Uk Vape Brands UK

E-cigs vs. T-cigs

Electronic cigarettes may be less harmful in the UK than cigarettes but may still be dangerous. Under which circumstances should a person use ecigs? Will they fill your body with plastic?

Electronic cigarettes can contain propylene glycol or vegetable glycerine with nicotine (and in at least two cases polyethylene glycol 400) to form a solution that when heated by an atomizer, produces a visible vapour that provides nicotine to the bloodstream via the lungs when inhaled.

Electronic cigarettes have not been studied enough by scientists in laboratories to form conclusive evidence that their use is either beneficial or harmful to humans. However, some are concerned that unknown side-effects could occur with continuous, consistent use of electronic cigarettes, including cancer.

Behaviour surrounding their use is worrisome because e-cigs are being used habitually by a percentage of non-smokers who otherwise would not use nicotine, they may seem attractive to children, they are not closely regulated, and their use makes it very easy to overdose on nicotine even for experienced smokers.

Ends Electronic Cigarette

UK Electronic Cigarettes and E-Liquid

Various types of e-cigarettes.

Electronic cigarettes or e-cigarettes[note 1] are handheld electronic devices that try to create a feeling like smoking tobacco. They work by heating a liquid to generate an aerosol, commonly called a "vapor", that the user inhales.[2] Using e-cigarettes is sometimes called vaping.[4] The liquid in the e-cigarette, called e-liquid,[5] is usually made of nicotine, propylene glycol, glycerine, and flavorings.[6] Not all e-liquids contain nicotine.[7]

The health risks of e-cigarettes are uncertain.[8][9][10] They are likely safer than tobacco cigarettes,[11][12] but the long-term health effects are not known.[13][14][15][16][17] They can help some smokers quit.[6][18] When used by non-smokers, e-cigarettes can lead to nicotine addiction, and there is concern that children could start smoking after using e-cigarettes.[19] According to some US sources, minors who use e-cigarettes are more likely to smoke later in life.[20][21] Public Health England attributes this link to a liability for the use of both products rather than one resulting in the other.[15][22] So far, no serious adverse effects have been reported in trials.[6] Less serious adverse effects include throat and mouth irritation, vomiting, nausea, and coughing.[23]

E-cigarettes create an aerosol, commonly called vapor,[23][24] generally containing nicotine, flavors, glycerol and propylene glycol.[25] Its exact composition varies.[24] The majority of toxic chemicals found in tobacco smoke are absent in e-cigarette aerosol.[26][27] Those present are mostly below 1% corresponding levels in tobacco smoke.[28][29] The aerosol can contain toxicants and traces of heavy metals at levels permissible in inhalation medicines,[25] and potentially harmful chemicals not found in tobacco smoke at concentrations permissible by workplace safety standards.[28] However, chemical concentrations may exceed the stricter public safety limits.[23]

The modern e-cigarette was invented in 2003 by Chinese pharmacist Hon Lik,[30] and as of 2015 most e-cigarettes are made in China.[31] Since they were first sold in 2004 their global use has risen exponentially.[32] In the United States and the United Kingdom their use is widespread, and some US schoolchildren use them.[33] Reasons for using e-cigarettes involve trying to quit smoking, reduce risk, or save money, though many use them recreationally.[13] A majority of users still smoke tobacco, causing concerns that dual use may "delay or deter quitting".[23] About 60% of UK users are smokers and roughly 40% are ex-smokers, while use among never-smokers is "negligible".[34] Because of overlap with tobacco laws and medical drug policies, e-cigarette legislation is debated in many countries.[35] A European directive in 2016, set limits for liquids and vaporizers, ingredients, and child-proof liquid containers.[36] As of August 2016, the US FDA extended its regulatory power to include e-cigarettes.[37] There are around 500 brands of e-cigarette with global sales in excess of US$7 billion.[38]

Electronic cigarettes are also known as e-cigarettes, e-cigs, EC,[1] electronic nicotine delivery systems (ENDS) or electronic non-nicotine delivery systems (ENNDS),[2] personal vaporizers, or PVs.[3] They are handheld devices, often made to look like conventional cigarettes, and used in a similar way.[2][39] E-liquid[5] or juice are names for the flavored solution that goes inside the e-cigarette.[40] An aerosol, or vapor, is produced by heating the e-liquid.[41] Irish public health discussions refer to NMNDS ("non-medicinal nicotine delivery systems").[42]

Aerosol (vapor) exhaled by an e-cigarette user.

Since their introduction to the market in 2004, global usage of e-cigarettes has risen exponentially.[32] By 2013, there were several million users globally.[43] Awareness and use of e-cigarettes greatly increased in a relatively short period of time.[44] However, growth in the US and UK had reportedly slowed in 2015, lowering market forecasts for 2016.[45][46]

Most users have a history of smoking regular cigarettes.[47] At least 52% of smokers or ex-smokers have vaped.[31] Of smokers who have, less than 15% became everyday e-cigarette users.[6] Though e-cigarette use among those who have never smoked is very low, it continues to rise.[48] A survey of e-cigarette users conducted from 2011–2012 found that only 1% of respondents used liquid without nicotine.[49]

Everyday use is common among e-cigarette users.[50] Vapers mostly keep smoking,[23] although many say vaping helps them cut down or quit smoking.[25][47] Most e-cigarette users are middle-aged men who also smoke traditional cigarettes, either to help them quit or for recreational use.[13] E-cigarette use was also rising among women as of 2014.[51] Some young people who have tried an e-cigarette have never smoked tobacco, so ECs can be a starting point for nicotine use.[23] On the other hand, Public Health England found no evidence e-cigarettes increase teen tobacco smoking. They noted tentative evidence that e-cigarettes divert youth away from cigarettes.[12] A 2014 review raised ethical concerns about minors' e-cigarette use and the potential to weaken cigarette smoking reduction efforts.[52]

In the US, as of 2014, 12.6% of adults had used an e-cigarette at least once and approximately 3.7% were still using them.[53] 1.1% of adults were daily users.[54] Non-smokers and former smokers who had quit more than four years earlier were extremely unlikely to be current users.[54] Former smokers who had recently quit were more than four times as likely to be daily users as current smokers.[54] Experimentation was more common among younger adults, but daily users were more likely to be older adults.[54]

Play media National Institute on Drug Abuse director Nora Volkow discussing a study that shows teens using e-cigarettes are more likely to start smoking tobacco.[55]

The recent decline in smoking has accompanied a rapid growth in the use of alternative nicotine products among young people and young adults.[56] In the US, vaping among young people exceeded smoking in 2014.[57] As of 2014, up to 13% of American high school students have used them.[33] Between 2013 and 2014, vaping among students tripled.[58] In 2013 the Centers for Disease Control and Prevention (CDC) estimated that around 160,000 students between 2011 and 2012 who had tried vaping had never smoked.[56] E-cigarette use among never-smoking youth in the US correlates with elevated desires to use traditional cigarettes.[8] Teenagers who had used an e-cigarette were more inclined to become smokers than those who had not.[59] In the 2015 Monitoring the Future survey, a majority of students who used electronic cigarettes reported using liquid without nicotine the last time they vaped.[60] The majority of young people who vape also smoke.[61] A 2010–2011 survey of students at two US high schools found that vapers were more likely to use hookah and blunts than smokers.[62] Among grade 6 to 12 students in the US, the proportion who have tried them rose from 3.3% in 2011 to 6.8% in 2012.[47] Those still vaping over the last month rose from 1.1% to 2.1% and dual use rose from 0.8% to 1.6%.[47] Over the same period, the proportion of grade-6-to-12 students who regularly smoke tobacco fell from 7.5% to 6.7%.[63]

In the UK, user numbers have increased from 700,000 in 2012 to 2.6 million in 2015, but use by current smokers remained flat at 17.6% from 2014 into 2015 (in 2010, it was 2.7%).[34] About one in 20 adults in the UK uses e-cigarettes.[64] In the UK in 2015, 18% of regular smokers said they used e-cigarettes and 59% said they had used them in the past.[34] Among those who had never smoked, 1.1% said they had tried them and 0.2% still use them.[65] In 2013, among those under 18, 7% have used e-cigarettes at least once.[65] Among non-smokers' children, 1% reported having tried e-cigarettes "once or twice", and there was no evidence of continued use.[65] About 60% of all users are smokers and most of the rest are ex-smokers, with "negligible" numbers of never-smokers.[66] In 2015 figures showed around 2% monthly EC-usage among under-18s, and 0.5% weekly, and despite experimentation, "nearly all those using EC regularly were cigarette smokers".[67] 10–11-year-old Welsh never-smokers are more likely to use e-cigarettes if a parent used e-cigarettes.[68]

In France in 2014, between 7.7 and 9.2 million people have tried e-cigarettes and 1.1 to 1.9 million use them on a daily basis.[69] 67% of French smokers use e-cigarettes to reduce or quit smoking. Of French people who have tried e-cigarettes, 9% have never smoked tobacco.[69] Of the 1.2% who had recently stopped tobacco smoking at the time of the survey, 84% (or 1% of the population surveyed) credited e-cigarettes as essential in quitting.[69]

The frequency of vaping in youth is low.[70] Minors who use one tobacco product such as e-cigarettes are more likely to later use other tobacco products such as cigarettes,[20] which likely arises from a common liability for the use of both products.[15] Young people who vape but do not smoke are more likely to try smoking than their peers who do not vape.[71]

E-cigarettes often have a high-tech look.[72] Candy, fruit and coffee flavored e-liquid.[73]

Reasons for e-cigarette use often relate to quitting smoking and recreation.[13][50][74] Many users believe vaping is healthier than smoking, although some are concerned about possible adverse health effects.[50] Some use them to circumvent smoke-free laws and policies, or to cut back on cigarette smoking.[23] 56% of respondents in a US 2013 survey had tried vaping to quit or reduce their smoking.[9] In the same survey, 26% of respondents would use them in areas where smoking was banned.[9] Not having odor from smoke on clothes on some occasions prompted interest in or use of e-cigarettes.[50] Many e-cigarette users use them because they believe they are safer than conventional cigarettes.[74]

Non-smoking adults tried e-cigarettes due to curiosity, because a relative was using them, or because they were given one.[62] College students often vape for experimentation.[75] Expensive marketing aimed at smokers suggests e-cigarettes are "newer, healthier, cheaper and easier to use in smoke-free situations, all reasons that e-cigarette users claim motivate their use".[76] Exposure to e-cigarette advertising influenced people to try them.[59]

Some researchers are concerned about vaping during pregnancy.[8][77] E-cigarettes feel or taste similar to traditional cigarettes, and vapers disagreed about whether this was a benefit or a drawback.[50] The majority of committed e-cigarette users interviewed at an e-cigarette convention found them cheaper than traditional cigarettes.[50]

Some users stopped vaping due to issues with the devices.[50] Dissatisfaction and concerns over safety can discourage ongoing e-cigarette use.[64] Some surveys found that a small percentage of users' motives were to avoid smoking bans, but other surveys found that over 40% of users said they used the device for this reason.[50]

The health and lifestyle appeal may also encourage young non-smokers to use e-cigarettes, as they may perceive that trying e-cigarettes is less risky and more socially appealing. This may decrease negative beliefs or concerns about nicotine addiction.[73] Marketing might appeal to young people as well as adults.[78] Adolescent experimenting with e-cigarettes may be sensation seeking behavior, and is not likely to be associated with tobacco reduction or quitting smoking.[8] Young people may view e-cigarettes as a symbol of rebellion.[48] The main reasons young people experimented with e-cigarettes were due to curiosity, flavors, and peer influences.[79] The National Association of County and City Health Officials say there is concern that e-cigarettes may appeal to youth because of their high-tech design, assortment of flavors, and accessibility online.[72] The Heart and Stroke Foundation claims that candy and fruit flavored e-cigarettes are designed to appeal to young people.[80] Infants and toddlers could ingest the e-liquid from an e-cigarette device out of curiosity.[81]

Users may begin by trying a disposable e-cigarette.[70] Users often start with e-cigarettes resembling normal cigarettes, eventually moving to a later-generation device.[82] Most later-generation e-cigarette users shifted to their present device to get a "more satisfying hit",[82] and users may adjust their devices to provide more vapor for better "throat hits".[83]

Special e-liquid mixes with THC or other cannabinoids are sold.[84]

The emergence of e-cigs has given cannabis smokers a new method of inhaling cannabinoids.[84] E-cigs differ from traditional marijuana cigarettes in several respects.[84] It is assumed that vaporizing cannabinoids at lower temperatures is safer because it produces smaller amounts of toxic substances than the hot combustion of a marijuana cigarette.[84] Recreational cannabis users can discreetly "vape" deodorized cannabis extracts with minimal annoyance to the people around them and less chance of detection, known as "stealth vaping".[84] While cannabis is not readily soluble in the liquid used for e-cigs, recipes containing synthetic cannabinoids which are soluble may be found on the Internet.[84]

E-cigarettes may be used with other substances and cartridges can potentially be filled with e-liquid containing substances other than nicotine, thus serving as a new and potentially dangerous way to deliver other psychoactive drugs,[85] for example THC.[84]

Cannabinoid-enriched e-liquids require lengthy, complex processing. Some are available on the Internet despite lack of quality control, expiry date, conditions of preservation, or any toxicological and clinical assessment.[84] The health consequences of vaping cannabis preparations are largely unknown.[84]

Exploded view of electronic cigarette with transparent clearomizer and changeable dual-coil head. This model allows for a wide range of settings.[86] Electronic cigarettes can come in very different forms—such as this hand-grenade-shaped variant.

The main components of an e-cigarette are a mouthpiece, a cartridge (tank), a heating element/atomizer, a microprocessor, a battery, and possibly a LED light on the end.[87] The only exception to this are mechanical e-cigarettes (mods) which contain no electronics; the circuit is closed by a mechanical action switch.[88] An atomizer comprises a small heating element, or coil, that vaporizes e-liquid and wicking material that draws liquid onto the coil.[89] When the user pushes a button,[75] or (in some variations) activates a pressure sensor by inhaling, the heating element atomizes the liquid solution.[13] The e-liquid reaches a temperature of roughly 100-250 °C within a chamber to create an aerosolized vapor,[90] which the user then inhales, rather than cigarette smoke.[24] The aerosol provides a flavor and feel similar to tobacco smoking.[91]

There are three main types of e-cigarettes: cigalikes, looking like cigarettes; eGos, bigger than cigalikes with refillable liquid tanks; and mods, assembled from basic parts or by altering existing products.[8] As the e-cigarette industry continues to evolve, new products are quickly developed and brought to market.[92] First generation e-cigarettes tend to look like tobacco cigarettes and so are called "cigalikes".[93] Most cigalikes look like cigarettes but there is some variation in size.[94] A traditional cigarette is smooth and light while a cigalike is rigid and slightly heavier.[91] Second generation devices are larger overall and look less like tobacco cigarettes.[95] Third generation devices include mechanical mods and variable voltage devices.[93] The fourth generation includes Sub ohm tanks and temperature control devices.[96] The power source is the biggest component of an e-cigarette,[32] which is frequently a rechargeable lithium-ion battery.[97]

E-liquid is the mixture used in vapor products such as e-cigarettes[98] and generally consists of propylene glycol, glycerin, water, nicotine, and flavorings.[18] While the ingredients vary[6][70][98] the liquid typically contains 95% propylene glycol and glycerin.[99] There are many e-liquids manufacturers in the USA and worldwide,[100] and upwards of 8,000 flavors.[38] While there are currently no US Food and Drug Administration (FDA) manufacturing standards for e-liquid, the FDA has proposed regulations that were expected to be finalized in late 2015.[100][needs update] Industry standards have been created and published by the American E-liquid Manufacturing Standards Association (AEMSA).[101]

Main article: Positions of medical organizations on electronic cigarettes 2014 Centers for Disease Control (CDC) press release about e-cigarettes.[102]

Medical organizations differ about the health implications of vaping.[103] Many medical organizations have made statements about their health and safety. There is general agreement that e-cigarettes expose users to fewer toxicants than tobacco.[6][103] International organizations have hesitated to recommend e-cigarettes for quitting smoking, because of limited evidence of effectiveness and safety.[19][44][104] Some from the UK have recommended their use by smokers unwilling or unable to quit.[105][106]

In August 2016, a World Health Organization (WHO) report found "there is not enough research to quantify the relative risk of ENDS/ENNDS over combustible products. Therefore, no specific figure about how much 'safer' the use of these products is compared to smoking can be given any scientific credibility at this time."[107] In July 2014, a WHO report found limited evidence that e-cigarettes may help some smokers quit, but did not reach conclusions.[19] Smokers should be encouraged to use approved methods for help with quitting,[19] although e-cigarettes may have a role in helping those who have failed to quit by other means.[19] Smokers will get the maximum health benefit if they completely quit all nicotine use.[19] A policy briefing by the Framework Convention Alliance notes widespread agreement that e-cigarettes are "almost certainly considerably less hazardous for individuals than cigarettes", but also notes widespread disagreement on the likelihood and impact of dual use, uptake by never-smokers, and re-normalisation of smoking.[103] The World Lung Foundation has applauded the WHO report's recommendation of tighter regulation due to safety concerns and the risk of increased nicotine addiction or tobacco use among young people.[108]

In a 2015 joint statement, Public Health England and twelve other UK medical bodies concluded "e-cigarettes are significantly less harmful than smoking".[29] PHE also stated that e-cigarettes are estimated to be 95% less harmful than smoking.[109] The UK National Health Service believes that e-cigarettes have about 5% of the risk of tobacco cigarettes,[110] but also feels there will not be a complete understanding of their safety for many years.[110] There are clinical trials in progress to test the quality, safety and effectiveness of e-cigarettes, but until these are complete the NHS maintains that the government could not give any advice on them or to recommend their use.[111] In 2016, the Royal College of Physicians called to "promote e-cigarettes widely as substitute for smoking", concluding that "e-cigarettes are likely to be beneficial to UK public health".[15][112]

The United States Centers for Disease Control and Prevention released a 2016 report titled E-cigarette Ads and Youth which concerned marketing towards adolescents.[113]

In 2016, the FDA stated its position that e-cigarettes are "likely less hazardous for an individual user than continued smoking of traditional cigarettes", but that the net population effect is unknown.[16] In 2015, the United States Preventive Services Task Force concluded there is insufficient evidence to recommend e-cigarettes for smoking cessation, and recommended clinicians instead recommend more proven smoking cessation aids.[114] The National Institute on Drug Abuse raises concern over the possibility that they could perpetuate nicotine addiction and thus interfere with quitting.[115] In 2015, the American Academy of Pediatrics strongly recommended against using e-cigarettes to quit smoking, stating that for adolescents e-cigarettes are not effective in treating tobacco dependence.[116] In August 2014, the American Heart Association released a policy statement concluding that while e-cigarette aerosol is much less toxic then cigarette smoke, there is insufficient evidence for clinicians to counsel smokers to use them as a primary cessation aid. If a patient failed initial treatment or refuses to use cessation medication, and wishes to use e-cigarettes to quit, it is reasonable to support the attempt after informing about the uncertainties.[117] In 2014, the US FDA said "E-cigarettes have not been fully studied, so consumers currently don't know: the potential risks of e-cigarettes when used as intended, how much nicotine or other potentially harmful chemicals are being inhaled during use, or whether there are any benefits associated with using these products. Additionally, it is not known whether e-cigarettes may lead young people to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death."[104]

Play media CDC launches "Tips From Former Smokers" ad campaign in 2015. The main information on e-cigarettes begins at 24:45.[118]

The available research on e-cigarette use for smoking cessation is limited to three randomized controlled trials and some user surveys, case reports, and cohort studies.[119] Some consider the evidence contradictory,[9][117] while others attribute negative outcomes to inappropriate study design.[6][105][120] Some medical authorities recommend that e-cigarettes have a role in smoking cessation, and others disagree. On the one hand, Public Health England recommends that stop-smoking practitioners should (1) advise people who want to quit to try e-cigarettes if they are failing with conventional nicotine replacement therapy (NRT); and (2) advise people who cannot or do not want to quit to switch to e-cigarettes.[29] On the other hand, the United States Preventive Services Task Force advised only use of conventional NRT products in smoking cessation and found insufficient evidence to recommend e-cigarettes for this purpose.[9]

There is tentative evidence that they can help people quit smoking,[6] but studies pertaining to their potential impact on smoking cessation and reduction is very limited.[121] However, a 2016 meta-analysis based on 20 different studies found that smokers who used electronic cigarettes were 28% less likely to quit than those who had not tried electronic cigarettes.[122] This finding persisted whether the smokers were initially interested in quitting or not.[122] A 2015 meta-analysis on clinical trials found that nicotine-containing e-liquids are more effective than nicotine-free ones for quitting smoking. They compared their finding that nicotine-containing e-cigarettes helped 20% of people quit with the results from other studies that found conventional NRT helps 10% of people quit.[123] There has only been one study directly comparing first generation e-cigarettes to conventional NRT as smoking cessation tools, so the comparative effectiveness is not known.[123] Two 2016 reviews found a trend towards benefit of e-cigarettes with nicotine for smoking cessation, but that the evidence was of low quality.[124][125] Another 2016 review found that the combined abstinence rate among smokers using e-cigarettes in prospective studies was 29.1%. The same review noted that few clinical trials had yet been conducted on their effectiveness, and only one had included a group using other cessation methods.[126]

However, e-cigarettes have not been subject to the same efficacy testing as nicotine replacement products. Several authorities, including the World Health Organisation, take the view that there is not enough evidence to recommend e-cigarettes for quitting smoking in adults,[9] and there are studies showing a decline in smoking cessation among dual users.[122] A 2014 review found that e-cigarettes do not seem to improve cessation rates compared to regulated nicotine replacement products, and a trial found 29% of e-cigarette users were still vaping at 6 months, but only 8% of patch users still wore patches at 6 months.[47] There is low-quality evidence that vaping assists smokers to quit smoking in the long-term compared with nicotine-free vaping.[127] Nicotine-containing e-cigarettes were associated with greater effectiveness for quitting smoking than e-cigarettes without nicotine.[123] E-cigarettes without nicotine may reduce tobacco cravings because of the smoking-related physical stimuli.[128]

Tobacco harm reduction (THR) is replacing tobacco cigarettes with lower risk products to reduce death and disease.[129] THR has been controversial out of fear that tobacco companies cannot be trusted to make products that will reduce this risk.[128] E-cigarettes can reduce smokers' exposure to carcinogens and other toxic substances found in tobacco.[128][130]

Tobacco smoke contains 100 known carcinogens, and 900 potentially cancer causing chemicals,[98] none of which has been found in more than trace quantities in e-cigarette vapor.[128] While e-cigarettes cannot be considered "safe" because there is no safe level for carcinogens, they are doubtless safer than tobacco cigarettes.[128] E-cigarettes are not dangerous enough to warrant serious public health concerns given the known risks of conventional cigarettes. The same review concluded that evidence supported "the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking", provided efforts were also made to protect vulnerable groups from e-cigarettes.[131]

A core concern is that smokers who could have quit completely will develop an alternative nicotine addiction instead.[128] A 2014 review stated that promotion of vaping as a harm reduction aid is premature,[132] but they could help to lower tobacco-related death and disease if examined more thoroughly.[18] Another review found that compared with cigarettes, e-cigarettes are likely to be much less, if at all, harmful to users or bystanders.[25] The authors warned against the potential harm of excessive regulation and advised health professionals to consider advising smokers who are reluctant to quit by other methods to switch to e-cigarettes as a safer alternative to smoking.[25] A 2015 Public Health England report concluded that e-cigarette use "releases negligible levels of nicotine into ambient air with no identified health risks to bystanders".[133] A 2014 review recommended that regulations for e-cigarettes could be similar to those for dietary supplements or cosmetic products to not limit their potential for harm reduction.[134] A 2012 review found e-cigarettes could considerably reduce traditional cigarettes use and they likely could be used as a lower risk replacement for traditional cigarettes, but there is not enough data on their safety and efficacy to draw definite conclusions.[91] E-cigarette use for risk reduction in high-risk groups such as people with mental disorders is unavailable.[135]

Hazards associated with products currently on the market are probably low, and certainly much lower than smoking. However, harms could be reduced further through appropriate product standards.[26] Many smokers want to reduce harm from smoking by using these products.[26] The British Medical Association encourages health professionals to recommend conventional nicotine replacement therapies, but for patients unwilling to use or continue using such methods, health professionals may present e-cigarettes as a lower-risk option than tobacco smoking.[136] The American Association of Public Health Physicians (AAPHP) suggests those who are unwilling to quit tobacco smoking or unable to quit with medical advice and pharmaceutical methods should consider other nicotine containing products such as electronic cigarettes and smokeless tobacco for long term use instead of smoking.[137] In an interview, the director of the Office on Smoking and Health for the U.S. federal agency Centers for Disease Control and Prevention (CDC) believes that there is enough evidence to say that using e-cigarettes is likely less harmful than smoking a pack of conventional cigarettes.[138] However, due to the lack of regulation of the contents of e-cigarettes and the presence of nicotine, the CDC has issued warnings.[138] A 2014 WHO report concluded that some smokers will switch completely to e-cigarettes from traditional tobacco but a "sizeable" number will use both.[19] This report found that such "dual use" of e-cigarettes and tobacco "will have much smaller beneficial effects on overall survival compared with quitting smoking completely."[19]

Main articles: Safety of electronic cigarettes and Electronic cigarette aerosol and e-liquid Adverse effects of vaping.[139]

The safety of electronic cigarettes is uncertain.[8][9][10] However, they are likely substantially safer than tobacco cigarettes.[6][117][140] There is considerable variation between vaporizers and in quality of their liquid ingredients and thus the contents of the vapor.[23][141][142] Reviews on the safety of electronic cigarettes, analyzing almost the same studies, resulted in substantially different conclusions.[143] In July 2014 the World Health Organization (WHO) report cautioned about potential risks of using e-cigarettes.[19] Regulated US Food and Drug Administration (FDA) products such as nicotine inhalers are probably safer than e-cigarettes.[132] In 2015, Public Health England stated that e-cigarettes are estimated to be 95% less harmful than smoking.[109] A 2014 systematic review concluded that the risks of e-cigarettes have been exaggerated by health authorities and stated that while there may be some remaining risk, the risk of e-cigarette use is likely small compared to smoking tobacco.[27]

The long-term effects of e-cigarette use are unknown.[75][13][127] Improvements in lung function and pulmonary health have been demonstrated among smokers who have switched to e-cigarettes.[144][145] A 2014 Cochrane review found no serious adverse effects reported in clinical trials.[6] Less serious adverse effects from e-cigarette use include throat and mouth irritation, vomiting, nausea, and cough.[23] The evidence suggests they produce less harmful effects than tobacco.[146] A 2014 WHO report said, "ENDS use poses serious threats to adolescents and fetuses."[19] Aside from toxicity, there are also risks from misuse or accidents[27] such as contact with liquid nicotine,[147] fires caused by vaporizer malfunction,[23] and explosions as result from extended charging, unsuitable chargers, or design flaws.[27] Battery explosions are caused by an increase in internal battery temperature and some have resulted in severe skin burns.[8] There is a small risk of battery explosion in devices modified to increase battery power.[90]

The e-liquid has a low level of toxicity, but contamination with various chemicals has been found.[148] The majority of toxic chemicals found in tobacco smoke are absent in e-cigarette vapor.[26][27] Those which are present are mostly below 1% of the corresponding levels in tobacco smoke, and far below safety limits for occupational exposure.[28][149] Metal parts of e-cigarettes in contact with the e-liquid can contaminate it with metals.[27] Normal usage of e-cigarettes generates very low levels of formaldehyde.[150] A 2015 review found that later-generation e-cigarettes set at higher power may generate equal or higher levels of formaldehyde compared to smoking.[75][151] A 2015 review found that these levels were the result of overheating under test conditions that bear little resemblance to common usage.[150] The 2015 Public Health England report looking at the research concluded that by applying maximum power and increasing the time the device is used on a puffing machine, e-liquids can thermally degrade and produce high levels of formaldehyde.[12] Users detect the "dry puff" and avoid it, and the report concluded that "There is no indication that EC users are exposed to dangerous levels of aldehydes."[12] E-cigarette users who use e-cigarettes that contain nicotine are exposed to its potentially harmful effects.[24] Nicotine is associated with cardiovascular disease, potential birth defects, and poisoning.[152]In vitro studies of nicotine have associated it with cancer, but carcinogenicity has not been demonstrated in vivo.[152] There is inadequate research to demonstrate that nicotine is associated with cancer in humans.[153] The risk is probably low from the inhalation of propylene glycol and glycerin.[25] No information is available on the long-term effects of the inhalation of flavors.[148] Most of the cardiovascular effects of ECs are consistent with those of nicotine. According to a 2017 review, it is possible that ECs may have adverse cardiovascular effects on users, especially those who already have cardiovascular disease. However, this review also concluded that "the risk is thought to be less than that of cigarette smoking based on qualitative and quantitative comparisons of EC aerosol versus cigarette smoke constituents."[154]

E-cigarettes create vapor that consists of ultrafine particles, with the majority of particles in the ultrafine range.[23] The vapor has been found to contain flavors, propylene glycol, glycerin, nicotine, tiny amounts of toxicants, carcinogens, heavy metals, and metal nanoparticles, and other chemicals.[23][25] Exactly what comprises the vapor varies in composition and concentration across and within manufacturers.[24] However, e-cigarettes cannot be regarded as simply harmless.[155] There is a concern that some of the mainstream vapor exhaled by e-cigarette users can be inhaled by bystanders, particularly indoors.[32] E-cigarette use by a parent might lead to inadvertent health risks to offspring.[77] A 2014 review recommended that e-cigarettes should be regulated for consumer safety.[134] There is limited information available on the environmental issues around production, use, and disposal of e-cigarettes that use cartridges.[156] A 2014 review found "disposable e-cigarettes might cause an electrical waste problem."[135]

The World Health Organization has concluded regarding second hand aerosol (SHA) "that while there are a limited number of studies in this area, it can be concluded that SHA is a new air contamination source for particulate matter, which includes fine and ultrafine particles, as well as 1,2-propanediol, some VOCs [volatile organic compounds], some heavy metals, and nicotine" and "[i]t is nevertheless reasonable to assume that the increased concentration of toxicants from SHA over background levels poses an increased risk for the health of all bystanders".[107] Public Health England has concluded that "international peer-reviewed evidence indicates that the risk to the health of bystanders from secondhand e-cigarette vapour is extremely low and insufficient to justify prohibiting e-cigarettes".[157] A systematic review concluded, "the absolute impact from passive exposure to EC [electronic cigarette] vapour has the potential to lead to adverse health effects. The risk from being passively exposed to EC vapour is likely to be less than the risk from passive exposure to conventional cigarette smoke."[158]

Nicotine, a key ingredient in e-liquids, is a highly addictive substance, on a level comparable to heroin and cocaine.[159] Nicotine stimulates regions of the cortex associated with reward, pleasure and reducing anxiety.[90] When nicotine intake stops, withdrawal symptoms include cravings for nicotine, anger/irritability, anxiety, depression, impatience, trouble sleeping, restlessness, hunger or weight gain, and difficulty concentrating.[48][160] It is not clear whether e-cigarette use will decrease or increase overall nicotine addiction,[161] but the nicotine content in e-cigarettes is adequate to sustain nicotine dependence.[162]

The World Health Organization is concerned about addiction for non-smokers,[19] and the National Institute on Drug Abuse said e-cigarettes could maintain nicotine addiction in those who are attempting to quit.[163] The limited available data suggests that the likelihood of abuse from e-cigarettes is smaller than traditional cigarettes.[164] A 2014 systematic review found that the concerns that e-cigarettes could lead non-smokers to start smoking are unsubstantiated.[27] No long-term studies have been done on the effectiveness of e-cigarettes in treating tobacco addiction,[132] but some evidence suggests that dual use of e-cigarettes and traditional cigarettes may be associated with greater nicotine dependence.[75]

Many studies have focused on young people, since youthful experimentation with e-cigarettes could lead to lifelong addiction.[59] Various organizations, including the UATLD, the AAP and the FDA, have expressed concern that e-cigarette use could increase nicotine addiction in youth.[138][163][165][166][167][168][169] Although regular use of e-cigarettes is generally very low by people who have never smoked,[25] significant numbers of teenagers who have never smoked tobacco have experimented with e-cigarettes.[23] The degree to which teens are using e-cigarettes in ways the manufacturers did not intend, such as increasing the nicotine delivery, is unknown,[147] as is the extent to which e-cigarette use could lead to addiction or substance dependence in youth.[147]

Smoking a traditional cigarette yields between 0.5 and 1.5 mg of nicotine,[162] but the nicotine content of the cigarette is only weakly correlated with the levels of nicotine in the smoker's bloodstream.[170] The amount of nicotine in the e-cigarette aerosol varies widely either from puff-to-puff or among products of the same company.[24] In practice e-cigarette users tend to reach lower blood nicotine concentrations than smokers, particularly when the users are inexperienced or using earlier-generation devices.[93] Nicotine in tobacco smoke is absorbed into the bloodstream rapidly, and e-cigarette vapor is relatively slow in this regard.[93] The concentration of nicotine in e-liquid ranges up to 36 mg/mL.[26] New EU regulations cap this at a maximum of 2% (20 mg/mL), but this is an arbitrary ceiling based on limited data.[8] In practice the nicotine concentration in an e-liquid is not a reliable guide to the amount of nicotine that reaches the bloodstream.[26]

The earliest e-cigarette can be traced to American Herbert A. Gilbert,[171] who in 1963 patented "a smokeless non-tobacco cigarette" that involved "replacing burning tobacco and paper with heated, moist, flavored air".[172][173] This device produced flavored steam without nicotine.[173] The patent was granted in 1965.[174] Gilbert's invention was ahead of its time.[175] There were prototypes, but it received little attention[176] and was never commercialized[173] because smoking was still fashionable at that time.[177] Gilbert said in 2013 that today's electric cigarettes follow the basic design set forth in his original patent.[174]

Hon Lik, a Chinese pharmacist and inventor who worked as a research pharmacist for a company producing ginseng products, is credited with the invention of the modern e-cigarette.[30] Lik quit smoking after his father, also a heavy smoker, died of lung cancer.[30] In 2001, he thought of using a high frequency, piezoelectric ultrasound-emitting element to vaporize a pressurized jet of liquid containing nicotine.[178] This design creates a smoke-like vapor.[30] Lik said that using resistance heating obtained better results and the difficulty was to scale down the device to a small enough size.[178] Lik's invention was intended to be an alternative to smoking.[178]

The Ruyan e-cigar was first launched in China in 2004.

Hon Lik registered a patent for the modern e-cigarette design in 2003.[178] The e-cigarette was first introduced to the Chinese domestic market in 2004.[30] Many versions made their way to the U.S., sold mostly over the Internet by small marketing firms.[30] E-cigarettes entered the European market and the US market in 2006 and 2007.[50] The company that Lik worked for, Golden Dragon Holdings, registered an international patent in November 2007.[179] The company changed its name to Ruyan (如烟, literally "Resembling smoking") later the same month[180] and started exporting its products.[30] Many US and Chinese e-cig makers copied his designs illegally, so Lik has not received much financial reward for his invention (although some US manufacturers have compensated him through out of court settlements).[181] Ruyan later changed its company name to Dragonite International Limited.[180] Most e-cigarettes today use a battery-powered heating element rather than the earlier ultrasonic technology design.[117]

When e-cigarettes entered the international market, some users were dissatisfied with their performance,[182][183] and the e-cigarette continued to evolve from the first generation three-part device.[94] In 2007 British entrepreneurs Umer and Tariq Sheikh invented the cartomizer.[184] This is a mechanism that integrates the heating coil into the liquid chamber.[184] They launched this new device in the UK in 2008 under their Gamucci brand,[183] and the design is now widely adopted by most "cigalike" brands.[94] Other users tinkered with various parts to produce more satisfactory homemade devices, and the hobby of "modding" was born.[182] The first mod to replace the e-cigarette's case to accommodate a longer-lasting battery, dubbed the "screwdriver", was developed by Ted and Matt Rogers[182] in 2008.[97] Other enthusiasts built their own mods to improve functionality or aesthetics.[182] When pictures of mods appeared at online vaping forums many people wanted them, so some mod makers produced more for sale.[182]

The demand for customizable e-cigarettes prompted some manufacturers to produce devices with interchangeable components that could be selected by the user.[97] In 2009, Joyetech developed the eGo series[184] which offered the power of the screwdriver model and a user-activated switch to a wide market.[97] The clearomizer was invented in 2009.[184] Originating from the cartomizer design, it contained the wicking material, an e-liquid chamber, and an atomizer coil within a single clear component.[184] The clearomizer allows the user to monitor the liquid level in the device.[184] Soon after the clearomizer reached the market, replaceable atomizer coils and variable voltage batteries were introduced.[184] Clearomizers and eGo batteries became the best-selling customizable e-cigarette components in early 2012.[97]

International tobacco companies dismissed e-cigarettes as a fad at first.[185] However, recognizing the development of a potential new market sector that could render traditional tobacco products obsolete,[186] they began to produce and market their own brands of e-cigarettes and acquire existing e-cigarette companies.[187]blu eCigs, a prominent US e-cigarette manufacturer, was acquired by Lorillard Inc. in 2012.[188]British American Tobacco was the first tobacco business to sell e-cigarettes in the UK.[189] They launched Vype in 2013, while Imperial Tobacco's Fontem Ventures acquired the intellectual property owned by Hon Lik through Dragonite International Limited for $US 75 million in 2013 and launched Puritane in partnership with Boots UK.[190] On 1 October 2013 Lorillard Inc. acquired another e-cigarette company, this time the UK based company SKYCIG.[191] SKY was rebranded as blu.[192] On 3 February 2014, Altria Group, Inc. acquired popular electronic cigarette brand Green Smoke for $110 million.[193] The deal was finalized in April 2014 for $110 million with $20 million in incentive payments.[193] Altria also markets its own e-cigarette, the MarkTen, while Reynolds American has entered the sector with its Vuse product.[187] Philip Morris, the world's largest tobacco firm, purchased UK's Nicocigs in June 2014.[194] On 30 April 2015, Japan Tobacco bought the US Logic e-cigarette brand.[195] Japan Tobacco also bought the UK E-Lites brand in June 2014.[195] On 15 July 2014, Lorillard sold blu to Imperial Tobacco as part of a deal for $7.1 billion.[196]

In 2014, dollar sales of customizable e-cigarettes and e-liquid surpassed sales of cigalikes in the US, despite the fact that customizables are less expensive.[197]

Consumers of e-cigarettes, sometimes called "vapers", have shown passionate support for e-cigarettes that other nicotine replacement therapies did not receive.[26][198] This suggests e-cigarettes have potential mass appeal that could challenge combustible tobacco's market position.[26]

A subculture of "vapers" has emerged.[198][199] Members of this emerging subculture often see e-cigarettes as a safer alternative to smoking,[25] and some view it as a hobby.[200] The online forum Electronic Cigarette Forum was one of the first major communities.[182] It and other online forums, such as, were the origins of the hobby of modding.[182] There are also groups on Facebook and Reddit.[201] Online forums based around modding have grown in the vaping community.[202] Vapers energetically embrace activities associated with e-cigarettes and sometimes act as unpaid evangelists according to a 2014 review.[83] A 2014 Postgraduate Medical Journal editorial stated that e-cigarette companies have a substantial online presence, as well as many individual vapers who blog and tweet about e-cigarette related products.[203] The editorial stated that vapers "also engage in grossly offensive online attacks on anyone who has the temerity to suggest that ENDS are anything other than an innovation that can save thousands of lives with no risks".[203] A 2014 review stated that tobacco and e-cigarette companies interact with consumers for their policy agenda.[23] The companies use websites, social media, and marketing to get consumers involved in opposing bills that include e-cigarettes in smoke-free laws.[23] The same review said this is similar to tobacco industry activity going back to the 1980s.[23] These approaches were used in Europe to minimize the EU Tobacco Product Directive in October 2013.[23] True grassroots lobbying also influenced the TPD decision.[204]Rebecca Taylor, a member of the European Parliament, stated, "to say it's an orchestrated campaign is absolute rubbish."[204] Contempt for "big tobacco" is part of vaping culture.[205][206]

E-cigarette user blowing a cloud of aerosol (vapor). The activity is known as cloud-chasing.[207]

Large gatherings of vapers, called vape meets, take place around the US.[198] They focus on e-cig devices, accessories, and the lifestyle that accompanies them.[198] Vapefest, which started in 2010, is an annual show hosted by different cities.[201] People attending these meetings are usually enthusiasts that use specialized, community-made products not found in convenience stores or gas stations.[198] These products are mostly available online or in dedicated "vape" storefronts where mainstream e-cigarettes brands from the tobacco industry and larger e-cig manufacturers are not as popular.[208] Some vape shops have a vape bar where patrons can test out different e-liquids and socialize.[209] The Electronic Cigarette Convention in North America which started in 2013, is an annual show where companies and consumers meet up.[210]

A subclass of vapers configure their atomizers to produce large amounts of vapor by using low-resistance heating coils.[211] This practice is called "cloud-chasing"[212][213] By using a coil with very low resistance, the batteries are stressed to a potentially unsafe extent.[212] This could present a risk of dangerous battery failures.[212] As vaping comes under increased scrutiny, some members of the vaping community have voiced their concerns about cloud-chasing, claiming the practice gives vapers a bad reputation when doing it in public.[214] The Oxford Dictionaries' word of the year for 2014 was "vape".[215]

Main articles: Regulation of electronic cigarettes and List of vaping bans in the United States A no smoking or vaping sign from the US.

Regulation of e-cigarettes varies across countries and states, ranging from no regulation to banning them entirely.[216] Others have introduced strict restrictions and some have licensed devices as medicines such as in the UK.[217] As of 2015[update], around two thirds of major nations have regulated e-cigarettes in some way.[218] Because of the potential relationship with tobacco laws and medical drug policies, e-cigarette legislation is being debated in many countries.[35] The companies that make e-cigarettes have been pushing for laws that support their interests.[219] In 2016 the US Department of Transportation banned the use of e-cigarettes on commercial flights.[220] This regulation applies to all flights to and from the US.[220]

The legal status of e-cigarettes is currently pending in many countries.[23] Many countries such as Brazil, Singapore, the Seychelles, Uruguay, and Norway have banned e-cigarettes.[217] In Canada, they are technically illegal to sell, as no nicotine-containing e-fluid is approved by Health Canada, but this is generally unenforced and they are commonly available for sale Canada-wide.[221] In the US and the UK, the use and sale to adults of e-cigarettes are legal.[222]:US[223]:UK As of August 8, 2016, the FDA extended its regulatory power to include e-cigarettes.[37] Under this ruling the FDA will evaluate certain issues, including ingredients, product features and health risks, as well their appeal to minors and non-users.[224] The FDA rule also bans access to minors.[224] A photo ID is required to buy e-cigarettes,[225] and their sale in all-ages vending machines is not permitted.[224] In May 2016 the FDA used its authority under the Family Smoking Prevention and Tobacco Control Act to deem e-cigarette devices and e-liquids to be tobacco products, which meant it intended to regulate the marketing, labelling, and manufacture of devices and liquids; vape shops that mix e-liquids or make or modify devices were considered manufacturing sites that needed to register with FDA and comply with good manufacturing practice regulation.[16] E-cigarette and tobacco companies have recruited lobbyists in an effort to prevent the FDA from evaluating e-cigarette products or banning existing products already on the market.[226]

In February 2014 the European Parliament passed regulations requiring standardization and quality control for liquids and vaporizers, disclosure of ingredients in liquids, and child-proofing and tamper-proofing for liquid packaging.[36][227] In April 2014 the FDA published proposed regulations for e-cigarettes along similar lines.[228][229] In the US some states tax e-cigarettes as tobacco products, and some state and regional governments have broadened their indoor smoking bans to include e-cigarettes.[76] As of 9 October 2015, at least 48 states and 2 territories banned e-cigarette sales to minors.[230]

E-cigarettes have been listed as drug delivery devices in several countries because they contain nicotine, and their advertising has been restricted until safety and efficacy clinical trials are conclusive.[231] Since they do not contain tobacco, television advertising in the US is not restricted.[232] Some countries have regulated e-cigarettes as a medical product even though they have not approved them as a smoking cessation aid.[233] A 2014 review stated the emerging phenomenon of e-cigarettes has raised concerns in the health community, governments, and the general public and recommended that e-cigarettes should be regulated to protect consumers.[134] It added, "heavy regulation by restricting access to e-cigarettes would just encourage continuing use of much unhealthier tobacco smoking."[134] A 2014 review said these products should be considered for regulation in view of the "reported adverse health effects".[233]

A 2014 review said, "the e-cigarette companies have been rapidly expanding using aggressive marketing messages similar to those used to promote cigarettes in the 1950s and 1960s."[23] E-cigarettes and nicotine are regularly promoted as safe and beneficial in the media and on brand websites.[77] While advertising of tobacco products is banned in most countries, television and radio e-cigarette advertising in some countries may be indirectly encouraging traditional cigarette smoking.[23] There is no evidence that the cigarette brands are selling e-cigarettes as part of a plan to phase out traditional cigarettes, despite some claiming to want to cooperate in "harm reduction".[23] In the US, six large e-cigarette businesses spent $59.3 million on promoting e-cigarettes in 2013.[234] Easily circumvented age verification at company websites enables young people to access and be exposed to marketing for e-cigarettes.[73]

A national US television advertising campaign starred Steven Dorff exhaling a "thick flume" of what the ad describes as "vapor, not tobacco smoke", exhorting smokers with the message "We are all adults here, it's time to take our freedom back."[235] The ads, in a context of longstanding prohibition of tobacco advertising on TV, were criticized by organizations such as Campaign for Tobacco-Free Kids as undermining anti-tobacco efforts.[235] Cynthia Hallett of Americans for Non-Smokers' Rights described the US advertising campaign as attempting to "re-establish a norm that smoking is okay, that smoking is glamorous and acceptable".[235] University of Pennsylvania communications professor Joseph Cappella stated that the setting of the ad near an ocean was meant to suggest an association of clean air with the nicotine product.[235] In 2012 and 2013, e-cigarette companies advertised to a large television audience in the US which included 24 million youth.[236] The channels on which e-cigarette advertising reached the largest numbers of youth (ages 12–17) were AMC, Country Music Television, Comedy Central, WGN America, TV Land, and VH1.[236]

A 2014 review said e-cigarettes are aggressively promoted, mostly via the internet, as a healthy alternative to smoking in the US.[32]Celebrity endorsements are used to encourage e-cigarette use.[78] "Big tobacco" markets e-cigarettes to young people,[237] with industry strategies including cartoon characters and candy flavors to sell e-cigarettes.[238] E-cigarette companies commonly promote that their products contain only water, nicotine, glycerin, propylene glycol, and flavoring but this assertion is misleading as scientists have found differing amounts of heavy metals in the vapor, including chromium, nickel, tin, silver, cadmium, mercury, and aluminum.[57] The assertion that e-cigarette emit "only water vapor" is false because the evidence indicates e-cigarette vapor contains possibly harmful chemicals such as nicotine, carbonyls, metals, and organic volatile compounds, in addition to particulates.[239]

Vaping stand, London shopping centre.

The number of e-cigarettes sold increased every year[117] from 2003 to 2015, when a slowdown in the growth in usage occurred in both the US and the UK.[45][46] As of 2014[update] there were at least 466 e-cigarette brands.[49] Worldwide e-cigarette sales in 2014 were around US$7 billion.[240] Approximately 30–50% of total e-cigarettes sales are handled on the internet.[32]

As of 2015[update] most e-cigarette devices were made in China,[31] mainly in Shenzhen.[241][242] Chinese companies' market share of e-liquid is low.[243]

In the US, tobacco producers have a significant share of the e-cigarette market.[59][244] As of 2015[update], 80% of all e-cigarette sales in convenience stores in the U.S. were products made by tobacco companies.[245] According to Nielsen Holdings, convenience store e-cigarette sales in the US went down for the first time during the four-week period ending on 10 May 2014.[246] Wells Fargo analyst Bonnie Herzog attributes this decline to a shift in consumers' behavior, buying more specialized devices or what she calls "vapor/tank/mods (VTMs)" that are not tracked by Nielsen.[246] Wells Fargo estimated that VTMs accounted for 57% of the 3.5 billion dollar market in the US for vapor products in 2015.[247] In 2014, the Smoke-Free Alternatives Trade Association estimated that there were 35,000 vape shops in the US, more than triple the number a year earlier.[248] However the 2015 slowdown in market growth affected VTMs as well.[45]

In Canada, e-cigarettes had an estimated value of 140 million CAD in 2015.[249] There are numerous e-cigarette retail shops in Canada.[250] A 2014 audit of retailers in four Canadian cities found that 94% of grocery stores, convenience stores, and tobacconist shops which sold e-cigarettes sold nicotine-free varieties only, while all vape shops stocked at least one nicotine-containing product.[251]

In the UK in 2015 the "most prominent brands of cigalikes" were owned by tobacco companies, but except for one model all the tank types came from "non-tobacco industry companies".[105] However some tobacco industry products, while using prefilled cartridges, resemble tank models.[105]

France's electronic cigarette market was estimated by Groupe Xerfi to be €130 million in 2015. Additionally, France's e-liquid market was estimated at €265 million.[252] In December 2015, there were 2,400 vape shops in France, 400 fewer than in March of the same year.[252] Industry organization Fivape said the reduction was due to consolidation, not to reduced demand.[252]

Other devices to deliver inhaled nicotine have been developed.[253] They aim to mimic the ritual and behavioral aspects of traditional cigarettes.[253]

British American Tobacco, through their subsidiary Nicoventures, licensed a nicotine delivery system based on existing asthma inhaler technology from UK-based healthcare company Kind Consumer.[254] In September 2014 a product based on this named Voke obtained approval from the United Kingdom's Medicines and Healthcare Products Regulatory Agency.[255]

Philip Morris International (PMI) bought the rights to a nicotine pyruvate technology developed by Jed Rose at Duke University.[256] The technology is based on the chemical reaction between pyruvic acid and nicotine, which produces an inhalable nicotine pyruvate vapor.[257]

PAX Labs has developed vaporizers that heats the leaves of tobacco to deliver nicotine in a vapor.[258][259] On 1 June 2015, they introduced Juul a different type of e-cigarette which delivers 10 times as much nicotine as other e-cigarettes, equivalent to an actual cigarette puff.[260]

BLOW started selling e-hookahs, an electronic version of the hookah, in 2014.[261] Several companies including Canada's Eagle Energy Vapor are selling caffeine-based e-cigarettes instead of nicotine.[262]

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Electronic Nicotine Cigarette

E-Cigarettes Are Like Vaporizing Windshield Washer Fluid


Nicole Aune: I think we're going to go ahead and get started.

So, hello everybody.

Thank you all so much for coming out today, and we may have a few more trickling in, but, um, I just wanted to thank you guys for just taking time out of your evening to come here.

My name is Nicole Aune.

I am a program manager with the Montana Tobacco Use Prevention Program.

I oversee the policy and cessation work.

Um, and we're really here today because there is a new product on the market and it's really captured the attention of our youth and it is the most commonly used tobacco product among our high school students in Montana, and that's E-cigarettes.

So there's a lot of mis-information out there about E-cigarettes and, and it's a confusing thing.

Um, there's a lot of questions and, depending on who you talk to, you're getting different answers.

So, we're here today, um, to hopefully answer those questions for you and give you all the facts and information for you to go out and then talk to your kids and other young people about, about the facts and share this information with others.

We're going to go into what we're going to cover today, so we have some awesome speakers and we're going to be covering what E-cigarettes are.

Um, looking at how many, how many kids in Montana are actually using them.

The appeals.

The why are kids actually using these products.

Why, why are they so into them, and the health dangers that, the health risks associated with E-cigarettes.

Um, and we're also going to talk about how the tobacco industry targets kids with these products, and then mention what you can do.

And we have an excellent line-up of speakers.

Kris Minard: All right.

So Nicole mentioned this is mostly for adults right now, although it's very important kids know about this too.

But this particular um, presentation is, is geared for you.

We'll talk about Montana youth trends and um, let you know more about what electronic cigarettes are, their appeal to youth and then what's actually in the E Juice.

Every time we give a presentation we have to remind people we're talking about tobacco products and tobacco is still the leading cause of preventable death in the United States, killing almost a half a million people every year, which is the same as three fully-loaded 747's crashing every day, with no survivors.

So, if something like that happened, I think people would really take up, take notice and we, we need to remember we still have a lot of, we've done some great work on tobacco, but we have a long way to go.

So, as far as Montana youth trends go, we have great data, stretching back into the early 90's from the Montana Youth Risk Behavior Survey.

Our high school students are asked every other year, um, about their risky behaviors and how much they participate in them.

And, as you can see, these are the kids who say they have every tried smoking cigarettes, even one or two puffs.

We've got a nice trend down from the 90's.

We're at about 39% of our high school students who say they've even tried using tobacco.

These are the students we call current users.

The CDC says if a student responds that they've smoked a cigarette in the last 30 days, then we're going to call them current users.

A lot of people might think that Montana has more smokers on average than the rest of the country, but our, our students have really much um, kept up with the national average all through these last 20+ years.

However, you can see in 2015, 13% of our high school students say they smoked cigarettes and only 11% um, in the nation said they are, so we are above the national average there.

Then we've got these guys, these fruity-flavored, cheap, inexpensive um, cigars, cigarillos, that are kids have, have noticed and, and started using.

We are well above the national average at about 13% compared to 10.

Still a little bit of a decline, but nothing like, you know, it hasn't been as high as the cigarette use, but it's right at 12.

6%, which is pretty, I mean, they're both basically 13%.

Here's where we stand out.

Our smokeless tobacco.

Still 12% of our high school students say they use smokeless, um, snoose, chew, and ah, compared to the national average of 7.

3%, so our high school boys are huge users.

One in five of our high school boys report using smokeless tobacco, fourth highest prevalence of use in the country.

Our girls also have the fourth highest prevalence of use, but it's at a much lower um, prevalence, 4.


So here are all three of the traditional tobacco products.

You can see they're all at about the same level in 2015.

So now we have these guys, these electronic cigarettes.

Well, they all basically deliver nicotine.

There are a very few that don't have some of the E Juice, has zero nicotine in it, but by far most deliver nicotine and they almost all have lithium.

Well, I don't know any that don't have a lithium battery.

They look like lots of different things.

Some look like cigarettes.

Some look like marking pens.

The one on the right, I say kind of looks like a mini lunar lander, and they're just constantly changing.

These things are evolving practically daily.

We also have um, electronic cigarettes we call mods that, these are the products that people typically drip the E-Juice into and they create the great big huge, we say vapor and vaping, but it's really not a vapor, it's an aerosol.

There are tiny particles of metals and, and it's actually an aerosol.

You can see someone even ingeniously made a E-cigarette out of a Coke can.

But they all basically have a mouth piece and someplace to put the E-Juice, whether it's already contained and in a cartomizer or if it's a tank that you have to fill, or if it's an atomizer that you drip onto a cotton swab with E-Juice.

Then they have the heating element, which is the atomizer which heats up, so there's no combustion as with cigarettes.

There's nothing burning.

It just heats up it and creates this, this aerosol in the lithium battery.

Here's a video that NJOY has for anybody to watch on the Internet about how to vape.

(Video) This is NJOY's vape pen.

You picked it up off the shelf or got it in the mail, but it might be intimidating.

No worries.

We're here to help.

If you're ready to vape watch on.

Part One: Assembling the Vape Pen.

First, you're going to need a bottle of E Liquid, like this.

You can buy NJOY E Liquid wherever you purchased your vape pen.

Next, make sure the battery is detached from the tank.

Don't try to fill the tank with E Liquid when it's attached to the battery.

Unscrew the mouthpiece from the tank.

Open your E Liquid.

NJOY E Liquids are in bottles with child resistant caps.

So to open it, you'll need to push down on the cap as you turn it.

You don't want E Liquid in the center tube.

So when you fill your tank, tilt it and drip the E Liquid down the side.

You can check the milliliter amount by the markings on the side of the tank.

Remember to keep E Liquid away from your skin.

If you happen to get some E Liquid on your hands, make sure to wash them immediately.

We also recommend that you have different tanks for different flavors of E Liquid and that you discard any tank after about two weeks of regular use, depending on how you vape.

Changing your tank will assure that your vapor always tastes great.

Once you fill the tank, screw the mouthpiece back on.

Make sure the mouthpiece is on tight, then screw the tank on to the battery piece.

Now you're ready to vape.

Part Two: How to Vape.

Your pen comes activated right out of the box.

To deactivate your vape or to reactivate it, quickly press the button five times in a row like this.

The LED light flashes five times when your vape pen changes state.

When your vape is activated, put your lips to the mouthpiece.

Inhale as you press the button, and just like that you're vaping.

Part Three: Charging.

The LED light will flash 10 times during use when you need to charge your vape pen.

To charge, simply unscrew the battery from the tank and into the USB charger.

To preserve the battery, don't charge it in a place that's too hot or too cold.

You'll know it's charged when the LED light goes off.

Kris Minard: Anything, time for a little audience interaction.

Anything kind of catch you off guard on, on that one? Anything kind of noticeable? __: Wash your hands.

KM: (Laughter) If you get any of this E Juice on your hands, wash them immediately.

It's okay to inhale it into your lungs, but by golly, if you get it on your hands, wash it off.

Well, nicotine absorbs through everything and um, Dr.

Shepard will talk to us more about the effects of nicotine.

All right, um, gimmicks, there are lots of gimmicks.

The industry, the tobacco industry has had gimmicks for years.

Coupons and products, give aways and things like this, and make no mistake, the tobacco industry is invested in electronic cigarettes.

Yes, there are mom and pop vape shops, but RJ Reynolds, Phillip Morris, Lorillard are all into, into these products.

blu is one that you may have seen ads for on T.


These are what they call the starter kits, and this particular thing costs about $75.

00 a couple of years ago.

I don't know what they cost now.

I would think that the price has gone down.

They look like a cigarette.

They charge right in these cases and their gimmick is each case has a little wireless transistor radio in it, a radio wave, that if you turn this on, this is, this it'll, this is what it will do.

If you're within 50 feet of another person who has one of these.

So they want you to know who's around, who can you go buddy up with, turn it into a social experience again, and um, find somebody, you know, there's somebody around who's using this.

Let's find out who they are.

They also do this if they're within 50 feet of a place that sells the refill cartridges.

So, that's their, that's their gimmick on, on these.

The I Phone case.

It's all set up.

It's got it's own battery and ah, I think this is for ah, I'm not sure, I think it was an I Phone 5, but it's got a mouthpiece.

You can screw your own mouthpiece into the top and, and vape away.

Green Smoke.

They want to appeal to the environmentally conscious folks.

Our landfills are being filled by these batteries, these empty cartridges.

You know, a lot of really bad toxins and, and pollutants.

So they say, send us your old products and for every 50 old cartridges or old lithium batteries, whatever you send us, we'll give you so many points to buy our products.

So it never ends.

Ah, this woman is going to show you how to use blu and a couple of the, of the other products.

(Video) Um, and this is a blu disposable.

We're going to pull the little seal off of here.

Pull the little rubber cap off and puff.

That's it, nice and simple.

Now the blu starter kit has um, two batteries, five cartomizers and a charger.

These are re-changeable.

Um, this same concept.

Screw the closed cartomizer.

Everything you need is mixed up in here already.

Screw it on and again puff.

Nice and simple.

Another company we carry Smoke Stick, same, same principle.

We have a disposable.

You have an E, the starter kit.

Again, screw it on.

That, as you can tell, is a little bit more vapor than the blu gave me.

Kris Minard: So she had a lot of quick hits of nicotine right there and you can tell she kind of liked that Smoke Stick brand, because it created a little bit more, more vapor.

Um, we'll talk a little bit about these mods.

Um, the people build these themselves, and you can learn all about them on the Internet.

There are people who have their own YouTube channels that show you how to create these things, and they take great pride in creating the coils, and how many, how many turns and twists you have in them, um, relative to how many ohms it's going to produce, and you want to heat it up just.

It's all supposed to be red when it heats up and you put the cotton wick between it and that's what you pour the E Juice onto.

This is an RDA, re-build able dripping atomizer, and this is a mod that has fully computerized.

This whole set costs about $140.

00 here locally.

The battery is another $80.


I did not purchase it, and you can set it to all sorts of different levels to decide how hot you want it to get, how much vapor your, how much aerosol you want to create, and, um, all these little buttons help you.

We'll just pass this stuff around so you all can, can look at it.

There's a great tobacco prevention specialist out, out east who told me, she likes to put things in pencil kits and pass them around and see if people can figure out what's really a pencil and a marker, and what's really a, an E-cigarette, and I said that is a great idea.

So I copied her and it's pretty impressive.

Take a look through this pencil kit, see if you can pick out the E-cigarettes.

This is the fellow who's got one of the YouTube stations or channels and he's got over four million views on, they call them clouds making this big huge cloud with a, with a mod.

So now let's talk about teen vaping and why, why our kids are so, so interested in them.

The 2015 Youth Risk Behavior for their first time asked the question, "Have you ever tried an electronic cigarette and in the last 30 days how many times have you used one?" And you can see by the description they couldn't just say an E-cigarette, they had to define it so that the kids would know what they're talking about, because they're called so many different things.

I mean now you might just hear the word vapes, um, but the responses in Montana really caught us off guard and we were alarmed.

Fifty-one percent of our high school students said they tried them compared to 45% in the rest of the country, which is also huge.

This is what the percentage of people, the high school students who have tried them, broken down by male and female, so not a big difference between the two.

Boys typically have riskier behavior than girls, but you can see it increases with grade level.

A, every year you have more kids using these products.

And granted by 12th grade, some people are 18.

There's no question.

It would not be illegal for them.

Another reason, as Nicole has pointed out, why it would be great to have 21 be the age for using tobacco.

There would be no question.

There are no 21 year olds in high school.

Not in Montana.

They don't fund them.


And this is a question of whether they're current users.

Have they used one in the last 30 days.

So 30% of our high school students said they were current users.

Almost one in three.

And here's that breakdown.

Same, same thing.


Pretty close to the same, but still more boys, and again the same kind of transition from nine through twelfth grade, increasing each, each grade level.

So here are the three traditional tobacco products and then the E-cigarettes in green.

It's kind of a visual deal that boy, twice as many kids, more than twice as many kids are using this product and are smoking.

So anybody who tells you, oh it's just the kids who are smokers who are using this product, that's not true, and this shows you that.

Here's a breakdown by groups.

Um, the state averages of cigarette smokers and vapers, um, on the left and then some of our middle schools actually take the very same Youth Risk Behavior Survey, so those that do have showed us that, wow, twice as many middle school students are vaping as are smoking.

NAR, our Native Americans on a reservation, so that is the only group who are smoking cigarettes is still higher than vaping, but, but not much.

NAU, our Native American's in an urban setting, big difference.

NPA, Non-Public Accredited schools.

A lot of your private religious schools, um, like Central in Butte, Central in Billings.

ALT, those are alternative schools.

That's where our risk takers are and we know that there are huge issues there, and we've got a few projects that we're working on, but boy we, we need to do a lot of work there.

SWD, our Students With Disabilities.

So they're attracting all, all users.

Yale had a great study a few years ago, where they asked 5,400 young people who did vape, what's cool about it? What do they think makes them cool? They were not surprised by the answer, the flavors.

We've all seen and heard, and you're going to hear more from Sara tonight about the flavors, but they were taken back by the fact that kids said we can do vape tricks with them.

So vape tricks.

We're going to show issue, show you a few videos from on-line about what they're doing with these products.

(Video) What's up guys.

I'm ________.

We're here at Flawless Vape Shop in Anaheim Hills, California for the 8th Trick Qualified __________________________.

(Music) Ricky was sad.

He just won the 8th Trick Qualifier for the BC Cog Championship.

How do you feel? I'm stoked Still a little nervous? Yeah.

(Laughter) What did you do to prepare for this competition? I vape every day because I work in a vape shop, so.

What vape shop do you work at? Vaper Hub.



Would you like to thank any of your sponsors today? Of course.

Got to thank LindaLace, Good Vibes, Vape Socks, Native Wakes of course, you know.

Good Vibes is my sponsor too.

Good Vibes is awesome.

(Laughter) So before you go, ah, do a signature trick for us.

Kris Minard: Um, anything catch you off guard? Anything kind of impressed you with that? __: The sponsorships.

KM: Sponsorships.

They have sponsors.

It's like NASCAR and these are young kids.

I mean, he, he was probably 18 or 20.

To me he looked like he was 16 or so, but he said he vaped every day.

I mean, what is he doing to his lungs.

You have to practice a lot to, ah, when you see the next ones you'll, you'll be impressed.

(Video) Kris Minard: I just wanted to show you that girls are doing this as we know.

How'd you like to be the little brother pushed through the aerosol there? The last one is the, oh __: ________________ Is there an odor to it? Kris Minard: There is a slight odor to it, but that's a really good question because someone asked last night, are they using marijuana in these things? And they are, they are.

__: Something like for the feel um, my parents said on the clothing Kris Minard: Oh, can't smell the clothing, right.

Definitely not like tobacco.

There, there is an odor, but the thing about marijuana, is if they are using marijuana, there is no distinctive marijuana odor with these, so someone could be vaping pot right in front of you, um, and you wouldn't know it.

So, but, but, they say there is not much of an odor with these, but I have smelled bubble gum.

I have smelled some of the flavors, when we have done some experiments with, with bottles.

Um, oh yeah, this, this guy, I think this is the one that use.

Oh, you'll want to go back and then that one is a video.

This guy is a real professional.

(Video) Kris Minard: So, you can see.

There's a challenge to them.

There's a competition.

Um, this guy won $10,000, making as big of a cloud as he could possibly could.

So, there are competitions all around the country.

I've not heard of any in Montana, but you know how we are, a little bit behind other states sometimes on things.

We'll hope, we'll hope that we don't get any here, but there's money, there's challenge and kids get good at it.

They take pride in it and who knows what they're doing to their lungs.

So, we often hear well it's just a harmless water vaper.

Well, it's really not.

In fact, there isn't water in these things.

The three main ingredients are propylene glycol, which is something that we use in the theatre in fog machines, and it's generally recognized as safe as an edible, um, chemical.

But that doesn't mean that it's safe for our, for our lungs.

You know, eating something and inhaling something are totally different.

I often say it's okay to eat a peanut, but if you inhale a peanut, you're in trouble.

The flavorings are another thing that's typically in, in the E Juice and nicotine.

Um, and these have not been regulated by the FDA, so some have been found to contain all sorts of carcinogens as well as other toxic chemicals.

Um, the carcinogens on the left, Acetaldehyde, Benzene, Formaldehyde is created as the E-cigarette heats up and, and, so it's actually the heating of the E Juice that creates the Formaldehyde.

Nickel, Nitrosamines, um, and then other toxins, other irritants.

A Diacetyl is an ingredient that has added to the flavorings to help make the flavorings work better.

And you may have heard of popcorn lung.

People who were working in microwave popcorn factories were getting this irreversible lung disease, and they finally figured out it was from the Diacetyl.

Well, Diacetyl is in a lot of E Juice.

I have, I always say if you have to dress like this to work with this product and develop this product in a hazemat suit, then why on earth would anybody want to be putting it into their lungs? Congress did pass a Child Nicotine Prevention Act because a teaspoon can kill a child.

In fact, there was a young toddler who died just before Christmas a couple of years ago.

He got into his parent's E Juice, so, um, now they do have to have child-resistant tops.

Poison Control Center calls have grown exponentially.

In 2014 they increased from one a month to 215 a month for exposure to, to nicotine.

These, this is a little bit deceiving because the 2015 and 2016 data isn't complete on this.

I've been looking for better, updated charts, but, um, it's been a major increase for Poison Center Control calls.

And then you also heard about these exploding lithium batteries.

Um, the industry will tell you, oh it's user error.

You know, it's always user error, but I read an article about a man who opened a package and it blew up.

You know, he wasn't even using them.

We have a, had a young student in Missoula who was vaping and ended up losing four teeth and I really, I mean that was a very traumatic experience.

He had a really hard time getting back to school.

I mean, you can imagine.

It caused a fire on the couch he was sitting on.

So, not good.

This is an example.

Watch the guy standing at the counter on the right.

(Video) Kris Minard: Huge vap, you know plume of, of aerosol and he had to take off his pants and you, you saw the burns ahead of time.

So that's the end of my presentation and we have an, um, question and answer session.

So if you have some questions, we'll do that at, at the very end.

But thanks a lot for coming and thanks for listening, and if I can help you in any way, let me know.


Kathy Rogers: Research suggests that compared to adults, teens value reward more than consequence.

And we kind of all know that, but that is really an integral part of brain development in adolescents.

It is part of what gets them to grow up and leave home.

To go on the adventure of leaving the security of a household where somebody feeds them and clothes them, and takes care of their needs, and goes out to where they're going to have to figure it out.

And so it's, it's an important part of development, but it is also is what makes them take the risks that they do.

Brain development takes a long time, sort of from age 12 to age 25.

And so at 18 and 19, when these kids legally can do a lot of things, they still don't have a very mature brain.

They think they do and if you think back, you thought you did.

And then you got a little older and you realized your parents were not nearly as stupid as you thought they were.

And we hear that said all the time, but it really is true and there's no way to explain it as we grow up.

You can say it to your kids and they nod and think you're full of it, but it's really the truth.

So it, brain maturation moves in really slow waves.

It starts at the base of your brain and kind of moves forward in very basic functions, so it starts with your vision, what you see, and then movement, and then fundamentally how you process things.

The more complicated executive functions.

So this front part of your brain, which is the last part that really puts together, if I jump off of this very tall building, I may break my legs.

And the other part of it says, yeah, but won't it be really cool if I don't.

That part takes a long time to come together, and so there's all these different parts of the brain that you're going to hear talked about as, as more of the issues of brain development go on.

You're going to hear them talk about your hippocampus, which is part of your memory.

The frontal areas set goals.

They weigh agendas and risk and that frontal part is really important.

Um, head injuries, a lot of frontal injuries impact how well we do our executive functions and this is sort of a side comment, but the whole business of concussion relates to what happens when you're constantly impacting that frontal area, which becomes your consequence setting goals, agenda, risk assessment area.

Um, so ultimately development allows us to balance our impulse and desire and our self interest and put that together with ethics and rules, and to put all of that together.

But it takes time and you can have a kid who will say, I know I shouldn't, but they still will until they get on the other side of that fence.

If you think of teen decision making like an equation, where consequences aren't given the weight they should be, rewards weigh more heavily than they should, and where being friends throws the equation off any more.

So that plastic part of your brain really looks at thrill seeking, risk taking, and I don't have a graph to show you, but when you look at higher risk and lower risk and then age, the ones who enjoy it the most are 16 to 17 year olds.

They just, that high risk is like a really good reward, and it's interesting because at 18 and 21 it starts to drop, but it doesn't get down to a level less than when you're 10 years old till you're 26 years old.

So, there's a long time where that is all really important.

Most long-term drug use, alcohol, tobacco, nicotine, starts in adolescence.

And we all recognize that.

Teens do know they're mortal.

They can estimate risk, often over-estimating risk.

They simply value the reward so much more heavily and the more risk they take, if the reward is good, is perceived as a better payout.

And what helps them add to the risk? Doing something with their friends.

So when you look at kids who are learning to drive, there's lots of good valid studies that show.

If you put a kid in a car with an adult, their parent, they will drive beautifully.

They take Driver's Ed, they do really well, and as long as they are in the car with the adult, they're great.

You put one person in the car their age and all of a sudden they run through the red light.

You put two or three kids in the car with them and suddenly it's what can we do? Where can we race? Why? Because there's this huge reward of doing these things, taking these risks with their friends.

So, when you're looking at kids related to cigarette smoking, vaping, it's the same thing.

And so one of the key questions I always ask kids when I'm interviewing them, is do any of your friends vape? Because if you ask them directly, you may or may not get a straight answer, but they don't have any problem telling you if their friends do.

And that's a really good way to kind of come in through the back door when you want to find out what's going on.

Because if their friends are vaping, you can bet that for them it's a greater opportunity, even if they think they're only going to do it once.

So, what their friends do does make a really big difference.

Now, this time of taking all these risks is important.

They need to do this.

It doesn't make them obnoxious, although sometimes it feels like it does when you're the parent.

Um, but that's partly again what gets them to learn how to be independent and on their own.

So adolescence brings a peak in brain sensitivity to dopamine, which is a neurotransmitter, that kind of primes you for reward.

And it fires off the reward circuits.

So anything that improves and effects dopamine is something that they like, and nicotine will effect that as does marijuana and so these sort of spark that area and kids go, oh that felt good.

And feeling good is something you want to do.

Believe it or not, texting fires off that part of your brain, which is why those ridiculous texts of what'ch doing.

Not much.

Where're you going to be? Not sure.

And yet they're just addicted to it.

They literally fire off that little bit of dopamine over and over again, which is a little pleasure center.

Um, for those of you are old enough, if you remember what it was like to get a letter in the mail and you would wait for the mailman to come.

It's the same thing.

It just didn't happen every five seconds.

So that's part of the difficulty and again, anything that will allow them to get there.

Teen brains, neuro networks are being pruned, and so they're still in that developmental phase.

And it's really interesting, teens prefer teens.

So the things you say do make a difference, but they search out their friends and that's, those people are their investment in the future.

They're not going to spend their life living with you.

You guys are their mentors/directors, but they know you and you're not exciting any more.

Their friends are exciting and that's where they want to be.

So again, who they spend time with and we're back to, what makes me feel good? What's exciting? Um, you guys have the statistics and will probably go over them, so I'm not going to take about the percentages of kids who are using E-cigarettes.

But what I will tell you is, for child, for kids, it's not a reduction of harm.

They use E-cigarettes and they talk about it for adults as a reduction of harm, getting them off of cigarettes.

It doesn't do that for kids.

It becomes the gateway.

It addicts them to nicotine, and we know from both human studies and mouse models, that at the developmental point in your brain that you are when you're a teen, your brain is more plastic and nicodine, nicotine is far more addicting.

We don't know why.

We just know it is.

And it's that developmental phase.

We also know that the various products like nicotine and marijuana at that stage long term will affect brain function.

So when you were talking about the different products that are in there.

So nicotine poisoning, what does it look like? Vomiting, sweating, dizziness, increased heart rate, lethargy, seizures, breathing difficulty, um, it's a neural stimulant at low doses, but at high doses it's a depressant, and it really gets them into trouble.

A couple of things that you need to know and that parents should share with each other; anti smoking actions by parents are a strong predictor of non-smoking in teens.

Anti tobacco opinions, anti vaping opinions and discussions with parents are factors that protect kids against tobacco, even if a parents smokes.

So even if you're a parent who does smoke, the very fact that you say no, makes a huge difference.

The bottom line is, is that you want to make the risk and the reward enough like the reward for not doing this, greater than the reward for doing it, and because nicotine's so addicting, you've got to find ways to sort of them, it's like the toddler thing.

You have to distract them over here.

You keep them busy with other things that are rewarding and fun for them whether it's school or trips with friends that you get to help plan and organize.

But it's pretty basic and it's pretty simple and I can go through all of the neurochemistry and, and all of the brain development doesn't mean anything.

The bottom line is, they like what feels good and what you have to do is find things that make them feel better and make it new and exciting and just sort of distract them until their brain gets to that point and then you also make it clear that this isn't something that you want them to do.

But that's not what you harp on all the time.

You just do the distraction.

That's my line.


Robert Shepard: Um, all right.

I entitled this Nicotine, Safe or Dangerous because I was up at the Legislature trying to get them to increase the tobacco tax, the bill supported by the Governor and Cancer Society and Heart Association, to increase the tobacco tax and ah, they were going to include E-cigarettes on that increase, and actually I was flabbergasted, is the best way to put it, at some of the claims that were made by the E-cigarette proponents about the safety of E-cigarettes and the safety of nicotine.

So, since nicotine is the predominant ingredient in all of the E-cigarette liquids that are set out, I wanted to talk a little bit tonight about nicotine.

Now, before we get to there, we can talk about tobacco and several different oranis, several different kind of categories.

Obviously, there's combustible tobacco, cigarettes, cigars, pipes, and those, those things have a completely different of chemistry.

After all, they're, they're burning, they're burning at a very low temperature really, so they create all kinds of chemicals that get into the air, and that creates all the second-hand smoke and other stuff which is the primary motivation for second-hand smoke laws.

Ah, but we're not going to really talk about combustible tobacco tonight.

You've got your various forms of spit tobacco.

I like to refer to it as spit tobacco to make sure that it's overly glamorized.

Um, but in any case, you've got the various forms of spit tobacco and they also have their own set of chemicals, but they're not heated.

They have chemicals that also that occur a lot during the curing process from the way the tobacco industry cures it, which creates a lot of extra stuff in the, in the leaf beyond just the tobacco plant.

And then lastly we have the E-cigarettes which you've heard about it, and they're not really combustible, but they're not exactly like ah, non-combustible chewing tobacco products because they are heated, and that also has a potential to create different chemicals.

Um, so, and I want to focus a little bit on nicotine now because, 90, somewhere around 97, 99% of all E-cigarette capsules and liquids that are sold are sold with nicotine in them.

So they talk about all the other stuff that goes on, but it really has to do with the nicotine.

So, is nicotine safe? Is it beneficial? Is it addictive? So let's kind of explore some of that.

First of all, there, the way the body works is most of the cells in our body have little tiny receptors on them.

You can consider the receptive would be a lock.

A molecule, a chemical will come by and insert itself into that lock and that creates, causes the cell to do something.

That's the way hormones work, whether they're thyroid hormones or testosterone or estrogen or any of the other, you know, cortisone, any of the other, ah, hormones around the body all work by attaching to a receptor on a cell.

And each cell will have tens of thousands of receptors on it.

It's hard to believe something so small can have that many receptors and there will be dozens of different kinds of receptors on every cell.

Some of these receptors then in the body are triggered by nicotine.

That's how nicotine does what it does.

So nicotine will glom on to, you know, insert itself as a key into that lock and then tell the cell to do something.

And they're really high in concentration in the brain, which should come as no surprise.

Secondly, there are a lot in the lungs and there's, one important thing is that there are an awful lot in the lining of the arteries, what we call the endothelium.

That's a lining of the arteries, incredibly important for the arteries being able to dilate and contract, and also important because when the lining gets torn or injured, cholesterol then leaks into the wall of the artery and that begins the plaque formation, ah, of heart disease.

And nicotine has profound impacts on that.

So there are impacts on the way the cell functions.

If you're looking at an embryo that's developing, these receptors will trigger development in different ways and consequently their impacts on the way the body develops as a result of that.

Ah, and this particularly in the brain impairs the development of neurons.

So as we are adding neurons as the fetus is growing it's brain, it's going to end up with fewer neurons in the brain because of nicotine exposure during pregnancy.

Now, how do we know all this? Well, there are lots of different ways that we know this.

First of all, there's studies of animals that we can, we particularly use a lot of rats and mice in these kinds of studies.

They're small, they grow quickly and we can study them a lot faster.

We also use primates, various kinds of monkeys and, and stuff in that.

Also we can know because we can look at systems in humans that are really vulnerable.

Systems like in pregnancy, where we have a growing, the fetus and the, that system is very very vulnerable to affects, so we can look for these sorts of things, ah, in that area.

We can also just grow the cells in a lab in a cell culture and then expose them to these products and see what impact it has on individual cells.

And there are not just multiple studies, but we're talking about thousands of studies about the impact of nicotine studied through all these different systems.

Now, the nicotine system in the brain, the nicotine receptors in the brain, have impacts on memory, how well we think, how well we focus our attention, and also on emotional responses.

Now, some people think that in adults, I'm going to say that again, in adults, nicotine might slightly enhance our memory, our ability to think and our ability to focus.

There are no good human studies that prove that that's the case.


When I was up at the state they were talking about the study in Discover Magazine, I like Discover Magazine.

I read it cover to cover every month when it comes out, and there was this highly speculative article about the im, the positive impact nicotine might have on the adult brain.

And it says right in the center of the article, there are no studies that show that this is true.

And yet, this, this journalist was making this great case for how wonderful nicotine was going to be on our brains.

Well, it ain't true.

Well, at least it's not been proven true yet.

However, when we are talking about a developing brain, again we're talking about fetuses, infants, toddlers, and we're also talking about adolescents as we hit, hit that period of time when that judgment part of our brain between 15 and 25, when we develop judgment in our frontal cortex, that presence of nicotine changes the way the brain develops, and that's not a good thing.

So there are fewer nerve cells, some of the nerve cells are damaged.

There are fewer connections between the nerve cells and there's all kind of changes in the brain chemistry.

Nicotine is a very powerful stimulant of the dopamine system.

Dopamine is our pleasure reward system.

When you get dopamine you feel good.

There are all kinds of things that give us dopamine.

Nicotine is one of them.

So, what about the fetus? Well, nicotine crosses the placenta.

There are more nicotine receptors in a developing brain because the body uses those receptors to guide the development, but when you add a bunch of nicotine to that and over-stimulate those receptors, you end up with some brain cells dying and some brain cells getting malformed and the number of some brain cells not forming the connections to other brain cells that they're supposed to have.

We know in human studies we haven't really been able to check this because for obvious ethical reasons, you're not going to take 1,000 women and say you get to take the nicotine and take another 1,000 women and say you don't get to take any nicotine, and see what happens to the baby.

Nobody is going to do a study like that.

But, we have seen what happens in smokeless tobacco from the nicotine.

We've done lots and lots of studies on animals to see how the brain develops in animals, and what we can see is there's a real strong correlation between the affects of nicotine and the effects we see on human studies that are using nicotine, in human subjects that are using nicotine as well.

So in other words, they're consistent with each other.

Now, let's talk about one other thing here for a second and that is, what do you do about nicotine in pregnancy and nicotine replacement? And how do you get women to quit? Well, first of all 40 women who are pregnant, 40% of women who are pregnancy find that to be a powerful motivator and they will in fact quit smoking.

An unstressingly amount of them will go back to smoking once the baby's born, which doesn't help the baby a whole lot either, but they will quit during pregnancy.

Nicotine replacement therapy has been something that medicine has used a long time to help people quit smoking, but both ACOG and the FDA say that's a last choice in pregnancy, because we just don't want to expose the fetus to nicotine.

Well, what about harm reduction.

The concept is here that perhaps if we do something that's less dangerous, there will be fewer people that are hurt by it.

So, if we move people from tobacco to pure nicotine like in an E-cigarette that that's going to be good for them.

I just want to point out that the lowest possible risk is from quitting nicotine all together.

At that point, you've reduced your risk to zero in terms of the nicotine.

So E-cigarette are counted as great because they're going to reduce the harm.

But what happens with the 40% of women who successfully quit smoking, instead switch to E-cigarettes and still get the nicotine? I would just suggest that that's not going to be helpful for their baby and this case the harm reduction isn't really going to be a harm reduction at all.

So, this is just theoretical again.

This is smokeless tobacco again, because we don't have studies on E-cigarettes yet, but several studies, and I've just given you some quotes from a couple of them, have looked at the impact and what we see is the impact on fetal exposure mirrors what we see in animals, including adverse behavioral outcome, such as attention deficit disorders, disruptive behavioral disorders and other things that we all struggle with in the school system today.

And, I'm not going to spend much time but I just do want to mention that nicotine has an impact.

The receptors alone decrease the number of lung cells along size and volume, the lungs become less elastic and impacts the lungs too.

Okay, are there any studies then on children with E-cigarettes? And the answer is no, not yet.

But we've looked at this and second-hand smoke a lot, and we know that children who are exposed to second-hand smoke at the home, in the home have more difficulty with reading and arithmatic comprehension.

Their school test scores are lower, ah, and, so we know that there are effects from, from that.

We aren't absolutely certain that's just the nicotine, but it's certainly consistent with pure nicotine research in animals.

There is also a concept called third-hand smoke and third-hand smoke is what's left after the second-hand smoke dissipates.

So you smoke a cigarette in a room, the smoker gets the primary smoke, everybody else in the room gets the second-hand smoke that's just out in the room.

When the smoking stops, what happens to the smoke? Well, it goes some place.

Some of it's absorbed onto the walls, onto the ceiling.

Cigarette smoke is composed of lots and lots of little particles.

These particles fall like rain onto the carpeting.

When you have a little rug rat rolling around and anybody who's ever had an adorable six-month-old crawling around, of course, they never put their hand in their mouth, and they never touch anything on the floor.

And you can show that these kids have nicotine levels that are equal to our, almost equal to the kids that are exposed to second-hand smoke.

So when you move into an apartment where somebody has been smoking in that, that out gassing continues for six months to a year.

Everything that was absorbed onto the walls starts coming out again when the smoking stops.

Everything that's in the carpeting gets picked up and blown again through the air when you vacuum.

And if you're down on the carpeting, ah, the five-second rule doesn't apply because it's going to be full of nicotine.

Okay, last third-hand smoke.

What we know from that that's pure nicotine in a lot of cases and that sort of gives us a good clue that those sorts of things are still happening with nicotine.

And as mentioned earlier, ah, children get into these E-cigarette cartridges and 40% of the tobacco related calls and Poison Control Centers are related to nicotine.

So, and this is really alarming.

Now we're seeing this incredible increase in E-cigarette use in adolescents.

Adolescence is a time when higher cognitive functioning begins.

Nicotine impairs that.

Development of the prefrontal cortex, which is this area, this part of the brain, which is where our judgment comes in.

Um, and the receptors are a major influence on how this executive kind of control mechanism that we all have to control our impulses, ah, begin to occur.

This animal studies again show that nicotine has a major impact on the way that these, the brain develops at this point and adolescents are going to be really a problem with this.

And if we go back and think about just how many percentage of kids are using E-cigarettes, we've got a real cause for alarm here now.

Now, adolescents are also much more likely to become addicted to any substance they use.

A Dr.

DeFrance, a guy in Boston who's been studying this for a long time, just shows that nicotine really is the true gateway drug people become addicted to nicotine and that leads to experimentation with other, ah, ah, drugs.

He shows that an adolescence, meaning say from 14 to 18, smoking one cigarette a week for six weeks is enough to get 50% of the kids that are addicted, are addicted to it at that.

One cigarette a week for six weeks and 50% of kids become addicted.

But the really scary thing and the really kind of interesting thing is that about 5% of kids will literally become addicted on their first cigarette.

And he, he says you can pick those kids out because they'll tell you when they had that cigarette, it was the greatest sensation they'd ever felt.

For that moment, they felt better than they'd ever felt in their life.

And those kids are the ones that are going to get hooked really on just one cigarette.

Now, the other thing is is that we've now follow, had an opportunity, cigarettes have been out long enough to follow these kids over time.

And kids who use E-cigarettes but don't smoke and have never smoked are three to five times more likely to start smoking than kids who have never used E-cigarettes.

So they clearly are an initiator for the use of cigarettes as a whole.

So, well, doesn't that mean that this is addictive? I couldn't believe it.

They actually tried to make the claim, the state, the Legislature, that nicotine was not addictive.

God, I so wanted one of the, the Representatives to ask me a question about that, Senators, I guess it was, ask me a question about that.

I was just absolutely flabbergasted that anybody would make that claim.

But, let's go back and look at it.

I had the opportunity once to share the stage with Victor DeNoble.

He was one of the guys that used to work for the tobacco industry.

They hired him in the 1970's to produce a heart-safe cigarette.

Um, he says he was successful at it, but since Phillip Morris never really brought the cigarette out, we don't know if he was successful or not.

But, be that as it may.

He started studying.

He had to get the rats addicted to nicotine and he was using pure nicotine I.


and was just a steady drip.

He was having a little trouble with rats would kind of like it but they didn't seem to be very crazy about it.

And he was sitting in the cafeteria watching people smoke one day and he realized that people smoke intermittently.

They take a puff, they put the cigarette down.

They take a puff, put the cigarette down.

So he went back to the lab and changed his pump for the rats, so that it pulsed the nicotine and those rats went crazy for nicotine.

That pulsing creates a surge of dopamine, a drop off, a surge of dopamine and a drop off, and that leads to powerful addiction.

There are now dozens and dozens, if not hundreds of studies showing that nicotine is in fact addictive.

So, that, we ought to be able to put that aside.

Are there other substances in tobacco that also produce physical dependence? Certainly.


But it's nicotine that the tobacco industry manipulates.

One of those things that was in cigarettes is formaldehyde.

Formaldehyde is also found in tobacco.

Formaldehyde's that really great smelling stuff that they used to put the, the frogs and the rats in in your biology class to preserve it.

You have to wear gloves when you use it because it's a carcinogen.

It also is mildly addictive.

That is, you actually get physically dependent on it.

I can't imagine something that would be worse than that.

However, it's real value to the tobacco industry is that formaldehyde increases the addictiveness of nicotine.

So the more formaldehyde there is in a cigarette, the same amount of nicotine is more likely to make you addicted.

So, ammonium does the same thing and there's a fair amount of ammonium in cigarettes.

I haven't seen any reports about ammonium in E-cigarettes.

So the tobacco industry deliberately manipulates the content of other chemicals in the cigarettes to potentiate the nicotine and make it more addictive.

They wouldn't be doing that if nicotine weren't addictive in the first place.

They'd be manipulating whatever it is that really is addictive.

They're not.

They're manipulating the nicotine.

Okay, so what about addiction.

Well, if you dabble with alcohol, about one out of every 10 people is going to become an alcoholic.


But hey, if you dabble with cocaine, about one out of every six people is going to get addicted to cocaine.

Okay, now take a second and just think about what the addictive potential is of nicotine.

And the answer is, that one out of every two is going to get hooked in the long run.

As I said half of them will be hooked in adolescences, one cigarette a week for six weeks, but you keep going and at least 50% of people are going to get hooked.


This isn't scientifically proven, I should say.

This is the opinion of the addiction experts at John Hopkins.

So I would take that as a reasonable effect.

Okay, what about quitting? Well, nicotine replacement, you may have already heard about that's the gum, the patch.

They make an inhaler now, a nasal squirter.

Different ways of replacing nicotine.

They work about 5% of the time.

The inhaler works a little bit better than that.

But the gum and the patch will help about 5% of people who quit smoking.

Some antidepressants have been tried and they'll help about 10% of people who quit smoking.

Chantix, which is the, another smoking aid will help about 20 % of people who quit smoking.

Counseling is in the 15-20% range and counseling and medication get up to 30%, sometimes 35%, in that range.

Ah, to put that in perspective, when a doctor tells a patient to quit, about 2% of people will quit.

So, I always used to say I'll take my 2%, but I'm not very effective at getting people to quit smoking, just by telling people to quit smoking.

I have to do something else.

So, what about E-cigarettes? Well, first of all let's point out that E-cigarettes are not FDA approved as a quit aid.

Let's also point out that no company has applied to the FDA to present data to say that they're a quit aid.


So making a claim that they're a quit aid is completely bogus from a scientific point of view or a regulatory point of view.

Now, you, it is important that you do long-term followup when you do these kinds of studies.

Your quit rate in 30 days is always going to be better than your quit rate at a year, always.


Um, survey with some other, early studies did that suggest that E-cigarettes could be a reasonable help in quitting, helping people quit smoking.

The trouble was there were methodological problems.

They didn't follow them long enough.

They didn't check to see that they were really quitting exactly.

They didn't double-check them.

Some of the questions that, were whether or not they still smoking.

So they didn't really get rid of the dual use group.

So, they kept working at the studies and the studies kept getting better and they eliminated the methodological problems and as they did, they began to see that there really was no impact.

That is, people using E-cigarettes did not quit at a greater rate.

And recently they did what is called a Meta-Analysis, which is one way of combining a whole bunch of different studies into a much larger number, so you get bigger numbers and you get better statistical probabilities because you've got more people.

And when they do that, they showed that E-cigarette users were actually 28% less likely to quit smoking than people who used other quit aids.


So, another thing is, is that 80% of E-cigarette users in several surveys, but somewhere between 60 and 80% also use traditional cigarettes.

That is, that they're dual users.

So they're really not getting the benefit of cigarette cessation anyway.


So, ah, first of all we can build a little bit.

We've been researching cigarettes for more than 40 years.


And we have learned a lot about how cigarettes cause disease, whether it's cancer, whether it's heart disease.

As I mentioned, some of the effects of the brain, but we're still really, research into pure E-cigarettes.


Still, there are some effects that have been shown.

So for example, at heart disease, one of the things you need to be able to do is to make the arteries open up, so when you're heart's stressed, your coronary arteries have to get larger so you can pump more blood to your heart too, and the heart can work harder.

You can't do that effectively if you've had nicotine in your system, because nicotine, wants the ability of an artery to open up.

It can't open it up.

It just stays stuck.

Now, you get under some stress and you can't get enough oxygen or blood going to the heart muscle, and that can cause a heart attack.

This is due to the adverse impact on the endothelium, and we know that nicotine actually kills endothelial cells.

When you give somebody nicotine and then filter their blood, you can find dead endothelial cells floating around their blood stream.

When the endothelium is damaged like that, it tears more easily just from the normal movement and then you start getting stuff from the blood stream into the artery wall, and that's how plaque forms.

Also, there are these things called platelets.

Platelets are little tiny cell particles and their function in the blood is to clump together, so when you get a cut, they clump and plug the end of the blood vessels like a cork in a bottle and stops the bleeding.

Which is why we tell people to take aspirin when they have a heart attack because aspirin tells the platelets don't clump, and we know people can get a heart attack because the blood literally clumps inside of the blood vessel, instead of when it's bleeding like it's supposed to, and that cork in a bottle can cause a heart attack because it stops the blood flowing through that artery into the heart.

We tell people to take an aspirin because it keeps the platelets from clumping together like that.

However, nicotine in the particles, particularly the particles which are in E-cigarettes, that's why you see the cloud of smoke.

Those particles tell the platelets to clump together faster so they make it worse.


Now, we actually do have one study that just came out in March of this year that showed people who used E-cigarettes had an increased risk of having a heart attack of 42% compared to people who didn't use the E-cigarettes.

So we now have one study.

That by the way is very consistent with the studies on second-hand smoke, which is about in the same ballpark.

So, harm reduction.

Well, my analogy is this.

You have a ten-story building, you jump off the building you really don't expect to survive.

I apologize, this has only nine stories if you count the roof.

I didn't have a ten-story building.


So my idea, my thought is, is, sure when you do E-cigarettes, you might be jumping out of the third floor instead of the tenth floor.

You're still likely to get hurt and you might survive.

That's harm reduction.

That's what they mean by harm reduction.

The best thing to do is to walk out on the ground floor because it's the safest way to get out of the building, not jumping.

Now, if the data on heart disease pans out the way I've outlined it, after all we only have a few studies and we're still working on this a lot, we only have to move that from the third to the fourth or fifth floor.

Okay, on my last slide and then I'll shut up, is that again, and this is a slide that Kris showed you earlier about this dramatic decrease in ah, of Montana of people using cigarettes.

But remember, I don't have, do I have a pointer on this thing? Oh yes, okay.

The, there's 30%, somewhere around here, is where the E-cigarette use is.

Now, stop and think about this.

Those kids are three to five times more likely to start smoking.

I don't know what's going to happen to this number, but with this dramatic increase in E-cigarette use, we may be seeing this bottom out and starting back up again.

Only the future will tell us that, but I'd be really alarmed at what we're seeing.


Thank you.

Sarah Shapiro: All right.

So, I'm Sara Shapiro, I work for Lewis and Clark Public Health and I'll be talking about the tobacco marketing, um, in Montana, specifically the point-of-sale marketing.

So each year 9.

6 billion dollars is spent on marketing tobacco.

That's 26 million dollars every day and that's over 1 million dollars an hour.

In Montana that's 30.

5 million dollars spent a year from big tobacco and 95% of that money is spent at the point-of-sale location.

So when I'm talking about point of sale, I'm talking about where we buy our milk.

Where we buy our soda.

Where we buy candy.

It's where tobacco is sold.

So that is at convenience stores, gas stations, pharmacies, etc.

So this also mainly what I'm talking about.

This is what you see when you're checking out of those places.

So you're being marketed to at all aspects of these locations, so this is the outside, the advertisements, the price discounts.

Inside you go look where the Slushies are, there's something about Marlboro.

By the ice cream you'll see it, and then you also see it near the drinks.

You see it on all angles.

No matter where you go you're going to see these advertisements.

Some price discounts right above where you're checking out.

And so I'm mainly going to talk about this power wall.

So this is where the majority of the tobacco products are located.

So when you go to check out you really can't miss it.

Raise your hand if you recognize this.


So big tobacco is targeting for specific groups.

They're targeting people who are using.

They want them to continue using the product.

People who quit, they want them to start using again.

Would be users, those are the social smokers, the every once in awhile, the when they're drinking smokers, and then youth, who is what I'll be talking about most of my presentation.

Nine out of ten tobacco users start before the age of 18 and once they start, most are hooked for a long time, or the rest of their life, and so they're trying to get these replacement smokers.

So I'll go over the tactics that are specific to big tobacco is specifically using to hook these populations.

The first is eye level is buy level so most of the tobacco products are in front of the counter are at about three feet, so that's definitely not my eye level.

It's a younger population's eye level and it's mixed in with the candy.

So they already know that kids are looking at the candy, looking at the bright colors and the flavors and ah, that is where they're putting these tobacco products, and so I'm talking a lot about cigarillos, the flavor chew, E-cigarettes as well.

So as you can see, it's at this young girl's eye level, mixed in with this gum.

So, the, the kid is at 45 inches and the poster is at 45 inches, the tobacco poster.

Another thing is flavors.

So E-cigarettes, cigarillos, they come in a million flavors.

There's bubble gum, fruit loops, strawberry, mango, root beer float.

So these are definitely flavors that are targeting the inner crowd that is looking for that candy already, and sometimes these are mixed in so they look like candy.

If you've seen the commercials recently, you can look them up and they look identical, and they also look identical because of the packaging.

A lot of these products have the really bright colored packaging, so it looks like candy.

Another tactic is price discounts, so younger populations tend to not have as much spare money.

So using discounts, coupons, buy one, get one free, um, helps it seem more affordable and seem like something they could try to hook people.

I'll read this quote.

It's "The industries extensive use of price-reducing promotions has led to higher rates of tobacco use among young people than would have occurred in the absence of these promotions.

" The U.


Surgeon General, 2012.

And so that's saying that these are working, that more people are using because of these price discounts.

So why are they going after youth? Is cause they want their replacement smokers.

So Phillip Morris, one of the main tobacco companies, has been noted saying "The ability to attract new smokers and develop them into a young adult franchise is key to brand development.

" So, they're older population is getting older, getting sick and they need to replace, they need to replace people who are going to use it for the rest of their lives.

So that is why they're going for youth.

Place is really important.

Can we raise our hands if you've been inside a gas station or convenience store in the last week.


So normally when I go to the gas station, I don't go inside any more.

I pay at the pump and I leave and I don't really go inside very often, but 70% of youth go into gas stations and convenience stores weekly.

So they're extremely vulnerable to this number, um, because of all the different advertisements.

They go during lunch to get candy.

They go on their walk home.

Um, it's kind of like a right of passage to be able to go to one of these places with your friends.

And so place is really important because of the amount of them in Helena alone and then Broadwater.

This is just our area and how many places you can see it and be victim to this advertising.

So adver, this pays off.

There's a reason that 30.

5 million dollars a year is spending in Montana.

So each day 3,300 youth under the age of 18 will try their first cigarette, 700 of these children will become regular smokers.

So it's a scary number.

Um, but it's showing that this advertising is working.

And again this is another graph showing that same thing.

It's showing how the green bars are showing the dollars spent on E-cigarette advertising and the line is showing the past 30 day great use among youth, and as you can see, as advertising goes up, so is the use among youth.

So this is just another graph showing that um, the amount of E-cigarette users is going up every year.

So this tobacco marketing is working and why we should be scared of it is because it normalizes the presence of tobacco products, meaning when youth go into these locations and they see how much tobacco is and where it is all over the place, it seems like more people are using it.

And when more people use it, the way to fit in.

So, it normalizes the idea of it.

It encourages youth to use tobacco and eventually get hooked.

It makes it harder for current users to quit.

You know they want to buy the milk, but they're seeing this tobacco product every time they try to check out.

It encourages people who quit tobacco to start using again.

So these are some pictures that I did from a recent scavenger hunt that I've been doing with the youth.

What I do is I take youth to these different locations and they have check marks and they have to check if they see products below three feet, what flavors they're seeing, what discounts are seen.

Can you see it from the road.

Things like that.

And so I'm able to work with youth to understand this and it tends to be empowering because they don't like being targeted.

You know, they want that independence and that freedom, and so they don't like how these companies are targeting them.

Um, I'm also doing presentations to multiple groups trying to get the word out because once you learn these tactics it's really hard to not notice them.

So that's one thing I encourage everyone here to do, is to go into these stores and notice them and realize them, and then tell your friends.

Tell your peers.

Tell the youth, um, to keep educating.

Nicole Aune: So, I'm just going to do a final wrap up here and kind of leave us with, so now what.

We've heard all these things.

What do we do next? What are our actions steps? So, just to talk a little bit about the, the laws that are in place now.

In January of 2016 Montana set a law that you have to be 18 in order to purchase E-cigarettes.

Before that anybody, any age, could go and get these.

You could be 7 years old and walk into a store and be able to buy an E-cigarette, which is just absolutely atrocious.

So at least now we do have that law in place.

That was set here in the state in January of 2016 and then the FDA came and set it, set a law in May of 2016 at the national level.

So now that's a national law that you have to be 18 in order to purchase these products.

Um, they are also not allowed to be sold in vending machines where kids can, where kids are present.

Um, they're not allowed to give out free samples.

And starting in May of 2018, um, if we get there with this administration, um, warning labels ah are, are going to be required.

And I thought that this, this is kind of interesting this warning label right here, because um, it, you'll hear as Dr.

Shepard said many times, you hear the E-cigarette industry saying, oh nicotine is, is actually good for you.

It's not harmful at all.


So, now you're being required to put a warning label on that explicitly states that nicotine is harmful and extremely addictive.

So, just putting that out there.

All right.

So then, we actually have some other laws here in, in Montana.

So we've had a few counties that have taken it upon themselves to include E-cigarettes in their local Clean Indoor Air Act protocols and actually Lewis and Clark County was the first county to do that.

So, yeah, Lewis and Clark County.


Round of applause.

And there are actually four other counties now from Montana that have E-cigarettes in their Clean Indoor Air Act protocol.

That's Sanders County, Carbon, Powell, and Granite recently added there then too.

I'll just mention too that in addition to those businesses in other, in other counties where this isn't a law, businesses have the authority and, and the um, and the right to ban E-cigarettes in their business.

So different businesses or housing authorities, um, hospitals, they can, they can choose to ban the use of E-cigarettes on their property.


So I did want to mention that lots of other localities across the national have taken it upon themselves to enact some policies that are even, even more strict on these products, and help protect our youth.

So in California, and Hawaii, they have made it illegal to purchase any tobacco product, including E-cigarettes, um, if you (cough) (excuse me) if you are under the age of 21.

So there are at least 225 other localities where it's illegal to purchase tobacco if you're under the age of 21.

So this is really good for a number of reasons.

Um, one is because it reduces, or it delays the age of initiation and then two, it helps keep tobacco out of schools, um, as Kris had mentioned earlier.

You have, have 18 year olds who can buy these products and they're still in high school.

When you raise the age to 21, you don't have a lot of 21 year olds who are still in high school, so it makes it difficult for those kids to be buying a tobacco product or E-cigarettes and passing along to their friends in high school.

And then the other reason is, um, it reduces sales to minors because it's harder to pass off as a 21 year old than it is to pass off as an 18 year old.

So, so doing that, that's a really, that's a really good policy that the Surgeon General promotes.

In Minnesota, they've applied a tax to E-cigarettes.

You heard Dr.

Shepard talk about how we've, we recently tried to do that and it didn't go so well.

But raising the price, raising the price on tobacco products is one of the most effective mechanisms to re, to prevent youth initiation of tobacco products.

So, like some other, um, some of our counties in Montana, New Jersey and our neighbor North Dakota, the whole state has prohibited the use of E-cigarettes in indoor public places.

So that's something that a whole state can do, is, is include that in the state Clean Indoor Air Act.

Um, Chicago has actually banned the sale of flavored products within 500 feet of a school.

So they're taking action on these flavors, because E-cigarettes, they come in 7,700 different flavors.

I mean, that, that's insane and, as Sarah mentioned, they're in all these different flavors that are appealing specifically to kids.

Um, Providence, Rhode Island has prohibited discounts like coupons and buy one, get one free.

And then New York City has actually had a law that requires that all of their tobacco products be placed behind the counter or in another area that's not freely accessible and can't just be picked up by a kid and walked out.

So this is just kind of a sample.

There are a lot of other localities across the nation that have taken action like this.

This is just a sample of some of the, some of the policies that are in place across the nation.

All right.

So what can you do? What we're wanting from the community outright is to, to know the facts so you've taken the right step today coming and hearing, hearing what we do know about E-cigarettes, so I applaud you for doing that.

The other thing is, talk to your kids and other young people about the risks associated with E-cigarettes, not just water vapor and now you guys know that.

And you know, find the right time to talk to them.

It may not just be, oh I'm going to pull my kid aside and we're going to have a sit down conversation in our living room.

Maybe take the opportunity when you're in a convenience store with your kid or with another young person, and you're seeing those tobacco products placed right next to the candy bars.

Take that moment to stop and say, "hey what do you think about this?" And get their thoughts on it.

Or if you see somebody, you're walking by somebody who's using an E-cigarette or if you're hearing, hearing advertisements on E-cigarettes.

Um, the other thing is, you know, reach out to other, other adults and, and talk to your decision makers, educate your decision makers about these products.

Like, like I said at the very beginning, there's so much misinformation about these products and depending on who you talk to, you're getting different types of, of facts.

So, it's really important that you're communicating to your decision makers and your legislatures, the real facts about these, about these E-cigarettes and what they're doing to our kids and why we're, why we're concerned.

And this can look at, look in a lot of different ways, it could, it could also take the form of, you know, writing, writing a letter to the editor for your newspaper, going and speaking at different groups.

So, so just getting, getting your voice out there is a good way too.

And the last one that I'd like to mention is, is really important, is lead by example.

You know, be tobacco-free yourself.

So if, if you are a tobacco user, there is help for you.

There's a Montana Tobacco Quit Line.

It offers free nicotine replacement therapy which is little gums and gum and lozenges and patches.

It offers reduced cost medication and free coaching.

These, these things like Dr.

Shepard mentioned, combined offer you the greatest success rate that you can get.

So there is help for you and, and it doesn't help to, it's harder for you to have a conversation with your kids about tobacco products and E-cigarettes, if you yourself are using them.

It's harder to get that message across.

So there is hope for you and your set, 1-800-QUIT-Now.


Uk E Liquid Free Delivery UK

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E-cigs vs. T-cigs

Electronic cigarettes may be less harmful in the UK than cigarettes but may still be dangerous. Under which circumstances should a person use ecigs? Will they fill your body with plastic?

Electronic cigarettes can contain propylene glycol or vegetable glycerine with nicotine (and in at least two cases polyethylene glycol 400) to form a solution that when heated by an atomizer, produces a visible vapour that provides nicotine to the bloodstream via the lungs when inhaled.

Electronic cigarettes have not been studied enough by scientists in laboratories to form conclusive evidence that their use is either beneficial or harmful to humans. However, some are concerned that unknown side-effects could occur with continuous, consistent use of electronic cigarettes, including cancer.

Behaviour surrounding their use is worrisome because e-cigs are being used habitually by a percentage of non-smokers who otherwise would not use nicotine, they may seem attractive to children, they are not closely regulated, and their use makes it very easy to overdose on nicotine even for experienced smokers.

E Cigs Electronic Cigarette

UK Electronic Cigarettes and E-Liquid

E-cigs vs. T-cigs

Electronic cigarettes may be less harmful than cigarettes but may still be dangerous. Under which circumstances should a person use electronic cigarettes? Will they fill your body with plastic?

Electronic cigarettes can contain propylene glycol or vegetable glycerine with nicotine (and in at least two cases polyethylene glycol 400) to form a solution that when heated by an atomizer, produces a visible vapour that provides nicotine to the bloodstream via the lungs when inhaled.

Electronic cigarettes have not been studied enough by scientists in laboratories to form conclusive evidence that their use is either beneficial or harmful to humans. However, some are concerned that unknown side-effects could occur with continuous, consistent use of electronic cigarettes, including cancer.

Behaviour surrounding their use is worrisome because e-cigs are being used habitually by a percentage of non-smokers who otherwise would not use nicotine, they may seem attractive to children, they are not closely regulated, and their use makes it very easy to overdose on nicotine even for experienced smokers.

Additionally, they're being marketed to children.

Do E-cigs Impact Society?

Are electronic cigarettes safe to use in public?

Many countries, states, cities, companies, bars and restaurants, and other organizations are banning the use of electronic cigarettes. There are a variety of reasons for their ban.

In 'Drugs And Society' by Glen R. Hanson, Peter J. Venturelli, Annette E. Fleckenstein, the implications the use of drugs has on society is explored in detail. The findings are quite fascinating.

De-icing your lungs?

Many articles about e-cigarettes will focus on the legality of their use and sale, their addictiveness, and the demographics who uses them. What few articles mention though, is what the ingredients in electronic cigarettes are and why you may not want them in your body.

Propylene glycol is basically plastic. Actually it's an additive for manufacturing plastic. The single largest use of PG is for the production of unsaturated polyester resins. It is also used as a humectant (an additive that keeps something moist), and as a preservative for food and tobacco. Mmm, yummy.

Propylene glycol has similar thermal properties to ethylene glycol in that it can lower the freezing point of water when added to it. As a result, propylene glycol is often used as aircraft de-icing fluid, according to Steve Ritter's article What's That Stuff?" on the C&EN website.

Another fun fact: disclosure of which chemicals are in any given electronic cigarette are often not made available by manufacturers or retailers. The most recent information regarding the health effects on humans of acute exposure to propylene glycol by inhalation is from 2002. Please find this information made available by the EPA at the bottom of this article.

Formaldehyde in Cigarettes; Nicotine could Kill a Child

You are probably not a doctor (although, you might be), and you probably rely on the advice of experts for medical information and health recommendations. Using your best judgement, do you think that electronic cigarettes are safe to use? Would you recommend using an electronic cigarette to your friends and family? How about your kids?

Take a look at this video from reports in France. It says that e-cigarettes contain level of formaldehyde near that of tobacco cigarettes. What? I do not know if that information is true, but if it is, it's not good!

The reports urge people to understand that electronic cigarettes are not healthy. Furthermore, the reports say that some models of e-cigarette do not have protective safety caps even though they have enough nicotine to kill a child. That is a liability. Yikes!

Quick facts

  • The molecular formula for propylene glycol is C3H8O2
  • It is a clear and colorless liquid and is non-corrosive
  • It is unknown whether or not is adversely affects human health
  • It is a main ingredient in electronic cigarettes and windshield washer liquid
  • Using it, you might look cool to some people (but they are pathetic losers)
  • Plastic boogers – your snot turns white and is now made of plastic

Ready for the formula? It's CH3CHOHCH2OH

The molecular formula for propylene glycol is C3H8O2. It is a clear and colourless liquid and is non-corrosive.

C3H8O2 can accumulate in your body from the use of shampoo, deodorant, moisturisers and creams, pain medication and a host of food products. So there's probably already enough in there without the use of e-cigs.

E-cigarettes offer you the opportunity to pay money to suck PG directly into the center of your body.

What Should You Do About It?

At best, e-cigarettes are neutral for your health and at worst they are detrimental to your health. How bad for you are they?

You'll need good luck if you are currently using an electronic cigarette! Because the health effects are largely unknown, using an e-cig is a gamble and you'll need all the luck you can get.


Propylene Glycol Reference from the EPA

It looks like a few people have looked into it before. It's surprising there's not a lot of available data as to the effects of inhalation on humans. Shocking!

Check out this Propylene Glycol Reference List from the EPA:

Support: [] - Acute Toxicity to Daphnids (Daphnia Magna) under Static Conditions, with Cover Letter Dated 8/28/96 (Sanitized). EPA/OTS; Doc #89960000203S . 1996.
Code: 8

Methoxypropanol, dipropylene glycol methyl ether. S.Hirzel Verlag, P.O.Box 10 10 61, 70009 Stuttgart, Germany, 1997.vii, 142p.Bibl.ref. 1997.
Code: 8

A 2-Year Vapor Inhalation Oncogenicity Study & Evaluation of Hepatic Cellular Proliferation & P450 Enzyme Induction in B6c3f1 Mice W/Cover Letter Dated 06/02/99 (Sanitized). EPA/OTS; Doc #86990000051S . 1999.
Code: 9

2-Year Vapor Inhl Chronic/Oncogenicity Study & Evaluation of Hepatic & Renal Cellular Proliferation, P450 Enzyme Induction & Protein Droplet Nephropathy W/Cover Letter Dated 060299. EPA/OTS; Doc #86990000050 . 1999.
Code: 9

Initial Submission: Letter from Ciba Specialty Chems Inc to Usepa Re Acute Toxicity Studies of Alcopol 0 70pg, Collafix Pp2, & Cfr 5651/Magnafloc 1697, W/Attchmts & Dated 12/23/98. EPA/OTS; Doc #88990000073 . 1999.
Code: 9

Comparative Metabolism and Disposition of Ethylene Glycol Monomethyl Ether and Propylene Glycol Monomethyl Ether in Male Rats with Attachments. EPA/OTS; Doc #86-890001230 . 2000.
Code: 9

Propylene Glycol Monomethyl Ether: Inhalation Teratology Study in Rats and Rabbits. EPA/OTS; Doc #86-890001233 . 2000.
Code: 9

Propylene Glycol Monomethyl Ether: Inhalation Teratology Probe Study in Rats and Rabbits. EPA/OTS; Doc #86-890001232 . 2000.
Code: 9

Evaluation of Propylene Glycol-N-Butyl Ether in an Vitro Chromosomal Aberration Assay Utilizing Chinese Hamster Ovary (Cho) Cells (Final Report) (Sanitized). EPA/OTS; Doc #86-890001243S . 2000.
Code: 9

Evaluation of Propylene Glycol-N-Butyl Ether in the Ames Salmonella/Mammalian-Microsome Bacterial Mutagenicity Assay (Final Report) (Sanitized). EPA/OTS; Doc #86-890001244S . 2000.
Code: 9

Nonlinear Kinetics of Inhaled Propylene Glycol Monomethyl Ether in Fischer 344 Rats Following Single and Repeated Exposures (Final Report) with Attachments. EPA/OTS; Doc #86-890001164 . 2000.
Code: 9

Analysis of Dowanol Cx, a Mixture of Dipropylene Glycol Methyl Ether & Propylene Glycol Isobutyl Ether in the Aquatic Environment (Final Report) (Sanitized). EPA/OTS; Doc #86-890001114S . 2000.
Code: 8

Evaluation of the Acute Dermal Toxicity of Dowanol-Pnb in Rat with Attachments (Sanitized). EPA/OTS; Doc #86-890001250S . 2000.
Code: 9

Evaluation of the Acute Oral Toxicity of Dowanol-Pnb in the Rat (Final Report) (Sanitized). EPA/OTS; Doc #86-890001246S . 2000.
Code: 9

Results of Range Finding Toxicological Test on Three Samples of 4-Tert Octyl Phenol. EPA/OTS; Doc #40-5462011 . 2000.
Code: 8

Blood Pharmacokinetics of Propylene Glycol Methyl Ether and Propylene Glycol Methyl Ether Acetate in Male F-344 Rats after Dermal Application, with Cover Letter Dated 2/10/2000. EPA/OTS; Doc #FYI-OTS-0600-1385 . 2000.
Code: 9

Propylene Glycol Monomethyl Ether: A 13-Week Inhalation Toxicity Study in Rats and Rabbits. EPA/OTS; Doc #86-890001229 . 2000.
Code: 9

Warning for oral solution. AIDS Patient Care STDS 14(9):519-20. 2000.
Code: 8

Odor Evaluation Study on Dowtherm 209 Coolant (Dowanol Pm; Monomethyl Ether of Propylene Glycol) in Humans. EPA/OTS; Doc #86-890001220 . 2000.
Code: 8

Assessment of the Oral Toxicity, Including the Haemolytic Activity of Dowanol-Pnb in the Rat: 14-Day Study with Attachments. EPA/OTS; Doc #86-890001253 . 2000.
Code: 9

Chronic Skin Absorption of Propylene Glycol Methyl Ether (33b) and Dipropylene Glycol Methyl Ether (50b) in Rabbits. EPA/OTS; Doc #86-890001219 . 2000.
Code: 9

Propylene Glycol-N-Butyl Ether: An Acute Vapor Inhalation Study in Fischer 344 Rats (Final Report) with Attachments (Sanitized). EPA/OTS; Doc #86-890001245S . 2000.
Code: 9

Propylene Glycol Monomethyl Ether (Pgme): 21-Day Dermal Study in New Zealand White Rabbits. EPA/OTS; Doc #86-890001162 . 2000.
Code: 9

Propylene Glycol Monomethyl Ether: 2-Week Vapor Inhalation Study in Rats and Mice (Sanitized). EPA/OTS; Doc #86-890001235S . 2000.
Code: 9

Propylene Glycol-N-Butyl Ether: Two-Week Vapor Inhalation Study with Fischer 344 Rats (Final Report) (Sanitized). EPA/OTS; Doc #86-890001260S . 2000.
Code: 9

Subchronic (13-Wk) Dermal Toxicity Study with Propylene Glycol-N-Butyl Ether in Rats (Final Report). EPA/OTS; Doc #86-890001257 . 2000.
Code: 9

Alfons, K. and Engstrom, S. Drug compatibility with the sponge phases formed in monoolein, water, and propylene glycol or poly(ethylene glycol). J Pharm Sci 87(12):1527-30. 1998.
Code: 8

Altaras, N. E. and Cameron, D. C. Metabolic engineering of a 1,2-propanediol pathway in Escherichia coli. Appl Environ Microbiol 65(3):1180-5. 1999.
Code: 8

Altaras, N. E. and Cameron, D. C. Enhanced production of (R)-1,2-propanediol by metabolically engineered Escherichia coli. Biotechnol Prog 16(6):940-6. 2000.
Code: 8

Altaras, N. E., Etzel, M. R., and Cameron, D. C. Conversion of sugars to 1,2-propanediol by Thermoanaerobacterium thermosaccharolyticum HG-8. Biotechnol Prog 17(1):52-6. 2001.
Code: 8

Andrews, A. H. and Wilkinson, J. Recombinant bovine somatotropin and propylene glycol following glucose injection in treating pregnancy toxaemia. Large Animal Practice; 19 (6).1998.31-33. 1998.
Code: 8

Anon. BIBRA Toxicity Profile of propylene glycol. Govt Reports Announcements & Index (GRA&I), Issue 19, 1996 . 1996.
Code: 7

Anon. Toxicology and Carcinogenesis Studies of 1-Chloro-2-Propanol (Technical Grade) (CAS No. 127-00-4) in F344 Rats and B6C3F1 Mice (Drinking Water Studies). Govt Reports Announcements & Index (GRA&I), Issue 06, 1999 . 1998.
Code: 8

Anonymous. Joint Assessment of Commodity Chemicals No. 33, 1,1-Dichloro-2,2,2-trifluoroethane (HCFC-123) CAS No. 306-83-2. European Centre for Ecotoxicology and Toxicology of Chemicals, Brussels, 55 pages, 92 references, 1996 . 1996.
Code: 8

Anonymous. Propylenglykol (Aug 1995). TA:Beratergremium fuer umweltrelevante Altstoffe (BUA) PG:25 p YR:1996 IP: VI:166 . 1996.
Code: 7

Anonymous. Dipropylene glycol (December 1993). TA:Beratergremium fuer umweltrelevante Altstoffe (BUA) PG:70 p YR:1996 IP: VI:162 . 1996.
Code: 8

Anonymous. Reproductive toxicology. Propylene glycol. Environ Health Perspect 1997 Feb;105 Suppl 1:231-2 . 1997.
Code: 9

Anonymous. Reproductive toxicology. Propylene glycol monomethyl ether. Environ Health Perspect 1997 Feb;105 Suppl 1:233-4 . 1997.
Code: 8

Anonymous. Toxicological profile for Ethylene Glycol and Propylene Glycol. TA:Agency for Toxic Substances and Disease Registry U.S.Public Health Service PG:249 p YR:1997 IP: VI. 1997.
Code: 7

Anonymous. Reproductive toxicology. 2,2-bis(bromomethyl)-1,3-propanediol. Environ Health Perspect 1997 Feb;105 Suppl 1:271-2 . 1997.
Code: 8

Anonymous. Final report on the safety assessment of Yarrow (achillea millefolium) extract. TA:Int J Toxicol PG:79-84 YR:2001 IP:Suppl 2 VI:20 . 2001.
Code: 8

Anonymous. Final report on the safety assessment of Calendula officinalis extract and calendula officinalis. TA:Int J Toxicol PG:13-20 YR:2001 IP:Suppl 2 VI:20 . 2001.
Code: 8

Anonymous. Final report on the safety assessment of Arnica montana extract and arnica montana. TA:Int J Toxicol PG:1-11 YR:2001 IP:Suppl.2 VI:20 . 2001.
Code: 9

Anonymous. Final report on the safety assessment of Hypericum perforatum extract and hypericum perforatum oil. TA:Int J Toxicol PG:31-9 YR:2001 IP:Suppl 2 VI:20 . 2001.
Code: 8

Aoshima, H. Effects of alcohols and food additives on glutamate receptors expressed in Xenopus oocytes: Specificity in the inhibition of the receptors. Bioscience Biotechnology and Biochemistry; 60 (3).1996.434-438. 1996.
Code: 8

Aouizerate, P., Dume, L., and Astier, A. Ethylene glycol poisoning: Presence of propylene glycol traces, and research of analytic interference due to propylene glycol, in the colorimetric determination of glycolic acid. Journal De Pharmacie Clinique; 15 (Spec.Issue).1996.40-42. 1996.
Code: 8

Appleton, R. E. The new antiepileptic drugs [published erratum appears in Arch Dis Child 1997 Jan;76(1):81]. Arch Dis Child 1996 Sep;75(3):256-62 . 1996.
Code: 8

Araki, Y., Andoh, A., Fujiyama, Y., Takizawa, J., Takizawa, W., and Bamba, T. Short-term oral administration of a product derived from a probiotic, Clostridium butyricum induced no pathological effects in rats. Int J Mol Med 9(2):173-7. 2002.
Code: 8

Arbour, R. B. Propylene glycol toxicity related to high-dose lorazepam infusion: case report and discussion. Am J Crit Care 8(1):499-506. 1999.
Code: 9

Arellano, A., Santoyo, S., Martn, C., and Ygartua, P. Surfactant effects on the in vitro percutaneous absorption of diclofenac sodium. Eur J Drug Metab Pharmacokinet 23(2):307-12. 1998.
Code: 8

Arellano, A., Santoyo, S., Martin, C., and Ygartua, P. Influence of propylene glycol and isopropyl myristate on the in vitro percutaneous penetration of diclofenac sodium from carbopol gels. Eur J Pharm Sci 7(2):129-35. 1999.
Code: 8

Baker, R. C. and Kramer, R. E. Cytotoxicity of short-chain alcohols. Cho, A.K.(Ed.).Annual Review of Pharmacology and Toxicology, Vol.39.Vii+470p.Annual Reviews Inc.: Palo Alto, California, USA.Isbn 0-8243-0439-X; 39 (0).1999.127-150. 1999.
Code: 8

Barber, J. T., Thomas, D. A., Ensley, H. E., and Yatsu, L. Y. Duckweed Diols and Death. Plant Biology '97: 1997 Annual Meetings of the American Society of Plant Physiologists and the Canadian Society of Plant Physiologists, Japanese Society of Plant Physiologists and the Australian Society of Plant Physiologists, Vancouver, British Columbia, Canada, August 2-6, 1997.Plant Physiology (Rockville); 114 (3 Suppl.).1997.124. 1997.
Code: 8

Barratt, M. D. QSARS for the eye irritation potential of neutral organic chemicals. Toxicology in Vitro; 11 (1-2).1997.1-8. 1997.
Code: 8

Basketter, D. A., Chamberlain, M., Griffiths, H. A., Rowson, M., Whittle, E., and York, M. The classification of skin irritants by human patch test. Food and Chemical Toxicology; 35 (8).1997.845-852. 1997.
Code: 8

Basketter, D. A., Gerberick, G. F., and Kimber, I. Strategies for identifying false positive responses in predictive skin sensitization tests. Food and Chemical Toxicology; 36 (4).1998.327-333. 1998.
Code: 8

Bausmith, D. S. and Neufeld, R. D. Soil biodegradation of propylene glycol based aircraft deicing fluids. Water Environment Research; 71 (4).1999.459-464. 1999.
Code: 8

Bennett, G. N. and San, K. Y. Microbial formation, biotechnological production and applications of 1,2-propanediol. Appl Microbiol Biotechnol 55(1):1-9. 2001.
Code: 8

Bjerre, C., Bjork, E., and Camber, O. Bioavailability of the sedative propiomazine after nasal administration in rats. Int.J.Pharm.; VOL 144 ISS Nov 29 1996, P217-224, (REF 22) . 1996.
Code: 8

Blake, D. A., Whikehart, D. R., Yu, H., Vogel, T., and Roberts, D. D. Common cryopreservation media deplete corneal endothelial cell plasma membrane Na+,K+ ATPase activity. Curr Eye Res 15(3):263-71. 1996.
Code: 8

Bobik, T. A., Xu, Y., Jeter, R. M., Otto, K. E., and Roth, J. R. Propanediol utilization genes (pdu) of Salmonella typhimurium: three genes for the propanediol dehydratase. J Bacteriol 179(21):6633-9. 1997.
Code: 8

Bobik, T. A., Havemann, G. D., Busch, R. J., Williams, D. S., and Aldrich, H. C. The propanediol utilization (pdu) operon of Salmonella enterica serovar Typhimurium LT2 includes genes necessary for formation of polyhedral organelles involved in coenzyme B(12)-dependent 1, 2-propanediol degradation. J Bacteriol 181(19):5967-75. 1999.
Code: 8

Bolon, B., Bucci, T. J., Warbritton, A. R., Chen, J. J., Mattison, D. R., and Heindel, J. J. Differential follicle counts as a screen for chemically induced ovarian toxicity in mice: Results from continuous breeding bioassays. Fundamental and Applied Toxicology; 39 (1).1997.1-10. 1997.
Code: 8

Boman, A. and Maibach, H. Influence of Evaporation and Repeated Exposure on the Percutaneous Absorption of Organic Solvents. Elsner, P., Et Al.(Ed.).Current Problems in Dermatology (Basel), Vol.25.Prevention of Contact Dermatitis; International Conference on the Prevention of Contact Dermatitis, Zurich, Switzerland, October 4-7, 1995.X+226p.S.Karger Ag: Basel, Switzerland; New York, New York, USA.Isbn 3-8055-6311-6.; 25 (0).1996.57-66. 1996.
Code: 8

Brayden, D., Creed, E., O'Connell, A., Leipold, H., Agarwal, R., and Leone-Bay, A. Heparin absorption across the intestine: effects of sodium N-[8-(2- hydroxybenzoyl)amino]caprylate in rat in situ intestinal instillations and in Caco-2 monolayers. Pharm Res 14(12):1772-9. 1997.
Code: 8

Bremmer, D. R., Trower, S. L., Bertics, S. J., Besong, S. A., Bernabucci, U., and Grummer, R. R. Etiology of fatty liver in dairy cattle: effects of nutritional and hormonal status on hepatic microsomal triglyceride transfer protein. J Dairy Sci 83(10):2239-51. 2000.
Code: 5

Breslin, W. J., Cieszlak, F. S., Zablotny, C. L., Corley, R. A., Verschuuren, H. G., and Yano, B. L. Evaluation of the developmental toxicity of inhaled dipropylene glycol monomethyl ether (DPGME) in rabbits and rats. Occup Hyg 1996;2:161-70 . 1996.
Code: 8

Bruyas, J. F., Martins-Ferreira, C., Fieni, F., and Tainturier, D. The effect of propanediol on the morphology of fresh and frozen equine embryos. Equine Vet J Suppl (25):80-4. 1997.
Code: 8

Burkhart, J., Piacitelli, C., Schwegler-Berry, D., and Jones, W. Environmental study of nylon flocking process. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH PART A; 57 (1).1999.1-23.AB - BIOSIS COPYRIGHT: BIOL ABS.Environmental measurements for a variety of gas, particulate, and microbiological agents have been made in order to characterize exposures associated with the nylon flocking process.Of all agents measured, particulate is the predominant exposure.Levels of total particulate ranged from 0.1 to 240 mg/m3 ( x = 11.4 mg/m3).Average respirable particulate was 2.2 mg/m3, ranging from 0.5 to 39.9 mg/m3.Highest levels of particulates were found in the flocking room, and direct reading dust measuremen veral of which were linked directly to the process.Of special interest were elongated respirable particles, which by microscopic analysis, complemented with melting-point determination, were found to be shreds of nylon. 1999.
Code: 8

Cameron, D. C., Altaras, N. E., Hoffman, M. L., and Shaw, A. J. Metabolic engineering of propanediol pathways. Biotechnol Prog 14(1):116-25. 1998.
Code: 8

Carney, E. W., Crissman, J. W., Liberacki, A. B., Clements, C. M., and Breslin, W. J. Assessment of adult and neonatal reproductive parameters in Sprague-Dawley rats exposed to propylene glycol monomethyl ether vapors for two generations. Toxicol Sci 1999 Aug;50(2):249-58 . 1999.
Code: 8

Carney, E. W. and Johnson, K. A. Comparative developmental toxicity of the glycol ether metabolites, methoxyacetic acid and methoxypropionic acid. Teratology 2000 Jun;61(6):454 . 2000.
Code: 8

Chapin, R. E., Sloane, R. A., and Haseman, J. K. The relationships among reproductive endpoints in Swiss mice, using the reproductive assessment by Continuous Breeding database. Fundam Appl Toxicol 1997 Aug;38(2):129-42 . 1997.
Code: 8

Chapin, R. E. and Sloane, R. A. Reproductive assessment by continuous breeding: evolving study design and summaries of ninety studies. Environ Health Perspect 1997 Feb;105 Suppl 1:199-205 . 1997.
Code: 8

Chicu, S. A. and Berking, S. Interference with metamorphosis induction in the marine cnidaria Hydractinia echinata (hydrozoa): A structure-activity relationship analysis of lower alcohols, aliphatic and aromatic hydrocarbons, thiophenes, tributyl tin and crude oil. Chemosphere; 34 (8).1997.1851-1866. 1997.
Code: 8

Chou C-H, S. J., Holler, J., and De Rosa, C. T. Minimal risk levels (MRLs) for hazardous substances. Journal of Clean Technology Environmental Toxicology and Occupational Medicine; 7 (1).1998.1-24. 1998.
Code: 8

Christensen, J. O., Grummer, R. R., Rasmussen, F. E., and Bertics, S. J. Effect of method of delivery of propylene glycol on plasma metabolites of feed-restricted cattle. J Dairy Sci 80(3):563-8. 1997.
Code: 8

Cicolella, A. [Evaluation of risks of glycol ethers for the reproductive health]. Sante Publique 1997 Jun;9(2):157-83 . 1997.
Code: 8

Colin, T., Bories, A., and Moulin, G. Inhibition of Clostridium butyricum by 1,3-propanediol and diols during glycerol fermentation. Appl Microbiol Biotechnol 54(2):201-5. 2000.
Code: 8

Cook, G., Papich, M. G., Roberts, M. C., and Bowman, K. F. Pharmacokinetics of cisapride in horses after intravenous and rectal administration. Am J Vet Res 58(12):1427-30. 1997.
Code: 8

Corley, R. A., Crissman, J. W., Redmond, J. M., McGuirk, R. J., Cieszlak, F. S., and Stott, W. T. Adaptive Metabolic and Pathologic Changes following Chronic Inhalation of Propylene Glycol Monomethyl Ether in Rats and Mice. Occupational Hygiene, Vol.2, Nos.1-6, pages 319-328, 24 references, 1996 AB - The temporal relationships between propylene-glycol-monomethyl-ether (107982) (PGME) induced metabolic and morphological changes in rats and mice which have been chronically exposed to up to 3,000 parts per million (ppm) of PGME vapors were characterized.B6C3F1-mice and F344-rats were exposed to 300, 1,000, or 3,000ppm for 6 hours a day, 5 days a week, for up to 2 years.Results indicated that there is potential for adaptive biochemical and cellular changes in response to chemical exposure to modify the toxicity of PGME in rats and mice.Nearly all inhaled PGME was absorbed, resulting in high systemic levels of PGME.These levels may result in central nervous system depression and the clinically observable sedation of exposed animals.A disruption in male rats was noted in the processing of alpha2micro-globulin resulting in mild degenerative effects in renal tubule epithelial cells.The pronounced sedation of rats and mice exposed to 3,000ppm resolved by the second week of exposure.The induction of O-dealkylase activity in these animals suggests an increase in the potential of metabolized PGME via its major metabolic route to propylene-glycol and then to carbon-dioxide.Exposed animals may also have effectively enhanced PGME metabolism by increasing the number of hepatocytes in response to PGME exposure resulting in the increase in liver weights.Clearly defined, treatment related renal effects were only observed in male rats.The authors conclude that high concentrations of PGME cause an adaptive hepatic response in both sexes of rats and mice that is partially reversed in rats. 1996.
Code: 8

Cornwell, P. A., Barry, B. W., Bouwstra, J. A., and Gooris, G. S. Modes of action of terpene penetration enhancers in human skin; differential scanning calorimetry, small-angle x-ray diffraction and enhancer uptake studies. Int.J.Pharm.; VOL 127 ISS Jan 15 1996, P9-26, (REF 50) . 1996.
Code: 8

Corsi, S. R., Booth, N. L., and Hall, D. W. Aircraft and runway deicers at General Mitchell International Airport, Milwaukee, Wisconsin, USA. 1. Biochemical oxygen demand and dissolved oxygen in receiving streams. Environ Toxicol Chem 20(7):1474-82. 2001.
Code: 8

Corsi, S. R., Hall, D. W., and Geis, S. W. Aircraft and runway deicers at General Mitchell International Airport, Milwaukee, Wisconsin, USA. 2. Toxicity of aircraft and runway deicers. Environ Toxicol Chem 20(7):1483-90. 2001.
Code: 8

Daniel, R., Bobik, T. A., and Gottschalk, G. Biochemistry of coenzyme B12-dependent glycerol and diol dehydratases and organization of the encoding genes. FEMS Microbiol Rev 22(5):553-66. 1998.
Code: 8

Davison, S., Benson, C. E., Ziegler, A. F., and Eckroade, R. J. Evaluation of disinfectants with the addition of antifreezing compounds against nonpathogenic H7N2 avian influenza virus. Avian Dis 43(3):533-7. 1999.
Code: 8

De Bortoli, M., Ghezzi, E., Knoppel, H., and Vissers, H. A new test chamber to measure material emissions under controlled air velocity. Environmental Science & Technology; 33 (10).1999.1760-1765. 1999.
Code: 8

Debellefontaine, H., Chakchouk, M., Foussard, J. N., Tissot, D., and Striolo, P. Treatment of organic aqueous wastes: Wet air oxidation and Wet Peroxide Oxidation. Environmental Pollution; 92 (2).1996.155-164. 1996.
Code: 8

Dib, R., Chobert, J. M., Dalgalarrondo, M., and Haertle, T. Secondary structure changes and peptic hydrolysis of beta-lactoglobulin induced by diols. Biopolymers 39(1):23-30. 1996.
Code: 8

Ding, P., Xu, H., Wei, G., and Zheng, J. Microdialysis sampling coupled to HPLC for transdermal delivery study of ondansetron hydrochloride in rats. Biomed Chromatogr 14(3):141-3. 2000.
Code: 8

Doenicke, A., Roizen, M. F., Hoernecke, R., Mayer, M., Ostwald, P., and Foss, J. Haemolysis after etomidate: comparison of propylene glycol and lipid formulations. Br J Anaesth 79(3):386-8. 1997.
Code: 8

Dorr, R. T., Bellamy, W., Liddil, J. D., Baker, A., and Bair, K. W. Correlation of cytotoxicity and protein-associated DNA strand breaks for 2-(arylmethylamino)-1,3-propanediols. Anticancer Drug Des 1998 Oct;13(7):825-35 . 1998.
Code: 8

el-Fiky, M. A. Hyperglycemic effect of a neurotoxic fraction (F3) from Naja haje venom: role of hypothalamo-pituitary adrenal axis (HPA). J Nat Toxins 8(2):203-12. 1999.
Code: 8

Elliott, R. C., Jones, J. R., McElvenny, D. M., Pennington, M. J., Northage, C., Clegg, T. A., Clarke, S. D., Hodgson, J. T., and Osman, J. Spontaneous abortion in the British semiconductor industry: An HSE investigation. Health and Safety Executive [see comments]. Am J Ind Med 1999 Nov;36(5):557-72 . 1999.
Code: 8

Emiliani, S., Van den Bergh, M., Vannin, A. S., Biramane, J., and Englert, Y. Comparison of ethylene glycol, 1,2-propanediol and glycerol for cryopreservation of slow-cooled mouse zygotes, 4-cell embryos and blastocysts. Hum Reprod 15(4):905-10. 2000.
Code: 8

Farshid, A. A., Rajan, A., and Nair, M. K. Ultrastructural pathology of the lymphoid organs in Japanese quail embryos in experimental ochratoxicosis. Indian Veterinary Journal; 73 (12).1996.1225-1230. 1996.
Code: 8

Farshid, A. A. and Rajan, R. Assessment of the cell-mediated immune response of Japanese quails in experimental ochratoxicosis. Indian Veterinary Journal; 73 (11).1996.1117-1121. 1996.
Code: 8

Farshid, A. A., Rajan, A., and Nair, M. K. Ultrastructural pathology of the lymphoid organs in Japanese quail embryos in experimental ochratoxicosis. Journal of Veterinary and Animal Sciences; 27 (1).1998.21-26. 1998.
Code: 8

Gabiga, H., Cal, K., and Janicki, S. Effect of penetration enhancers on isosorbide dinitrate penetration through rat skin from a transdermal therapeutic system. Int J Pharm 199(1):1-6. 2000.
Code: 8

Gallacher, G. and Maibach, H. I. Is atopic dermatitis a predisposing factor for experimental acute irritant contact dermatitis? Contact Dermatitis; 38 (1).1998.1-4. 1998.
Code: 8

Gao, D. Y., Neff, K., Xiao, H. Y., Matsubayashi, H., Cui, X. D., Bonderman, P., Bonderman, D., Harvey, K., McIntyre, J. A., Critser, J., Miraglia, C. C., and Reid, T. Development of optimal techniques for cryopreservation of human platelets. I. Platelet activation during cold storage (at 22 and 8 degrees C) and cryopreservation. Cryobiology 38(3):225-35. 1999.
Code: 8

Garnier, R. [Acute poisoning with industrial products]. Rev Prat 50(4):377-84. 2000.
Code: 8

Garzon-De la Mora, P., Garcia-Lopez, P. M., Garcia-Estrada, J., Navarro-Ruiz, A., Villanueva-Michel, T., Villarreal-de Puga, L. M., and Casillass-Ochoa, J. Casimiroa edulis seed extracts show anticonvulsive properties in rats. J Ethnopharmacol 68(1-3):275-82. 1999.
Code: 8

George, J. and Murray, E. Toxicological Profile for Ethylene Glycol and Propylene Glycol. Govt Reports Announcements & Index (GRA&I), Issue 05, 1998 . 1997.
Code: 7

Germann, P. G., Ockert, D., and Heinrichs, M. Pathology of the oropharyngeal cavity in six strains of rats: Predisposition of Fischer 344 rats for inflammatory and degenerative changes. Toxicologic Pathology; 26 (2).1998.283-289. 1998.
Code: 8

Gilmore, J. A., Liu, J., Gao, D. Y., and Critser, J. K. Determination of optimal cryoprotectants and procedures for their addition and removal from human spermatozoa. Hum Reprod 1997 Jan;12(1):112-8 . 1997.
Code: 8

Glover, M. L. and Reed, M. D. Propylene glycol: safe diluent that continues to cause harm. Pharmacotherapy; VOL 16 ISS 4 1996, P690-693, (REF 18) . 1996.
Code: 5

Godwin, D. A. and Michniak, B. B. Influence of drug lipophilicity on terpenes as transdermal penetration enhancers. Drug Dev Ind Pharm 25(8):905-15. 1999.
Code: 8

Gotvajn, A. Z. and Zagorc-Koncan, J. Laboratory simulation of biodegradation of chemicals in surface waters: closed bottle and respirometric test. Chemosphere 38(6):1339-46. 1999.
Code: 8

Groning, R. and Kuhland, U. Pulsed release of nitroglycerin from transdermal drug delivery systems. Int J Pharm 193(1):57-61. 1999.
Code: 8

group, Bibra working. Propylene Glycol. TA:Toxicity profile.BIBRA Toxicology International PG:16 p YR:1996 IP: VI. 1996.
Code: 7

group, N. T. P. working. Toxicology and carcinogenesis studies of 1-Chloro-2-Propanol (Technical grade) in F344/N rats and B6C3F1 mice (drinking water studies). TA:National Toxicology Program Technical Report Series PG:264 p YR:1998 IP: VI:477 . 1998.
Code: 8

Guerriero, F. J., Seaman, C. W., Sprague, G. L., Sutton, T. J., and Toseland, C. D. Developmental toxicity in rats treated orally with 2-(2-iodoethyl)-1,3-propanediol diacetate. Toxicologist 2000 Mar;54(1):291-2 . 2000.
Code: 8

Guin, J. D. Contact Dermatitis and Other Contact Reactions. Lieberman, P.And J.A.Anderson (Ed.).Current Clinical Practice: Allergic Diseases: Diagnosis and Treatment.X+402p.Humana Press Inc.: Totowa, New Jersey, USA.Isbn 0-89603-367-8.; 0 (0).1997.233-254. 1997.
Code: 8

Gupta, A. K., Einarson, T. R., Summerbell, R. C., and Shear, N. H. Overview of topical antifungal therapy in dermatomycoses: North American perspective. Drugs; VOL 55 ISS May 1998, P645-674, (REF 447) . 1998.
Code: 8

Gupta, G., Dawn, G., and Forsyth, A. The trend of allergic contact dermatitis in the elderly population over a 15-year period. Contact Dermatitis; 41 (1).1999.48-50. 1999.
Code: 8

Hall, S. and Godwin-Saad, E. Effects of Pollutants on Freshwater Organisms. Water Environment Research; 68 (4).1996.776-784. 1996.
Code: 8

Hattori, T. and Maehashi, H. Increase in Calcium Influx by Propylene Glycol at Mouse Motor Nerve Terminals. In Vitro Toxicology.A Journal of Molecular and Cellular Toxicology, Vol.9, No.4, pages 373-375, 10 references, 1996 . 1996.
Code: 5

Hattori, T. and Maehashi, H. Facilitation of calcium influx by propylene glycol through the voltage- dependent calcium channels in PC12 cells. Res Commun Mol Pathol Pharmacol 105(3):179-84. 1999.
Code: 5

Hattori, T. and Maehashi, H. Rise in intracellular calcium concentration by propylene glycol in PC12 cells. Int J Neurosci 99(1-4):151-7. 1999.
Code: 5

Hattori, T., Maehashi, H., Miyazawa, T., and Naito, M. Enhancement of dopamine release by propylene glycol in PC12 cells. Res Commun Mol Pathol Pharmacol 107(3-4):323-9. 2000.
Code: 5

Havemann, G. D., Sampson, E. M., and Bobik, T. A. PduA is a shell protein of polyhedral organelles involved in coenzyme B(12)-dependent degradation of 1,2-propanediol in Salmonella enterica serovar typhimurium LT2. J Bacteriol 184(5):1253-61. 2002.
Code: 8

Heylings, J. R., Clowes, H. M., Cumberbatch, M., Dearman, R. J., Fielding, I., Hilton, J., and Kimber, I. Sensitization to 2,4-dinitrochlorobenzene: influence of vehicle on absorption and lymph node activation. Toxicology 109(1):57-65. 1996.
Code: 8

Ho, H. O., Chen, L. C., Lin, H. M., and Sheu, M. T. Penetration enhancement by menthol combined with a solubilization effect in a mixed solvent system. J Control Release 51(2-3):301-11. 1998.
Code: 8

Hostynek, J. J. and Magee, P. S. Fragrance allergens: Classification and ranking by QSAR. Toxicology in Vitro; 11 (4).1997.377-384. 1997.
Code: 8

Huang, K., Rudolph, F. B., and Bennett, G. N. Characterization of methylglyoxal synthase from Clostridium acetobutylicum ATCC 824 and its use in the formation of 1, 2- propanediol. Appl Environ Microbiol 65(7):3244-7. 1999.
Code: 8

Imamura, S., Nozawa, I., Imamura, M., and Murakami, Y. Pathogenesis of experimental aural cholesteatoma in the chinchilla. ORL J Otorhinolaryngol Relat Spec 61(2):84-91. 1999.
Code: 5

Inoue, K., Nakazawa, K., Fujimori, K., Ohno, Y., Takanaka, A., Itagaki, H., Kato, S., Kobayashi, T., and Kuroiwa, Y. Evaluation of stinging-inducing chemicals using cultured neuronal cells: An electrophysiological approach. Toxicology in Vitro; 10 (4).1996.455-462. 1996.
Code: 8

Ishidate, M. Jr, Miura, K. F., and Sofuni, T. Chromosome aberration assays in genetic toxicology testing in vitro. Mutation Research; 404 (1-2).1998.167-172. 1998.
Code: 8

Ishiwata, H., Nishijima, M., Fukasawa, Y., Ito, Y., and Yamada, T. Evaluation of the contents of BHA, BHT, propylene glycol, and sodium saccharin in foods and estimation of daily intake based on the results of official inspection in Japan in fiscal year 1994. Journal of the Food Hygienic Society of Japan; 39 (2).1998.89-100. 1998.
Code: 8

Jaiswal, J., Poduri, R., and Panchagnula, R. Transdermal delivery of naloxone: ex vivo permeation studies. Int J Pharm 179(1):129-34. 1999.
Code: 8

Janik, M., Kleinhans, F. W., and Hagedorn, M. Overcoming a permeability barrier by microinjecting cryoprotectants into zebrafish embryos (Brachydanio rerio). Cryobiology 2000 Aug;41(1):25-34 . 2000.
Code: 8

Jewgenow, K., Penfold, L. M., Meyer, H. H., and Wildt, D. E. Viability of small preantral ovarian follicles from domestic cats after cryoprotectant exposure and cryopreservation. J Reprod Fertil 112(1):39-47. 1998.
Code: 8

Johnson, C. L., Pechonick, E., Park, S. D., Havemann, G. D., Leal, N. A., and Bobik, T. A. Functional genomic, biochemical, and genetic characterization of the Salmonella pduO gene, an ATP:cob(I)alamin adenosyltransferase gene. J Bacteriol 183(5):1577-84. 2001.
Code: 8

Johnson, W. Final report on the safety assessment of Propylene Glycol (PG) Dicaprylate, PG Dicaprylate-Dicaprate, PG Dicocoate, PG Dipelargonate, PG Isostearate, PG Laurate, PG Myristate, PG Oleate, PG Oleate SE, PG Dioleate, PG Dicaprate, PG Diisostearate, and PG Dilaurate. International Journal of Toxicology; 18 (Suppl.2).1999.35-52. 1999.
Code: 8

Jones, T. D. On 'toxicity equivalent factors' and 'relative potency' to account for differential toxicity and carcinogenicity: Concerns about uncommon effects of dose in animal experiments and environmental exposures to humans. Environmetrics; 9 (5).1998.525-539. 1998.
Code: 8

Kang, L., Jun, H. W., and McCall, J. W. Physicochemical studies of lidocaine-menthol binary systems for enhanced membrane transport. Int J Pharm 206(1-2):35-42. 2000.
Code: 8

Karami, K. and Beronius, P. On iontophoretic delivery enhancement: ionization and mobility of lidocaine hydrochloride in propylene glycol. Int.J.Pharm.; VOL 168 ISS Jun 8 1998, P85-95, (REF 17) . 1998.
Code: 8

Karran, G. and Legge, M. Non-enzymatic formation of formaldehyde in mouse oocyte freezing mixtures. Hum Reprod 11(12):2681-6. 1996.
Code: 8

Kataoka, M., Sasaki, M., Hidalgo, A. R., Nakano, M., and Shimizu, S. Glycolic acid production using ethylene glycol-oxidizing microorganisms. Biosci Biotechnol Biochem 65(10):2265-70. 2001.
Code: 8

Kedzierewicz, F., Darme, X., Etienne, A., Lemut, J., Hoffman, M., and Maincent, P. Preparation of silicone microspheres by emulsion polymerization: application to the encapsulation of a hydrophilic drug. J Microencapsul 15(2):227-36. 1998.
Code: 8

Kellner, D. L. Sorption of the Aircraft Deicing Fluid Component Methyl-Benzotriazole in Soil. /u0014 . 1999.
Code: 8

Kerai, M. Dj, Waterfield, C. J., and Timbrell, J. A. The Effects of Propylene Glycol on Paracetamol Toxicity in Hamsters. Annual Progress of the British Toxological Society, Warwick, England, Uk, March 24-26, 1997.Human & Experimental Toxicology; 16 (7).1997.407. 1997.
Code: 9

Kimber, I., Dearman, R. J., and Basketter, D. A. Estimation of relative skin sensitization potency using the local lymph node assay. Annual Congress of the British Toxicology Society, Stoke on Trent, England, Uk, April 18-21, 1999.Yhuman & Experimental Toxicology; 18 (8).1999.524. 1999.
Code: 8

Kiriyama, A., Sugahara, M., Yoshikawa, Y., Kiso, Y., and Takada, K. Bioavailability of oral dosage forms of a new HIV-1 protease inhibitor, KNI-272, in beagle dogs. Biopharm.Drug Dispos.; VOL 17 ISS Mar 1996, P125-134, (REF 20) . 1996.
Code: 8

Kolloffel, W. J., Weekers, L. E., and Goldhoorn, P. B. Pharmacokinetics of propylene glycol after rectal administration. Pharm World Sci 18(3):109-13. 1996.
Code: 5

Kowalczyk, C. L., Stachecki, J. J., Schultz, J. F., Leach, R. E., and Armant, D. R. Effects of alcohols on murine preimplantation development: Relationship to relative membrane disordering potency. Alcoholism Clinical and Experimental Research; 20 (3).1996.566-571. 1996.
Code: 5

Kruszewski, F. H., Walker, T. L., and Dipasquale, L. C. Evaluation of a human corneal epithelial cell line as an in vitro model for assessing ocular irritation. Fundamental and Applied Toxicology; 36 (2).1997.130-140. 1997.
Code: 8

Krzymien, M., Day, M., Shaw, K., Mohmad, R., and Sheehan, S. The role of feed composition on the composting process. II. Effect on the release of volatile organic compounds and odours. Journal of Environmental Science and Health Part a Toxic-Hazardous Substances & Environmental Engineering; 34 (6).1999.1369-1396. 1999.
Code: 8

Kucherenko, Y. U. and Moiseev, V. A. The use of 1H-NMR spectroscopy and refractometry for investigation of the distribution of nonelectrolytes of N-alcohol series between human red blood cells and extracellular medium. Membr Cell Biol 13(5):633-44. 2000.
Code: 8

Kulkarni, A. S. and Hopfinger, A. J. Membrane-interaction QSAR analysis: Application to the estimation of eye irritation by organic compounds. Pharmaceutical Research (New York); 16 (8).1999.1245-1253. 1999.
Code: 8

Kusunoki, J., Kai, A., Yanagawa, Y., Monma, C., Shingaki, M., Obata, H., Itoh, T., Ohta, K., Kudoh, Y., and Nakamura, A. [Biochemical and molecular characterization of Salmonella ser. enteritidis phage type 1 isolated from food poisoning outbreaks in Tokyo]. Kansenshogaku Zasshi 73(5):437-44. 1999.
Code: 8

Kuznetsova, N., Chi, S. L., and Leikin, S. Sugars and polyols inhibit fibrillogenesis of type I collagen by disrupting hydrogen-bonded water bridges between the helices. Biochemistry 37(34):11888-95. 1998.
Code: 8

LaDou, J. and Rohm, T. The international electronics industry. Int J Occup Environ Health 1998 Jan-Mar;4(1):1-18 . 1998.
Code: 8

Laitinen, J. Biomonitoring of technical grade 1-alkoxy-2-propanol acetates by analysing urinary 2-alkoxypropionic acids. Sci Total Environ 1997 Jun 20;199(1-2):31-9 . 1997.
Code: 8

Laitinen, J., Liesivuori, J., and Savolainen, H. Biological monitoring of occupational exposure to 1-methoxy-2-propanol. J Chromatogr B Biomed Sci Appl 694(1):93-8. 1997.
Code: 8

LaKind, J. S., McKenna, E. A., Hubner, R. P., and Tardiff, R. G. A review of the comparative mammalian toxicity of ethylene glycol and propylene glycol. Crit Rev Toxicol 29(4):331-65. 1999.
Code: 7

Lanigan, R. S. Special report: reproductive and developmental toxicity of ethylene glycol and its ethers. Int J Toxicol 1999;18(Suppl 2):53-67 . 1999.
Code: 8

Lansdown, A. B. and Taylor, A. Zinc and titanium oxides: promising UV-absorbers but what influence do they have on the intact skin? Int.J.Cosmet.Sci.; VOL 19 ISS 4 1997, P167-172, (REF 10) . 1997.
Code: 8

Larrucea, E., Arellano, A., Santoyo, S., and Ygartua, P. Combined effect of oleic acid and propylene glycol on the percutaneous penetration of tenoxicam and its retention in the skin. Eur J Pharm Biopharm 52(2):113-9. 2001.
Code: 8

Lee, B. J., Lee, T. S., Cha, B. J., Kim, S. H., and Kim, W. B. Percutaneous absorption and histopathology of a poloxamer-based formulation of capsaicin analog. Int.J.Pharm.; VOL 159 ISS Dec 15 1997, P105-114, (REF 21) . 1997.
Code: 8

Lee, B. J., Cui, J. H., Parrott, K. A., Ayres, J. W., and Sack, R. L. Percutaneous absorption and model membrane variations of melatonin in aqueous-based propylene glycol and 2-hydroxypropyl-beta-cyclodextrin vehicles. Arch Pharm Res 21(5):503-7. 1998.
Code: 8

Leone-Bay, A., Leipold, H., Agarwal, R., Rivera, T., and Baughman, R. A. Evolution of an oral heparin dosing solution. Drugs Future; VOL 22 ISS Aug 1997, P885-891, (REF 22) . 1997.
Code: 8

Leppik, I. E. Role of new and established antiepileptic drugs. Epilepsia 1998;39 Suppl 5:2-6 . 1998.
Code: 8

Levang, A. K., Zhao, K., and Singh, J. Effect of ethanol/propylene glycol on the in vitro percutaneous absorption of aspirin, biophysical changes and macroscopic barrier properties of the skin. Int J Pharm 181(2):255-63. 1999.
Code: 8

Li, B., Pinch, H., and Birt, D. F. Influence of vehicle, distant topical delivery, and biotransformation on the chemopreventive activity of apigenin, a plant flavonoid, in mouse skin. Pharm Res 13(10):1530-4. 1996.
Code: 8

Li, B. and Birt, D. F. In vivo and in vitro percutaneous absorption of cancer preventive flavonoid apigenin in different vehicles in mouse skin. Pharm.Res.; VOL 13 ISS Nov 1996, P1710-1715, (REF 9) . 1996.
Code: 8

Liesivuori, J., Laitinen, J., and Savolainen, H. Rat model for renal effects of 2-alkoxyalcohols and their acetates. Arch Toxicol 73(4-5):229-32. 1999.
Code: 5

Lin, S. Y., Duan, K. J., and Lin, T. C. Microscopic FT-IR/DSC system used to simultaneously investigate the conversion process of protein structure in porcine stratum corneum after pretreatment with skin penetration enhancers. Methods Find Exp Clin Pharmacol 18(3):175-81. 1996.
Code: 8

Liu, C. J., Ueda, M., Kosaka, S., Hirata, T., Yokomise, H., Inui, K., Hitomi, S., and Wada, H. A newly developed solution enhances thirty-hour preservation in a canine lung transplantation model. J Thorac Cardiovasc Surg 112(3):569-76. 1996.
Code: 8

Longo, D. L., Duffey, P. L., Kopp, W. C., Heyes, M. P., Alvord, W. G., Sharfman, W. H., Schmidt, P. J., Rubinow, D. R., and Rosenstein, D. L. Conditioned immune response to interferon-gamma in humans. Clin Immunol 90(2):173-81. 1999.
Code: 8

Loskutoff, N. M., Simmons, H. A., Goulding, M., Thompson, G., De Jongh, T., and Simmons, L. G. Species and individual variations in cryoprotectant toxicities and freezing resistances of epididymal sperm from African antelope. Animal Reproduction Science; 42 (1-4).1996.527-535. 1996.
Code: 8

Louik, C., Frumkin, H., Ellenbecker, M. J., Goldman, R. H., Werler, M. M., and Mitchell, A. A. Use of a job-exposure matrix to assess occupational exposures in relation to birth defects. J Occup Environ Med 42(7):693-703. 2000.
Code: 8

Machate, T. and Kettrup, A. Spectrophotometric method for the determination of 1,2-propylene glycol. Fresenius' Journal of Analytical Chemistry; 360 (1).1998.137-138. 1998.
Code: 8

Mahadevan, M. M., McIntosh, Q., Miller, M. M., Breckinridge, S. M., Maris, M., and Moutos, D. M. Formaldehyde in cryoprotectant propanediol and effect on mouse zygotes. Hum Reprod 1998 Apr;13(4):979-82 . 1998.
Code: 8

Mailhes, J. B., Young, D., and London, S. N. 1,2-propanediol-induced premature centromere separation in mouse oocytes and aneuploidy in one-cell zygotes. Biol Reprod 57(1):92-8. 1997.
Code: 3, 6

Malandain, H. and Cano, Y. An Enzymatic Assay for the Emergency Diagnosis of Propylene Glycol Intoxication. 48th Annual Meeting of the American Association for Clinical Chemistry, Inc., Chicago, Illinois, USA, July 28-August 1, 1996.Clinical Chemistry; 42 (6 Part 2).1996.S213. 1996.
Code: 8

Mallidis, C., Phelan, D., Coles, M., and Jones, G. Does the composition of propane-1,2-diol alter over time? J Assist Reprod Genet 13(1):53-5. 1996.
Code: 8

Malonne, H., Fontaine, J., and Moes, A. In vitro/in vivo characterization of a tramadol HCl depot system composed of monoolein and water. Biol Pharm Bull 23(5):627-31. 2000.
Code: 8

Manganaro, A. M. and Wertz, P. W. The effects of permeabilizers on the in vitro penetration of propranolol through porcine buccal epithelium. Mil Med 161(11):669-72. 1996.
Code: 8

Massaad, C., Entezami, F., Massade, L., Benahmed, M., Olivennes, F., Barouki, R., and Hamamah, S. How can chemical compounds alter human fertility? Eur J Obstet Gynecol Reprod Biol 100(2):127-37. 2002.
Code: 8

Matthews, H. B. Chemical Metabolism and Toxicokinetics. Crisp Data Base National Institutes Of Health . 1996.
Code: 8

Mauldin, R. E., Goodall, M. J., Volz, S. A., Griffin, D. L., Petty, E. J., and Johnston, J. J. Zinc phosphide residue determination in alfalfa (Medicago sativa). Journal of Agricultural and Food Chemistry; 45 (6).1997.2107-2111. 1997.
Code: 8

McCain, W. C., Lee, R., Johnson, M. S., Whaley, J. E., Ferguson, J. W., Beall, P., and Leach, G. Acute oral toxicity study of pyridostigmine bromide, permethrin, and DEET in the laboratory rat. Journal of Toxicology and Environmental Health; 50 (2).1997.113-124. 1997.
Code: 8

McClanahan, S., Hunter, J., Murphy, M., and Valberg, S. Propylene glycol toxicosis in a mare. Veterinary and Human Toxicology; 40 (5).1998.294-296. 1998.
Code: 5

Mead, C. and Pentreath, V. W. Evaluation of toxicity indicators in rat primary astrocytes, C6 glioma and human 1231N1 astrocytoma cells: Can gliotoxicity be distinguished from cytotoxicity? Archives of Toxicology; 72 (6).1998.372-380. 1998.
Code: 8

Medlicott, N. J., Foster, K. A., Audus, K. L., Gupta, S., and Stella, V. J. Comparison of the effects of potential parenteral vehicles for poorly water soluble anticancer drugs (organic cosolvents and cyclodextrin solutions) on cultured endothelial cells (HUV-EC). J Pharm Sci 87(9):1138-43. 1998.
Code: 8

Meshitsuka, S., Inoue, M., Seki, A., Koeda, T., and Takeshita, K. Screening of urine by one-dimensional and pulsed-field gradient two- dimensional 1H NMR spectroscopy: intoxication by propylene glycol in an infant patient. Clin Chim Acta 279(1-2):47-54. 1999.
Code: 8

Mirochnick, M., Clarke, D. F., McNamara, E. R., and Cabral, H. Bioequivalence of a propylene glycol-based liquid dapsone preparation and dapsone tablets. Am J Health Syst Pharm 57(19):1775-7. 2000.
Code: 8

Mitchell, H. L. Toxicity of Tolyltriazole to Gram-Positive Coccus Microorganisms. /u0019 . 2000.
Code: 8

Miyoshi, S., Pate, J. L., and Palmquist, D. L. Effects of propylene glycol drenching on energy balance, plasma glucose, plasma insulin, ovarian function and conception in dairy cows. Anim Reprod Sci 68(1-2):29-43. 2001.
Code: 5

Mochimaru, M. and Sakurai, H. Effects of organic solvents and tentoxin on enzyme-bound ATP synthesis in isolated chloroplast coupling factor 1. Photosynthesis Research; 57 (3).1998.305-315. 1998.
Code: 8

Mori, T., Sakimoto, M., Kagi, T., and Sakai, T. Secondary alcohol dehydrogenase from a vinyl alcohol oligomer-degrading Geotrichum fermentans; stabilization with Triton X-100 and activity toward polymers with polymerization degrees less than 20. 1998.
Code: 8

Morshed, K. M., Jain, S. K., and McMartin, K. E. Propylene glycol-mediated cell injury in a primary culture of human proximal tubule cells. Toxicol Sci 46(2):410-7. 1998.
Code: 5

Moser, K., Kriwet, K., Froehlich, C., Kalia, Y. N., and Guy, R. H. Supersaturation: enhancement of skin penetration and permeation of a lipophilic drug. Pharm Res 18(7):1006-11. 2001.
Code: 8

Mukaida, T., Wada, S., Takahashi, K., Pedro, P. B., An, T. Z., and Kasai, M. Vitrification of human embryos based on the assessment of suitable conditions for 8-cell mouse embryos. Hum Reprod 13(1O):2874-9. 1998.
Code: 8

Mura, P., Faucci, M. T., Bramanti, G., and Corti, P. Evaluation of transcutol as a clonazepam transdermal permeation enhancer from hydrophilic gel formulations. Eur J Pharm Sci 9(4):365-72. 2000.
Code: 8

Murakami, T., Yoshioka, M., Yumoto, R., Higashi, Y., Shigeki, S., Ikuta, Y., and Yata, N. Topical delivery of keloid therapeutic drug, tranilast, by combined use of oleic acid and propylene glycol as a penetration enhancer: evaluation by skin microdialysis in rats. J Pharm Pharmacol 50(1):49-54. 1998.
Code: 8

Mushrush, G. W., Basak, S. C., Slone, J. E., Beal, E. J., Basu, S., Stalick, W. M., and Hardy, D. R. Computational Study of the Environmental Fate of Selected Aircraft Fuel System Deicing Compounds. Journal of Environmental Science and Health.Part A: Environmental Science and Engineering and Toxic and Hazardous Substance Control, Vol.A32, No.8, pages 2201-2211, 17 references, 1997 . 1997.
Code: 8

Neurath, G., Franke, S., Francke, W., and Marquardt, H. Mutagenicity of Trichlorinated Dipropylether Isomers. 39th Spring Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology, Mainz, Germany, March 17-19, 1998.Naunyn-Schmiedeberg's Archives of Pharmacology; 357 (4 Suppl.).1998.R142. 1998.
Code: 8

Newton, H., Fisher, J., Arnold, J. R., Pegg, D. E., Faddy, M. J., and Gosden, R. G. Permeation of human ovarian tissue with cryoprotective agents in preparation for cryopreservation. Hum Reprod 13(2):376-80. 1998.
Code: 8

Niazy, E. M. Differences in penetration enhancing effect of Azone through excised rabbit, rat, hairless mouse, guinea pig and human skins. Int.J.Pharm.; VOL 130 ISS Mar 22 1996, P225-230, (REF 24) . 1996.
Code: 8

Noddegaard, F. and Kennaway, D. J. A method of achieving physiological plasma levels of melatonin in the chicken by oral administration. J Pineal Res 27(3):129-38. 1999.
Code: 8

Nordic steering group for assessment of health effects of, chemicals. Health effects of selected chemicals 4-5. 2,2ï-Oxydiethanol (Diethylene glycol). TA:Nord PG:317-41 YR:1999 IP: VI:15 . 1999.
Code: 8

Ogier de Baulny, B., Labbe, C., and Maisse, G. Membrane integrity, mitochondrial activity, ATP content, and motility of the European catfish (Silurus glanis) testicular spermatozoa after freezing with different cryoprotectants. Cryobiology 39(2):177-84. 1999.
Code: 8

Ogiso, T., Niinaka, N., and Iwaki, M. Mechanism for enhancement effect of lipid disperse system on percutaneous absorption. J Pharm Sci 85(1):57-64. 1996.
Code: 8

Oh, S. Y., Jeong, S. Y., Park, T. G., and Lee, J. H. Enhanced transdermal delivery of AZT (Zidovudine) using iontophoresis and penetration enhancer. J Control Release 51(2-3):161-8. 1998.
Code: 8

Oude Elferink, S. J., Krooneman, J., Gottschal, J. C., Spoelstra, S. F., Faber, F., and Driehuis, F. Anaerobic conversion of lactic acid to acetic acid and 1, 2-propanediol by Lactobacillus buchneri. Appl Environ Microbiol 67(1):125-32. 2001.
Code: 8

Palmer, R., Godwin, D., and McKinney, P. Transdermal Kinetics of a Mercurous Chloride Beauty Cream an in Vitro Human Skin Analysis. Annual Meeting of the North American Congress of Clinical Toxicology, Orlando, Florida, USA, September 9-15, 1998.Journal of Toxicology Clinical Toxicology; 36 (5).1998.528-529. 1998.
Code: 8

Panchagnula, R., Salve, P. S., Thomas, N. S., Jain, A. K., and Ramarao, P. Transdermal delivery of naloxone: effect of water, propylene glycol, ethanol and their binary combinations on permeation through rat skin. Int J Pharm 219(1-2):95-105. 2001.
Code: 8

Parker, M. G., Fraser, G. L., Watson, D. M., and Riker, R. R. Removal of propylene glycol and correction of increased osmolar gap by hemodialysis in a patient on high dose lorazepam infusion therapy. Intensive Care Med 28(1):81-4. 2002.
Code: 8

Patro, N., Mishra, S. K., Chattopadhyay, M., and Patro, I. K. Neurotoxicological effects of deltamethrin on the postnatal development of cerebellum of rat. Journal of Biosciences (Bangalore); 22 (2).1997.117-130. 1997.
Code: 8

Peleg, O., Bar-Oz, B., and Arad, I. Coma in a premature infant associated with the transdermal absorption of propylene glycol. 1998.
Code: 5

Pendergrass, S. M. Determination of glycols in air: Development of sampling and analytical methodology and application to theatrical smokes. American Industrial Hygiene Association Journal July-Aug.1999, Vol.60, No.4, p.452-457.Illus.23 ref. 1999.
Code: 8

Peng, L. and Nimni, M. E. Delivery of erythromycin to subcutaneous tissues in rats by means of a trans-phase delivery system. J Pharm Pharmacol 51(10):1135-41. 1999.
Code: 8

Perkins, M. A., Osborne, R., and Johnson, G. R. Development of an in vitro method for corrosion testing. Fundamental and Applied Toxicology; 31 (1).1996.9-18. 1996.
Code: 8

Perkins, M. A., Osborne, R., Rana, F. R., Ghassemi, A., and Robinson, M. K. Comparison of in vitro and in vivo human skin responses to consumer products and ingredients with a range of irritancy potential. Toxicological Sciences; 48 (2).1999.218-229. 1999.
Code: 8

Pilgram, G. S., Engelsma-van Pelt, A. M., Koerten, H. K., and Bouwstra, J. A. The effect of two azones on the lateral lipid organization of human stratum corneum and its permeability. Pharm Res 17(7):796-802. 2000.
Code: 5

Pillard, D. A. and Dufresne, D. L. Toxicity of formulated glycol deicers and ethylene and propylene glycol to Lactuca sativa, Lolium perenne, Selenastrum capricornutum, and Lemna minor. Archives of Environmental Contamination and Toxicology; 37 (1).1999.29-35. 1999.
Code: 8

Pistoor, F. Hm, Rambukkana, A., Kroezen, M., Lepoittevin, J. P., Bos, J. D., Kapsenberg, M. L., and Das, P. K. Novel predictive assay for contact allergens using human skin explant cultures. American Journal of Pathology; 149 (1).1996.337-343. 1996.
Code: 8

Poppe, L. and Retey, J. Kinetic investigations with inhibitors that mimic the posthomolysis intermediate in the reactions of coenzyme-B12-dependent glycerol dehydratase and diol dehydratase. Eur J Biochem 245(2):398-401. 1997.
Code: 8

Price-Carter, M., Tingey, J., Bobik, T. A., and Roth, J. R. The alternative electron acceptor tetrathionate supports B12-dependent anaerobic growth of Salmonella enterica serovar typhimurium on ethanolamine or 1,2-propanediol. J Bacteriol 183(8):2463-75. 2001.
Code: 8

Proniuk, S., Dixon, S. E., and Blanchard, J. Investigation of the utility of an in vitro release test for optimizing semisolid dosage forms. Pharm Dev Technol 6(3):469-76. 2001.
Code: 8

Qatibi, A. I., Bennisse, R., Jana, M., and Garcia, J. L. Anaerobic degradation of glycerol by Desulfovibrio fructosovorans and D. carbinolicus and evidence for glycerol-dependent utilization of 1,2-propanediol. Current Microbiology; 36 (5).1998.283-290. 1998.
Code: 8

Qian, W., Amin, R. H., and Shichi, H. Cytotoxic metabolite of acetaminophen, N-acetyl-p-benzoquinone imine, produces cataract in DBA2 mice. J Ocul Pharmacol Ther 15(6):537-45. 1999.
Code: 8

Rayburn, W., Christensen, D., and Gonzalez, C. Neurobehavior effects in four strains of mice offspring exposed prenatally to alprazolam (XanaxÑ). Am J Obstet Gynecol 2001 Dec;185(6 Pt 2):S184 . 2001.
Code: 8

Reddy, I. K., Khan, M. A., Wu, W. M., and Bodor, N. S. Permeability of a soft steroid, loteprednol etabonate, through an excised rabbit cornea. J Ocul Pharmacol Ther 12(2):159-67. 1996.
Code: 8

Rice, P. J., Anderson, T. A., and Coats, J. R. The Use of Vegetation to Enhance Biodegradation and Reduce Offsite Movement of Aircraft Deicers. 212th American Chemical Society National Meeting, Orlando, Florida, USA, August 25-29, 1996.Abstracts of Papers American Chemical Society; 212 (1-2).1996.Agro 54. 1996.
Code: 8

Rice, P. J. and Coats, J. R. The Use of Plants for Reducing the Environmental Impact of De-Icing Agents Au - Anderson Ta. 212th American Chemical Society National Meeting, Orlando, Florida, USA, August 25-29, 1996.Abstracts of Papers American Chemical Society; 212 (1-2).1996.Agro 97. 1996.
Code: 8

Rondon, M. R. and Escalante-Semerena, J. C. High levels of transcription factor RpoS (sigma S) in mviA mutants negatively affect 1,2-propanediol-dependent transcription of the cob/pdu regulon of Salmonella typhimurium LT2. FEMS Microbiol Lett 169(1):147-53. 1998.
Code: 8

Rosenkranz, M., Rosenkranz, H. S., and Klopman, G. Intercellular communication, tumor promotion and non-genotoxic carcinogenesis: relationships based upon structural considerations. Mutat Res 1997 Nov 28;381(2):171-88 . 1997.
Code: 8

Saini, M., Dash, S., and Nagpaul, J. P. Hematological Alterations in Propylene Glycol-Dosed Female Rats Are Minimal. Veterinary and Human Toxicology, Vol.38, No.2, pages 81-85, 27 references, 1996 . 1996.
Code: 5

Schenker, M. B. Reproductive health effects of glycol ether exposure in the semiconductor industry. Occup Hyg 1996;2(1-6):367-72 . 1996.
Code: 8

Schneider, I. M., Dobner, B., Neubert, R., and Wohlrab, W. Evaluation of drug penetration into human skin ex vivo using branched fatty acids and propylene glycol. Int.J.Pharm.; VOL 145 ISS Dec 6 1996, P187-196, (REF 32) . 1996.
Code: 8

Schoenberg, T., Veltman, S., and Switzenbaum, M. Kinetics of anaerobic degradation of glycol-based type I aircraft deicing fluids. Biodegradation 12(1):59-68. 2001.
Code: 8

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Code: 8

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E Cig Electronic Cigarette

E-Cigarette Forum 051817


Disassembled parts of a first generation e-cigarette. A. LED light cover B. battery (also houses circuitry) C. atomizer (heating element) D. cartridge (mouthpiece) Parts of a second generation e-cigarette. An electronic cigarette is a battery-powered vaporizer.[1] The primary parts that make up an e-cigarette are a mouthpiece, a cartridge (tank), a heating element/atomizer, a microprocessor, a battery, and possibly a LED light on the end.[2] An atomizer comprises a small heating element that vaporizes e-liquid and wicking material that draws liquid onto the coil.[3] When the user pushes a button,[4] or (in some variations) activates a pressure sensor by inhaling, the heating element then atomizes the liquid solution[5] The e-liquid reaches a temperature of roughly 100-250 °C within a chamber to create an aerosolized vapor.[6] The user inhales the aerosol, commonly called vapor, rather than cigarette smoke.[7] The aerosol provides a flavor and feel similar to tobacco smoking.[1] There are three main types of e-cigarettes: cigalikes, looking like cigarettes; eGos, bigger than cigalikes with refillable liquid tanks; and mods, assembled from basic parts or by altering existing products.[8] As the e-cigarette industry continues to evolve, new products are quickly developed and brought to market.[9] First generation e-cigarettes tend to look like tobacco cigarettes and so are called "cigalikes".[10] Most cigalikes look like cigarettes but there is some variation in size.[11] Second generation devices are larger overall and look less like tobacco cigarettes.[12] Third generation devices include mechanical mods and variable voltage devices.[10] The fourth generation includes Sub ohm tanks and temperature control devices.[13] The power source is the biggest component of an e-cigarette,[14] which is frequently a rechargeable lithium-ion battery.[15] A later-generation box mod e-cigarette. Image courtesy of Ecigclick An e-cigarette is a handheld battery-powered vaporizer that simulates smoking, but without tobacco combustion.[1] Once the user inhales, the airflow activates the pressure sensor, and then the heating element atomizes the liquid solution.[5] Most devices have a manual push-button switch to turn them on or off.[16] E-cigarettes do not turn on by trying to "light" the device with a flame.[4] The e-liquid reaches a temperature of roughly 100-250 °C within a chamber to create an aerosolized vapor.[6] However, variable voltage devices can raise the temperature.[17] A glycerin-only liquid vaporizes at a higher temperature than a propylene glycol-glycerin liquid.[17] Rather than cigarette smoke, the user inhales an aerosol, commonly but inaccurately called vapor.[7] E-cigarettes do not create vapor between puffs.[18] Vaping is different than tobacco smoking, but there are some similarities with their behavioral habits, including the hand-to-mouth action and a vapor that looks like cigarette smoke.[1] E-cigarettes provide a flavor and feel similar to smoking.[1] A noticeable difference between the traditional cigarette and the e-cigarette is sense of touch.[1] A traditional cigarette is smooth and light but an e-cigarette is rigid, cold and slightly heavier.[1] Since e-cigarettes are more complex than traditional cigarettes, a learning curve is needed to use them correctly.[19] Compared to traditional cigarettes, the general e-cigarette puff time is much longer, and requires a more forceful suction than a regular cigarette.[20] The volume of vapor created by e-cigarette devices in 2012 declined with vaping.[1] Thus, to create the same volume of vapor increasing puff force is needed.[1] Later-generation e-cigarettes with concentrated nicotine liquids may deliver nicotine at levels similar to traditional cigarettes.[21] Many e-cigarette versions include a voltage potentiometer to adjust the volume of vapor created.[4] The amount of vapor produced is controlled by the power from the battery, which has led some users to adjust their devices to increase battery power.[6] An ordinary cigarette compared to a "cigalike" e-cigarette E-cigarettes are usually approximately cylindrical, with many variations: pen-styles, tank-styles etc.[22] Some e-cigarettes look like traditional cigarettes, but others do not.[19] There are three main types of e-cigarettes: cigalikes, looking like cigarettes; eGos, bigger than cigalikes with refillable liquid tanks; and mods, assembled from basic parts or by altering existing products.[8] The primary parts that make up an e-cigarette are a mouthpiece, a cartridge (tank), a heating element/atomizer, a microprocessor, a battery, and possibly a LED light on the end.[2] The only exception to this are mechanical e-cigarettes (mods) which contain no electronics and the circuit is closed by using a mechanical action switch.[23] E-cigarettes are sold in disposable or reusable variants.[8] Disposable e-cigarettes are discarded once the liquid in the cartridge is used up, while rechargeable e-cigarettes may be used indefinitely.[24] A disposable e-cigarette lasts to around 400 puffs.[25] Reusable e-cigarettes are refilled by hand or exchanged for pre-filled cartridges, and general cleaning is required.[4] A wide range of disposable and reusable e-cigarettes exist.[26] Disposable e-cigarettes are offered for a few dollars, and higher-priced reusable e-cigarettes involve an up-front investment for a starter kit.[19] Some e-cigarettes have a LED at the tip to resemble the glow of burning tobacco.[21] The LED may also indicate the battery status.[1] The LED is not generally used in personal vaporizers or mods.[2] First-generation e-cigarettes usually simulated smoking implements, such as cigarettes or cigars, in their use and appearance.[10] Later-generation e-cigarettes often called mods, PVs (personal vaporizer) or APVs (advanced personal vaporizer) have an increased nicotine-dispersal performance,[10] house higher capacity batteries, and come in various shapes such as metal tubes and boxes.[27] They contain silver, steel, metals, ceramics, plastics, fibers, aluminum, rubber and spume, and lithium batteries.[28] A growing subclass of vapers called cloud-chasers configure their atomizers to produce large amounts of vapor by using low-resistance heating coils.[29] This practice is known as cloud-chasing.[30] Many e-cigarettes are made of standardized replaceable parts that are interchangeable between brands.[31] A wide array of component combinations exists.[32] Many e-cigarettes are sold with a USB charger.[33] E-cigarettes that resemble pens or USB memory sticks are also sold for those who may want to use the device unobtrusively.[34] As the e-cigarette industry continues to evolve, new products are quickly developed and brought to market.[9] Various types of e-cigarettes. First-generation e-cigarettes tend to look like tobacco cigarettes and so are called "cigalikes".[10] The three parts of a cigalike e-cigarette initially were a cartridge, an atomizer, and a battery.[35] A cigalike e-cigarette currently contains a cartomizer (cartridge atomizer), which is connected to a battery.[35] Most cigalikes look like cigarettes but there is some variation in size.[35] They may be a single unit comprising a battery, coil and filling saturated with e-juice in a single tube to be used and discarded after the battery or e-liquid is depleted.[10] They may also be a reusable device with a battery and cartridge called a cartomizer.[12] The cartomizer cartridge can be separated from the battery so the battery can be charged and the empty cartomizer replaced when the e-juice runs out.[10] The battery section may contain an electronic airflow sensor triggered by drawing breath through the device.[12] Other models use a power button that must be held during operation.[12] An LED in the power button or on the end of the device may also show when the device is vaporizing.[36] Charging is commonly accomplished with a USB charger that attaches to the battery.[37] Some manufacturers also have a cigarette pack-shaped portable charging case (PCC), which contains a larger battery capable of recharging the individual e-cigarette batteries.[38] Reusable devices can come in a kit that contains a battery, a charger, and at least one cartridge.[38] Varying nicotine concentrations are available and nicotine delivery to the user also varies based on different cartomizers, e-juice mixtures, and power supplied by the battery.[22] These manufacturing differences affect the way e-cigarettes convert the liquid solution to an aerosol, and thus the levels of ingredients, that are delivered to the user and the surrounding air for any given liquid.[22] First-generation e-cigarettes use lower voltages, around 3.7 V.[39] Second-generation PV. Second generation devices tend to be used by people with more experience.[12] They are larger overall and look less like tobacco cigarettes.[12] They usually consist of two sections, basically a tank and a separate battery. Their batteries have higher capacity, and are not removable.[10] Being rechargeable, they use a USB charger that attaches to the battery with a threaded connector. Some batteries have a "passthrough" feature so they can be used even while they are charging.[40][41] Second-generation e-cigarettes commonly use a tank or a "clearomizer".[12] Clearomizer tanks are meant to be refilled with e-juice, while cartomizers are not.[10] Because they're refillable and the battery is rechargeable, their cost of operation is lower.[10] Hovever, they can also use cartomizers, which are pre-filled only.[10] Some cheaper battery sections use a microphone that detects the turbulence of the air passing through to activate the device when the user inhales.[42] Other batteries like the eGo style can use an integrated circuit, as well as a button for manual activation. The LED shows battery status.[42] The power button can also switch off the battery so it is not activated accidentally.[43] Second generation e-cigarettes may have lower voltages, around 3.7 V.[39] However, adjustable-voltage devices can be set between 3 V and 6 V.[44] Third-generation PV. The third-generation includes mechanical mods and variable voltage devices.[45][46] Battery sections are commonly called "mods," referencing their past when user modification was common.[10] Mechanical mods do not contain integrated circuits.[46] They are commonly cylindrical or box-shaped, and typical housing materials are wood, aluminium, stainless steel, or brass.[47] A larger "box mod" can hold bigger and sometimes multiple batteries.[47] Mechanical mods and variable devices use larger batteries than those found in previous generations.[48] Common battery sizes used are 18350, 18490, 18500 and 18650.[49] The battery is often removable,[46] so it can be changed when depleted. The battery must be removed and charged externally.[46] Variable devices permit setting wattage, voltage, or both.[40][46] These often have a USB connector for recharging; some can be used while charging, called a "passthrough" feature.[40][50] Mechanical mods do not contain integrated circuits.[46] The power section may include additional options such as screen readout, support for a wide range of internal batteries, and compatibility with different types of atomizers.[12] Third-generation devices can have rebuildable atomizers with different wicking materials.[10][12] These rebuildables use handmade coils that can be installed in the atomizer to increase vapor production.[48] Hardware in this generation is sometimes modified to increase power or flavor.[51] The larger battery sections used also allow larger tanks to be attached that can hold more e-liquid.[47] Recent devices can go up to 8 V, which can heat the e-liquid significantly more than earlier generations.[39] A fourth-generation e-cigarette became available in the U.S. in 2014.[21] Fourth-generation e-cigarettes can be made from stainless steel and pyrex glass, and contain very little plastics.[13] Included in the fourth-generation are Sub ohm tanks and temperature control devices.[13] An e-cigarette atomizer with the coil (heating element) in view. An atomizer comprises a small heating element that vaporizes e-liquid and a wicking material that draws liquid onto the coil.[3] Along with a battery and e-liquid the atomizer is the main component of every personal vaporizer.[12] A small length of resistance wire is coiled around the wicking material and connected to the integrated circuit, or in the case of mechanical devices, the atomizer is connected directly to the battery through either a 510, 808, or ego threaded connector.[52] 510 being the most common.[52] When activated, the resistance wire coil heats up and vaporizes the liquid, which is then inhaled by the user.[53] The electrical resistance of the coil, the voltage output of the device, the airflow of the atomizer and the efficiency of the wick all affect the vapor coming from the atomizer.[54] They also affect the vapor quantity or volume yielded.[54] Atomizer coils made of kanthal usually have resistances that vary from 0.4Ω (ohms) to 2.8Ω.[54] Coils of lower ohms have increased vapor production but could risk fire and dangerous battery failures if the user is not knowledgeable enough about electrical principles and how they relate to battery safety.[55] Wicking materials vary from one atomizer to another.[56] "Rebuildable" or "do it yourself" atomizers can use silica, cotton, rayon, porous ceramic, hemp, bamboo yarn, oxidized stainless steel mesh and even wire rope cables as wicking materials.[56] A 45mm length, extra-long cartomizer. The cartomizer was invented in 2007, integrating the heating coil into the liquid chamber.[57] A "cartomizer" (a portmanteau of cartridge and atomizer.[58]) or "carto" consists of an atomizer surrounded by a liquid-soaked poly-foam that acts as an e-liquid holder.[3] They can have up to 3 coils and each coil will increase vapor production.[3] The cartomizer is usually discarded when the e-liquid starts to taste burnt, which usually happens when the e-cigarette is activated with a dry coil or when the cartomizer gets consistently flooded (gurgling) because of sedimentation of the wick.[3] Most cartomizers are refillable even if not advertised as such.[3][59] Cartomizers can be used on their own or in conjunction with a tank that allows more e-liquid capacity.[3] The portmanteau word "cartotank" has been coined for this.[60] When used in a tank, the cartomizer is inserted in a plastic, glass or metal tube and holes or slots have to be punched on the sides of the cartomizer so liquid can reach the coil.[3] eGo style e-cigarette with a top-coil clearomizer. Silica fibers are hanging down freely inside of the tank, drawing e-liquid by capillary action to the coil that is located directly under the mouthpiece. The clearomizer was invented in 2009 that originated from the cartomizer design.[57] It contained the wicking material, an e-liquid chamber, and an atomizer coil within a single clear component.[57] This allows the user to monitor the liquid level in the device.[57] Clearomizers or "clearos", are like cartotanks, in that an atomizer is inserted into the tank.[61] There are different wicking systems used inside clearomizers.[3] Some rely on gravity to bring the e-liquid to the wick and coil assembly (bottom coil clearomizers for example) and others rely on capillary action or to some degree the user agitating the e-liquid while handling the clearomizer (top coil clearomizers).[3][62] The coil and wicks are typically inside a prefabricated assembly or "head" that is replaceable by the user.[63] Clearomizers are made with adjustable air flow control.[64] Tanks can be plastic or borosilicate glass.[65] Some flavors of e-juice have been known to damage plastic clearomizer tanks.[65] Box mod e-cigarette fitted with a rebuildable dripping atomizer (RDA). A view of the RDA deck showing the wicks and coils, juice is dripped into a hopper where the wicks rest as well as atop the coil assembly. A rebuildable atomizer or an RBA is an atomizer that allows the user to assemble or "build" the wick and coil themselves instead of replacing them with off-the-shelf atomizer "heads".[10] They are generally considered advanced devices.[66] They also allow the user to build atomizers at any desired electrical resistance.[10] These atomizers are divided into two main categories; rebuildable tank atomizers (RTAs) and rebuildable dripping atomizers (RDAs).[67] Rebuildable tank atomizers (RTAs) have a tank to hold liquid that is absorbed by the wick.[68] They can hold up to 4ml of e-liquid.[69] The tank can be either plastic, glass, or metal.[65] One form of tank atomizers was the Genesis style atomizers.[68] They can use ceramic wicks, stainless steel mesh or rope for wicking material.[68] The steel wick must be oxidized to prevent arcing of the coil.[68] Another type is the Sub ohm tank.[69] These tanks have rebuildabe or RBA kits.[69] They can also use coilheads of 0.2ohm 0.4hom and 0.5ohm.[69] These coilheads can have stainless steel coils.[70] Rebuildable dripping atomizers (RDAs) are atomizers where the e-juice is dripped directly onto the coil and wick.[71] The common nicotine strength of e-liquids used in RDA's is 3 mg and 6 mg.[71] Liquids used in RDA's tend to have more vegetable glycerin.[71] They typically consist only of an atomizer "building deck", commonly with three posts with holes drilled in them, which can accept one or more coils.[51] The user needs to manually keep the atomizer wet by dripping liquid on the bare wick and coil assembly, hence their name.[71] Kanthal wire is commonly used in both RDA's and RTA's.[71] They can also use nickel wire or titanium wire for temperature control.[71] Variable devices are variable wattage, variable voltage or both.[40][46] Variable power and/or variable voltage have a electronic chip allowing the user to adjust the power applied to the heating element.[12][46] The amount of power applied to the coil affects the heat produced, thus changing the vapor output.[12][32] Greater heat from the coil increases vapor production.[32] Variable power devices monitor the coil's resistance and automatically adjust the voltage to apply the user-specified level of power to the coil.[72] Recent devices can go up to 8 V.[39] They are often rectangular but can also be cylindrical.[47] They usually have a screen to show information such as voltage, power, and resistance of the coil.[73] To adjust the settings, the user presses buttons or rotates a dial to turn the power up or down.[32] Some of these devices include additional settings through their menu system such as: atomizer resistance meter, remaining battery voltage, puff counter, and power-off or lock.[74] The power source is the biggest component of an e-cigarette,[14] which is frequently a rechargeable lithium-ion battery.[4] Smaller devices contain smaller batteries and are easier to carry but typically require more repeated recharging.[4] Some e-cigarettes use a long lasting rechargeable battery, a non-rechargeable battery or a replaceable battery that is either rechargeable or non-rechargeable for power.[26] Some companies offer portable chargeable cases to recharge e-cigarettes.[26] Nickel-cadmium (NiCad), nickel metal-hydride (NiMh), lithium ion (Li-ion), alkaline and lithium polymer (Li-poly), and lithium manganese (LiMn) batteries have been used for the e-cigarettes power source.[26] PV with variable and regulated power offering battery protection. Temperature control devices allow the user to set the temperature.[71] There is a predictable change to the resistance of a coil when it is heated.[75] The resistance changes are different for different types of wires, and must have a high temperature coefficient of resistance.[75] Temperature control is done by detecting that resistance change to estimate the temperature and adjusting the voltage to the coil to match that estimate.[76] Nickel, titanium, NiFe alloys, and certain grades of stainless steel are common materials used for wire in temperature control.[71] The most common wire used, kanthal, cannot be used because it has a stable resistance regardless of the coil temperature.[75] Nickel was the first wire used because of it has the highest coefficient of the common metals.[75] Mechanical PV with a rebuildable atomizer. The temperature can be adjusted in Celsius or Fahrenheit.[77] The DNA40 and SX350J are common control boards used in temperature control devices.[78] Temperature control can stop dry wicks from burning, or e-liquid overheating.[78] Mechanical PVs or mechanical "mods", often called "mechs", are devices without integrated circuits, electronic battery protection, or voltage regulation.[46] They are activated by a switch.[71] They rely on the natural voltage output of the battery and the metal that the mod is made of often is used as part of the circuit itself.[79] The term "mod" was originally used instead of "modification".[10] Users would modify existing hardware to get better performance, and as an alternative to the e-cigarettes that looked like traditional cigarettes.[32] Users would also modify other unrelated items like flashlights as battery compartments to power atomizers.[32][47] The word mod is often used to describe most personal vaporizers.[3] Mechanical PVs have no power regulation and are unprotected.[71] Because of this ensuring that the battery does not over-discharge and that the resistance of the atomizer requires amperage within the safety limits of the battery is the responsibility of the user.[79]


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