Experts hazy on smokeless smokes' risks

BEIJING — With its slim white body and glowing amber tip, it easily can pass as a regular cigarette. It even emits what look like curlicues of white smoke.

The Ruyan V8, which produces a nicotine-infused mist absorbed directly into the lungs, is one of a rapidly growing array of electronic cigarettes attracting attention in China, the United States and elsewhere — and the scrutiny of world health officials.

Marketed as a more healthful alternative to smoking and a potential way to kick the habit, the smokeless smokes have been distributed in swag bags at the British film awards and hawked at an international trade show.

Because no burning is involved, makers said there's no hazardous cocktail of cancer-causing chemicals and gases like those produced by a regular cigarette. There's no secondhand smoke, so they can be used in places where cigarettes are banned, the makers said.

Health authorities are questioning those claims.

The World Health Organization (WHO) officials warned in September there was no evidence to back up claims that e-cigarettes are a safe substitute for smoking or a way to help smokers quit.

Agency officials also said companies should stop marketing them that way, especially because the product may undermine smoking prevention because they look like the real thing and may lure nonsmokers, including children.

"There is not sufficient evidence that (they) are safe products for human consumption," Timothy O'Leary, a communications officer at WHO's Tobacco Free Initiative in Geneva, said this week.

The list of WHO's concerns includes the lack of conclusive studies and information about e-cigarette contents and their long-term health effects, he said.

Unlike other nicotine-replacement therapies such as patches for slow delivery through the skin and some inhalers and nasal sprays, e-cigarettes have not gone through rigorous testing, O'Leary said.

Nicotine is highly addictive and causes the release of the "feel-good" chemical dopamine when it goes to the brain. It also increases heart rate and blood pressure and restricts blood to the heart muscle.

Patented technology

Ruyan — which means "like smoking" — introduced the world's first electronic cigarette in 2004. It has patented its ultrasonic atomizing technology, in which nicotine is dissolved in a cartridge containing propylene glycol, the liquid that is vaporized in smoke machines in nightclubs or theaters and is commonly used as a solvent in food.

When a person takes a drag on the battery-powered cigarette, the solution is pumped through the atomizer and comes out as an ultrafine spray that resembles smoke.

Hong Kong-based Ruyan contends the technology has been illegally copied by Chinese and foreign companies and is embroiled in several lawsuits. It's also battling questions about the safety of its products.

Most sales take place over the Internet.

Prices range from about $60 to $240. Kits include battery chargers and cartridges that range in flavors (from fruit to menthol) and nicotine levels (from zero — basically a flavored mist — to 16 milligrams, higher than a regular cigarette.)

National Institutes of Health officials said regular cigarettes contain about 10 milligrams of nicotine.

Online sales make it even more difficult to regulate the industry, which falls in a gray area in many countries.

In the United States, the Food and Drug Administration has "detained and refused" several brands of electronic cigarettes because they were considered unapproved new drugs and could not be legally marketed in the country, said spokesman Christopher Kelly.

He did not give more details but said the determination of whether an e-cig is a drug is made on a case-by-case basis after the agency considers its intended use, labeling and advertising.

Access to e-cig varies

In Australia, the sale of electronic cigarettes containing nicotine is banned. In Britain, the products appear to be unregulated and are sold in pubs.

Smoking is part of daily life in Ruyan's home turf of China, the world's largest tobacco market, where about 2 trillion cigarettes are sold every year.

Tobacco sales, the biggest source of government revenue, brought in $61 billion in the first 11 months of last year, up 18 percent from 2007, the Communist Party's People's Daily newspaper reported.

In a country where the cheapest brands of cigarettes cost about 20 cents a pack, the e-cig is pricier. Ruyan's V8 costs $240 and includes batteries and 20 cartridges of nicotine solution, roughly the same number of puffs as 20 packs of tobacco cigarettes. The line has expanded to include cigars and pipes crafted from agate and rosewood.

Some international experts back Ruyan's claims that its product is safe.

Dr. Murray Laugesen, a New Zealand physician involved in tobacco control for 25 years who was commissioned by Ruyan to test its e-cigs, said he found "very little wrong" with them.

"It looks more like a cigarette and feels more like a cigarette than any other device so far, and yet it does not cause the harm," he said. "It's the best substitute so far invented for tobacco cigarettes."

In the United States, Philip Morris and RJ Reynolds have introduced cigarettes that did not burn tobacco, but the technologies were different from the e-cigarette. Neither has been successful.