This may be a long post because it details something that has been life-changing for me and thousands of others. Parts of it will be technical, parts may use jargon which I will do my best to define, and parts will include research links.
I am a steam-powered human. For a bit of background:
I’ve smoked since I was 12. Started when I found I wouldn’t get sick on the second-hand smoke from my parents cigarettes. After 42 years of smoking my lungs protested violently. I’ve tried every form of NRT (the gum works, sort-of as a short-term (hours) substitute), but couldn’t stick with them and always ended up smoking again. Knowing I had to kick the burning leaf I researched e-cigarettes and, using the advice of the fellowship at E-Cigarette Forum, made a committed purchase of equipment. It takes a (very) little while to learn to ‘vape’; once some skill is acquired it becomes natural. In short order I found the burning leaf intolerable, preferring my e-cigarettes instead.
After three months, I went for a visit with my doctor. He immediately commented on how much better I looked, and after giving me the once-over how much better my chest sounded. While I’ll always have stage I COPD due to the emphysema the chronic bronchitis flares very rarely now. Heavy concentrations of cigarette smoke will set it off as will seasonal allergies. However, being in our local e-cigarette shop does NOT cause a flare up! I’m impressed as there is usually a large number of fellow ‘vapers’ gathered and the clouds, were they cigarette smoke, would certainly cause a flare.
It is now well over a year since my last tobacco cigarette, I’ve reduced the strength of nicotine from 24mg/ml to 6mg/ml and I am comfortable and much healthier. Thanks to the free availability of an electronic vapor alternative I am tobacco free for the longest I have ever been. I don’t smell awful, I don’t hack constantly, I can taste and smell subtleties I’ve missed while smoking and I spend a fraction of what I paid for tobacco products or prescription NRT.
My vaping equipment list has grown and changed as I’ve become more experienced and developed my tastes:
- I still have my 510 pen-style with a Vision Nano clearomizers for discrete out-and-about use but this is rarely used. Vapor production is fair and really easy to stealth.
- There are quite a few eGo style VV batteries in 1100mA and 900mA. I use these mostly for work and discrete vaping. They’re topped with either Smok Aero’s at 1.8ohm or Artemis slim locking tanks with 1.5ohm DCT cartos. Very discrete and very reliable. The adjustable voltage is a must for me now.
- I broke into mechanicals with a KTS Storm using an 18500 with a Kick. Set to 10.5Watts a ProTank II sits on this one with hand wound 1.6ohm Kanthal coils over cotton wick. I use this for my signature flavor, Kashmir; a tobacco flavor blend I spent a long time tweaking and its my All Day Vape. This is my pocket rig.
-I switched to a Kayfun/Russian 91% clone on a Nemesis with a kick-tube for daily use. It’s setup for Kashmir at 1.4ohm (10 wraps 28ga Kanthal A-1 on a #50 (0.0700″) drill) with a cotton wick. It’s a heavy monster but it is reliable and tasty.
- I have a Innokin SVD for my UDCT tanks and for flavor testing at my local B&M’s as it is quickly adjustable for wattage/voltage as the tank/clearo and juice toppers change. It’s a beast but very reliable.
-My dripping rig is a Stainless Steel Electric Angel clone with gold plated switch parts and a copper atty pin. The atomizers are both Patriot clones from Fasttech. Closed circuit resistance at the atty posts is 0.079 ohms (that’s why my lowest regular build is 0.15 ohms! [That's 0.24ohms 4.2v 18.26A 76.7W]). My ‘daily’ setup is two coils 10 wraps of #28ga Kanthal on a #50 (0.0700″) drill bit (1.4 ohm per coil) wicked with cotton. The Patriot hood is drilled out with two #54 (0.0550″) holes and I use AW 18650 1600mAh batteries for this configuration. The experimental Patriot hood is drilled out with 4 holes 5/32″ (0.0781″).
Self-blended flavors: Kashmir, Irish Coffee, Chocolate Cherry, Amaretto Creme Truffle, Strawberries & Cream, Butter Rum Truffle
Purchased flavors: CoffeeShop Hodgepodgery (Plumes), Belgian Cocoa (Halo), Creme Brule, Custard’s Last Stand, PBC and Doodle (Nickoticket).
Vaping has become a very satisfying hobby and I’ve met some really good folks, converted some good people and enjoyed the experience. I am a CASAA member and actively work with the legislators at the state and federal level.
Recently several things are happening at the federal level to regulate the industry and its customers. Not all of these regulations (proposed) may be a Bad Thing™ but enough of them are sufficiently questionable to give a reasonable man cause to pause, reflect, and take action. This blog entry is a collection for the actions taken as of this date.
It begins with the local effort to regulate electronic cigarette sales to minors and consider taxing them. This was my response to our unicameral legislative committee:
September 30, 2013
The Honorable Members of the General Affairs Committee:
Senator Russ Karpisek (Chairperson),
Senator Bob Krist,
Senator Scott Lautenbaugh,
Senator Colby Coash,
Senator Dave Bloomfield,
Senator John Murante,
Senator Ken Schilz,
And including my representative
The Honorable Senator Jim Smith (District 14),
And including the committee secretary
Ms. Christina Case.
I am, by distributing a copy of this letter to Ms. Case, authorizing the following as a statement to be included in the record of the General Affairs Committee’s special hearing set for Friday October 4th at 1:30pm in regard to LR283 to “Examine issues related to the acquisition and use of electronic cigarettes by minors”.
I write this in support of certain efforts, and opposition to certain efforts of the General Affairs Committee in regards to the regulation, sale and use of electronic cigarettes. I am a citizen of Sarpy County, City of Papillion, Legislative District 14 and I am represented in the legislature by Senator Jim Smith.
First a very brief introduction: I am a 55 year old registered nurse currently working in the field of surgical trauma at one of Omaha’s Level I trauma centers. I had smoked tobacco cigarettes from the age of 13. That’s a 42 year history of smoking.
I developed the smoking habit after exposure to the second hand smoke of my parents’ cigarettes appeared to no longer make me ill after smoking my first cigarette. I was no longer bothered by the smell of their tobacco use either. I attempted over a dozen times to quit the habit once I was on my own and noted the impact my habit was having on my ability to breathe. My longest previous success was 10 weeks in 1991 using support therapy and nicotine replacement patches. I was able to get through the entire reduction therapy of 8 weeks and remained nicotine and tobacco free for two weeks. Sadly that attempt was ruined when I was again exposed to tobacco smoke and stress and took up the habit again.
Over the next 22 years I tried again to quit with each new resource, including several combinations of drug therapy, nicotine replacement, counseling and environmental changes. None had the success at relieving the craving for nicotine and the habit would quickly return.
On September 25, 2012 I was diagnosed with Stage II Chronic Obstructive Pulmonary Disease (COPD) subsequent to my smoking history and my fifth episode of bacterial pneumonia. My physician, Dr. Shalindra Saxena, MD urged me to do whatever it took to stop smoking as my health would likely rapidly deteriorate from this point forward.
I had heard of electronic cigarettes from a colleague who had some success in smoking cessation with these devices. After researching the subject, including reading several journal articles available at that time though The Consumer Advocates for Smoke-free Alternatives Association (CASAA), I discussed the alternative of using electronic cigarettes with my physician and was encouraged to try it. I purchased my first electronic cigarette kit two days later on September 27th 2012.
That day I began using the electronic cigarette as an exclusive alternative to smoking. Even with a spouse who continued to smoke, I was able to continue the use of the electronic cigarette and completely avoid primary smoking. As the weeks elapsed my spouse graciously limited her smoking to specific areas of our home to reduce my exposure to second-hand smoke. My lungs began the course of healing.
Today, I am one year tobacco free and I have reduced my nicotine exposure through the strength reduction of the liquid that is used to refill my electronic cigarette. My COPD is now at stage I and I am able to take the entire flight of stairs at my place of employment from the first to fifth floors where before I could barely do one floor without severely impairing my breathing.
Having experienced this result of tobacco harm reduction directly as a result of using electronic cigarettes I have chosen to become an active advocate for their use as an alternative to smoking. Through CASAA I have become aware of this committee’s hearing regarding the perceived need of regulation of these devices to minors in our state and the possible taxation or other regulation of electronic cigarettes. I do support the idea that those of adult age should have free and unfettered access to these devices. I strongly support the idea that minors in our state should not have access to tobacco, alcohol, nicotine (the addictive substance in tobacco) and street and pharmaceutical drugs for illicit use. As such I believe that legislative support for our local retailers of electronic cigarettes (see Appendix I) in banning access to their facilities to minors would be beneficial.
I am opposed, however, to classifying electronic cigarettes as tobacco products for the purpose of taxation. Foremost among the reasons for my opposition is the association of electronic cigarettes with tobacco use creates a perception that electronic cigarette use is similar to tobacco. This is at odds with the goal of harm reduction and smoking cessation. While studies are still sparse, there is a growing body of evidence that electronic cigarette use is an effective alternative to and radically less harmful than tobacco use. To create a false equivalence may damage the ability of citizens such as me to promote this safer alternative against the perception that it would be “just like smoking”.
My second objection to special taxation of electronic cigarettes stems from the treatment of other nicotine replacement therapies (Nicotine patches, gums and inhalers) as exempt from tobacco taxes where their ingredients are basically the same as that found in electronic cigarettes: Those ingredients being a base, a variable amount of nicotine, and an optional flavor. To make a separate law for electronic cigarettes will not likely survive legal challenge. The efforts to defend such challenges would be a drain on precious public revenues.
My third objection to special taxation of electronic cigarettes stems from the problem of what constitutes the taxable entity. In the construction of an electronic cigarette there are three main parts: A battery, the vapor producing mechanism (often called an atomizer), and the liquid which is used to produce the vapor. As I mentioned previously, but worth repeating, the liquid consists of a base, a variable amount of nicotine, and optional flavor agents. In erecting a tax structure related to the notion of a tobacco product how would the committee handle the fact that the nicotine content is entirely variable by user selection? Taxing a non-tobacco product without even a trace of nicotine would open the legislation to litigation which would eventually overturn it. Basing the tax on the nicotine content would complicate compliance to a point where the revenues received would be substantially reduced by the likelihood of fraud, and the reporting, enforcement and prosecution required. That kind of legislative inefficiency is counterproductive to our society.
My final objection to special taxation of electronic cigarettes is the public perception that such taxes are “Sin taxes”. Reduction of harm from tobacco use should never be considered a “Sin”.
In closing, I urge the General Affairs Committee to proceed with haste to legislatively limit the availability of electronic cigarettes to minors. Such legislation would relieve the public concern that a possible route for an addicting substance (nicotine) to minors should have the same level of regulation as other nicotine replacement and tobacco products. I further urge the committee to proceed with due caution in further legislation of these products for purposes of taxation. At this time there is a growing body of evidence supporting the reduction of harm that electronic cigarettes afford those who, like me, are unable to quit tobacco use through any other means. To legislate from emotion, ignorance or incomplete knowledge is a fool’s errand which would likely have harmful unintended consequences.
I have included in Appendix II some internet resources that will help to educate the senators further on this issue. Let us all work together to help make a healthier Nebraska.
Thank you for your consideration. I can be reached for questions through the following means:
Robert Bruce Nye, RN
1105 Hickory Hill Rd.
Papillion, NE 68046
Exclusive retailers of electronic cigarettes personally known to me to limit sales to adults only:
Plumes (Omaha location)
725 North 120th St.
Omaha, NE 68154
Plumes (Bellevue location)
11527 South 36th St.
Bellevue, NE 68123
14803 W. Maple Rd.
Omaha, NE 68116
Sources for further information:
CASAA – The Consumer Advocates for Smoke-free Alternatives Association
c/o Elaine Keller
7481 Huntsman Blvd. #420
Springfield, VA 22153
Website (Clinical Research): http://casaa.org/Clinical_Research.html
Website (Scientific Opinion): http://casaa.org/Scientific_Opinon.html
The final bill passed and contained only language limiting the sale of electronic cigarettes to minors. Hallelujah!
I continue to follow news about electronic cigarettes with increasing vigilance. Finally there was this article published at Huffington Post’s website that really irritated me. The inaccuracies contained in it were just too much to bear. It took two posts in reply to decimate the article’s premise:
From the first paragraph: “Vaping” is the word used by the majority of e-cigarette users to distinguish it from smoking. It differentiates the act of inhaling the vapor produced by an electronic vaporizer from the act of inhaling the smoke produced from cigarettes, cigars and pipes. It is not originated by or limited to middle and high school students.
It may be a shock, but a majority of e-cigarette users support the idea that e-cigarettes should not be sold to minors, just as the majority of drinkers support the idea that alcohol should not be sold to minors.
The FDA is currently studying the flavor issue, though what research we have has shown that flavorings do not favor any particular age group. Perhaps taking a look at the sales of breakfast cereal preferences would be illuminating. The point, just because someone has aged into adulthood is no reason to believe that flavor isn’t important.
The FDA is also cautious and deliberately points out, in several places in the ruling, that the efficacy of e-cigarettes as harm reduction is both important and in need of further study.
The information regarding nitrosamines and diethylene-glycol being contained in e-cigarettes is from a single source study that has long been shown to be in error. In truth there are far more studies completed and more in progress that show or will likely show that there are both far fewer carcinogens in e-cigarette vapor and the levels are orders of magnitude lower than those in traditional tobacco products. Add to that the numerous studies that demonstrate that the risks to health of unintended exposure (aka second-hand vapor) is vanishingly small.
The statement: “We do know that e-cigarette manufacturers have been very clever in marketing to middle- and high-school students with colorful packaging, fun flavors and cool accessories.” is completely without reference or support. Indeed, when challenged it is nearly impossible to find 1st hand proof of such tactics. Why? Because the “industry” is based on folks who are making products for people who want to *quit* smoking.
The CDC study citation leaves out the most important information in that study, and one glaringly obvious fact. The most important information is that the survey questions are “ever used” and not continue to use. The most glaring information is the use of drugs, alcohol and tobacco is significantly higher than the use of e-cigarettes. All of these are obtained the same way e-cigarettes are obtained, they are stolen or paid for by adults. It is the adults who are responsible for these phenomena, not the manufacturers.
The ‘gateway’ idea postulates something that is not provable and is mere speculation. The notion of the gateway theory is currently being challenged by research in a variety of areas and is coming up short.
Again, the notion that an industry has to “do right by America’s children” attempts to lay blame for adults failing to care for their children at the feet of some pseudo-anonymous oligarcy. This is fallacious reasoning at best.
In conclusion, it appears that an MD diagnostic radiologist who’s father was a well connected politician has taken half-baked facts ex-totum of the growing body of research along with a grand misdirection of culpability to make an emotional appeal to ban something that could, could, just be the next big thing to lower the death rate from tobacco use. Perhaps this is because without tobacco use the need of her services, and the viability of the organizations she directs would suffer economic harm due to a declining rate of cancer caused by smoking.
Hippocratus gave us Primum non nocere: First, do no harm. It would be a wise physician who studied and weighed the benefits and harms thoroughly before prescribing treatment. The author has demonstrably failed this basic tenet of medical ethics.
Most recently I’ve had to take on the fight at the federal level, responding to the ludicrous ravings of a would-be distinguished senator. I look at this senator’s publications and note that he believes he and some of his colleagues do science to prove that electronic cigarettes are advertised to attract children with this. And then he joins a few other colleagues in evidencing prescient understanding of research as-yet-unpublished because it is still under review here. Finally he decides to hold a hearing on the subject of tobacco regulation and turns it into a pseudo-referendum against the industry and its customers prompting this response.
Having finished watching the recent hearing you chaired of the Health, Education, Labor and Pensions committee entitled “Progress and Challenges: The State of Tobacco Use and Regulation in the U.S.” I am disappointed.
I am disappointed first because, during your opening statement, you attempted to demonize electronic cigarettes without acknowledging any of the redeeming qualities that have multiple scientific studies supporting them. You assume that flavors like “Gummy Bear”, “Rocket Pop” [A Cherry, Lime and Raspberry flavor reminiscent of a Bomb Pop popsicle], “Cotton Candy”, “Strawberry”, and “Cherry Crush” are only marketing to children. Indeed “Gummy Bear, that appeals to adults doesn’t it?” was uttered by you in a derisive tone as a rhetorical question. Senator, your conduct is demeaning to your intelligence and stature as an adult, let alone as a representative legislator of these United States. To imply that any of these flavors is exclusively meant to “target” children is ludicrous. To further imply that any flavoring would be evidence, a priori, of a campaign to target youth ignores evidence from food research going back many decades. Adults like flavor too. Indeed human beings are wired physiologically to respond to flavor, especially to fruits and other sources of carbohydrate energy the consumption of which gives a temporary feeling of well being. In considering the reenforcing effect this may have to a smoker trying to quit using electronic cigarettes, this reward system is a positive.
I get it. I do. I don’t want children to start smoking, I don’t want them to become addicted to nicotine, I don’t want them to suffer the harm that tobacco produces when ‘used as directed’. But I also don’t want children to suffer the loss of their parents and other family members from the harm produced by smoking. I am not alone in the sentiment, supported by a growing body of evidence, that the electronic cigarette products represent a huge step forward in reducing the harm from tobacco use. With statistics from the CDC as cited by your coleague Senator Alexander, that one in four high school students are smoking cigarettes, it would behoove a thoughtful man to ask the question of the CDC: “What percentage of high school students who are using electronic cigarettes smoked, and how many of them continue to use cigarettes or their electronic counterpart on a regular basis?” This would be a thoughtful question meant to discern further the impact that electronic cigarettes may be having on our youth. Instead, you assume facts not in evidence and attempt to condemn an entire industry on the basis of this assumption. You assumed that any game on a website is targeted at children. This, again, represents a narrow and uninformed viewpoint. If this were true, what accounts for the massive success of games like “Candy Crush Saga”, “Angry Birds” and other games among adults? Surely these are not targeted at children exclusively and are enjoyed by folks of all ages. I acknowledge that the site “White Cloud E-Cigarettes” does not appear to have a means to verify the age of its viewers. Certainly you realize that completing an on-line transaction would require a willing adult with a credit card or an act of theft and deception on the part of the child.
Mr. Zeller’s testimony that “the reality is that one in five adults continue to smoke” is telling. In your opening statement you declared you know what works. Indeed you have some success. The reduction of smokers from 50% to 20% is significant. But the numbers from the CDC demonstrate that the 20% of the population that continues to smoke has not changed significantly or sustainably for many decades, despite numerous efforts at control, the availability of newer forms of support for smoking cessation and the efforts of the Family Smoking and Tobacco Control Act now 5 years in effect. The only thing that has moved the needle may be the rise in use of electronic cigarettes. Since their introduction in 2007 there has been a reduction in tobacco use among adults, sometimes reported as high as 10%. Still, there is no correlating questions being asked. No studies or research by the CDC at present that would help to understand whether or not this is the case. But, rather than encourage such research, you focus on speculation and innuendo as evidenced by your recent letter to the FDA using the statements made by a reporter in a New York Times article: “A study to be published this month in the journal Nicotine and Tobacco Research found that the high-power e-cigarettes known as tank systems produce formaldehyde, a known carcinogen, along with the nicotine-laced vapor that their users inhale.” Yet the current issue of the journal does not, in fact, have such an article nor alludes to the second article mentioned thus you could not have had access to the facts. While Dr. Goniewicz and colleagues have done significant research in this area, enough to warrant recognition as an authority, the article presents de-facto hearsay evidence that you have misinterpreted as fact. I’ll cite two of her other studies which demonstrate a positive effect of electronic cigarettes.
In summary, your behavior evidences a bias, based on conjecture and emotion, against what may be the most significant development in the field of tobacco harm reduction to come along in decades. Such a bias in unworthy of an educated man, and certainly inappropriate for a United States Senator, whose job is to legislate based on both upon the will of their constituents and the facts in evidence that support it. I am reminded of the words of a very wise man: “The considered views and opinions of even the most highly qualified scholars and experts seldom outweigh the determinations of the voters. When challenged, however, the voters’ determinations must find at least some support in evidence. This is especially so when those determinations enact into law classifications of persons. Conjecture, speculation and fears are not enough. Still less will the moral disapprobation of a group or class of citizens suffice, no matter how large the majority that shares that view.” – Judge Vaughn R. Walker. I strongly urge you to reform your thinking on this issue, evidence some concerted effort to understand the breadth of evidence, and to take some time to personally explore both sides of the issues in both their scientific evidence and the effects on the lives of those whom you would propose legislation. I recommend that you invite representatives of the following organizations to be witnesses at a further hearing of the Health, Education, Labor and Pensions committee on the subject:
CASAA – The Consumer Advocates for Smoke-free Alternatives Association
c/o Julie Woessner
PO Box 652
Wilbraham, MA 01095-0652
AEMSA – American E-liquid Manufacturing Standards Association
SFATA – Smoke-Free Alternatives Trade Association
1155 F Street NW, Suite 1050
Washington, DC 20004
These organizations can provide valuable information which can inform you and the committee regarding tobacco harm reduction.
-Robert Bruce Nye, RN
Maciej Lukasz Goniewicz, Jakub Knysak, Michal Gawron, et.al., “Levels of selected carcinogens and toxicants in vapour from electronic cigarettes”, Tob Control tobaccocontrol-2012-050859 Published Online First: 6 March 2013 doi:10.1136/tobaccocontrol-2012-050859
Jan Czogala, Maciej L. Goniewicz, Bartlomiej Fidelus, et.al., “Secondhand Exposure to Vapors From Electronic Cigarettes” Nicotine Tob Res (2014) 16 (6): 655-662 first published online December 11, 2013 doi:10.1093/ntr/ntt203
Okay so reading all of this it is reasonable to conclude that I’m some sort of “Vaping Zealot”. That may be true, it may not. The point is that there is a sea-change movement that is helping thousands of Americans give up cigarettes successfully. The scope of this revolution hasn’t happened since the Surgeon General’s report on tobacco’s harmful effects in the 1960′s when we began the decline from nearly 50% of our population using combustible tobacco products to the near 20% use levels in the 1990′s. And our public servants want to take steps to squash this evolution.
Imagine what would happen if these tactics had been applied to the burgeoning computer and software industry in the 1970′s when folks were suffering tremendous job losses and inflation. Using the reasoning that passes as acceptable, legislators and regulators could have squashed the industry on the basis of harm to workplace job security and privacy concerns.
Instead we let the industry grow and change under the pressures of a free market. Sure there were problems, and those problems were addressed successfully. Certainly there have been impacts both economic and social. Yet those impacts have been overwhelmingly positive, enough so that the negatives are still the exception rather than the rule. And even the shortcomings are being addressed by the industry.
That is why, being an engineer and a nurse, I will continue to fight against the silliness that passes for legislative and regulatory wisdom that is being foist upon the electronic cigarette industry. An industry that is just at the stage where personal computers were in the early 1980′s before the emergence of IBM Personal Computer Products, Apple, Microsoft, Borland, Lotus, VisiCalc, WordPerfect and others. It is a time of invention and discovery, a time where the science and markets should prevail.