E-Cigarettes Deliver Nicotine - JF Etter

[rolygate]

Yeah, well, trying to have a sensible debate in the Outside would need an analogy like that

 

[Lisa66]

I got the questionnaire & saliva sample kit for part 2 of this study in the mail today.

I got mine today, too.

 

[Spazmelda]

I found this commentary on the Etter piece by Foulds and Veldheer. Commentary on Etter & Bullen (2011): Could E-cigs become the ultimate nicotine maintenance device? - FOULDS - 2011 - Addiction - Wiley Online Library

 

[jtpjc]

@Spazmelda: yet another sensible article. Could common sense go viral?

 

[Papa Lazarou]

I got mine today, too.

Does anyone know what the purpose of part 2 is? Are they looking for something different now, are they just continuing the study to get more data?

 

[Placebo Effect]

I found this commentary on the Etter piece by Foulds and Veldheer. Commentary on Etter & Bullen (2011): Could E-cigs become the ultimate nicotine maintenance device? - FOULDS - 2011 - Addiction - Wiley Online Library

Very nice to see Dr. Foulds write such a positive article and not end it with, "Until more is known, smokers looking to quit should use products deemed safe and effective by the FDA."

 

[Spazmelda]

Very nice to see Dr. Foulds write such a positive article and not end it with, "Until more is known, smokers looking to quit should use products deemed safe and effective by the FDA."

Heh, yeah it is. LOL!

 

[rothenbj]

@Spazmelda: yet another sensible article. Could common sense go viral?

Only if they can establish a new way of generating the money to pay the interest on the government's bills. We all know the bills never get paid, just a large, revolving credit card with no limit.

 

[Ande]

I found this commentary on the Etter piece by Foulds and Veldheer. Commentary on Etter & Bullen (2011): Could E-cigs become the ultimate nicotine maintenance device? - FOULDS - 2011 - Addiction - Wiley Online Library

Not a bad article- and anything that suggests to the public that ecigs could be considered beneficial is worth keeping around.

I had a slight sneer at the reference to "smoking cessation medications that have been demonstrated to be safe and effective for that purpose."

Which medications are those, exactly? I might want some.

But all the ones I know are either useless, dangerous, or most frequently both.

Still, not a bad article.

Ande

 

[rolygate]

As you say, there are no NRTs or other quit-smoking drugs that are both "safe and effective". They are either virtually useless, or ineffective and also dangerous. The one with the highest success rate, Chantix, is believed to have caused 62,500 heart attacks in the USA last year. I'm not sure how that qualifies as 'safe', but perhaps they have a different definition in the FDA.

I haven't come across a 20-month success figure for Chantix but it is supposed to be about 8%. Maybe someone knows of a reference?

My personal opinion is that a doctor who prescribes it, knowing how dangerous it is, is getting very close to negligence. With a better than one in thirty chance of ruining that person's life (and that of their families), and knowing the scale of the problem - and since there are far better options available - I fail to see how there can be any other interpretation.

 

[rothenbj]

They should have to say, "safe or somewhat effective" to be honest.

 

[Spazmelda]

As you say, there are no NRTs or other quit-smoking drugs that are both "safe and effective". They are either virtually useless, or ineffective and also dangerous. The one with the highest success rate, Chantix, is believed to have caused 62,500 heart attacks in the USA last year. I'm not sure how that qualifies as 'safe', but perhaps they have a different definition in the FDA.

I haven't come across a 20-month success figure for Chantix but it is supposed to be about 8%. Maybe someone knows of a reference?

My personal opinion is that a doctor who prescribes it, knowing how dangerous it is, is getting very close to negligence. With a better than one in thirty chance of ruining that person's life (and that of their families), and knowing the scale of the problem - and since there are far better options available - I fail to see how there can be any other interpretation.

I asked my doctor about Chantix maybe about a year ago, and he wrote me a prescription, but strongly encouraged me not to have it filled. He also told me that if I did have it filled to let him know so that we could schedule follow ups to see whether I was having any ill effects. I had bad experiences with Wellbutrin years ago, so after reading about Chantix I decided I didn't want to try it.

 

[rolygate]

Bet you're glad you didn't go down that road.

 

[Spazmelda]

Definitely! I wish I'd heard of e-cigs at that time, but I hadn't.

I do remember back in graduate school (would have been about 2002ish?) my ethics professor showed us an electronic cigarette (but I'm not sure if that's what he called it). He used to work for RJ Reynolds, or some other big tobacco company, and I he had been working on this e-cigarette project and was very proud of the work he'd done on it. For some reason it fell through and I wish I could remember the reason he gave for it not being pursued. I remember thinking it was a brilliant idea and I wished they were available. I stayed after class to have a closer look and remember being fascinated.

That was the last I'd ever even thought about them until my neighbor told me they had them at a pharmacy nearby.

 

[Vocalek]

Ashtray Blog comments on the study:

Ecig research floundering to understand what vapers already know

 

[sonicdsl]

Ashtray Blog comments on the study:

Ecig research floundering to understand what vapers already know

Nice article! Thanks, as always, for sharing your findings!

 

[bruiser]

When will the snot nosed punk electricman show up in the comments on that article?

 

[Rob0506]

I find it interesting that they want to reduce nicotine level in cigarettes. So let's think this through... We cut nicotine (an addictive but fairly safe compound) by half. Smokers start smoking twice as much to compensate. More cigarette sales, more cancer, more COPD, more die. Yep, that sounds like the right answer, let's go with that!

 

[Vocalek]

I find it interesting that they want to reduce nicotine level in cigarettes. So let's think this through... We cut nicotine (an addictive but fairly safe compound) by half. Smokers start smoking twice as much to compensate. More cigarette sales, more cancer, more COPD, more die. Yep, that sounds like the right answer, let's go with that!

Oh, no. That would never happen! (sarcasm alert)

Jarvik ME, Popek P, Schneider NG, Baer-Weiss V, Gritz ER. Can cigarette size and nicotine content influence smoking and puffing rates? Psychopharmacology (Berl). 1978 Jul 19;58(3):303-6.

The stimuli controlling the rate at which people smoke cigarettes have not been clearly defined. On the hypothesis that smoking is basically nicotine-seeking behavior, nicotine available to the subject was experimentally manipulated through controlling cigarette size and nicotine content. In Experiment I, subjects given their won cigarettes in whole, half, quarter, and eighth lengths, increased the number of cigarettes smoked and number of puffs to compensate for reductions in size. Satisfaction was directly related to cigarette length. In Experiment II, subjects given special cigarettes delivering 0.2 or 2.0 mg nicotine/cigarette smoked significantly more of the low than of the high nicotine cigarettes and took significantly more puffs. As in Experiment I, significantly more quarter length than full length cigarettes were smoked, but total number of puffs did not differ. These results support the hypothesis that nicotine controls smoking behavior.

Can cigarette size and nicotine co... [Psychopharmacology (Berl). 1978] - PubMed - NCBI


Russell MA, Jarvis M, Iyer R, Feyerabend C. Relation of nicotine yield of cigarettes to blood nicotine concentrations in smokers. Br Med J. 1980 Apr 5;280(6219):972-6.

These results suggest that the assumed health advantage of switching to lower-tar and lower-nicotine cigarettes may be largely offset by the tendency of smokers to compensate by increasing inhalation.

Relation of nicotine yield of cigarettes to blood n... [Br Med J. 1980] - PubMed - NCBI


Withey CH, Papacosta AO, Swan AV, Fitzsimons BA, Ellard GA, Burney PG, Colley JR, Holland WW. Respiratory effects of lowering tar and nicotine levels of cigarettes smoked by young male middle tar smokers. II. Results of a randomised controlled trial. J Epidemiol Community Health. 1992 Jun;46(3):281-5.

Analyses of the urinary nicotine metabolites showed that smokers allocated to each of the three study cigarettes adjusted their smoking so that throughout the trial their nicotine inhalation differed little from their pretrial intakes when they were smoking their own cigarettes. As a result of the altered patterns of smoking to compensate for the reduced nicotine yields of the three study cigarettes, the tar intake of those allocated to smoke the middle tar, middle nicotine cigarettes remained essentially unchanged, while those allocated to smoke the low tar, low nicotine and low tar, middle nicotine cigarettes had calculated reductions in tar intakes of about 14% and 18%, respectively.
CONCLUSIONS: Due to the phenomenon of compensation, tar intake can only be reduced substantially by using a cigarette with a markedly lower tar/nicotine ratio.

Respiratory effects of lowering... [J Epidemiol Community Health. 1992] - PubMed - NCBI


Bridges RB, Humble JW, Turbek JA, Rehm SR. Smoking history, cigarette yield and smoking behavior as determinants of smoke exposure. Eur J Respir Dis Suppl. 1986;146:129-37.

These data suggest that smoking history, nicotine yield of the cigarette and smoking behavior are all determinants of smoke exposure. Further, although smokers of low-yield cigarettes appear to compensate by puffing larger volumes per cigarette, this compensation appears to be inadequate to attain an equivalent smoke exposure.

Smoking history, cigarette yield and ... [Eur J Respir Dis Suppl. 1986] - PubMed - NCBI

Does smoking fewer cigarettes work?


Benowitz NL, Jacob P 3rd, Kozlowski LT, Yu L. Influence of smoking fewer cigarettes on exposure to tar, nicotine, and carbon monoxide. N Engl J Med. 1986 Nov 20;315(21):1310-3.

We measured the intake of tar (estimated as mutagenic activity of the urine), nicotine, and carbon monoxide during short-term cigarette restriction. With a reduction from an average of 37 cigarettes to an average of 5 cigarettes per day, the intake of tobacco toxins per cigarette increased roughly threefold and daily exposure to tar and carbon monoxide declined only 50 percent. We conclude that smoking fewer cigarettes may reduce exposure to toxins and related adverse health consequences. However, consistent with a tendency to maintain intake of nicotine, the magnitude of the benefit is much less than expected. Whether "oversmoking" persists during long-term restriction of cigarettes requires further investigation.

Influence of smoking fewer cigarettes on exposu... [N Engl J Med. 1986] - PubMed - NCBI


Scherer G. Smoking behaviour and compensation: a review of the literature. Psychopharmacology (Berl). 1999 Jul;145(1):1-20.

CONCLUSIONS: The available data suggest that smokers partially compensate for a different smoke yield. While the factors and their interaction responsible for compensational smoking are not fully understood, there are data suggesting that a subgroup of smokers may partially compensate for nicotine

Smoking behaviour and compensation... [Psychopharmacology (Berl). 1999] - PubMed - NCBI

But inexplicbly, when Dorothy Hatsukami et al. studied the question, they did not observe compensatory smoking with cigarettes providing only 0.05 mg of nicoitne.

Hatsukami DK, Kotlyar M, Hertsgaard LA, Zhang Y, Carmella SG, Jensen JA, Allen SS, Shields PG, Murphy SE, Stepanov I, Hecht SS. Reduced nicotine content cigarettes: effects on toxicant exposure, dependence and cessation.Addiction. 2010 Feb;105(2):343-55.

Abstract

AIMS:
To examine the effects of reduced nicotine cigarettes on smoking behavior, toxicant exposure, dependence and abstinence.

DESIGN:
Randomized, parallel arm, semi-blinded study. Setting University of Minnesota Tobacco Use Research Center.

INTERVENTIONS:
Six weeks of: (i) 0.05 mg nicotine yield cigarettes; (ii) 0.3 mg nicotine yield cigarettes; or (iii) 4 mg nicotine lozenge; 6 weeks of follow-up. Measurements Compensatory smoking behavior, biomarkers of exposure, tobacco dependence, tobacco withdrawal and abstinence rate.

FINDINGS:
Unlike the 0.3 mg cigarettes, 0.05 mg cigarettes were not associated with compensatory smoking behaviors. Furthermore, the 0.05 mg cigarettes and nicotine lozenge were associated with reduced carcinogen exposure, nicotine dependence and product withdrawal scores. The 0.05 mg cigarette was associated with greater relief of withdrawal from usual brand cigarettes than the nicotine lozenge. The 0.05 mg cigarette led to a significantly higher rate of cessation than the 0.3 mg cigarette and a similar rate as nicotine lozenge.

CONCLUSION:
The 0.05 mg nicotine yield cigarettes may be a tobacco product that can facilitate cessation; however, future research is clearly needed to support these preliminary findings.

Reduced nicotine content cigarettes: effects on to... [Addiction. 2010] - PubMed - NCBI

 

[Spazmelda]

Here's a link to the full text of that last one, in case anyone is interested in reading the whole thing: http://davidhammond.ca/downloads/Backup/Quest stuff for Alex/New papers/Quest Hatsukami 2010.pdf