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Electronic cigarette

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Electronic cigarette resembling a tobacco cigarette
Different types of electronic cigarettes

An electronic cigarette (or e-cigarette), electronic vaping device[citation needed], personal vaporizer (PV), or electronic nicotine delivery system (ENDS) is a battery-powered device which simulates tobacco smoking. It generally uses a heating element that vaporizes a liquid solution. Some solutions contain a mixture of nicotine and flavourings, while others release a flavoured vapor without nicotine. Many are designed to simulate traditional smoking implements, such as cigarettes or cigars, in their use and/or appearance, while others are considerably different in appearance.[1][2]

The benefits and risks of electronic cigarette use are, as of 2013, uncertain,[3][4] but they are likely safer than smoking tobacco.[5] Laws vary widely concerning their use and sale, and are the subject of pending legislation and ongoing debate.

Health effects

Smoking cessation

The World Health Organization states that as of July 2013, no rigorous studies have been conducted to determine if electronic cigarettes are a useful method for helping people to stop smoking.[4] There are some non-controlled studies that show possible benefit.[6]

The British Medical Association agrees that there is evidence for smoking cessation benefits, but has concerns that e-cigarettes are less regulated than conventional nicotine replacement therapy (NRT), and that there is no peer reviewed evidence of their safety or efficacy. They recommend a "strong regulatory framework" for e-cigarette distribution in order to ensure their safety, quality, and that their marketing and sales are restricted to adults. The BMA encourages health professionals to recommend conventional nicotine replacement therapies, but for patients unwilling to use or continue those methods, they say health professionals may present e-cigarettes as a lower-risk option than tobacco smoking.[7]

A 2011 review states that electronic cigarettes may aid in smoking cessation and are likely to be more effective than traditional pharmacotherapy.[8] The American Association of Public Health Physicians (AAPHP) views electronic cigarettes as similar to nicotine replacement therapy and recommend them as a harm reduction method for those who have failed to quit by other means.[9] In one study, nicotine cessation was observed in 10% of users six months after beginning use of electronic cigarettes. In that same period, 31% of users had ceased smoking and a further two-thirds had reduced their tobacco consumption.[10]

Toxicity

Electronic cigarettes should theoretically have fewer toxic effects than traditional cigarettes.[11][12] Nevertheless, concrete evidence is insufficient as of 2013,[4][11] although tentative evidence suggests they are safer than real cigarettes, and possibly as safe as other nicotine replacement products.[8] In November 2013 a British Medical Association spokesman said it was "clear" that they are several orders of magnitude less harmful than smoking.[13]

The electronic systems appear to generally deliver less nicotine than smoking.[11] The amount of nicotine delivered is believed to vary between different brands of electronic cigarettes.[4]

A preliminary analysis of e-cigarette cartridges by the US Food and Drug Administration (FDA) in 2009 identified that some contain tobacco-specific nitrosamines (TSNAs), known cancer-causing agents.[14][15] The amounts of TSNAs present were on par with existing NRT products like nicotine gum and inhalers. The FDA's analysis also detected diethylene glycol, a poisonous and hygroscopic liquid, in a single cartridge manufactured by Smoking Everywhere and nicotine in some cartridges claimed to be nicotine-free.[14][15] Diethylene glycol has not been found in any cartridge tested since 2009. Further concerns were raised over inconsistent amounts of nicotine delivered when drawing on the device.[16] In some e-cigarettes, "Tobacco-specific impurities suspected of being harmful to humans – anabasine, myosmine, and β-nicotyrine – were detected in a majority of the samples tested." It is not clear if these chemicals were detectable in exhaled vapour.[17] The UK National Health Service noted that the toxic chemicals found by the FDA were at levels one-thousandth that of cigarette smoke, and that while there is no certainty that these small traces are harmless, initial test results are reassuring.[18]

Concerns

Addiction

E-cigarettes could hypothetically result in nicotine addiction in those who are not already addicted[19] if they were being used by non-smokers. A number of organizations including the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the Food and Drug Administration have concerns that e-cigs might increase addition to and use of nicotine and tobacco products in children.[20][21]

There is little data available on pure nicotine use by humans [22] although it has proven to be only weakly addictive in animal studies. Studies indicate that pure nicotine has a lower abuse liability than tobacco, which is highly addictive in both humans and animals.[22]

Construction

Disassembled cigarette-styled electronic cigarette.
A. LED light cover
B. battery (also houses circuitry)
C. atomizer (heating element)
D. cartridge (mouthpiece)
Battery connected to a USB charger

Most electronic cigarettes take an overall cylindrical shape although a wide array of shapes can be found; box, pipe styles etc. Most are made to look like the common tobacco cigarette. Common components include a liquid delivery and container system, an atomizer, and a power source.[23] Many electronic cigarettes are composed of streamlined replaceable parts, while disposable devices combine all components into a single part that is discarded when its liquid is depleted.

Atomizer

Along with the battery, the atomizer is the central component of every personal vaporizer. Although many kinds of atomizers are in use, they generally consist of a small heating element responsible for vaporizing liquid, as well as a wicking material that draws liquid in.

A small length of resistance wire is wrapped around the wicking material and then connected to the positive and negative poles of the device. When activated the resistance wire (or coil) quickly heats up thus turning the liquid into a vapor, which is then inhaled by the user.[24]

The electrical resistance of the coil and the voltage output of a device play important roles in the perceived quality of the vapor that is produced by an atomizer. Atomizer resistances usually vary from 1.5Ω (ohms) to 3.0Ω from one atomizer to the next but can go as low as 0.1Ω in the most extreme cases of DIY coil building which produce large amounts of vapor but could present a fire hazard and other dangerous battery failures if the user is not knowledgeable enough about basic electrical principles and how they relate to battery safety.[25][26]

Wicking materials vary greatly from one atomizer to another but silica fibers are the most commonly used in manufactured atomizers. "Rebuildable" or "do it yourself" atomizers can use silica, cotton, porous ceramic, hemp, bamboo yarn, oxidized stainless steel mesh and even wire rope cables as wicking materials.[27]

A wide array of atomizers and e-liquid container combinations are available:[28]

  • Cartomizers

Most of the devices that imitate the cigarette form factor use a "cartomizer" (a portmanteau of cartridge and atomizer) as an e-liquid delivery system. The piece consists of a heating element surrounded by a liquid-soaked poly-foam that acts as an e-liquid holder. It is usually disposed of once the e-liquid acquires a burnt taste, which is usually due to a activation when the coil is dry or when the cartomizer gets consistently flooded (gurgling) because of sedimentation of the wick. Most cartomizers are refillable even if not advertised as such and some are fully "rebuildable".

Cartomizers can be used on their own or in conjunction with a tank that allows more e-liquid capacity. In this case the portmanteau word of "cartotank: has been coined. 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 to allow liquid to reach the coil.

  • Clearomizers
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 locate directly under the mouth piece.

Clearomizers, not unlike cartotanks, use a clear tank in which an atomizer is inserted. Unlike cartotanks, however, no poly-foam material can be found in them. There are a lot of different wicking systems employed inside of clearomizers to ensure good moistening of the wick without flooding the coil. Some rely on gravity to bring the e-liquid to the wick and coil assembly (bottom coil clearomizers for example) whereas others rely on capillary action alone (top coil clearomizers).

  • Rebuildable Atomizers

A rebuildable atomizer is an atomizer that allows the user to assemble or "build" the wick and coil themselves.

Power

Most portable devices contain a rechargeable battery, which tends to be the largest component of an electronic cigarette. The battery may contain an electronic airflow sensor whereby activation is triggered simply by drawing breath through the device, while other models employ a power button that must be held during operation. An LED to indicate activation may also be employed. Some manufacturers also offer a cigarette pack-shaped portable charging case (PCC), which contains a larger battery capable of charging e-cigarettes. Devices aimed at more experienced users may sport additional features, such as variable power output and support of a wide range of internal batteries and atomizers configurations and tend to stray away from the cigarette form factor. Some cheaper recent devices use an electret microphone with a custom IC to detect airflow and indicate battery status on the included blue LED.

Variable power and voltage devices

PV with variable and regulated power offering battery protection

Variable voltage or power personal vaporizers are devices that contain a built in electronic chip that allows the user to adjust the power that goes through the heating element. They usually incorporate a LED screen to display various information. Variable PV's eliminate the need of having to replace an atomizer with another one of lower or higher electrical resistance to change the intensity of the vapor. They also feature voltage regulation and some battery protection.

Some of these device offer additional features through their menu system such as: atomizer resistance checker, remaining battery voltage, puff counter, activation cut-off etc.

Mechanical personal vaporizers

Mechanical PV with a rebuildable atomizer

Mechanical PVs or mechanical "mods", often called "mechs" are devices without electronic components, electrical wires and battery protection (apart from vent holes drilled in some mechanical devices). They are activated by spring loaded or opposing magnetic mechanical switches, hence their name. Since no wires are found in them, they are usually solder free. They rely entirely on the natural voltage output of a battery.

They are commonly used with "low resistance" (1.0Ω ~ 0.5Ω) rebuildable atomizers. Seeing that most e-cigarettes containing electronic battery protection will interpret sub ohm resistance coils as a short circuit, thus prohibiting the device from being activated, mechanical mods are among the only devices that will accept such atomizer resistances.

Since mechanical PVs are unregulated and unprotected, they require special attention on the users part that other regulated and protected PVs do not need. Making sure that the battery does not over-discharge and that the atomizer will not require more amperage than what the battery can safely allow are the users responsibilities.

Liquid

Liquid for producing vapor in electronic cigarettes, commonly known as e-juice or e-liquid, is a solution of propylene glycol (PG), vegetable glycerin (VG), and/or polyethylene glycol 400 (PEG400) mixed with concentrated flavors; and optionally, a variable concentration of nicotine.[29]

The solution is often sold in a bottle or in pre-filled disposable cartridges. They are manufactured with various tobacco, fruit, and other flavors, as well as variable nicotine concentrations (including nicotine-free versions). The standard notation "mg/ml" is often used in labeling for denoting nicotine concentration, and is sometimes shortened to a simple "mg".[30]

Usage

Electronic cigarette sales increased from 50,000 in 2008 to 3.5 million in 2012.[29] As of 2011, in the United States, one in five adults who smoke have tried electronic cigarettes.[31] In a UK survey conducted in 2013 of more than 12,000 adults, 11% of regular smokers in the sample identified themselves as using electronic cigarettes and 24% stated that they had used them in the past. Amongst non-smokers in the same sample, 1% said they had tried them and 0% stated that they were currently using them.[32]

Among grade 6 to 12 students in the United States, those who have ever used the product increased from 3.3% in 2011 to 6.8% in 2012.[33] 10% of students who have used e-cigs have never smoked.[33] A 2013 UK survey by Action on Smoking and Health found that among non-smokers under 18, 1% reported having tried e-cigarettes "once or twice," 0% reported continuing use, and 0% intended to try them in the future. ASH concluded that among children who have heard of e-cigarettes, sustained use is rare and confined to children who smoke or have smoked.[32]

As the electronic cigarette industry grows in popularity, a subculture has emerged which calls itself "the vaping community".[28][34][35] More and more store fronts organize what are known as "vape meets", a gathering of e-cigarette users that talk about and compare various devices and e-liquids. These meetings are a growing trend, sometimes hosted in hotels,[36][37][38][39] and full blown electronic cigarette conventions are now occurring.[40][41]

Members of this emerging subculture often view electronic cigarettes as a safer alternative to traditional smoking and some even view it as a hobby. They tend to use highly customized devices that do not resemble what are known, by some, as "cig-a-likes," or electronic cigarettes that resemble real cigarettes.

History

The earliest electronic cigarette can be traced to Herbert A. Gilbert,[42] who in 1963 patented a device described as "a smokeless non-tobacco cigarette" that involved "replacing burning tobacco and paper with heated, moist, flavored air." This device heated the nicotine solution and produced steam. In 1967, Gilbert was approached by several companies interested in manufacturing it, but it was never commercialized and disappeared from the public record after 1967.[43][44][45][46][47][48]

Hon Lik, a Chinese pharmacist, is widely credited[49][50][51] with the invention of the first generation electronic cigarette. In 2003,[52] he came up with the idea of using a piezoelectric ultrasound-emitting element to vaporise a pressurized jet of liquid containing nicotine diluted in a propylene glycol solution.[53] This design produces a smoke-like vapour that can be inhaled and provides a vehicle for nicotine delivery into the bloodstream via the lungs. He also proposed using propylene glycol to dilute nicotine and placing it in a disposable plastic cartridge which serves as a liquid reservoir and mouthpiece.

The device was first introduced to the Chinese domestic market in May 2004 as an aid for smoking cessation and replacement. The company that Hon Lik worked for, Golden Dragon Holdings, changed its name to Ruyan (如烟, literally "Resembling smoking"), and started exporting its products in 2005–2006[54] before receiving its first international patent in 2007.[55]

Several e-cigarette models marketed by tobacco companies were launched or are set to launch in 2013, including the Vuse, MarkTen, and Vype. Blu, a prominent e-cigarette producer, was also acquired by Lorillard Inc., a tobacco industry leader, in 2012.[56]

Legal status

Because of the relative novelty of the technology and the possible relationship to tobacco laws and medical drug policies, electronic cigarette legislation and public health investigations are currently pending in many countries. Current regulations vary widely, from regions with no regulations to others banning the devices entirely.[57]

The European Economic Area

Whether electronic cigarettes could be regarded as falling under Directive 93/42/EEC on medical devices depends on the claimed intended use and whether this intended use has a medical purpose. An EC orientation note stated that "It is for each national authority to decide, account being taken of all the characteristics of the product, whether it falls within the definition of a medicinal product by its function or presentation."[58] In late 2012, the EU proposed and update to EU laws that would introduce tougher restrictions on the use and sales of e-cigarettes.[59][60][61] On October 8, 2013 the European Parliament in Strasbourg voted for the marketing of e-cigarettes to be regulated in the same way that tobacco marketing is regulated. That means sales of e-cigarettes to children under 18 would be prohibited in the European Union, along with most advertising. Health-warning labels also would be required. [62]

  • In Austria nicotine-containing cartridges are classified as medicinal products and e-cigarettes for nicotine inhalation as medical devices.[63]
  • In Bulgaria, the sale and use of electronic cigarettes is legal, as well as the sale of cartridges and liquids with nicotine. There are no specific regulations from EU.[64]
  • In the Czech Republic, the use, sale and advertising of electronic cigarettes is legal.[citation needed]
  • In Denmark, the Danish Medicines Agency classifies electronic cigarettes containing nicotine as medicinal products. Thus, authorization is required before the product may be marketed and sold, and no such authorization has currently been given. The agency has clarified, however, that electronic cigarettes that do not administer nicotine to the user, and are not otherwise used for the prevention or treatment of disease, are not considered medicinal devices.[65]
  • In Estonia, the Estonian State Agency of Medicines had previously banned e-cigarettes, but the ban was overturned in court on 7 March 2013.[66] Currently e-liquids containing more than 0.7 mg/ml of nicotine are still considered medicine and as such cannot be legally purchased within the country due to no manufacturer being licensed properly. Following the outcome of EU tobacco directive in october 2013, the legislation is moving towards a more relaxed stance on the issue. As stated by the Estonian minister of social affairs Taavi Rõivas (in charge of tobacco regulation), e-cigarettes will receive an advertisement ban and will clearly be banned for minors but will be available for adults before the end of 2013.
  • In Finland, the National Supervisory Authority of Welfare and Health (Valvira) declared that the new tobacco marketing ban (effective 1 January 2012) will also cover electronic cigarettes,[67] resulting in that Finnish stores or webstores can't advertise e-cigarettes because they might look like regular cigarettes. In theory, e-cigarettes with nicotine-free cartridges may still be sold, as long as their images and prices are not visible. Ordering from abroad remains allowed. Sale of nicotine cartridges is currently prohibited, as nicotine is considered a prescription drug requiring an authorization that such cartridges do not yet have. However, the Finnish authorities have decided that nicotine cartridges containing less than 10 mg nicotine, and e-liquid containing less than 0,42 g nicotine per bottle, may be legally brought in from other countries for private use. If the nicotine content is higher, a prescription from a Finnish physician is required. From a country within the European Economic Area a maximum of one year's supply may be brought in for private use when returning to Finland, while three months' supply may be brought in from outside the EEA. Mail order deliveries from EEA countries, for a maximum of three months' supply, are also allowed.[68][69]
  • In Germany, the sale and use of electronic cigarettes is legal.[70]
  • In Hungary, the sale and use of electronic cigarettes is legal. The sale of cartridges and liquids with nicotine is illegal.
  • In Ireland, the sale and use of electronic cigarettes is legal.[citation needed]
  • In Italy, by a Health Ministry decree (G.U. Serie Generale, n. 248 del 23 ottobre 2012) electronic cigarettes containing nicotine cannot be sold to individuals under 18 years old.[citation needed]
  • In Latvia, e-cigarettes are legal.[citation needed]
  • In the Netherlands, use and sale of electronic cigarettes is allowed.
  • In Norway the sale and use of electronic cigarettes are legal, but nicotine cartridges can only be imported from other EEA member states (e.g. the UK) for private use.[citation needed]
  • In Poland, the sale and use of electronic cigarettes are legal.[citation needed]
  • In Portugal, the sale and use of electronic cigarettes are legal.[citation needed]
  • In Romania, the sale and use of electronic cigarettes are legal.
  • In the United Kingdom, the use, sale and advertising of electronic cigarettes is legal. Electronic cigarettes are not covered by smoking bans, but the owners of public places may forbid their use.[citation needed]

United States

Federal regulation

The FDA classified electronic cigarettes as drug delivery devices and subject to regulation under the Food, Drug, and Cosmetic Act (FDCA) before importation and sale in the United States. The classification was challenged in court, and overruled in January 2010 by Federal District Court Judge Richard J. Leon, citing that "the devices should be regulated as tobacco products rather than drug or medical products."[71] Judge Leon ordered the FDA to stop blocking the importation of electronic cigarettes from China and indicated that the devices should be regulated as tobacco products rather than drug or medical devices.[72]

In March 2010, the U.S. Court of Appeals for the District of Columbia stayed the injunction pending an appeal, during which the FDA argued the right to regulate electronic cigarettes based on their previous ability to regulate nicotine replacement therapies such as nicotine gum or patches. Further, the agency argued that tobacco legislation enacted the previous year "expressly excludes from the definition of 'tobacco product' any article that is a drug, device or combination product under the FDCA, and provides that such articles shall be subject to regulation under the pre-existing FDCA provisions."[73] On 7 December 2010, the appeals court ruled against the FDA in a 3–0 unanimous decision, ruling the FDA can only regulate electronic cigarettes as tobacco products, and thus cannot block their import.[74] The judges ruled that such devices would only be subject to drug legislation if they are marketed for therapeutic use – E-cigarette manufacturers had successfully proven that their products were targeted at smokers and not at those seeking to quit. The District of Columbia Circuit appeals court, on 24 January 2011, declined to review the decision en banc, blocking the products from FDA regulation as medical devices.[75]

State regulation

With an absence of federal regulations, many states and cities have adopted their own e-cigarette regulations, most commonly to prohibit sales to minors, including Maryland, Kentucky, Minnesota, New Jersey, New Hampshire, Tennessee, Utah, Wisconsin, and Colorado. Other states are considering similar legislation.[76]

  • California Governor Arnold Schwarzenegger vetoed a bill that would regulate the sale of electronic cigarettes within the state on grounds that "if adults want to purchase and consume these products with an understanding of the associated health risks, they should be able to do so."[77] Senate Bill 648(Authored by Senator Ellen Corbett), proposed a bill that would classify eCigarettes as tobacco products, thus banning their use wherever smoking was banned. In August 2013, SB648 was shelved for the session, just hours before its hearing in the State Assembly. It has not been determined if Sen Corbett will revise the bill and re-introduce it next year.[78]
  • New Jersey voted in 2009 to treat the electronic cigarette in the same category as tobacco products by including them under the New Jersey Smoke-Free Air Act, which prohibits smoking in indoor work and public places. Assemblywoman Connie Wagner sponsored the legislation, claiming "that young people who use these things will get hooked on the nicotine and eventually move onto the real thing".[79]
  • In New Hampshire, the sale of electronic cigarettes to minors is illegal as of July 2010.[80]
  • Arizona is planning to ban the sale of electronic cigarettes to minors.[81]
  • In Washington, the King County board of health has banned use of electronic cigarettes in public places, and prohibited sales to minors.[82] Neighboring Pierce County also prohibits sales to minors, but allows e-cigarette use in places such as bars and workplaces.[83]
  • In Maryland, sales to minors are banned.[citation needed]
  • Iowa requires retailers in Linn County to have a retail tobacco license.[84]
  • New York State banned the use of e-cigarettes within 100 feet of a public or private school entrance in September 2012, and banned e-cigarette sales to minors starting on 1 January 2013.[85]

Other countries

  • In Australia, the Federal Department of Health and Ageing classifies every form of nicotine, except for replacement therapies and cigarettes, as a form of poison.[86][87] The Therapeutic Goods Administration has said that there were no laws preventing the importation of e-cigarettes bought over the internet for personal use, unless prohibited by state and territory legislation.[88] State laws in Australia’s various states are a little bit conflicting. According to the Poisons Standard of 2010, inhaled nicotine is Pharmacy Only, or a Schedule 2 medication when used to help quit smoking.[89][90]
  • In Brazil, the sale, importation and advertising of any kind of electronic cigarette is forbidden. The Brazilian health and sanitation federal agency, Anvisa, found the current health safety assessments about e-cigarettes to not be yet satisfactory for commercial approval eligibility.[91]
  • In Canada, as of March 2009, while the importation, sale, and advertising of electronic cigarettes containing nicotine is not endorsed, the products may be sold and used.
  • In China, the sale and use of electronic cigarettes is legal.[citation needed]
  • In Dubai, the sale and use of tobacco products and electronic cigarettes is illegal.[92]
  • In Egypt, the Egyptian Ministry of Health technical committee has rejected applications for marketing authorization of electronic cigarettes on the grounds that they contain harmful chemicals, and lack safety and toxicity data.[citation needed]
  • In Hong Kong the sale and possession of nicotine-based electronic cigarettes, classified as a Type I Poison, is governed under the Pharmacy and Poisons Ordinance. Sale or possession is not authorized and both are considered punishable with a fine of up to HK$100,000 and/or a prison term of 2 years. However, the law does not cover any non-nicotine inhalers.[93]
  • In India, the use of electronic cigarettes is currently legal. Under the Indian Health Law of 2006, tobacco smoking has been banned in public. Since e-cigarettes avoid the use of tobacco, they do not fall under this law.[94]
  • In Japan, no laws pertaining specifically to the use of electronic cigarettes exists. However, the sale of products containing nictoine in Japan is regulated and no express permission to sell e-liquids containing nicotine has been given. Because of this, the sale of vaporizers is legal, but the sale of e-liquid is not. Individuals may however import e-liquid from overseas for personal use.
  • In Lebanon, the council of ministers has banned the sale and use of electronic cigarettes, starting 21 September 2011.[citation needed]
  • In Malaysia, the sale of e-cigarettes is an offence under the Poisons Act 1952 and the Control of Drugs and Cosmetics Regulations 1984. Those found guilty of selling and distributing the product (as well as liquid nicotine for use in electronic cigarettes) will be fined no more than RM3,000, be jailed for no more than two years, or both.[95] The Malaysian Health Minister stated that e-cigarettes containing liquid nicotine is more harmful than normal cigarettes and warned Malaysians to avoid them.[96]
  • In Mexico, the Federal Commission for the Protection Against Sanitary Risks, announced that according to Mexican Law, the selling and promotion of non-tobacco objects that include elements generally associated with tobacco products are forbidden.[97]
  • In Nepal, under current cigarette laws, the use and sale of e-cigarettes is permitted. [citation needed]
  • In New Zealand, electronic cigarettes are legal and can be purchased from tobacconists and speciality stores or online. It is illegal to sell nicotine cartridges with the electronic devices but these can be purchased separately[30]
  • In Pakistan, the import and sale of electronic cigarettes is legal, but Pakistan Medical and Dental council find that the current health safety assessments of e-cigarettes to not yet be satisfactory. [citation needed]
  • In Panama, the importation, distribution and sale of electronic cigarettes have been prohibited since June 2009. The Ministry of Health cites the FDA findings as their reasoning for the ban.[98]
  • In Singapore, electronic cigarettes (e-cigarettes) are currently prohibited under Secion 16 (1) of the Tobacco (Control of Advertisements and Sale) Act, which is enforced by the Health Sciences Authority (HSA). This legislation prohibits the importation, distribution, sale or offer for sale of any confectionery or other food product or any toy or other article that is designed to resemble a tobacco product or the packaging of which is designed to resemble the packaging commonly associated with tobacco products. HSA takes a serious view on any person who contravenes the law. Those guilty of the offence are liable to a fine of up to $5, 000 upon conviction.[99] According to Health Minister Khaw Boon Wan, electronic cigarettes are the industry's attempt to attract new users and were marketed to appeal to younger customers, including women.[100]
  • In South Korea, the sale and use of electronic cigarettes is legal, but is heavily taxed. Electric cigarette possession among teenagers remains an issue.[101]
  • In Switzerland, the sale of nicotine-free electronic cigarettes is legal. The use and importation of electronic cigarettes containing nicotine is legal, but they cannot be sold within the country.[102] As of December 2011, the tobacco tax does not apply to e-cigarettes and respective liquids containing nicotine.[103]

Related nicotine inhalation technologies

There are other technologies currently under development that seek to deliver nicotine for oral inhalation in an effort to mimic both the ritualistic and behavioural aspects of traditional cigarettes.

  • British American Tobacco, through their subsidiary Nicoventures Limited, licensed a nicotine delivery system based on existing asthma inhaler technology. The technology is being developed by UK-based healthcare company Kind Consumer Limited.
  • Philip Morris International bought the rights to a nicotine pyruvate technology developed by Jed Rose at Duke University.[104] The technology is based on the chemical reaction between nicotine acid and a base, which produces an inhalable nicotine pyruvate vapour.[105]

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External links

Further reading

  • Erbach, Gregor. "Electronic cigarettes" (PDF). Library Briefing. Library of the European Parliament. Retrieved 27 March 2013.
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