I agree with you that we need definitive research as proof that the electronic cigarette is one of the most effective smoking abstinence tools the world has ever seen. But I fear that the “Tics” (
tobacco Control Community) will sabotage such research. They will insist on keeping the nicotine dosages low – which will be too low to help many people and thus make the product appear to be less effective than it actually is.
I, for example, was still experiencing problems with concentration and memory when I first began using an e-cigarette with what was then called the “high” level of nicotine – 16 mg. / g. When I purchased liquid and began refilling my cartridges with 24 mg. / g. solution, my problems were solved. Some of our community (e-cigarette-forum.com) report that something is missing from the e-cigarette experience and conjecture that it is the MAOIs present in
tobacco. Those folks have added some snus to their program and their problems were solved.
Another issue that arises among new e-cigarette users is proper technique. Just puffing the way you do on a smoked cigarette is not the most effective way to get nicotine into the body. To really measure the effectiveness of the product, the research would need to allow new users to be coached by experienced ones.
Another way I could see the Tics sabotaging the research is by insisting that the design includes weaning down off nicotine like the FDA-approved NRTs. In that case, I fear that we well see the same results as NRTs. They work fine while folks are using them. Once they stop, the overwhelming majority of ex-users relapse. And, unfortunately, they tend to relapse to the most efficient means of nicotine intake: smoking.
Levothyroxine comes in a wide variety of dosages because all bodies are not identical. By the same token, all smokers are not identical. Some can and do wean off nicotine with no ill effects. Some can maintain for years on low doses of nicotine delivered via gum or lozenges. Some can achieve and maintain smoking abstinence by using the 6 mg., 12 mg. or 16 mg. e-cigarette liquid. The CASAA survey indicates that 57% of users need 18 mg. or stronger, with 34% requiring 24 mg. or higher.
So, any ideas on how we get an IRB to approve a design that allows subjects to be coached by experienced users on proper technique? And allow subjects to increase their nicotine dosage until they experience no cravings to smoke and no abstinence symptoms? And that doesn’t insist they stop using the product after a set period of time?
Food for thought, no?