The US has recently seen a spate of law suits around the E-cigarette phenomenon, some filed by E-cigarette manufacturers and distributors seeking to overturn an FDA import ban (successfully achieved as of press time), while others seek to restrict or impose conditions on the sale and marketing of the product, such as the suit filed by Oakland, California attorney general Edmund G. Brown Jr., who is suing Florida-based electronic-cigarette retailer Smoking Everywhere in an effort to stop the company targeting minors and making "misleading and irresponsible" claims that electronic cigarettes are a safe alternative to smoking.

In fact, it seems quite obvious that E-cigs ARE likely to be a safer alternative to smoking tobacco if one believes what is on the packet, if only for the fact that there is no tobacco actually in an E-cigarette, only nicotine and, in some instances, FDA-approved food additives used for flavoring. The nicotine is delivered as a vapor (not as smoke), there is no sidestream or second-hand smoke as all that is exhaled, according to the manufacturers, is water vapor. So while there is clearly a need for further research and quality control assurances to ensure the public is actually getting when they buy an E-cigarette, it seems preposterous that legislators, and not only in the US, are taking such a jaundiced view of a product that essentially makes few outlandish claims and seems to offer a viable, safer alternative to smoking or even chewing actual tobacco. Israel was one of the first nations to refuse to allow the importation of E-cigarettes, citing the addictive properties of nicotine as the reason. E-cigarettes are "illegal" (meaning they can’t be sold) in Singapore and Hong Kong, although not in mainland China.

"We will do anything required by legislators to ensure or products satisfy all legal parameters, including providing full disclosure of ingredients, affixing health warnings and providing complete details of quality control procedures at our factory," said Galazan, adding that the flavor ban affecting cigarettes is currently understood to include E-cigarettes as well, so flavored cartridges are no longer on offer to US purchasers. Asia remains an extremely interesting potential market for it products, and Smoke51 is actively looking for distributors in the region.

In the UK, E-cigarettes remain unregulated and increasingly available, as they are in Holland, although advertising E-cigarettes is banned there.

In the US, The American Cancer Society, the American Heart Association, the American Lung Association and the Campaign for Tobacco Free Kids are among groups that have questioned the safety of E-cigarettes and are actively canvassing to have them removed from the market until they can be proved "safe".

Opponents of E-cigarettes, including the FDA, cite the inclusion of the chemical diethylene glycol in the nicotine cartridges, taking every opportunity to remind consumers that it is also used in anti-freeze. What they usually fail to mention, however, is that this same substance is found in many other products, including as a propellant for many FDA-approved pressurized food dispensers and other ingestible products.

Quite why they invoke such extreme reactions from some quarters is hard to understand. E-cigarettes are not noticeably being touted as primary smoke cessation aids, although there is evidence to suggest they do actually perform that task for some users, nor are they being widely promoted as an alternative to smoking cigarettes, although manufacturers point to the fact that a high percentage of users continue to purchase nicotine cartridges after making the initial purchase of a "starter kit", typically one or two battery units and a charger with a selection of nicotine cartridges, therefore indicating that they are replacing conventional cigarettes for some smokers.

The cartridges themselves are available in a variety of strengths (expressed in milligrams of nicotine – there are even 0mg nicotine cartridges available) and flavors such as menthol and chocolate are available.

"E-cigarettes do not burn the nicotine in the same way as tobacco is ignited in a conventional cigarette tip," Galazan explained. "Instead, an atomizer heats the nicotine solution to create the vapor. The foam nickel reaches a maximum temperature of 200 ºC. The vapor starts to be created when the temperature reaches 100ºC – far less than the 800ºC to 1,200ºC generated at the tip of a conventional cigarette. The outside of an E-cigarette tube is made of stainless steel, and reaches no more than 40º C even after continuous puffs, so it is not hot to the touch."

Perhaps because of facts like these, not everyone in the anti-smoking camp is convinced that E-cigarettes are a dangerous or an undesirable product.

According to E Cigarettes National’s website (www.ecigarettesnational.com), Indianapolis, Marion County Council Proposal 371 seeks to ban the use of e-cigarettes in all workplaces, but leading public health physicians and smokefree advocates aren’t pleased that e-cigarettes were quietly included in the legislation.

Smokefree Pennsylvania and the American Association of Public Health Physicians urged the Marion County Council to strike the wording "the use of an electronic cigarette (also known as an e-cigarette)" from the proposal, stating that it was an issue that the council had not even discussed.

"Banning smoking in public places and workplaces is an effective measure to both protect non-smokers and reduce exposure to tobacco-related toxic substances in cigarette smoke. Including e-cigarettes in this ban, however, will do more harm than good," states Dr. Joel Nitzkin in a letter representing the AAPHP.

"Changing the legal definition of "Smoking"... to include usage of smokefree nicotine products defies science and common sense, and is inconsistent with the original purpose of the legislation... would encourage e-cigarette users to switch back to lethal cigarettes... and would discourage smokers from switching to lifesaving smokefree alternatives," added Smokefree Pennsylvania’s letter.

Cigar-loving California governor Arnold Schwarzenegger’s recent veto of a bill that would have denied California citizens the right to purchase electronic cigarettes and a warning by the Food and Drug Administration (FDA) that it is claimed is based on a flawed, narrow study have also contributed to the growing debate.

"Unfortunately, many of the arguments we’ve seen recently against electronic cigarettes have been driven by fear of the unknown, insufficient evidence, political agendas, and ignorance about our members’ products," according to US-based Electronic Cigarette Association (ECA) president Matt Salmon. "As in the case of California governor Schwarzenegger, we’ve found that reasonable people, when willing to honestly and intellectually evaluate the information about electronic cigarettes, find that these products provide smokers a viable alternative to combustible tobacco cigarettes."

There are other reasons smokers may consider the E-cigarette option. For one thing, as they do not produce smoke, manufacturers claim that E-cigarettes can be used on airplanes and in places where conventional cigarettes are banned, such as pubs, bars restaurants and other public places.

And those who have tried them often agree that there are noticeable health benefits to be gained thanks to the lack of smoke. The option to choose the amount of nicotine in a cartridge, the absence of ash and odor, the pleasing and familiar feel of the tube and the option to individualize the product by decorating it with graphic ‘sleeves’ also contribute to consumer acceptance. There are no cigarette butts to dispose of. You can take as many drags as you like at a time, and the tip won’t burn a hole on your shirt or burn your house down either.

But perhaps most compelling reason to switch to E-cigarettes is the price.

A starter kit can cost anything up to US$150, typically consisting of two tubes (each containing a rechargeable battery and an atomizer) and a charger. A two-tube starter kit allows customers to recharge one unit while using anther. However, a basic kit may set a buyer back as little as US$25 for a disposable unit.

Once a basic unit is purchased, the E-cigarette replacement cartridges work out to be far cheaper than the cost for the equivalent number of conventional cigarettes. In the case of Smoke51, the cartridges for a standard starter kit unit retail in the US for US$2.80 per cartridge (supplied in packs of five and boxes of 50) each containing the equivalent of between 1.5 to 2 packs of 20 conventional cigarettes while the disposable stick’s cartridges are the equivalent of four packs and retails for US$25. So a 20 cigarette a day smoker will see significant savings if they were to switch exclusively to E-cigarettes.

But are they doing so in any appreciable numbers?

According to Galazan, they are. "Based on our sales figures, we see that around 40% of our starter kit customers ‘get it’, meaning they make regular purchases of replacement cartridges every month, implying they are using E-cigarettes frequently and regularly. We estimate about 25% are selective users, perhaps using the product in smoke-free areas, in offices and so on. Around 10% of new users drop it quite quickly or never really start using it , perhaps seeing it as a gimmick."

So how do E-cigarettes smoke? Well, obviously, they are different to conventional cigarettes. Vapor is not smoke and the tobacco smoke of a conventional cigarette imparts a flavor and sensation that an E-cigarette has yet to match for most smokers. However, the tactile effect of an E-cigarette is close to that of a conventional product, and the nicotine delivery system is effective and noticeable. Also, E-cigarettes are not social in the sense that a user is not going to offer E-cigarettes around as they might a conventional packet of cigarettes.

Nonetheless, although they are yet to demonstrate a significant challenge to conventional tobacco products in terms of market share, the rising popularity and acceptance of E-cigarettes is causing ripples of concern in the conventional industry.

E-cigarettes derive the nicotine used in the cartridges from tobacco leaves, but "the quality of tobacco is not important since we are only extracting the nicotine and not the flavor," according to Galazan.

Currently, most of the nicotine extraction for E-cigarettes is performed in China using Chinese tobacco. About 0.41mg.of nicotine is extracted per 1 gram of tobacco, so each 6mg cartridge takes 15 grams of tobacco to produce.

Clearly, if all the legal hurdles are overcome and E-cigarettes start to erode the sales of conventional tobacco products, the big players will have to take the segment more seriously than they appear to be currently. Rumors of a possible purchase of a leading Chinese E-cigarette manufacturer by Philip Morris have been repeatedly quashed – by Philip Morris – but E-cigarettes do appear to embody many of the properties Potentially Reduced Exposure Products (PREP) are intended to espouse, so it may only be a matter of time before they enter the mainstream.