Interesting response! :) I'm actually very happy with them since dec 2, 2012. :)
ARE E-CIGARETTES DANGEROUS?
Response from SNOKE® concerning the E-Cigarette Factsheet distributed by the Dutch National Institute for Public Health and the Environment
Bonn, 28.11.2013 - The Dutch National Institute for Public Health and the Environment (RIVM) released a statement regarding the dangers of consuming e-cigarettes. We understand the concerns of the Institute as we faced the same questions several years ago. Thus we developed the SNOKE® e-cigarette in order to offer a product which consumers can enjoy without having to worry about questionable ingredients and poor quality products. SNOKE® already meets the standards proposed by the European Commission regarding product safety and product information of e-cigarettes.
Many of the claims published in the Institute’s statement are based upon false information and wrong facts found in second and third party literature which haven’t been checked by the Institute. This alone shows that the credibility of the statement is very questionable. Many claims made in the statement are encompassed with words like “may pose harm” or “it is not clear” indicating that instead of relying on hard facts the RIVM wants to breed insecurity among consumers regarding e-cigarettes. None of the e-cigarettes available today claim to be smoking cessation devices that will help smokers quit their unhealthy habit of smoking - though studies do show that many smokers have reduced the consumption of cancerous tobacco cigarettes by switching to e-cigarettes.
Our own studies have shown that after switching to e-cigarettes the lung function improved by 30% after four weeks. Furthermore coughing was reduced and sleeping quality improved.
The false information and questionable issues stated by the RIVM are:
RIVM: Batteries, atomizers, cartridges, cartridge wrappers, packs and instruction manuals lack important information regarding e-cigarette content, use and essential warnings.
FACT: All SNOKE® products contain health warnings and a list of ingredients on the packaging. The enclosed information leaflet also contains information regarding the use if the product.
RIVM: E-cigarettes may contain toxic substances including diethylene glycol (a highly toxic substance), various nitrosamines (powerful carcinogens found in tobacco), and other chemicals suspected of being harmful to humans;
FACT: If diethylene glycol had appeared in any liquid at any point in time, the authorities would have immediately confiscated said liquid, and electric cigarettes would have been outlawed long since[1].
If all the scientific data are taken into account, the Frauenhofer-WKI study[2] claiming that e-cigarettes contain acetone, isoprene, acetaldehyde, formaldehyde, acetic acid, and methyl ethyl ketone only says one thing: a large part of the alarming substances are absolutely normal metabolites that every human being gives off[3] [4]. If anyone should really be alarmed by these data and advocate a ban on e-cigarettes, they would be well advised to consider the risks posed by "third-party breathers", as well as a "ban on passive breathers".
None of the various tests by laboratories in Germany[5] on liquids that are available in the meantime have been able to detect nitrosamines in e-cigarette liquids. The nitrosamine pollution found in the liquid samples tested by the "FDA study"[6] amounted to the equivalent of that provided in half a liter of beer[7] and/or one tomato.
RIVM: Some e-cigarette cartridges labeled as containing no nicotine have nicotine present.
FACT: SNOKE® CAPS meet the highest quality standards. We guarantee no contamination with substances that are not declared on the packaging. SNOKE® CAPS are filled under pharmaceutical supervision and SNOKE® only uses ingredients obtained from pharmacies and leading European flavor manufacturers.
RIVM: The presence of carcinogens as a result of ‘passive vaping’ in indoor air.
FACT: E-cigarettes do not give off any harmful side stream smoke, in contrast to tobacco cigarettes. But as a consumer of electrical cigarettes exhales some portions of the vaporized liquid again after inhaling it, scientific studies assume that there must be such a thing as passive "vaping"[8].
A study published in September 2012 shows that the impact of the studied passive vapor on indoor air is hardly measurable in comparison with traditional tobacco smoking. Passive vapor furthermore has none of the poisonous and carcinogenic properties of tobacco cigarettes. Researchers attribute the differences measured in the air pollution to the absence of combustion and side stream smoke with electrical cigarettes. The scientists come to the conclusion that one "can say on the basis of the ARPA data about air pollution in cities that breathing within a large city can be unhealthier than sharing a room with a person using an e-cigarette."[9] [10]
A study published in October 2012, which subjected the passive vapor to a risk analysis, found that no significant risks exist for human health. As part of their cancer risk analysis, the scientists furthermore discovered that the risk thresholds for children or adults had not been exceeded with any of the studied samples.[11]
Another study to appear in October 2012, this one carried out by the former WHO researcher and expert Andreas Flouris, looked at the effects of passive vapor on the human body. He came to the conclusion that the vapor has no effect on the blood values of bystanders. The author furthermore found that the use of electrical cigarettes by tobacco smokers also had no effect on the analyzed blood values. This is contrasted by the fact that active and passive tobacco smoke both lead to an increased number of leucocytes, lymphocytes, and granulocytes, according to the study.[12]
Nicotine is retained in the consumer's lungs to 98 % and propylene glycol to anything between 98.9 and 100 %[13] [14] [15]. According to an independent safety report by New Zealand tobacco control researcher Murray Laugesen, the vapor exhaled by e-cigarette users is not harmful to third parties because in contains hardly any nicotine and no combustion products at all. [16] [17]
RIVM: By simulating the cigarette experience, e-cigarettes might reactivate the habit in ex-smokers. They could also be a gateway into tobacco abuse for young people who are not yet hooked;
FACT: There is no doubt that Nicotine is an addictive substance. But even after 120 years of research into tobacco and nicotine, many questions are still awaiting an answer. There is no explanation, for example, why nicotine replacement preparations (NRT) are almost without effect in the treatment of tobacco addiction. The basic idea of NRT is to supply smokers with nicotine in another form during their withdrawal from tobacco in order to relieve their withdrawal symptoms by maintaining their nicotine levels (at least at the start). But as a matter of fact, this does not appear to work in the long term: The relapse rate for people who used NRT to quit smoking is just as high as that for people who stopped smoking "just like this", without aids.[18]
The reality is this: approx. 95 percent of the people who quit go back to smoking tobacco again.[19]
Researchers around the scientist Jean-Pol Tassin at College de France in Paris may have found an explanation for this: it is not just the nicotine that is addictive – other substances play a part, too!
Besides many other substances, tobacco smoke also contains so-called MAO-inhibitors. These MAO inhibitors are used in medicine in a targeted manner to treat depression. According to the scientists, it is the MAOIs in tobacco smoke that serve to reinforce the addictive effect of nicotine, or even enable it in the first place. If the brain stops being supplied with MAO inhibitors when a person stops smoking, their residues will be decomposed within a few weeks at the latest. According to the scientists, NRT only works in the beginning when people quit smoking because the effect of the MAO inhibitors still continues to be provided then.[20] US scientists have come to similar conclusions. Only that the scientists around James Belluzzi have identified a substance called "acetaldehyde" as an "accomplice" of nicotine. [21]
There is evidence, then, that nicotine is not solely responsible for the addictive effect of tobacco: On the one hand there are research findings that are largely focused on tobacco smoke, and on the other newer studies that identify other substances as suspicious "addiction reinforcers" and/or "addiction-formers", with both of them indicating that nicotine alone is not as addictive as many people believe.
And this is exactly the reason why extreme doubt is in order if one hears or reads that e-cigarettes could be a new source of nicotine addiction. [22]
Owing to the many substances in their smoke, tobacco cigarettes cannot (and must not!) be used as a yardstick – one should rather look at products that provide nicotine without tobacco, but with propylene glycol, glycerin and flavorings instead: nicotine replacement preparations! And this is where one will actually come up with results – or none, as it were!
In weeks of research, many authors have been unable to find a single documented case where a person became addicted to nicotine replacement preparations. There are indeed cases where smokers who quit with the help of nicotine gum thereafter consumed nicotine gum without cease – but: no-one has yet become addicted to nicotine or been led to the tobacco cigarette by nicotine gums, nicotine patches, or similar nicotine replacement preparations.
Some authors even claim that if there is such a thing as "nicotine addiction" at all, it would be a weak addiction and largely a psychological one, instead of a physical addiction! [23]
There is not only no case where a non-smoker started chewing nicotine gums, but also none where a non-smoker started with nicotine gum and then took to tobacco cigarettes. Many EU parliamentarians are currently concerned that adolescents, for example, could take to tobacco cigarettes by way of e-cigarettes – a number of studies on exactly this subject have been published "on time", so to speak, to coincide with the planned EU tobacco directive:
These studies now report that adolescents know about e-cigarettes and would love to try them and/or have already done so. I have nothing against these statements in principle, either. One should first of all consider that adolescents are inquisitive and want to try almost everything – as anyone who is still able to remember their own childhood can verify by seriously asking themselves: "What have I all tried and/or wished to try?"
Neither can I find anything wrong the rest of these statements: It goes without saying that adolescents know about e-cigarettes – the subject has turned up in the media again and again for months, after all. One would really need to live in an area without television, internet or newspapers to have never heard of them.
The point that makes EU parliamentarians sit up and take notice is the last one on the list: "Adolescents have already tried e-cigarettes!" At least this is what a study by the "Journal of Adolescent Health" maintains.[24] In this study, 228 adolescents where surveyed in exactly this subject area, with the following results:
• 67 % had heard of e-cigarettes
• 18 % wanted to try an e-cigarette
• 1 % had already done so
Does that sound like a reason for concern? Not if one knows that the 1 % of adolescents who had already tried an e-cigarette represented two smokers (the fact that these adolescents were smokers is hidden in a footnote of the study!).
So what the study data are really saying is this: Adolescents know about the e-cigarette and are also willing to try it – but out of 228 adolescents, only 2 smoking adolescents have ever done so.
RIVM: If e-cigarette cartridges with high levels of nicotine leak, they can expose nicotine, an addictive and dangerous chemical, to children, adults, pets and the environment.
FACT: In contrast to many other manufacturers SNOKE® does not use soft tips for the CAPS due to the danger that the liquid containing nicotine can be squeezed out of the cap under force. SNOKE® clearly states in the product leaflet that SNOKE® products must be kept out of reach of children and pets. The nicotine content in one SNOKE® CAP is limited to 16mg. In comparison to this, a tobacco cigarette contains ca. 12 mg to 18 mg of nicotine, and a typical nicotine patch with continuous release ca. 25 to a 100 mg.[25]
RIVM: Currently, there are no methods for proper disposal of e-cigarettes products and accessories, including cartridges, which could result in nicotine contamination from discarded cartridges entering water sources and soil, and adversely impacting the environment;
FACT: We recommend that the Dutch authorities should adapt the German example. In Germany the used CAPS are treated asresidual waste and disposed of in an environmentally friendly manner. Residual waste does not get into contact with ground water if disposed correctly.
RIVM: The manufacture, quality control, sales, and advertisement of e-cigarettes are unregulated.
SNOKE: SNOKE® is already in accordance with the regulations proposed by the EU commission regarding the packaging warnings for e-cigs and the nicotine levels permitted. Coming from a medical background (the founder and shareholder of SNOKE is a leading German medical professor of oncology and diagnostics) SNOKE® takes their responsibility towards consumers very seriously. SNOKE® only use raw materials of pharmaceutical quality obtained from German suppliers and analyzed by German pharmacies. The nicotine is supplied by either a German or Swiss manufacturer and the flavors used are from leading European producers, e.g. WILD in Germany. SNOKE® produces their liquids under pharmaceutical supervision and fills the SNOKE® CAPS in their own dust-free environment in their own production facility in Bonn, Germany (no outsourcing to third parties where you can't control the quality). SNOKE® products are made in Germany.
RIVM: Regarding Propylene Glycol: Volunteers exposed […] showed upper airway irritation.
FACT: A so-called "chest study" and/or "study of 30 smokers"[26] is often quoted with the words "also found was a decrease in the exhaled concentration of nitrogen oxide (FeNO), a marker for bronchitis" and "it was found in the process that constriction of the respiratory passages was significantly increased immediately, in contrast to the control group".[27] [28]
It is a weakness of the study design that the authors compare the inhalation of a nicotine-containing liquid with the inhalation of pure air and so ultimately arrive at the conclusion that the propylene glycol is responsible for a narrowing of the respiratory passages.
What has not been considered here is the long proven constrictive effect of nicotine on the bronchi, clearly recognized as an essential cause of the first effect stage of tobacco smoke. The comparison with pure air furthermore means that the "blinding" of studies required for scientific work is lacking – a simple comparison between the inhalation of a nicotine-containing liquid and that of a nicotine-free liquid would have therefore been able to eliminate two fundamental weaknesses of the study at the same time. Fact is that the findings of the "study of 30 smokers" indicate that e-cigarettes are markedly less harmful, and in no way demonstrate a harmful effect of propylene glycol on the respiratory tract.
RIVM: High concentrations of short-chain aldehydes such as formaldehyde, acetaldehyde and acrolein are produced during the heating of e-cigarettes.
FACT: In Dr. Schripp's (Fraunhofer Society – WKI) study "Does e-cigarette consumption cause passive vaping"[29] from 2012, table 4 (page 28) lists the substances found and their quantities. The only raised values involved the following substances:
acetone, isoprene, acetaldehyde, formaldehyde, acetic acid, and methyl ethyl ketone (MEK).
The quantities these substances were found in were approximately comparable with 20 % of the quantity released to the air by a tobacco cigarette.
In 2003, the scientist Dr. Ann Diskin (Keele University, England) published a study looking into the metabolites that are exhaled by people.[30]
If you compare the findings of the studies by Schripp et al. and Diskin et al. (exhaled pure air "in the early morning"), third parties are in greater danger if they breathe in the air exhaled by non-smokers and non-vapers.[31]
If all the scientific data are taken into account, the WKI study only says one thing: a large part of the alarming substances are absolutely normal metabolites that every human being gives off. If anyone should really be alarmed by these data and advocate a ban on e-cigarettes, they would be well advised to consider the risks posed by "third-party breathers", as well as a "ban on passive breathers".
Bonn, November 28th 2013
Prof. Dr. Dr. J. Ruhlmann
Medizin Center Bonn
Medizinisches Versorgungszentrum für Nuklearmedizin und Radiologie
Münsterstr. 20
53111 Bonn
Germany
Bron | Acvoda (actiecomite voor dampers) | Onderwerp | De E-sigaretten Factsheet van het RIVM | Soort | Pers- of nieuwsbericht | Datum publicatie | 25.11.2013 | Eerder deze week publiceerde het RIVM een factsheet omtrent e-sigaretten.
Helaas moeten we constateren dat het RIVM in dezen een document heeft opgeleverd dat onterecht de naam factsheet draagt. In plaats van feiten presenteert het document onvolledige, achterhaalde en zelfs foutieve informatie, aangevuld met impliciete opinies, een suggestieve vraagstelling en ongefundeerde zorgen.
Een betrouwbaar instituut als het RIVM dient een objectieve, wetenschappelijke en op actuele feitenkennis gebaseerde informatievoorziening en risicoanalyse te doen.
Met verbazing en verdriet moeten wij concluderen dat we deze pijlers en kernwaarden van het RIVM niet vertegenwoordigd zien in de gepubliceerde factsheet.
Deze publicatie lijkt erop gericht te zijn de e-sigaret negatief te belichten, teneinde over te kunnen gaan tot een (de facto) verbod op het gebruik dan wel de verkoop van de e-sigaret.
De feiten toegevoegd aan de factsheet
Op basis van de door ons opgedane kennis en ervaring ten aanzien van dit onderwerp hebben wij de factsheet voorzien van commentaar en duiding.
Op onderstaande link kunt u de PDF-versie downloaden met daarin 58 commentaren, verdeeld over de 8 pagina’s van het document.
RIVM E-Sigaret Factsheet met Acvoda commentaar (v2), PDF, 490 kb.
Opmerking: Om de commentaren goed te kunnen lezen adviseren we u het bestand buiten uw browser te openen in bijvoorbeeld Adobe Acrobat Reader.
Vraagstelling: Absolute veiligheid versus relatieve veiligheid
De belangrijkste vraag die de factsheet tracht te beantwoorden is of de e-sigaret veilig genoemd kan worden.
Dit is naar onze mening een volkomen onjuist uitgangspunt; er is immers geen enkele noodzaak voor absolute veiligheid van de e-sigaret. In plaats daarvan had de vraag moeten zijn of de e-sigaret minder schadelijk of veiliger is in gebruik dan de conventionele sigaret, en of de e-sigaret een acuut probleem vormt voor de volksgezondheid.
Immers, de e-sigaret heeft als primaire rol die van schade-verlagend alternatief voor conventionele tabaksconsumptie. De risicovergelijking met de conventionele sigaret wordt in de factsheet überhaupt niet behandeld, terwijl deze aan de hand van het ondertussen ruimschoots beschikbare onderzoek volkomen duidelijk is.
De RIVM factsheet staat nagenoeg haaks op de conclusies van het OFT in Frankrijk, de Norwegian Institute for Alcohol and Drug Research en Action on Smoking and Health in Groot-Brittannië.
In plaats daarvan richt het RIVM zich in de factsheet op irrelevante gemeten concentraties formaldehyde en acroleïne, op de marketing die gericht zou zijn op jongeren, op de kleur van de e-sigaret en op het hypothetische gateway-effect dat niet blijkt te bestaan.
Saillant is dat, alhoewel de factsheet rapporteert dat 0% van de gebruikers minderjarig is, het RIVM blijft volharden in de bewering dat het product op jongeren gericht zou zijn. De smaak ‘piña colada’ is daar volgens het RIVM een voorbeeld van.
De gevolgen van deze factsheet
Met deze publicatie heeft het RIVM een verkeerd signaal afgegeven aan de Nederlandse burger, maar ook aan de zorgverleners en gezondheidsinstanties.
Het valt te verwachten dat het gevolg hiervan zal zijn dat minder rokers conventionele tabaksconsumptie achter zich zullen laten, terwijl sommige gebruikers, die al geheel of gedeeltelijk overgestapt waren op e-sigaretten, de factsheet van het RIVM zullen zien als reden om toch weer te gaan roken.
Immers, van enige duiding van relatief risico is in deze publicatie geen sprake.
Wij achten de handelwijze van het RIVM in dezen laakbaar, onverantwoord en onwetenschappelijk. Een eenzijdige, grotendeels achterhaalde literatuurstudie zonder duiding, uit zorgvuldig geselecteerde negatieve rapporten, of zelfs negatief geformuleerd uit positieve rapporten zoals het RIVM hier levert, is gegeven het belang van de volksgezondheid volstrekt ongepast en het RIVM onwaardig.
De schadelijke gevolgen van tabaksgebruik zijn enorm, en betreffen de hele wereld. Elke ontwikkeling die bij kan dragen in het verminderen van die schadelijke gevolgen, verdient het derhalve op de juiste wijze benaderd en geanalyseerd te worden.
Acvoda is vanzelfsprekend bereid het RIVM te ondersteunen in het verkrijgen en beoordelen van de daadwerkelijke feiten omtrent de e-sigaret, als genotsmiddel en alternatief voor conventionele tabaksconsumptie.
Dit is in het belang van het RIVM, de inwoners van Nederland, en derhalve dus ook van onze overheid.
Een betrouwbaar instituut als het RIVM dient een objectieve, wetenschappelijke en op actuele feitenkennis gebaseerde informatievoorziening en risicoanalyse te doen.
Met verbazing en verdriet moeten wij concluderen dat we deze pijlers en kernwaarden van het RIVM niet vertegenwoordigd zien in de gepubliceerde factsheet.
Deze publicatie lijkt erop gericht te zijn de e-sigaret negatief te belichten, teneinde over te kunnen gaan tot een (de facto) verbod op het gebruik dan wel de verkoop van de e-sigaret.
De feiten toegevoegd aan de factsheet
Op basis van de door ons opgedane kennis en ervaring ten aanzien van dit onderwerp hebben wij de factsheet voorzien van commentaar en duiding.
Op onderstaande link kunt u de PDF-versie downloaden met daarin 58 commentaren, verdeeld over de 8 pagina’s van het document.
RIVM E-Sigaret Factsheet met Acvoda commentaar (v2) , PDF, 490 kb.
Opmerking: Om de commentaren goed te kunnen lezen adviseren we u het bestand buiten uw browser te openen in bijvoorbeeld Adobe Acrobat Reader.
Vraagstelling: Absolute veiligheid versus relatieve veiligheid
De belangrijkste vraag die de factsheet tracht te beantwoorden is of de e-sigaret veilig genoemd kan worden.
Dit is naar onze mening een volkomen onjuist uitgangspunt; er is immers geen enkele noodzaak voor absolute veiligheid van de e-sigaret. In plaats daarvan had de vraag moeten zijn of de e-sigaret minder schadelijk of veiliger is in gebruik dan de conventionele sigaret, en of de e-sigaret een acuut probleem vormt voor de volksgezondheid.
Immers, de e-sigaret heeft als primaire rol die van schade-verlagend alternatief voor conventionele tabaksconsumptie. De risicovergelijking met de conventionele sigaret wordt in de factsheet überhaupt niet behandeld, terwijl deze aan de hand van het ondertussen ruimschoots beschikbare onderzoek volkomen duidelijk is.
De RIVM factsheet staat nagenoeg haaks op de conclusies van het OFT in Frankrijk , de Norwegian Institute for Alcohol and Drug Research en Action on Smoking and Health in Groot-Brittannië.
In plaats daarvan richt het RIVM zich in de factsheet op irrelevante gemeten concentraties formaldehyde en acroleïne, op de marketing die gericht zou zijn op jongeren, op de kleur van de e-sigaret en op het hypothetische gateway-effect dat niet blijkt te bestaan.
Saillant is dat, alhoewel de factsheet rapporteert dat 0% van de gebruikers minderjarig is, het RIVM blijft volharden in de bewering dat het product op jongeren gericht zou zijn. De smaak ‘piña colada’ is daar volgens het RIVM een voorbeeld van.
De gevolgen van deze factsheet
Met deze publicatie heeft het RIVM een verkeerd signaal afgegeven aan de Nederlandse burger, maar ook aan de zorgverleners en gezondheidsinstanties.
Het valt te verwachten dat het gevolg hiervan zal zijn dat minder rokers conventionele tabaksconsumptie achter zich zullen laten, terwijl sommige gebruikers, die al geheel of gedeeltelijk overgestapt waren op e-sigaretten, de factsheet van het RIVM zullen zien als reden om toch weer te gaan roken.
Immers, van enige duiding van relatief risico is in deze publicatie geen sprake.
Wij achten de handelwijze van het RIVM in dezen laakbaar, onverantwoord en onwetenschappelijk. Een eenzijdige, grotendeels achterhaalde literatuurstudie zonder duiding, uit zorgvuldig geselecteerde negatieve rapporten, of zelfs negatief geformuleerd uit positieve rapporten zoals het RIVM hier levert, is gegeven het belang van de volksgezondheid volstrekt ongepast en het RIVM onwaardig.
De schadelijke gevolgen van tabaksgebruik zijn enorm, en betreffen de hele wereld. Elke ontwikkeling die bij kan dragen in het verminderen van die schadelijke gevolgen, verdient het derhalve op de juiste wijze benaderd en geanalyseerd te worden.
Acvoda is vanzelfsprekend bereid het RIVM te ondersteunen in het verkrijgen en beoordelen van de daadwerkelijke feiten omtrent de e-sigaret, als genotsmiddel en alternatief voor conventionele tabaksconsumptie.
Dit is in het belang van het RIVM, de inwoners van Nederland, en derhalve dus ook van onze overheid.
- See more at: http://www.acvoda.nl/2013/11/21/de-rivm-e-sigaretten-factsheet/#sthash.vedlSoMf.dpuf | | |
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