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misinformationcontinuestospread.ItisprofessorSiegelsopinionthatantismokinggroupsareingrainedwithanunderlyingideologythatsimplydoesnotallowfortheendorsementofadevicethatsimulatessmokingnomatterhowmanylivesthatdevicemightsave.Becauseelectroniccigarettesdontburnanddontgiveosmokerathertheygiveovaporuserscallthepracticevapingratherthansmokinglogicindicatestheywouldbeallowedinplaceswheresmokingisbanned.Buttheconfusionsurroundingthedevicefoundsomestatesandlocalitiesacrossthecountryscramblingtobanthemwithouttheproperbackupforhowgoodorbadtheyreallyare.Ignorantlawmakersdecidedtolumpe-cigusersinwithtraditionalsmokersandpenalizethemassuch.SofarNewJerseyistheonestatethatspecicallybanstheuseofe-cigaretteswhereregularsmokingisntallowed.ecityofSanFranciscoplanstoincludee-cigarettesinitscurrentsmokingordinancebasicallyrulingthatanythingthatlooksfeelsorfunctionslikeacigaretteisacigaretteandhastobebannedfrompublicplaces.InWashingtonstatetheTacoma-PierceCountyHealthDepartmentsimilarlyproposedtobantheuseofe-cigarettesinpublicplaceswherecigarandcigarettesmokingisalreadyillegalunderstatelawbutonJune1itmorewiselyvoted7-0foranamendedproposalthatprohibitsthesaleofelectroniccigarettestominorsandregulateswherepeoplecanusethedevices.eamendedlegislationsayse-cigswillbeallowedinadultestablishmentssuchasbarsprivateworkplacesiftheownerapprovesandbusinessesthatsellorpromoteelectronicsmokingdevices.Butbeyondthebansthepotentiallybigdownerfore-cigarettescouldbetheissueofSubstantialEquivalencewhichwillariseoncetheFDAstartsregulatinge-cigarettesasithassaiditwilleventuallydoinalettertointerestedparties.WhilenotimelinehasbeensetontheproposedrulechangestheSubstantialEquivalencequestionwillariseasithasforothertobaccoproductsunderFDArule.EssentiallyitmeansthatunderthegrandfatherclausetobaccoproductsthatwereavailableintheU.S.marketasofFeb.152007andsubstantiallyequivalentproductsintroducedafterthatdatearenotsubjecttopre-marketapproval.Whileitcouldbearguedthatalle-cigarettesusethesamebasictechnologyandthereforearesubstantiallyequivalenttooneanothertheFDAmaymakenerdistinctionsindustryobserversfear.TobaccoharmreductionexpertCarlV.Phillipssayshedoesnotseeanypro-THRthinkingonthepartoftheFDAandthatthiscouldseriouslymesswiththesellingofe-cigarettesmovingforward.RequiringaproductthatisnotalmostexactlythesameassomethingthatwasonthemarketbeforeFebruary2007togothroughpre-marketreviewwouldbelargelyprohibitivehebelieves.FurthermorePhillipssaysitappearslikelythattheFDAwillclingtoitsnuttyanti-scienticpositionbyprohibitingeventheobviouslyaccurateclaimthate-cigarettesareawaytonotsmoke.ProfessorSiegelsimilarlybelievesthattheimplicationswillbeinhowsevereorlenienttheFDAwillbeininterpretingthemeaningofsubstantiallyequivalentaswellastheinterpretationoftherapeuticclaimwithregardtoe-cigarettes.Siegelnotesthatsomee-cigarettesintroducedafterFeb.152007couldpotentiallyberemovedfromthemarket.Healsosaysthatitisridiculousthate-cigarettecompaniesmustrefrainfrommakingtherapeuticclaimsbecausethereisnoquestionthate-cigarettesaresaferthanregularcigarettes.AccordingtoWellsFargoSecuritiesanalystBonnieHerzogU.S.cigarettevolumeshavebeendecliningatabout3percentto4percentannuallywhilesmokelesssnusvolumeshavebeenincreasingbyabout6percentto7percent.InNewYorkCitycoincidingwithanoutdoorsmokingbanthattookeectonMay23ReynoldsAmericanInc.ranfull-pageadsforaweekinpublicationssuchasandtheurgingNYCsmokerstoswitchtoitsCamelSnusreportedlythetop-sellingsnusbrandinthecountry.Goodnewsforsnuscouldcomefromupcomingresearch.eNationalCancerInstituteisfundinganewone-yearstudythatwillevaluatetheimpactofCamelSnusonsmokingcessationconductedbyMatthewCarpenterattheMedicalUniversityofSouthCarolinawhofoundinapreviousstudythatStarScienticsArivaandStonewalldissolvablesmokelessproductswereeectiveinhelpingsmokersremainsmoke-free.ProfessorRoducallsthesnusstudyalandmarkdevelopmentfortobaccoharmreductionbecauseNCIsbackingsendsanunequivocalmessagethatinformingsmokersaboutsafersmokelesssubstitutesisethicalcredibleandworthyofseriousconsideration.Fewdetailsareavailableaboutthetrialexceptthatitwillbeconductedamong1250smokerswhoarenotmotivatedtoquit.Ofcoursetherecontinuestobealotofmisinformationcirculatingaroundthesnuscategoryjustaswithalltobaccoharmreduction.InablogDr.GlennBraunsteinoftheDepartmentofMedicineatCedars-SinaiMedicalCenterinLosAngeleswarnedagainstsmokelesstobaccouseassertingthatitcarriesrisksasseriousassmoking.BloggingonhisownwebsiteprofessorRoduhighlightedBraunsteinssmokelesshealthrisksasdemonstrablyctitiouspointingoutthatBraunsteinscommentsignorenumerousscienticstudiesthathavefoundsmokelesstobaccouseis98percentsaferthansmoking.Dr.GilbertRossoftheAmericanCouncilonScienceandHealthrecentlycriticizedaneditorialpostedonalocalSouthDakotanewswebsitethatwarnsagainstsmokelesstobaccousesayingitcontainedmorefalsehoodsandmisleadingstatementsinthefewestwordsthatIvehadthedispleasuretoreadrecently.eeditorialsdescriptionofCamelSnusasachewingtobaccobrandiswronghestatedbecauseitisactuallyamoistsmokelessproductthatinvolvesneitherchewingnorspitting.Whilehebelievesthatthebestuseoftobaccoproductsisnouseonesolutiontoreducesmoking-relatedmortalityistogetaddictedsmokerstoswitchtocleanernicotinedeliverysystemssuchassnus.AndsnusnowhastaxbackingfromtwostatesrstKentuckyandmostrecentlyIndianathatociallyrecognizeharmreductionbyallowingthetaxrateonsmokelesstobaccosnustoreecttherelativeriskbetweensmokelessproductsandcigarettes.ProfessorRoducallsthisacompellingandinnovativestrategybecauseitprovidesaneconomicincentiveforsmokerstotransitionfromhigh-riskhigh-taxcigarettestoverylow-risklow-taxsmokelessproducts.eideaofarisk-based36TeWallStreetJournalNewYorkDailyNewsHufngtonPostTOBACCOOUTLETBUSINESSJULYAUGUST2011asnUssmokElEsssEnsation