to say it was dangerous?

- by Nobody on May 4, 2009 at 12:37 AM | link

Here' what the "Kennedy Institute of Ethics Journal" said in
Volume 17, Number 2, June 2007

E-ISSN: 1086-3249 Print ISSN: 1054-6863

DOI: 10.1353/ken.2007.0013

Johnson, Summer.
Making Public Bioethics Sufficiently Public: The Legitimacy and Authority of Bioethics Commissions
Kennedy Institute of Ethics Journal - Volume 17, Number 2, June 2007, pp. 143-152

The Johns Hopkins University Press

Bioethics commissions have been critiqued on the basis that they are not sufficiently public or are too reliant upon expertise to have legitimacy or authority in regard to public policy debates. Adequately assessing the legitimacy and authority of commissions requires thinking clearly about the "publics" these commissions serve, the primary tasks of public bioethics, and how those tasks might be performed with a certain kind of ethical expertise and limited authority that makes them legitimate players in public policy debates concerning bioethics.

ANY QUESTIONS????

- by Wendee Hart on May 22, 2009 at 5:24 PM | link

Thank you for quoting my previously published work. I am wondering though what you are arguing with in the above quote. I am happy to discuss my scholarly work with you if you have a claim to make. Let's discuss.

- by Summer Johnson on May 26, 2009 at 9:29 PM | link

Well done, Summer Johnson, and look at all the comments you have received.

The fact is, the electronic cigarette may have had all the tar, chemicals and carcingons taken out - but it still contains filthy nicotine, more than ten percent of the amount in a cigarette. And it's made in China!

I agree with you - we should let smokers die of cigarettes instead of letting them have an alternative.

- by Electronic Cigarette Enemy No 1 on Jun 18, 2009 at 4:36 AM | link

Wow ! We just wrote a post on the electronic cigarette because two workers at our office want to try it to stop smoking. However, the article seems to be more about scaremongering than anything else. Really..

- by MacKinnon on Jan 27, 2010 at 12:33 AM | link