E-Cigarettes R Us Australia

Although the e-cigarette as most people know it has been around for about a decade, its origins go back to the early twentieth century and are intertwined with the modern history of tobacco use.

The Ill Effects of Smoking
Whilst the smoking of tobacco has been around since prehistoric times, the use of cigarettes became widespread during the First World War when many armies issued their soldiers with tobacco rations, creating tobacco addicts in the process who continued their unhealthy habit in the postwar years. The 1920s also saw a wave of feminism in many western countries, and many women took up smoking as a symbol of their freedom and political equality with men. The negative health consequences of tobacco smoking were as yet unknown. During the 1930s, however, German scientists noted the relationship between tobacco smoking and lung cancer and researched the link, publishing one of the earliest and most important articles on the subject in 1940 titled “Krebserzeugende Tabakwirkung”, which translates to “Carcinogenic Effects of Tobacco”. At the time, Nazi Germany had instituted a rigourous anti-tobacco campaign in an effort to improve the general health of the German people. More scientific research emerged after the war including the classic article “Smoking and Carcinoma of the Lung” which was published in the British Medical Journal in 1950.

The Invention of the Smokeless Non-Tobacco Cigarette
The relationship between tobacco smoke and numerous cancers, especially lung cancer, led to the development of a smokeless electronic cigarette which would not have any of the carcinogenic and toxic chemicals that are found in regular cigarettes. The first e-cigarette appeared in 1963 and was developed and patented by Herbert A. Gilbert. The new device was a battery-operated metal tube that contained a harmless liquid that was heated, producing a vapour that the user inhaled. Despite the enormous potential, the invention was never mass produced or marketed, and thus ended the first incarnation of the electronic cigarette.

The Invention of the Modern E-Cigarette
The e-cigarette that most people use and are familiar with is the brainchild of a Chinese pharmacist named Hon Lik, who came up with the concept of using a piezoelectric ultrasound emitting element to vapourise a liquid containing a propylene glycol and nicotine solution. The vapour was to be inhaled and exhaled in exactly the same way as a normal cigarette. Lik was inspired to develop the electronic cigarette after his father – a heavy smoker – developed lung cancer and eventually succumbed to the disease. In May 2004, the e-cigarette was introduced to the Chinese market by Golden Dragon Holdings, the company for which Lik worked. The device proved very popular in China and began to be exported to other Asian countries during 2005. It was introduced into the European and North American markets in 2006. The e-cigarette has proved to be a hit worldwide with smokers who want a product that helps them quit smoking.

Nicotine is the addictive substance in tobacco that makes smoking so pleasurable as well as so hard to quit. Many quit smoking products such as inhalers, gums, lozenges and e-cigarettes contain nicotine. Nicotine by itself is not dangerous; it is the multitude of other chemicals in tobacco smoke that cause the diseases which make smoking such a deadly habit.

In 1996, a group of researchers led by H L Waldum published the results of their experiment into the effects of inhaling nicotine vapour over an extended period of time on rats (Waldum H L, Nilsen O G, Nilsen T, Rorvik H, Syversen V, Sanvik A K, Haugen O A, Torp S H & Brenna E (1996) Long-term effects of inhaled nicotine, Life Sciences, Volume 58, Issue 16, 1339-1346). The laboratory rats were put in a chamber into which nicotine vapour was pumped for 20 hours per day, five days a week for two years. The experiment concluded that there was no increase in the death rate, and there was no increase in the likelihood of developing tumours. The researchers concluded that “our study does not indicate any harmful effect of nicotine when given in its pure form by inhalation.” Interestingly, the rats lost weight as well.

The appetite suppressing effects of nicotine have been studied in an effort to produce new medicines that can help people lose weight. In fact, people have known for centuries that nicotine is an appetite suppressant. The famous Italian explorer Christopher Columbus was initially angry upon learning that the sailors on his ships had picked up the habit of smoking tobacco from the inhabitants of the New World. He changed his mind, however, when he discovered that smoking suppressed their hunger. The sixteenth century Spanish physician Nicolas Monardes wrote in his History of Medicinal Plants in the New World in 1571 that tobacco had the ability to alleviate hunger and thirst. Monardes had a rather naive view of tobacco, writing that “To seek to tell the virtues and greatness of this holy herb, the ailments which can be cured of it, the evils from which it has saved thousands would be to go on to infinity … this precious herb is so general a need not only for the sick but for the healthy”. Throughout the twentieth century, tobacco companies marketed cigarettes as a product that could help men and women maintain a slim body. Kensitas cigarettes were marketed in the 1920s as an appetite suppressant and people were advised to substitute them for snacks in between meals. A famous marketing campaign by Slim cigarettes during the 1980s warned women that if they put on weight, they would lose their male partners to skinnier women who smoked Slim cigarettes.

In March it was reported in The Sydney Morning Herald that a trial into the efficacy of electronic cigarettes as a quit smoking tool will be conducted by researchers at the University of Queensland later in the year. The research will be funded by a Commonwealth government grant and it is hoped that 1600 participants can be recruited. The head of the research is Dr Carol Gartner, a research fellow at the Centre for Clinical Research at the University of Queensland. In response to questions as to whether she thought that e-cigarettes should be banned, Dr Gartner replied that rather then being banned, they should be regulated, since there are differences in the quality of the various devices on the market. Regarding the potential of electronic cigarettes to help people quit smoking, she said that “If a large enough proportion of the smoking population find them to be an acceptable substitute, it might be possible to encourage smokers to move to e-cigarettes with the longer-term aim of phasing out conventional cigarettes, which are the most harmful nicotine product and kill half of all long-term users” (Asher Moses, “Experts wary of e-cigarettes as test run looms”, The Sydney Morning Herald, 4 March 2013).

We recently received an email from Doug Fraser, who is a research assistant at the University of Queensland Centre for Clinical Research, asking us for help to recruit volunteers for the upcoming study. The email reads:

“The University of Queensland and the Australian National University are currently planning to conduct research looking at the experiences and opinions of people who have used electronic cigarettes. At the moment we are gathering interest from people who would be willing to participate in an online survey later in the year. Researchers at the University of Queensland and Australian National University would like to conduct research with people who use electronic cigarettes or other novel nicotine delivery systems to better understand their experiences with these products. If you have used an electronic cigarette or similar product and are interested in participating in research on this topic, please follow the URL link to a confidential online form to register your interest by providing your contact details (e.g. email address). When a research study on this topic is ready to start, the researchers will then send you an invitation with more details about the study so that you can decide if you would like to participate in the study. Your contact details will not be shared with anyone else and will not be used for any purpose other than to send you invitations to participate in research on this topic.”

We are very happy to hear that research will be conducted into e-cigarettes here in Australia by researchers at such a prestigious institution as the University of Queensland. We strongly urge all of you to sign up to participate in the study, which can be done clicking on the following link:

http://hs-web01.health.uq.edu.au/survey/index.php?sid=34348&lang=en

If you have any questions about the research, you can contact Doug Fraser at d.fraser2@uq.edu.au

The Medicines and Healthcare products Regulatory Agency (MHRA), the government agency responsible for regulating all medicines and medical devices in the United Kingdom to ensure that they work and are acceptably safe, has announced that it will regulate e-cigarettes as medicines from 2016 onwards. This means that electronic cigarettes will have to undergo stringent checks by the medicine regulator before they can be sold on the British market. It also means that physicians will be able to prescribe them to smokers as a quit smoking tool. The new regulations will extend to all nicotine-containing products.

Cigarette smoking is the biggest cause of preventable death in the United Kingdom, killing an estimated 80,000 people annually. Needless to say, this is a major health problem, and reducing the number of smokers is a national health priority.

Jeremy Means from the MHRA said in a press release dated 12 June 2013: “Reducing the harms of smoking to smokers and those around them is a key Government health priority. Our research has shown that existing electronic cigarettes and other nicotine containing products on the market are not good enough to meet this public health priority. Some NCPs are already licensed and the Government’s decision to work towards medicines licensing for all these products is designed to deliver quality products that will support smokers to cut down and to quit. The decision announced today provides a framework that will enable good quality products to be widely available. It’s not about banning products that some people find useful, it’s about making sure that smokers have an effective alternative that they can rely on to meet their needs.”

A number of leading British health figures endorsed the move by the MHRA, including Professor Dame Sally Davies, the United Kingdom Chief Medical Officer, Deborah Arnott, the Chief Officer of the anti-smoking charity ASH, and Dr Clare Gerada, the Chair of the General Council at the Royal College of General Practitioners.

The MHRA advises people to use nicotine-replacement products to quit smoking, and the purpose of the new regulation is to ensure that e-cigarettes meet minimum health and safety standards.

It is estimated that some 1.3 million people use electronic cigarettes in the United Kingdom.

Source: MHRA, “UK moves towards safe and effective electronic cigarettes and other nicotine-containing products”, 12 June 2013, MHRA website.

Recently, Lorillard, one of the biggest manufacturers of tobacco cigarettes in the United States, purchased an e-cigarette company called Blu Ecigs for the sum of $135 million. Blu Ecigs was founded by a young Australian entrepreneur named Jason Healy in 2008, and is based in the town of Charlotte, North Carolina. The young Australian, who hails from the town of Mareeba in north Queensland, founded the company with $50,000 that he managed to raise by convincing investors from Charlotte that he had a great business idea. Despite selling the company he founded, Healy has remained at its helm.

Healy says that he got the idea to start an electronic cigarette company when he was shown one by a Charlotte businessperson. He says: “At the time, I was spending time between Brisbane and Charlotte, North Carolina and while on a trip to Charlotte a local business owner was asking me to take a look at a new product hitting the market, e-cigs.” Healy immediately saw the potential: “Being a smoker and an avid marketer it immediately captured my mind and I was originally looking at purchasing the rights to an existing brand and marketing it in Australia.” The problem, however, was that nobody was actually branding their e-cigarettes, instead preferring the generic names used by the Chinese manufacturers: “Once I started to take a deeper look, I saw so many issues and opportunities that weren’t being addressed and basically came to the opinion that I needed to start a true brand of my own.” Thus, it is probably more accurate to say that Healy just took a good product and marketed it well, thereby making himself a millionaire in the process. He would not be the first person to have done this, and it in no way diminishes his great achievement.

There were, unsurprisingly, many hurdles that needed to be overcome. Questions existed about the safety of electronic cigarettes, which was far more of an issue in 2008 before any research had been undertaken into their safety as a quit smoking device. A number of health groups were, and indeed remain, opposed to e-cigarettes, claiming that they have not been sufficiently tested and that they might encourage children to take up the habit of smoking. These arguments hold much less weight today as more scientific evidence is accumulating that demonstrates that electronic cigarettes are safe, effective and improve the health of people by helping them quit smoking.

Source: Oliver Milman, “Sparking up a smoking hot start-up idea”, StartUpSmart, 12 October 2012.