Electronic Cigarette Manufacturers Warned

The Food and Drug Administration (FDA) sent letters last week to five manufacturers of electronic cigarettes (e-cigs), warning the companies that they were making unsubstantiated medical claims about their products, including the claim that the products were an aid to stopping smoking – a medical claim prohibited by the Federal Food, Drug, and Cosmetic Act. The FDA also signaled its intent to regulate e-sigs as a drugs or drug-delivery devices.

An “e-cig” (since you forgot to ask) is a battery-powered cigarette-shaped device that can be loaded with a cartridge of nicotine and other additives. When the user inhales through the device, the battery vaporizes the liquid so that it can be inhaled into the lungs. The product contains no tobacco. A wisp of “smoke” appears, but it’s just water vapor.

Several of the e-cig products contain herbal ingredients in addition to nicotine. One of the e-cig companies even sells other drugs in liquid form for use in the devices, including an erectile dysfunction drug (tadalafil) and a weight-loss drug not approved in the U.S. (rimonabant).

The names of the companies and copies of the FDA’s letters to them can be found on the FDA web site in a press announcement dated Sept. 9th. Whether this is the end of e-cigs isn’t clear.

Snus - Smokeless Tobacco Made Easy

Now available over the internet and in stores; Snus (rhymes with loose), a smokeless tobacco product containing nicotine that originated in Sweden. Snus comes in colorful tins and is packaged in small tea bag-like packets. It’s real advantage over traditional smokeless chewing tobacco is that no spitting is necessary - the small amount of juice produced can just be swallowed. It’s likely to become popular among teens who want their tobacco use to go undetected, patrons of bars and restaurants where smoking is not permitted, and smokers who want to quit.

The tobacco companies are looking to attract a whole new generation of tobacco users and to shore up profits in the face of declining cigarette sales. R.J. Reynolds launched a nationwide marketing campaign for “Camel Snus” in 2009. As usual, the company denies that it aims its marketing campaign toward underage users.

So far there is no evidence that Snus use may be a risk factor for cancers of the mouth and throat. Nevertheless, it is a tobacco product. It’s worth remembering that there were no clear health risks associated with cigarettes, either, when they first became popular in the 1940s.

Living With Cystic Fibrosis

Sixty years ago, before doctors knew very much about cystic fibrosis, most children with the disease died before school age. Today people with the disorder are living well into their 30s. Today we know that cystic fibrosis is a genetic disorder and we know what causes the symptoms.

What we don’t have is a cure. Prolonging the life of cystic fibrosis patients is largely based on improvement of care, including medicines that alleviate some manifestations of the disease and physical therapy to keep the lungs clear. What works for one patient doesn’t always work as well for the next.

An effective tool in the improvement of care for cystic fibrosis patients has been the establishment of a national registry of patients. The registry, which is managed by the Cystic Fibrosis Foundation, currently collects and stores patient records from more than 100 cystic fibrosis treatment centers across the country. The pooled data has proven very useful in learning what works best for which kinds of patients, and why. It’s like having the collective experience of thousands of doctors right at your fingertips.

The concept of a using a national registry of patients to improve patient care has proven so successful that other patient groups are copying it.

Exercising Your Head Cold

When you catch cold, should you continue your usual exercise routine or just stay at home and rest?

According to a pair of articles published about 10 years ago, maintaining your usual exercise regimen may be good for you when you have a cold, or at least it will do no harm. A typical head cold with a runny nose and sneezing does not affect lung function or exercise capacity. And although exercise doesn’t actually speed recovery time, people who continue to exercise during a head cold tend to report that they feel better than people who don't exercise. So the next time you catch a cold, go ahead and continue doing whatever exercise you enjoy doing.

References:
"Effect of rhinovirus-caused upper respiratory illness on pulmonary function test and exercise responses". Weidner TG et al. Med. Sci. Sports Exerc. 29:604-609, 1997.
"The effect of exercise training on the severity and duration of a viral upper respiratory illness". Weidner TG et al. Med. Sci. Sports Exerc. 30:1578-1583, 1998.