Electronic cigarettes are increasing in popularity but may carry risks

[capecodjim]

There should be a distinction between ecigs and PV's.

"ecig" sounds nasty and should be banished as a word. Any kind of cig sounds nasty and the "free trial" scams give ecigs a bad image.

"Personal vaporizer" on the other hand has a much better, almost exotic ring to it.

I hardly ever use anything that even looks like a "cig". I vape with a mod as many people do. PV's need some good public relations so they're perceived as something in their own right with no relation to ecigs... the greater the distance the better!! ecigs give PV's a bad name! ecigs give ecigs a bad name! lol.

Nicotine? It's not a necessary part of vaping and it's not always tobacco related... there's nicotine in things like tomatoes, eggplant and red peppers and is made in labs. Any vendor out there who need someone to work on this PM me......

Read the threads here and count how many people have quit tobacco in favor of PV's. PV's are a good thing! ecigs is a bad name!

 

[Our House]

I wish I had the funds to snail mail a professionally printed copy of the CASAA Medical Infograph to every internist in the country. http://www.casaa.org/files/CASAA Medical infograph(4).pdf

Great infograph!

In the interest of fairness though, the left (ecig) side of the graph should include negative effects of long term nicotine use like circulatory issues or birth defects, etc.

I kind of cringe knowing that health professionals are seeing the negatives of ecigs unnecessarily downplayed. There's no need to omit anything when the facts are so strongly on our side, and doing so (even accidentally) hurts our cause.

 

[Vocalek]

Some of the problems you have mentioned might be elevated (over non-users of tobacco) for smokeless tobacco users, but even reduced-toxin tobacco products such as Swedish snus may carry more health risks than a product that provides nothing toxic beyond the nicotine.

My guess would be that any health risks seen from vaping would pretty much match health risks seen from using FDA-approved nicotine products.

NRT should be offered because of decreased risk for low birth weight and preterm delivery compared to continued smoking. Additionally, NRT does not appear to increase the risk for malformations.

Nicotine Replacement Therapy's Effect on Pregnancy Outcomes (November) -- Forinash et al., 10.1345/aph.1P279 -- The Annals of Pharmacotherapy

Abstract— The purpose of this study was to compare circadian blood pressure and heart rate patterns and other cardiovascular effects of nicotine delivered rapidly (via nasal spray, NNS), slowly (transdermal nicotine, TDN), by cigarette smoking (rapid delivery of nicotine plus other smoke toxins), and placebo NNS. Twelve healthy cigarette smokers were studied on a research ward when they smoked cigarettes (16 per day) or used TDN (15 mg/16 h), NNS (24 1-mg doses per day), or placebo NNS, each for 5 days. There were no significant differences in systolic blood pressure, but diastolic blood pressure was slightly increased during cigarette smoking. Plasma epinephrine, ß-thromboglobulin, and fibrinogen levels were higher during cigarette smoking than with TDN. For most measurements, NNS values were intermediate between and not significantly different from those of cigarette smoking and TDN. We conclude that, at recommended doses, TDN and NNS have fewer effects on biomarkers of cardiovascular risk than does cigarette smoking.

Cardiovascular Effects of Nasal and Transdermal Nicotine and Cigarette Smoking -- Benowitz et al. 39 (6): 1107 -- Hypertension

 

[kristin]

We did consider that, but decided we were trying to show the difference in smoking vs. vaping, not the individual health risks of each method.

The risks you mention from nicotine use are not statistically significant compared to the severity and the occurrence of the known risks of smoking.

Statistically, switching from smoking to smokeless REDUCES your risks of circulatory issues or birth defects.

Great infograph!

In the interest of fairness though, the left (ecig) side of the graph should include negative effects of long term nicotine use like circulatory issues or birth defects, etc.

I kind of cringe knowing that health professionals are seeing the negatives of ecigs unnecessarily downplayed. There's no need to omit anything when the facts are so strongly on our side, and doing so (even accidentally) hurts our cause.

 

[Surf Monkey]

Exactly. The position is "risk reduction" not "100% safety."

 

[Our House]

Well obviously you shouldn't have something like:

ECIG | CIG
Small amount of cataracts | Cataracts

But the more important/significant risks should be mentioned. If someone like me is saying it, you KNOW someone like a pharma-bred physician is thinking it -- and will definitely use it to paint us as deceptive.

 

[PoliticallyIncorrect]

I've chanced across another story citing the same Annals of Internal Medicine piece. This one states that "The researchers also point to a lack of smoking cessation data, suggesting that although a majority of consumers buy e-cigarettes because they want to quit smoking, their efforts might well be pinned on false hopes."

As E-Cigarette Promotions Explode on the Web, Researchers Warn of Possible Risks | FairWarning

 

[Vocalek]

Well obviously you shouldn't have something like:

ECIG | CIG
Small amount of cataracts | Cataracts

But the more important/significant risks should be mentioned. If someone like me is saying it, you KNOW someone like a pharma-bred physician is thinking it -- and will definitely use it to paint us as deceptive.

We don't know of any significant risks associated with using nicotine. If you can produce research showing that any health risk associated with smoking is also significantly increased when using non-smoked nicotine (e.g. NRTs), let us know.

 

[Thulium]

I've chanced across another story citing the same Annals of Internal Medicine piece. This one states that "The researchers also point to a lack of smoking cessation data, suggesting that although a majority of consumers buy e-cigarettes because they want to quit smoking, their efforts might well be pinned on false hopes."

As E-Cigarette Promotions Explode on the Web, Researchers Warn of Possible Risks | FairWarning

I would tend to give them the benefit of the doubt and just laugh at them for actually thinking they are saying something that makes sense. What if they had said, "Researchers also point to a lack of rehabilitation data, suggesting that although a majority of consumers buy alcohol-free beers because they want to quit getting drunk, their efforts might be pinned on false hopes."?

 

[Our House]

We don't know of any significant risks associated with using nicotine.

I thought it was common knowledge that nicotine on its own was a culprit for circulatory issues after long term use.

If you can produce research showing that any health risk associated with smoking is also significantly increased when using non-smoked nicotine (e.g. NRTs), let us know.

I probably can't on the spot. Something in my memory says that I've read it from at least one of the huge ecig advocates (like Bill G., Mike S., Joel N., etc.) within the last two years.

 

[Bill Godshall]

While nicotine (like caffeine) causes a temporary increase in heart rate and blood pressure, long term use of nicotine isn't associated with cardiovascular disease, cancer, emphysema or any other disease.

The FDA held a two day conference last week addressing this very issue.


FDA Public Workshop: Risks and Benefits of Long-Term Use of Nicotine Replacement Therapy (NRT) Products
Risks and Benefits of Long-Term Use of Nicotine Replacement Therapy (NRT) Products; Public Workshop
http://www.fda.gov/downloads/Drugs/NewsEvents/UCM230910.pdf
All twelve public hearing speakers urge FDA to approve the marketing of NRT for long term usage
http://www.fda.gov/downloads/Drugs/NewsEvents/UCM230876.pdf
FDA accepting public comments until December 27, 2010
Regulations.gov

Testimony by CASAA's Elaine Keller:
http://www.casaa.org/files/CASAA_NRT_Testimony.pdf

My testimony is at:
http://www.e-cigarette-forum.com/fo...38-fda-urged-approve-nrt-long-term-usage.html

Our testimony generated a news story at:
Electronic Cigarettes' Nicotine Vapor Stokes U.S. Regulators - Bloomberg

 

[Bill Godshall]

Most of the ignorance and confusion about the health risks of nicotine has been created and perpetuated by abstinence-only anti-tobacco activists, researchers, organizations and government health agencies.

While nicotine can be highly addictive (i.e. daily dependence), much of the anti-tobacco research/education/propaganda during the past several decades has vilified nicotine, often using terms "carcinogen, neurotoxin, mutagen, poison".

Surveys find that 50% of the public inaccurately believe that nicotine causes cancer, and many also believe that nicotine gums, lozenges and patches are as hazardous as cigarettes because they inaccurately believe that nicotine is the most harmful consituent in tobacco smoke.

Ironically, the drug companies that market NRT have been giving lots of money to these groups that have intentionally confused and scared the public to believe that nicotine is a major health hazard.

 

[yvilla]

Our House, to add to what Bill and Elaine have already posted, I have to say I'm kind of surprised to see your comments on this thread. I and others have been posting about the myths of nicotine and huge cardiovascular risks for a very long time now. It is nicotine in combination with SMOKE (and especially the resulting carbon monoxide) that causes all the harm. Here are a few more resources on this topic, all of which I have cited to over and over again in the past couple of years on this forum.

From http://www.oasas.state.ny.us/admed/documents/TobaccoMyths.pdf:

"MYTH 13: Wearing a patch will bring on cardiovascular (heart) disease?
TRUTH: NRT’s can be used safely by the majority of people with cardiovascular
disease, even with concomitant smoking. 1-3 A meta-analysis shows no difference
in the rate of acute heart attacks when a NRT patch is worn versus wearing a
placebo patch. 4 The benefits of NRT outweigh the risks, even in smokers with
cardiovascular disease.

1 Joseph AM, et al. N Engl J Med 1996; 335:1792–1798.
2 Tzivoni D, et al. Cardiovasc Drugs Ther 1998; 12:239–244.
3 Working Group for the Study of Transdermal Nicotine in Patients with Coronary Artery Disease.
Arch Intern Med 1994; 154:989–995.
4 Greenland S, et al. Drug Saf 1998; 18: 297–308"

Neal L. Benowitz, MD, from http://content.onlinejacc.org/cgi/reprint/34/6/1791.pdf?ck=nck:

"Overall, the epidemiologic and experimental data suggest
that nicotine absorbed from smokeless tobacco, nicotine
gum or transdermal nicotine is not a significant risk factor
for accelerating coronary artery disease or causing acute
cardiovascular events."

And from Harm Reduction Journal | Full text | Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

"Over the past 15 years, eight epidemiologic studies have examined the risk of cardiovascular diseases among ST users. Six of the studies found that ST users had no increased risk for heart attacks or strokes [47,90,97-100] . The other two reported modestly positive associations, with ST users having RRs of 1.2 and 1.4 [92,101] , which are lower than those of smokers. In 2003, Asplund completed a comprehensive review of the cardiovascular effects of ST use [102] . He concluded that, in distinct contrast to smokers, ST users do not exhibit any significant differences from nonusers of tobacco with regard to the following measures of cardiovascular health: heart rate, blood pressure, cardiac output and maximal working capacity, levels of hemoglobin and hematocrit, leukocytes, antioxidant vitamins, fibrinogen, components of the fibrinolytic system, C-reactive protein and thromboxane A2 production. In addition, ST users did not show important smoking-associated vascular changes, including increased thickness of blood vessels and atherosclerotic plaque development. In summary, most of the medical and epidemiologic evidence documents that ST users do not have elevated risks for cardiovascular diseases."

 

[Our House]

Okay, I stand corrected. For a long time I was under the assumption that nicotine (when separated from tobacco) had that one major adverse effect. Thanks for clearing it up.

 

[rothenbj]

Our House, it's not your fault. The disinformation that has been delivered so long has confused many, many people. To me, it's verging on criminal.

 

[Our House]

I would like to question this though:

While nicotine can be highly addictive (i.e. daily dependence)

Is nicotine still addictive (or nearly as addictive) on its own? Any former smoker will tell you that only part of the addiction of smoking is the nicotine, and there's a TON of addiction associated with the actual habit and lifestyle. Given that nicotine has only recently (last 10 or so years I think) been studied outside of cigarettes, could this be another "fact" that has been embellished upon?

IOW, how would a non-smoking non-nicotine-using person react to taking nicotine pills? Would they become addicted as strongly and at a similar rate to a new smoker?

 

[Our House]

Our House, it's not your fault. The disinformation that has been delivered so long has confused many, many people. To me, it's verging on criminal.

I'm just starting to learn this about weed. My wife and I watched the documentary "The Union: The Business of Getting High" recently and decided to look into what they were saying. Almost everything checked out! Between that and the ecig prototype that was quietly stomped away in the 80s, I'm beyond ...... about being lied to for so long when my health and well being is at stake.

 

[rothenbj]

I don't know if you could get a fair scientific study of the true addictiveness of nicotine at this point, the puritan's have been in control for way too long. Is nicotine more addictive than h.. and c.. ? My guess, perhaps for some people based on their physiology. For many, the biggest addiction of smoking is the hand to mouth habit and the cues- eat, smoke....drink, smoke.... drive, smoke..... the list is endless. I think NRT could provide more nicotine and some people would have a difficult time not smoking unless they can get away from those activity cues.

Then there are those other alkaloids in tobacco that help calm and mellow some people, including myself. I'm finding the nicotine isn't very important for me, but there is something there that works in my case. It makes sense that in all my quit attempts with NRT, there wasn't a chance. I was on edge constantly and they never lasted very long. The only thing that really might have worked had I kept using it war Zyban, an anti-depressant. I really had no desire at all to smoke when I was on it, but the minute I quit the need came back. Now I probably could have quit smoking years ago and the Pharma industry could have kept me balanced with anti-depressants the rest of my life which probably would have been better than smoking all those years but that would have been an expensive proposition.

The health organizations also could have been honest about smokeless tobacco, I could have found a relatively inexpensive solution for my needs and there would have been one less smoker for decades. The reason that smoking is so difficult to break is that there really isn't a one size fits all solution. What is needed is some honesty and a breakaway from the zealots who feel that there is only "quit or die" as a solution. JMHO

 

[CJsKee]

I found this while roaming the interwebz re: addictiveness of nicotine: Addicdtion Research Unit/University at Buffalo: 1994 Report to the FDA. It's older (1994), but I believe relevant. I've also heard (will try to find cite) that nicotine was deemed addictive by court order to allow for NRTs. Anyone (Yvilla?) know about this one?

ETA: This is the blurp I was remembering -- Sign in to read: US ruling turns smokers into junkies - 13 August 1994 - New Scientist
Some more:

When you burn tobacco, you don't get any freebase nicotine. What you get is an assortment of harmless, stable chemicals that result from the oxidation of nicotine. Visit a drug store and read the ingredients of "nicotine" gum, lozenges and patches. You will find that most of them contain no nicotine, but rather nicotine sulfate or nicotine oxide, or even good old vitamin B3 (nicotinic acid).

The fallacy that makes "nicotine addiction" junk science is that: Yes, if you make freebase nicotine in a chemical laboratory and inject it intravenously, it will act as a potent, addictive drug, and do every evil thing ascribed to nicotine. However, burning the tobacco does not produce any freebase nicotine.

Many double blind studies have already shown that "nicotine" patches, gum and lozenges are no more effective than placebos at stopping a smoking habit. Strictly, scientifically speaking, there is no (freebase) nicotine in tobacco smoke; never has been and never will be.

The Smoker's Club, Inc. Encyclopedia 16 NOTE: this is not a research paper.

Just some stuff to think about. But for me (and I've heard a lot of other say the same), since switching to e-cigs, I have never experienced any "withdrawal" symptoms.