“Study finds e-cigarettes affect airways, and quickly”

[Uncle Willie]

Do you consider this study to be answering any questions?

In my opinion, this study is just one big DUH! and accomplishes nothing.
It's as if they are looking for ways to make electronic cigarettes look bad and went for something obvious.

What questions do you want answered?
What kinds of studies would you like to see that address those questions?

The thing is, I feel like you don't understand that everyone agrees with you.
We all pretty much agree we want to know what is in our electronic cigarettes.
We all pretty much agree we want to know the safety profile of any and all aspects of vaping.

What we are doing is encouraging people to do more studies.

And what we are also doing is trying to discourage and debunk misleading propaganda.
And much of that misleading propaganda comes from junk science funded and performed by anti-tobacco people.

Should we not be trying to debunk it?
What should we be doing in your opinion?

I'm pretty sure your answer will be we should be finding some way to force the vendors to come together.
If you have ideas on how to do that, I for one would be willing to listen.

Show me one study that was negative that ECF users supported and did not debunk immediately .. just one .. my point is simple .. any study that has a negative slant is torn apart immediately in a thread or multi thread .. no matter where it came from, no matter who did it .. I'd like to see one that is not ..

As well, the Forum is rife with anti this and that .. and those that push their own agenda .. paranoia runs deep ..

I believe we should welcome any and all info .. simple as that .. are we not smart enough to dig thru and form our own opinions or do we need others to attempt to discredit any negative information .. ?? In fact, the goal in life on many here on ECF is to discredit the bad news .. thus there is little to no neutrality ..

Yes, the PV helped me quit / Yes, the PV worked where others failed / Yes, I feel better / yes to it all ..

Thats does not make without any risk ..

 

[oldsoldier]

The links were broken at the direction of the Site Manager (Roly) as noted in the edit reason of the OP. If you insist on posting junk science articles for people to see, please break the links so that the anti's do not profit from search engine results. ECF is a highly ranked source of information in the e-cig searches and linking junk science and bogus articles gives them "Google juice".

 

[denali_41]

does that study say the strength of nicotine used ??? high nic juices affect me very strangely

 

[DC2]

Show me one study that was negative that ECF users supported and did not debunk immediately .. just one .. my point is simple .. any study that has a negative slant is torn apart immediately in a thread or multi thread .. no matter where it came from, no matter who did it .. I'd like to see one that is not ..

I'm trying to think of other studies that showed anything negative...

There was the study that showed electronic cigarette users are not getting appreciable amounts of nicotine.
As a group we tore that study apart (rightfully so) and when it was redone by the same researcher he reached the opposite conclusion.

Then there was the FDA testing, which we also rightfully tore apart.

Those FDA tests did, however, point out a couple of things which have become an accepted part of our collective knowledge...
--There are some carcinogens in the liquid, about as much as FDA approved quit-smoking products
--It is possible that some DEG contamination could be present in the liquid (not the vapor) and we need to be aware of that

Can you can show me one other study that produced negative results that we wrongfully did not give due consideration?
If so, I will concede your point, because I'm not yet willing to disagree with you entirely.

 

[EJH]

FYI

Here's a response to the study from a few doctors:

E-Cigarette study is just amateur propaganda

 

[Vocalek]

FYI

Here's a response to the study from a few doctors:

E-Cigarette study is just amateur propaganda

This line made me smile:

ACSH's Dr. Josh Bloom agrees. “The moment I saw that they didn’t run the same experiment using actual cigarettes," he says, "I knew this was pure (and not even especially well done) junk — an agenda-based report clumsily masquerading as science.”

 

[minigoat]

FYI

Here's a response to the study from a few doctors:

E-Cigarette study is just amateur propaganda

That is well worth a smile, thanks…

 

[teissenb]

There was the study that showed electronic cigarette users are not getting appreciable amounts of nicotine.
As a group we tore that study apart (rightfully so) and when it was redone by the same researcher he reached the opposite conclusion.

This statement is false. The study was not "redone by the same researcher" who then reached "the opposite conclusion".

I stand by the results reported in the Eissenberg (2010) Tobacco Control letter and the Vansickel et al (2010) CEBP paper, keeping in mind, of course, that (as noted in both publications) the data are limited to the products tested and the conditions described.

In fact, in a paper soon to be published (Vansickel et al., in press) you will see virtually identical data for virtually identical conditions: no reliable nicotine delivery in naive users after two, 10-puff bouts (thus demonstrating reliability of the earlier work) BUT then you will also see that additional 10-puff bouts did lead to reliable nicotine delivery. This result highlights the importance of manipulating puff topography (i.e., in this case puff number) when investigating e-cig induced nicotine delivery. Many experienced users on this forum commented on this issue, as indeed did I and my team (e.g., in Vansickel et al, 2010; "The results of some outcome measures might be influenced by longer-term use, **different puffing profiles**, other electronic cigarette models/cartridge strengths, and/or the user's previous experience with electronic cigarettes.") Note: I added the "**" for emphasis.

And, to follow up on some of the other possibilities mentioned in the sentence quoted above, another forthcoming paper (Vansickel and Eissenberg, in press) shows that experienced users using other e-cig products under different puffing conditions received substantial nicotine doses (an SRNT poster with preliminary data has been discussed elsewhere on this forum). Clearly then (again as noted by users on this forum and me and my team) device, cartridge, and user experience are all potentially important factors in understanding the conditions under which e-cigs deliver nicotine reliably. As we (Vansickel et al., 2010) wrote:

"Future clinical laboratory evaluation can build on
these methods and results to establish the extent to which
electronic cigarettes might be expected to substitute for tobacco
cigarettes, and help to identify under what conditions
this substitution might occur. Parallel studies addressing the
abuse liability and long-term adverse event profile of electronic
cigarettes are also required to ensure safety and appropriate
labeling and marketing of these products."

You may disagree, but I think building the knowledge base in this systematic manner is a reasonable approach.

And, I want to be clear that I stand by the results reported in Eissenberg (2010) and Vansickel et al (2010) while happily highlighting, as always, the limitations of the devices/methods used.

Thanks,

Tom E.

 

[DC2]

Fair enough Dr. Eissenberg.


If I had known you were reading I'd have tried to be more specific in my wording.

 

[Bill Godshall]

Please note the the last sentence of the Vardavas et al study stated: "The US FDA as other international regulatory bodies should pursue the regulation of the e-cigarette until manufacturers provide scientific evidence to support their claims, while additional research is warranted so as to obtain concrete evidence of an adverse health outcome."

I suspect that the authors intented to use the word "and" instead of "as" immediately after "The US FDA" in the previously cited sentence.

Regardless, the authors are basically stating that the FDA should once again ban the sale of e-cigarettes, and that more research should be conducted until e-cigarettes are found to pose health risks. So much for unbiased research. The authors also claimed to have no conflicts of interest, but they failed to mention that Greg Connolly had urged the FDA to ban e-cigarettes several years ago, that Connolly has advocated snus bans for the past 15 years, and that Connolly has also advocated banning new dissolvable tobacco products.

Also note that the Vardavas et al abstract claimed that "30 health non smokers participated in this laboratory based experimental vs. control group study."

But the text of the Vardavas et al study stated "All subjects were smokers with a minimum pack/year index of 5" and "All subjects were instructed not to eat and drink any kind of beverages for at least 2 hours prior to the exam, and to avoid smoking in the previous 4 hours."

And of course, this study found no respiratory problems among study participants, but the study's title and abstract attempted to scare uninformed readers to believe otherwise.

 

[Ande]

Show me one study that was negative that ECF users supported and did not debunk immediately .. just one .. my point is simple .. any study that has a negative slant is torn apart immediately in a thread or multi thread .. no matter where it came from, no matter who did it .. I'd like to see one that is not ..

As well, the Forum is rife with anti this and that .. and those that push their own agenda .. paranoia runs deep ..

I believe we should welcome any and all info .. simple as that .. are we not smart enough to dig thru and form our own opinions or do we need others to attempt to discredit any negative information .. ?? In fact, the goal in life on many here on ECF is to discredit the bad news .. thus there is little to no neutrality ..

Yes, the PV helped me quit / Yes, the PV worked where others failed / Yes, I feel better / yes to it all ..

Thats does not make without any risk ..

The thing is, I don't think we're going around debunking and criticizing articles and research procedures out of some blind prejudice that keeps us from seeing the truth.

I think we're going around debunking garbage. The question you should be asking yourself is not "Why do Vocalek, Kristin, DC2, Placebo Effect et al criticise all these articles." The question you have to ask yourself is "Are their arguments valid?"

IF the arguments used to debunk an article are valid, then...what's the problem?

It's as simple as that. If you can't find holes in the logic, you can't shout "You guys always pick on the anti-eciggers!" We pick on them because by and large, they are full of ...., and any well-informed read of their methodology makes it obvious.

I for one am more than willing to accept VALID studies that determine that the ecigarette has specific provable dangers. I'm inclined to believe, by the way, that we are not dealing with a "safe" product; merely one that is much much safer than cigarette smoking.

But that can't stop me from pointing out flawed methodology when I see it.


Best,
Ande

 

[Ande]

RE- the "no-nicotine" study mentioned here by others.

Another problem we have in this field is that studies with very limited implications (say, a valid study of how clueless new users absorb nicotine in brief inefficient use of low quality ecig products), are referred to as if they prove generalizable conclusions. Say, the widely published conclusion that ecigarettes in general do not provide nicotine.

This may not be the fault of individual researchers involved, but it's a serious problem we have to face. To the public, it matters less what's in the study, because few will read it. It matters a LOT what is in the press release.

And often enough, they don't match.

Best,
Ande

 

[Tom09]

while happily highlighting, as always, the limitations of the devices/methods used.
Tom E.

With excemption of one press release, the actual results of your study group have never been an issue, I’d think.
As a professional, devoted to examine the acute effects of nicotine delivery of e-cigs by measuring plasma nicotine, CO concentrations, cravings, and heart beat rate, could you please comment on the effects measured in the present study?

 

[teissenb]

Tom09:

The text of your question highlights the fact that my expertise is in measures OTHER than pulmonary function, so rather than focus on that issue, I'd like to address two other points about the Vardavas et al (2011) paper.

First, with regard to experimental design, there is in my mind absolutely NO FLAW in including a control condition that involved use of an e-cig without a cartridge. That control condition is a valid one, and is equivalent to the "sham smoking" condition (i.e., puffing on an unlit cigarette) I and others have used for years when studying the effects of cigarette smoking. It controls for any product specific inhalation-behaviors that may influence outcome measures. Now, that having been said, I would have loved to see outcomes measured for OTHER conditions, such as smoking a tobacco cigarette and inhaling from a 0 mg nicotine cartridge. However, and this goes to my point above about systematic progression of science, it is rarely possible to do everything we want in every study we run. What these investigators have reported is an effect that can be measured -- perhaps they intend to explore this effect more thoroughly in subsequent work. Indeed, they may have had financial limitations that this study, with the effect that they report, may help them overcome. I am sorry to say that science rarely moves as quickly as you or I would like it to.

Second, with regard to the conclusions the authors draw, I was struck by the near verbatim repetition of an extremely important qualifier:

"... We must state though that while the differences within our study are of statistical significance, the clinical changes may be too small to be of major clinical importance (i.e. to induce dyspnea or breathing difficulties), however..." (Page 10)

and then

"...We must state though that while the differences within our study are of statistical significance, the clinical changes may be too small to be of major clinical importance." (Page 12)

I find these statements very responsible and pay very close attention to them. They are saying they have a reliable effect but are uncertain of its meaning in terms of user health.

I also noted on Page 12:

"... It is possible that if e-cigarette use were a short term bridge to smoking cessation, the long term health benefits associated with their use might outweigh the short term risks; however this would need to be clarified."

In short, to me this paper is not "junk science". It demonstrates that short-term e-cig use influences lung function, states that the relevance of that influence is unknown, and suggests that this and other effects of e-cigs warrant further study. My guess (and it is a guess) is that these authors, as well as others, are already working to gather the resources to study these effects further.

There is an unfortunate tendency sometimes to expect a single study to answer all questions definitively: in my experience, such studies are very, very, very rare. The usual case, in my experience, is that individual studies reporting different effects under a variety of experimental conditions lead slowly but inexorably to an eventual answer.

Your mileage may vary, of course.

Tom E.

 

[Spazmelda]

I'd like to get a pdf of the paper (without paying $15). Does anyone have a link to free access?

One of the main problems with science on a topic of popular interest is that, while the researchers are generally cautious in their wording and interpretations, the popular press (and government agencies) are not so cautious. The press wants a headline and story that grabs attention. The governement agencies have their own agenda. Both will take a scientific report and twist it, cherry picking data and quotes, to fit their purposes, either intentionally or unintentionally because they don't understand the incremental nature of scientific research. Trying to get more out of it than it actually shows.

Now, the fact that Connoly was an author on this paper does raise some red flags as to the bias that might have been present. Although he was also an author on the recent NRT paper that shows that NRTs aren't that effective as used by the majority of smokers. In one article I read (NYT piece, I think) he admits that he is disappointed in the results, but apparently he did go ahead with the paper and reporting of the results even though they were not what he wanted them to be.

One thing that is interesting to me is the number of media outlets that ran this story versus the number than ran the story of the Polosa paper. I didn't go through a do a count, but I check google news just about every day for stories on e-cigs. I have to wade though a lot of 'fake' news reports to get to the real ones, but I found very few outlets reporting on the Polosa papers and numerous ones about the Vardavas study. Why is that? Was the Vardavas study stronger or did it provide more information? I don't know because I can't read the paper. I know one of the Polosa papers was just a case study reporting on 3 individuals, which is not very strong, but the other one was a pilot trial. Of course, we can say we wish it was more people, wish they had studied x, y, and z, but as Tom E. pointed out, that's not the way science goes about doing things for various reasons. The Vardavas study asked a limited question and found results, but we don't yet know if they are relevant to health of smokers/former smokers. Why did so many media outlets pick up that story compared to the Polosa one?

^Lot's of idle ramblings and disconnected thoughts above. LOL!

 

[McDougal]

Show me one study that was negative that ECF users supported and did not debunk immediately .. just one .. my point is simple .. any study that has a negative slant is torn apart immediately in a thread or multi thread .. no matter where it came from, no matter who did it .. I'd like to see one that is not ..

As well, the Forum is rife with anti this and that .. and those that push their own agenda .. paranoia runs deep ..

I believe we should welcome any and all info .. simple as that .. are we not smart enough to dig thru and form our own opinions or do we need others to attempt to discredit any negative information .. ?? In fact, the goal in life on many here on ECF is to discredit the bad news .. thus there is little to no neutrality ..

Yes, the PV helped me quit / Yes, the PV worked where others failed / Yes, I feel better / yes to it all ..

Thats does not make without any risk ..

I have a high respect for the scientific method, and when I want some insight into something, I research using a wide variety of credible sources. Regarding e-cigarettes, the bias I have largely does come from using them. The problem comes in when people let the bias cloud their reasoning and perspective.

That being said, anyone with any sense should know that e-cigarettes aren't good for you. But that is a large difference from saying or implying that they are "harmful," and stopping there, without explanation. The problem with this study is not that it was fraudulent, it was that it didn't put its findings in it's proper perspective.

I e-mailed an MD at a university, who has done well-known published research on e-cigarettes, and asked for clarification of this study. I don't think it would be right to publish what he wrote back to me without his consent (I was very surprised and impressed he wrote back, and so quickly), so maybe I can e-mail him and see if that's acceptable. Though he said it was only conjecture, he thinks there is a large chance that the inflammation was from propylene glycol irritation, and was interested if the same effect came from glycerol. Overall, he stated are still likely to be "much" safer than smoking.

Also, ACSH published an article critical of this study, which I posted in a new thread in this section.

 

[Spazmelda]

Is this who you wrote to, and basically what he said?

The Rest of the Story: Tobacco News Analysis and Commentary

 

[Vocalek]

It's unfortunate that the responsible statements highlighted by Dr. Eissenberg were buried in the paper. Most people do not have access to the full text of articles in scientific journals.

I find it problematic that the conclusion of the Abstract reads:

E-cigarettes assessed in the context of this study were found to have immediate adverse physiologic effects after short term use that are similar to some of the effects seen with tobacco smoking, however the long term health effects of e-cigarette use are unknown but potentially adverse and worthy of further investigation.

To put the study into the proper perspective for the public and the media, this statement quoted from page 10 should have appeared in the abstract.

We must state though that while the differences within our study are of statistical significance, the clinical changes may be too small to be of major clinical importance (i.e. to induce dyspnea or breathing difficulties).

(The remainder of the quoted sentence was "...however as these measurements were performed after only 5 minutes of ad lib e-cigarette use, a normal consumer would use the product most likely many times a day thus the clinical impact might be
greater.")

If they were going to include the remainder of that quoted sentence, then they should also point out that most users don't puff continuously for five minutes. After figuring out that continuous puffing is not required to keep the unit "lit" like a smoked cigarette, many e-cigarette users have a tendency to take a puff, put down the unit, and then several minutes later pick it up to take another puff. Thus the clinical impact might be less than found in this experiment. Also, under normal use, many (if not most) e-cigarette users do not fill their lungs to capacity, and then exhale over a 10 second period. I do know a few folks who fill their lungs with vapor, but I know many more who either do a shallow inhale, or who first draw the vapor into their mouths, and then inhale (I do this).

The final sentence of the article itself makes it appear that the authors were looking for something negative to say:

...while additional research is warranted so as to obtain concrete evidence of an adverse health outcome.

Why isn't anyone looking for evidence of improvements in health among users? A very easy way to measure this would be to construct a smoking cessation study, take baseline measures of lung function that are normally conducted in a doctor's office (e.g., peak flow meter readings), and then repeat these tests periodically, noting the number of cigarettes (if any) still being smoked on a daily basis.

I can tell you that my peak flow meter reading was 300 when I was smoking and has improved to 450.

The measures of lung function described in this experiment don't sound like any test my allergist has ever performed on me.

 

[Bill Godshall]

VocalEK inquired:

Why isn't anyone looking for evidence of improvements in health among users?

Because those who fund and conduct many of the studies on e-cigarettes have urged the FDA (and/or other countries) to regulate (i.e. ban) e-cigarette sales.

Prohibitionist ideology is incompatable with objective research. Anyone who has advocated e-cigarette prohibition (or who works for an organization/agency that has adopted an e-cigarette prohibition policy) has an ethical duty to acknowledge that as a conflict of interest in their research.

Unfortunately, most prohibitionists don't care about ethics or honesty.

 

[jamentertainment]

“Study finds e-cigarettes affect airways, and quickly”

Sorry people they are correct!!!...if you take your PV and RAM it down your throat you will find it hard to breathe...I dont think we can fight this!!