{"id":1035,"date":"2014-08-07T14:34:29","date_gmt":"2014-08-07T14:34:29","guid":{"rendered":"http:\/\/www.harpahreins.com\/blogg\/?p=1035"},"modified":"2014-08-07T14:38:49","modified_gmt":"2014-08-07T14:38:49","slug":"kostir-gallar-og-adgengi-ad-rafrettum","status":"publish","type":"post","link":"https:\/\/harpahreins.com\/blogg\/2014\/08\/07\/kostir-gallar-og-adgengi-ad-rafrettum\/","title":{"rendered":"Kostir, gallar og a\u00f0gengi a\u00f0 rafrettum"},"content":{"rendered":"

\u00deessi pistill er framhald af Rafrettur, Lyfjastofnun og nik\u00f3t\u00ednlyf<\/a>.<\/p>\n

Rafrettur komu fyrst \u00e1 marka\u00f0 \u00ed Evr\u00f3pu og Bandar\u00edkjunum \u00e1ri\u00f0 2006. Vins\u00e6ldir \u00feeirra hafa vaxi\u00f0 hr\u00f6\u00f0um skrefum, ekki vegna markvissrar marka\u00f0ssetningar heldur vegna Netsins: Notendur stofna h\u00f3pa og umr\u00e6\u00f0ubor\u00f0 og segja af reynslu sinni; umr\u00e6\u00f0an berst hratt \u00ed gegnum samskiptami\u00f0la; sm\u00e1fyrirt\u00e6ki\/vefs\u00ed\u00f0ur sem selja rafrettur, \u00edhluti og v\u00f6kva spretta upp eins og gork\u00falur. Vegna \u00feessarar hr\u00f6\u00f0u \u00fatbrei\u00f0slu hafa ekki veri\u00f0 ger\u00f0ar margar almennilegar ranns\u00f3knir \u00e1 rafrettum. En n\u00fa hafa tr\u00f6llin tv\u00f6 \u00ed vi\u00f0skiptaheimi Vesturlanda \u00e1tta\u00f0 sig og b\u00edtast um bitann: T\u00f3baksframlei\u00f0endur og lyfjaframlei\u00f0endur. \u00dev\u00ed mi\u00f0ur er \u00fatlit fyrir a\u00f0 \u00feessi \u00e1g\u00e6ta uppfinning falli \u00ed \u00feeirra hendur me\u00f0 dyggri a\u00f0sto\u00f0 stj\u00f3rnvalda sem f\u00f3\u00f0ra gj\u00f6rninga s\u00edna me\u00f0 \u00fev\u00ed a\u00f0 veri\u00f0 s\u00e9 a\u00f0 g\u00e6ta hagmuna notenda, \u00fe.e. passa \u00fe\u00e1 eins og \u00f3vita.<\/p>\n

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Geta rafrettur veri\u00f0 h\u00e6ttulegar?<\/h3>\n

Gr\u00e6jan sj\u00e1lf er ekki h\u00e6ttuleg nema lithium-rafhl\u00f6\u00f0urnar geta sprungi\u00f0 eins og allar sl\u00edkar rafhl\u00f6\u00f0ur. \u00dea\u00f0 hefur gerst einstaka sinnum ef marka m\u00e1 fr\u00e9ttir sem birst hafa \u00ed mis\u00e1rei\u00f0anlegum fj\u00f6lmi\u00f0lum en yfirleitt var \u00fe\u00e1 einhver vitleysingur a\u00f0 hla\u00f0a rafhl\u00f6\u00f0una rangt. (Sams konar s\u00f6gur m\u00e1 finna um t\u00f6lvur, fars\u00edma og fleira d\u00f3t me\u00f0 endurhla\u00f0anlegri lithium-rafhl\u00f6\u00f0u.)<\/p>\n

V\u00f6kvinn sem er \u00ed t\u00f6nkum (e\u00f0a geymum) rafretta getur innihaldi\u00f0 \u00fdmis \u00f3holl aukaefni \u00f6nnur en glycerol og nik\u00f3t\u00edn og s\u00f6mulei\u00f0is geta or\u00f0i\u00f0 \u00f3\u00e6skileg efnahv\u00f6rf vi\u00f0 hitun hans. \u00deessi aukaefni eru \u00ed \u00e1l\u00edka litlum m\u00e6li og \u00ed nik\u00f3t\u00edn\u00fa\u00f0a \u00feeim sem lyfjafyrirt\u00e6ki framlei\u00f0a og margfalt minni en m\u00e6last \u00ed s\u00edgarettureyk. M\u00e1lmagnir sem m\u00e6last \u00ed gufunni (t.d. kadm\u00edn, nikkel og bl\u00fd) eru \u00ed \u00e1l\u00edka magni og m\u00e6list \u00ed nik\u00f3t\u00edn\u00fa\u00f0a. V\u00e6ri \u00e1hugavert a\u00f0 sj\u00e1 samanbur\u00f0art\u00f6lur vi\u00f0 gufu \u00far hra\u00f0su\u00f0ukatli, \u00fatbl\u00e1stur b\u00edla o.fl. en \u00fe\u00e6r liggja ekki \u00e1 lausu. M\u00f6gulega g\u00e6ti einhver haft ofn\u00e6mi fyrir \u00feessum m\u00e1lm\u00f6gnum e\u00f0a efnum sem myndast vi\u00f0 hitun glycerols.<\/p>\n

Nik\u00f3t\u00edn er ekki s\u00e9rlega h\u00e6ttulegt efni. V\u00edsinda\u00fej\u00f3\u00f0saga fr\u00e1 lokum n\u00edtj\u00e1ndu aldar hefur hermt a\u00f0 30-60 mg af nik\u00f3t\u00edni v\u00e6ri banv\u00e6nt innt\u00f6ku en til eru n\u00fdleg sta\u00f0fest d\u00e6mi um sj\u00e1lfsv\u00edgstilraunir \u00fear sem f\u00f3lk drakk nik\u00f3t\u00ednv\u00f6kva me\u00f0 allt upp \u00ed 1500 mg af nik\u00f3t\u00edni \u00e1n \u00feess a\u00f0 takast \u00e6tlunarverk sitt.<\/p>\n

Ni\u00f0ursta\u00f0an hl\u00fdtur \u00fev\u00ed a\u00f0 vera s\u00fa a\u00f0 rafrettugufun s\u00e9 ekki h\u00e6ttuleg \u00a0manni. En au\u00f0vita\u00f0 m\u00e1 fara a\u00f0 d\u00e6mi fillifjonkunnar \u00ed s\u00f6gu Tove Jansson og ey\u00f0a orku sinni \u00ed a\u00f0 \u00f3ttast allar m\u00f6gulegar h\u00f6rmungar sem g\u00e6tu duni\u00f0 yfir, \u00ed \u00feessu tilviki komi\u00f0 \u00ed lj\u00f3s l\u00f6ngu seinna.<\/p>\n

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L\u00edti\u00f0 nik\u00f3t\u00edn<\/h3>\n

Kannski er st\u00e6rsti gallinn vi\u00f0 rafrettur, fr\u00e1 sj\u00f3narh\u00f3li notenda, a\u00f0 \u00fea\u00f0 er erfitt a\u00f0 gufa nik\u00f3t\u00edni \u00ed s\u00e6milegu magni \u00far \u00feeim. \u00cd n\u00fdlegri tilraun Maciej L. o.fl., sem segir fr\u00e1 \u00ed v\u00edsindaritinu Addiction<\/em> \u00e1ri\u00f0 2013 <\/a>\u00a0kom \u00ed lj\u00f3s a\u00f0 uppgefi\u00f0 nik\u00f3t\u00ednmagn \u00ed v\u00f6kva \u00ed geymum st\u00f3\u00f0st ekki n\u00e6rri alltaf. En \u00f6llu merkilegri var \u00fe\u00f3 s\u00fa uppg\u00f6tvun a\u00f0 samhengi milli nik\u00f3t\u00ednmagns \u00ed v\u00f6kvanum og nik\u00f3t\u00ednmagns \u00ed gufunni var \u00f3tr\u00falega l\u00edti\u00f0. \u00cd \u00feessari tilraun var notu\u00f0 reykv\u00e9l og kom \u00ed lj\u00f3s a\u00f0 gufa\u00f0 nik\u00f3t\u00edn \u00ed 300 \u201esm\u00f3kum\u201c (sem hver st\u00f3\u00f0 \u00ed 1,8 sek\u00fandu) m\u00e6ldist \u00e1 bilinu 2 mg – 15 mg. \u00cd grein Hajek o.fl. sem birtist \u00ed sama t\u00edmariti n\u00fa \u00ed j\u00fal\u00ed<\/a>\u00a0og v\u00edsa\u00f0 er til ne\u00f0st \u00ed \u00feessum pistli var ni\u00f0ursta\u00f0a ranns\u00f3kna \u00e1 raunverulegum gufurum s\u00fa a\u00f0 reyndur gufari sem gufa\u00f0i a\u00f0 vild \u00ed klukkustund g\u00e6ti n\u00e1\u00f0 sama magni nik\u00f3t\u00edns \u00ed inn\u00f6ndun og er \u00ed einni s\u00edgarettu!<\/p>\n

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Kostir rafretta<\/h3>\n

St\u00e6rsti kosturinn er v\u00e6ntanlega s\u00e1 a\u00f0 me\u00f0 \u00fev\u00ed a\u00f0 nota rafrettu m\u00e1 draga \u00far reykingum e\u00f0a jafnvel h\u00e6tta \u00feeim alveg. Og eins og raki\u00f0 hefur veri\u00f0 eru rafrettur \u00f3l\u00edklegar til a\u00f0 valda ska\u00f0a \u00e1 heilsu manns en allir \u00e6ttu a\u00f0 vita a\u00f0 \u00fea\u00f0 er hreint ekki raunin me\u00f0 s\u00edgarettur, raunar allt t\u00f3bak.<\/p>\n

Engin st\u00f3r og r\u00e9tt framkv\u00e6md kl\u00edn\u00edsk ranns\u00f3kn hefur veri\u00f0 ger\u00f0 \u00e1 \u00fev\u00ed hvort rafrettur n\u00fdtist betur e\u00f0a verr en hef\u00f0bundin nik\u00f3t\u00ednlyf til a\u00f0 h\u00e6tta a\u00f0 reykja. Raunar s\u00e9 \u00e9g ekki \u00e1st\u00e6\u00f0u til a\u00f0 efna til kl\u00edn\u00edskrar ranns\u00f3knar \u00e1 \u00feessu \u00fev\u00ed \u00fe\u00e1 er um lei\u00f0 b\u00fai\u00f0 a\u00f0 gefa \u00e1dr\u00e1tt lyfjaframlei\u00f0endum og \u00e1hangendum \u00feeirrar sko\u00f0unar a\u00f0 rafretta s\u00e9 einhvers konar l\u00e6kningat\u00e6ki.<\/p>\n

Skv. grein Hajek o.fl. \u00ed Addiction<\/em> \u00ed j\u00fal\u00ed sl<\/a>. nota mj\u00f6g margir rafrettur me\u00f0fram s\u00edgarettum og hefur tekist a\u00f0 draga umtalsvert \u00far reykingum me\u00f0 hj\u00e1lp \u00feeirra. \u00deetta eru \u201etv\u00ed-notendur\u201c (dual users) og telja h\u00f6fundar \u00feessarar greinar a\u00f0 \u00fea\u00f0 s\u00e9 ekki sl\u00e6mt \u00ed sj\u00e1lfu s\u00e9r \u00fev\u00ed \u00fea\u00f0 hlj\u00f3ti a\u00f0 vera til b\u00f3ta a\u00f0 draga \u00far reykingum. Grana o.fl. sem skrifu\u00f0u grein \u00ed Circulation<\/em> 2014<\/a>\u00a0(sj\u00e1 tilv\u00edsun ne\u00f0st i pistlinum) halda \u00fev\u00ed hins vegar fram a\u00f0 \u00fea\u00f0 \u00fe\u00fd\u00f0i ekkert a\u00f0 minnka reykingar, \u00feeim ver\u00f0i a\u00f0 h\u00e6tta algerlega. R\u00f6kin eru \u00feau a\u00f0 h\u00e6tta \u00e1 lungnakrabba og fleiri tegundum krabbameina r\u00e1\u00f0ist af hve lengi hefur veri\u00f0 reykt og skipti engu m\u00e1li hvort reykt s\u00e9 l\u00edti\u00f0 e\u00f0a miki\u00f0 \u00feann t\u00edma. (\u00c9g \u00e1kva\u00f0 umsvifalaust a\u00f0 h\u00e6tta vi\u00f0 a\u00f0 h\u00e6tta nokkurn t\u00edma a\u00f0 reykja \u00feegar \u00e9g las \u00feetta, \u00fea\u00f0 tekur \u00fev\u00ed ekki \u00far \u00feessu.)<\/p>\n

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A\u00f0gengi a\u00f0 rafs\u00edgarettum og nik\u00f3t\u00ednt\u00f6nkum\/geymum<\/h3>\n

Sem fram kom \u00ed s\u00ed\u00f0ast pistli flokkar Lyfjastofnun h\u00e9rlendis nik\u00f3t\u00ednv\u00f6kva sem lyf og fylgir \u00fear ford\u00e6mi Sv\u00eda<\/a> , Dana<\/a> og Nor\u00f0manna<\/a>,\u00a0auk fleiri \u00fej\u00f3\u00f0a innan Evr\u00f3pska efnahagssv\u00e6\u00f0isins.<\/p>\n

\u00cd l\u00e6knat\u00edmaritinu Lancet<\/em>\u00a0 var nokkur umr\u00e6\u00f0a \u00ed fyrra um hvernig skyldi flokka rafrettur og nik\u00f3t\u00ednv\u00f6kva og hafa eftirlit me\u00f0 \u00feeim. \u00dear m\u00e1 t.d. lesa greinina Regulation of e-cigarettes: the users’ perspective<\/a> eftir Ricardo Polosa og Pasquale Caponnetto, sem talsvert hafa tj\u00e1\u00f0 sig um rafrettur. \u00cd henni kemur fram a\u00f0 l\u00edklega f\u00e9lli nik\u00f3t\u00ednv\u00f6kvi \u00e1g\u00e6tlega undir l\u00f6g og regluger\u00f0ir \u00ed Evr\u00f3pusambandsr\u00edkjum um f\u00e6\u00f0ub\u00f3tarefni en: \u201eThe rapidly expanding popularity of e-cigarettes is a threat to the interests of both the tobacco and pharmaceutical industry and to their associated stakeholders.” \u00c6tli \u00feetta s\u00e9 ekki mergurinn m\u00e1lsins fremur en umhyggja fyrir heilsu gufara?<\/p>\n

Evr\u00f3pusambandi\u00f0 setti n\u00fdlega regluger\u00f0<\/a> \u00a0\u00fear sem nik\u00f3t\u00ednv\u00f6kvi \u00ed rafrettur sem inniheldur 20 mg e\u00f0a minna er flokka\u00f0ur sem t\u00f3baksvara, yfir 20 mg v\u00f6kvi er flokka\u00f0ur sem lyf (kr\u00e6kt er \u00ed fr\u00e9ttatilkynningu fr\u00e1 24. febr\u00faar 2014). Sko\u00f0a m\u00e1 s\u00e9rstakt \u00e1r\u00f3\u00f0ursplagg Evr\u00f3pusambandins \u201etil a\u00f0 sl\u00e1 \u00e1 kjaftas\u00f6gur” af \u00feessu tilefni<\/a> \u00a0(sem a\u00f0 m\u00ednu mati er \u00e1g\u00e6tt d\u00e6mi um algert kjaft\u00e6\u00f0i).<\/p>\n

Evr\u00f3pusambandi\u00f0 hefur sem sagt fellt sinn Sal\u00f3m\u00f3nsd\u00f3m: Gefi\u00f0 t\u00f3bakstr\u00f6llinu helminginn af nik\u00f3t\u00ednv\u00f6kvagr\u00f3\u00f0a og lyfjaframlei\u00f0str\u00f6llinu hinn helminginn. Au\u00f0valdi\u00f0 \u00e6tti a\u00f0 vera hamingjusamt.<\/p>\n

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Delluverk dau\u00f0ans<\/h3>\n

Sem betur fer hefur \u00feessi \u00e1kv\u00f6r\u00f0un Evr\u00f3pusambandsins ekki or\u00f0i\u00f0 a\u00f0 veruleika enn\u00fe\u00e1. Hins vegar er innflutningur \u00e1 nik\u00f3t\u00ednv\u00f6kvum n\u00fana gott d\u00e6mi um Catch-22 a\u00f0st\u00e6\u00f0ur \u00fev\u00ed r\u00e9tt \u00ed \u00feessu f\u00e9kk \u00e9g svar vi\u00f0 fyrirspurn minni um hvort m\u00e6tti flytja inn nik\u00f3t\u00ednv\u00f6kva til eigin nota \u00a0fr\u00e1 \u00fej\u00f3nustufulltr\u00faa Tollstj\u00f3raemb\u00e6ttisins:<\/p>\n

\u201eNei \u00fea\u00f0 er ekki leyfilegt. Nik\u00f3t\u00edn skilgreinist sem lyf og er \u00fev\u00ed \u00ed h\u00f6ndum Lyfjastofnunar a\u00f0 veita leyfi fyrir sl\u00edku. \u00dear sem varan er marka\u00f0ssett sem almenn vara f\u00e6r h\u00fan ekki marka\u00f0sleyfi \u00fear sem almennar v\u00f6rur mega ekki innihalda lyf.\u201c<\/strong><\/p>\n

Lyfjastofnun h\u00e9r (og sums sta\u00f0ar annars sta\u00f0ar) skilgreinir nik\u00f3t\u00ednv\u00f6kva sem lyf. Ekkert ap\u00f3tek \u00ed \u00feessum l\u00f6ndum selur nik\u00f3t\u00ednv\u00f6kva sem lyf \u00fev\u00ed enginn hefur s\u00f3tt um marka\u00f0sleyfi \u00e1 \u00fev\u00ed. Fullt af netverslunum selja nik\u00f3tinv\u00f6kva sem venjulega v\u00f6ru en \u201ealmennar v\u00f6rur mega ekki innihalda lyf\u201c og \u00fev\u00ed er ekki h\u00e6gt a\u00f0 v\u00edsa \u00ed regluger\u00f0ina um a\u00f0 sj\u00faklingur geti flutt inn lyf til eigin nota. Ef \u00feetta er ekki della dau\u00f0ans \u00fe\u00e1 veit \u00e9g ekki hva\u00f0!<\/p>\n

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Svo l\u00edklega sn\u00fd \u00e9g m\u00e9r aftur a\u00f0 ke\u00f0jureykingum \u00e1 Winston long \u00far \u00fev\u00ed Lyfjastofnun er svo umhuga\u00f0 um heilsu m\u00edna og Tollurinn svona l\u00f6ghl\u00fd\u00f0inn.<\/p>\n

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En … ef einhver vill pr\u00f3fa \u00fe\u00e1 l\u00fdk \u00e9g \u00feessum pistli \u00e1 kr\u00e6kjum \u00ed nokkrar vefs\u00ed\u00f0ur \u00fear sem kaupa m\u00e1 rafs\u00edgarettur og nik\u00f3t\u00ednv\u00f6kva.<\/p>\n

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\u00cdslenskar s\u00ed\u00f0ur \u00fear sem kaupa m\u00e1 rafrettur og \u00edhluti:<\/strong><\/p>\n

Gaxa<\/a> \u00a0(\u00c9g hef \u00e1g\u00e6ta reynslu af vi\u00f0skiptum vi\u00f0 \u00feennan a\u00f0ila en \u00e9g er svo sem \u00f3ttalegur gr\u00e6ningi \u00ed gufun.)<\/p>\n

Rafreykur\u00a0<\/a><\/p>\n

eLife<\/a><\/p>\n

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Evr\u00f3pskar s\u00ed\u00f0ur sem hafa veri\u00f0 vins\u00e6lar til a\u00f0 panta nik\u00f3t\u00ednv\u00f6kva:<\/strong><\/p>\n

The Pink Mule<\/a> \u00e1 Sp\u00e1ni<\/p>\n

eShop<\/a> \u00e1 \u00cdrlandi<\/p>\n

Digbys<\/a> \u00e1 Bretlandi<\/p>\n

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A\u00f0alheimildir fyrir utan \u00fe\u00e6r sem kr\u00e6kt er \u00ed \u00far texta<\/strong>:<\/p>\n

Grana, R., Benowitz, N., & Glantz, S. A. (2014). E-Cigarettes A Scientific Review<\/a>. Circulation<\/em>, 129(19<\/em>), 1972-1986.<\/p>\n

Hajek, P., Etter, J. F., Benowitz, N., Eissenberg, T., & McRobbie, H. (2014). Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit<\/a>. Addiction<\/em>.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

\u00deessi pistill er framhald af Rafrettur, Lyfjastofnun og nik\u00f3t\u00ednlyf. Rafrettur komu fyrst \u00e1 marka\u00f0 \u00ed Evr\u00f3pu og Bandar\u00edkjunum \u00e1ri\u00f0 2006. Vins\u00e6ldir \u00feeirra hafa vaxi\u00f0 hr\u00f6\u00f0um skrefum, ekki vegna markvissrar marka\u00f0ssetningar heldur vegna Netsins: Notendur stofna …<\/span> Read More …<\/span><\/a><\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[16,9],"tags":[],"class_list":["post-1035","post","type-post","status-publish","format-standard","hentry","category-daglegt-lif","category-gedheilsa"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1035","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/comments?post=1035"}],"version-history":[{"count":6,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1035\/revisions"}],"predecessor-version":[{"id":1041,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/posts\/1035\/revisions\/1041"}],"wp:attachment":[{"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/media?parent=1035"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/categories?post=1035"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harpahreins.com\/blogg\/wp-json\/wp\/v2\/tags?post=1035"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}