Regulatory Issues Surrounding Audit of Electronic Cigarette Charge Composition.

Abstract

A 29-year-old patient who was treated with buprenorphine for 2 years without recurrence attends regular psychiatric controls that include screening for psychoactive substances. During one of the visits, when he was accompanied by his parents, a test for psychoactive substances was positive for opiates. The patient denied that he used illegal substances, and his parents claimed so as well. During this period, the patient lived fairly in isolation, with themembers of his family. The only new substance that he used was a new cartridge for e-cigarette. The cartridge was bought at the market in another place, at a pretty low price. Since the father used the same cartridge, he offered to take the test on PAS. The test was positive for opiates (father had never used psychoactive substances in his life). This inspired us to do the following experiment: we poured the content of the cartridge into a glass with water, and the test was again positive for opiates. In this case, neither the outcome of the test of our patient and/or his father nor naive experiment (with the help of immunochromatographic test for the simultaneous qualitative detection of drugs and their metabolites in the urine) or experimental method that is highly dubious was important, but the questions (i.e., more questions) that open after these clinical experiences. The questions posed are: does any authority regularly control the composition of e-cigarettes, and if so, which one, under what circumstances, and whether it is regulated by law? Let us start from the known premise: electronic cigarettes (e-cigarettes) are battery-powered devices that allow nicotine intake with chemicals that have different tastes by inhalation, and they are substitutes for smoking ordinary cigarettes. It is known that there are over 250 different brands of e-cigarettes currently on the market. It is estimated that the number of users of e-cigarettes in the world is rapidly growing. In Europe, there are about 7million users of e-cigarettes. In France, there are about 1.5million e-cigarette users, while, for example, in the UK, the number of e-cigarette users has tripled since 2012 (from 700,000 to over 2million) (1). The tobacco industry is investing a huge sum of money into the development of e-cigarettes, and according to the researchers fromHSPH’s Center for Global Tobacco Control (CGTC), Department of Social andBehavioral Sciences, it is very important to identify the subpopulation thatwill probably use them more than others and determine the implications for public health. This research has shown that millions of people – including many young people and smokers who want to stop smoking – try e-cigarettes. This also points to the fact that the importance of determining the potential harm (or benefit) is being underestimated (2). Each e-cigarette contains the following components: batteries (mainly lithium ion) that can be automatic or manual; electronic atomizer spray (responsible for controlling the operation of the device and the release of nicotine vapor during inhalation); and tank in which the liquid for e-cigarette is poured (newer versions have atomizer and tank in one unit, and such a device is called clearomizer). The first e-cigarette appeared on the market in China in 2004, and since then, it is marketed as a healthier alternative to smoking.