Orange County NC Website
MINUTES -Draft <br />ORANGE COUNTY BOARD OF HEALTH <br />January 27, 2015 <br />Dr. Johnathan Thornburg, Director of Exposure and Aerosol Technology, Research Triangle <br />Institute International (RTI), began with a brief overview of electronic cigarettes. Electronic <br />cigarettes, also known as e- cigarettes, are battery- operated products designed to deliver <br />nicotine, flavor and other chemicals. They turn chemicals into an aerosol that is inhaled by the <br />user. E- cigarettes were created in 2007 and have become a global health issue. They have <br />attracted the attention of the World Health Organization but there still is very little information on <br />them due to a lack of scientific evidence. They contain a wide range of additives, some of which <br />can be transformed into carcinogens during the process of using the product. The engineering <br />of e- cigarettes has rapidly evolved. In spite of this, there is still a risk of overheating if they are <br />tampered with. E- cigarettes are the most prevalent tobacco product used by teenagers. <br />Currently, there are about 450 companies in the United States with an estimated 7,500 different <br />liquid flavors available for purchase. E- cigarettes liquids, which are comprised of propylene <br />glycol and /or glycerin, are available with or without nicotine and can contain flavorings. <br />Dr. Thornburg also described the structure of an e- cigarette and noted that they generate a <br />mixture of vapors and aerosols. He also detailed the composition of e- cigarette emissions by <br />chemical class which included nicotine, glycerin and glycol, alkylated cyclic compounds and <br />phenolic compounds based on their presence in the gas, aerosol or bulk liquid form. When <br />speaking about emissions and health implications, he noted that the particle size of their <br />emissions, which is very small, determines where the particles deposit in the lungs. He <br />continued by stating that the concentration determines how many particles deposit in the lungs. <br />Size and concentration determine the toxicity of the particles inhaled by the user and included in <br />secondhand exposure. The health effects and toxicity of nicotine are well known. In addition, <br />the toxicity of some ingredients, such as flavors with diacetyls and cinnaldehyde, is based on <br />industrial hygiene inhalation toxicology. However, the toxicity of other ingredients, as well as the <br />acute and chronic impacts that result from inhalation of high concentrations of many e- liquid <br />ingredients, are still largely unknown. About 50% of what is inhaled is exhaled. Approximately <br />47% of inhaled emissions are deposited into the lungs. Dr. Thornburg also mentioned that <br />exhaled e- cigarette vapors from a single user were detected indoors as far as 6 feet away; <br />concentrations were 25 times lower than adjacent to the user. He also stated that the tertiary <br />effects such as exposure to nicotine or other components of e- cigarette emissions that deposit <br />on surfaces have not been investigated. Lastly, Dr. Thornburg commented that there is still <br />much unknown as science has not kept up with technology; however, the Food and Drug <br />Administration (FDA) is currently funding research on e- cigarettes. <br />The BOH members had several questions that were addressed by Dr. Thornburg. <br />B. E- Cigarettes: Trends and Policy Options <br />Coby Austin, Senior Public Health Educator, opened her presentation by providing an overview <br />of the trends in adult and youth use of e- cigarettes. Some of the data Ms. Austin covered <br />included: <br />• About 16% of cigarettes smokers are "dual users" meaning that they may smoke <br />cigarettes as well as e- cigarettes. <br />• About 22% of former smokers now use e- cigarettes. <br />• The percentage of long -term former adults who currently use e- cigarettes is 2.3 %. <br />• Younger people are using e- cigarettes more than combustible, regular cigarettes. <br />S: \Managers Working Files \BOH \Agenda & Abstracts \2016 Agenda & Abstracts/ <br />February Page 2 <br />