From CNN.com Today/Eissenberg study with feedback

[teissenb]

Jamie: That is such a great study to cite in this context. In fact, when Dr. Eric Donny came to VCU to give a talk on the subject, I asked him if the results indicated that the animals were "addicted" to the light.

See also Buchhalter et al, 2005:

Tobacco abstinence symptom suppression: the role p... [Addiction. 2005] - PubMed result

 

[jamie]

I asked him if the results indicated that the animals were "addicted" to the light.

Thank you Dr T. I appreciate the additional reference.

Did he have a serious reply? What did he say?

 

[hifistud]

This is all fascinating stuff, and I have to admit, I wonder what the UK's MHRA will make of it. I suspect the FDA is currently running round in circles trying to discover what else it can latch onto in e-cigs, whereas the MHRA has already hung out its placard saying what it's after - and until something else comes along to gainsay its results, Dr. T's study effectively shoots that placard to bits.

It is, indeed, an interesting world in which we live.

 

[teissenb]

Well Eric and I are good friends (he post-doc'd at the same unit I did, but I left soon after he arrived) and he laughed but agreed with the concept -- that the motivating force for the behavior, which was once drug, has been transferred to some extent to the non-drug stimuli. I think Falk and Lau showed a similar effect with ....... using a schedule induced polydipsia paradigm in 1995. I think results like these are really important.

 

[Kilroy]

That is why this has worked for us. We have all of the cues that we are smoking. We may or may not have the effective transference of nicotine, but we have the feel, the sight, the sensation of smoking a cigarette. The results of cotinine tests should be fascinating. My wife asked me "What if you find that you haven't been getting nicotine?" My answer was "Then I fooled myself off smoking tobacco, who cares?"

 

[trailblazer6]

There will be more tests. Dr. Eissenberg is reading this forum and others, and will take into consideration valid points made about testing protocol.

Here's a paragraph from an email exchange we had:



Everyone who e-smokes should welcome research. After all, what we don't know about e-smoking is .. virtually everything, and that fact is being used against us by the anti's. We need knowledge. And if that knowledge smudges our rose-tinted glasses, then take off the glasses and recognize reality.

And as Dr. Siegel suggests in his column, delivering no significant nicotine could be a blessing in disguise for e-smoking. No nicotine = no problem.

Very good point tropical Bob. Look at what happened here in NJ. Vapers have to go outside with the smokers. Why ? Because of all the unknowns. Testing vaping needs to be done. Is it a harmless indulgence or not ? One thing I do know is that it is in fact far better then smoking.

 

[Mister]

Jamie: That is such a great study to cite in this context. In fact, when Dr. Eric Donny came to VCU to give a talk on the subject, I asked him if the results indicated that the animals were "addicted" to the light.

See also Buchhalter et al, 2005:

Tobacco abstinence symptom suppression: the role p... [Addiction. 2005] - PubMed result

Those are both excellent references, thank you.

Many conditioned reinforcers are difficult to generalize because they're individual, e.g. smoking after a meal.

However, based on the very large number of anecdotal reports on this forum, it is interesting that at least two physical aspects of smoking appear to significantly affect a majority of cigarette addicts. Products which don't deliver these aspects well are unpopular; users who start vaping with such products arrive here with questions about what's wrong and quickly switch to another product.

1) Visible vapor exhalation. Seems to have very high importance.

2) "Throat hit", i.e. the physical sensation of the vapor in the mouth. Common but not as near to being universal.

It is also interesting that two physical aspects which might be expected to affect a large majority seem to not have that affect:

3) Appearance of a cigarette. Most new users intuitively expect that this will matter to them and choose devices which most resemble cigarettes. Many experienced users switch to devices which do not resemble cigarettes, in their effort to maximize other rewards.

4) Flavor. Again most new users intuitively expect this to matter and choose a flavor similar to their cigarettes. Many experienced users switch to non-cigarette flavors.

There's another obvious aspect for cigarette and e-cigarette users which we don't have any experience in evaluating:

5) Hand/mouth gratification. All e-cigarettes include this component so although we suspect that it matters we don't really know.

 

[leathermonkey7]

I say we give the ol doctor a 6V device loaded with some uncut 60mg juice and see if he still thinks it doesn't deliver nicotine after he picks himself off the floor.. lol

 

[Kilroy]

Right on Mister.

 

[slybootz]

Consider the following hypothetical test:

--------------------------

You are a DIY mixer, and you use some TW 54 mg PI (well known for containing highly pure pharma grade nicotine in pharma PG) to make the following liquids in PG:

- 0 mg (PG only)
- 10 mg
- 20 mg
- 30 mg

You fill 4 fresh carts identically, one for each of the above nicotine concentrations. You have an assistant mark each cart with a code a, b, c, or d (unknown to you) that indicates which concentration the cart contains. You're doing a "single blind" study.

Next, take 4 fresh atomizers, blow out the primer fluid, connect each cartridge to one of the atomizers, hook up a battery and wait several minutes for the liquid to wick.

Spend a few minutes vaping and comparing the four ecigs. Try to see if you can determine which cartridge contains 0, 10, 20, and 30 mg. Record your conclusions, and have your assistant then reveal which code corresponds to which nicotine level.
​

--------------------------

How many of you are certain that you correctly identify the nicotine level in each cart? I see a lot of hands raised... and I could correctly identify them as well.

Heck, if you're a DIY mixer, feel free to perform this experiment if you're inclined.

I'll be trying this tomorrow(when I have more time to mix), and see what my own results are. I'm sure I can distinguish 10mg from 40mg, but 20 from 30 might be more of a stretch(my personal 'sweet spot' is 26mg)

 

[CJsKee]

Those are both excellent references, thank you.

Many conditioned reinforcers are difficult to generalize because they're individual, e.g. smoking after a meal.

However, based on the very large number of anecdotal reports on this forum, it is interesting that at least two physical aspects of smoking appear to significantly affect a majority of cigarette addicts. Products which don't deliver these aspects well are unpopular; users who start vaping with such products arrive here with questions about what's wrong and quickly switch to another product.

1) Visible vapor exhalation. Seems to have very high importance.

2) "Throat hit", i.e. the physical sensation of the vapor in the mouth. Common but not as near to being universal.

It is also interesting that two physical aspects which might be expected to affect a large majority seem to not have that affect:

3) Appearance of a cigarette. Most new users intuitively expect that this will matter to them and choose devices which most resemble cigarettes. Many experienced users switch to devices which do not resemble cigarettes, in their effort to maximize other rewards.

4) Flavor. Again most new users intuitively expect this to matter and choose a flavor similar to their cigarettes. Many experienced users switch to non-cigarette flavors.

There's another obvious aspect for cigarette and e-cigarette users which we don't have any experience in evaluating:

5) Hand/mouth gratification. All e-cigarettes include this component so although we suspect that it matters we don't really know.

I totally agree...and Sherid has an excellent observation (IMO) regarding your #5 Mister, which she has posited a couple of times in Dr Siegel's blog. She thinks it may have to do with the act of sucking...which begins in the womb and carries us through the early years of our lives, and even further for some. I think someone, here or in another thread, remarked they bit their fingernails to the quick until they started smoking. Sheri's theory sounds right to me.

 

[deewal]

I always wondered why Zero Nic Prefilled Carts cost the same as 18mg High Nic Carts.

 

[TropicalBob]

I love where this has gone:

Smoking is a two-pronged activity -- habit and addiction. With e-smoking, the habit is nicely addressed. Consider: In my case, I smoked 30 cigarettes a day for 50 years. I did hand-to-mouth with a cigarette 4.5-million times. That makes a pretty strong habit. I've replaced my habit with one involving electronic cigarettes.

And some on this forum have left smoking behind just by breaking their "bad habit." That's wonderful. But even if only habit is addressed, e-cigs are the most effective "quit" solution yet available for smokers, far superior to lozenges and patches and gums and nasal sprays. They most closely replicate smoking. They do what Big Pharma's expensive NRT products can't. I feel the inhale; I see the exhalation.

But, with only e-cigs, I could not escape the addiction. Cravings remained. Overwhelming at times. So I threw every nicotine alternative into the mix and now use snus, dissolvables and nasal snuff on a daily basis, fully concurrent with vaping non-stop.

In this way, both the habit and the addiction can be replaced with what I consider a healthier practice.

They call it .. harm reduction. And I'm a believer.

 

[wmrwl]

I saw this article right before it was posted here and at first I dismissed it because I know that no other smoking cessation method was as effective for me as the e-cig. In fact, I didn't even plan on quitting but after trying the e-cig I haven't smoked since.

After a few days of thinking about this I began to wonder what the vapor point was for nicotine vs. VG or PG. Sorry if this point was addressed but after about 20 pages of reading this my vision started to blur. From my Google search it looks like the vapor point for nicotine is around 340-350F and VG and PG is far less. I also found that attys heat to around 240F. Again, these numbers could be totally off, but the point is...does it make any difference if the liquid that the nicotine is suspended in vaporizes at a lower temperature is it possible to get very little nicotine?

 

[deewal]

I love where this has gone:


They call it .. harm reduction. And I'm a believer.

Me too TropicalBob. Although you have brainwashed me to that conclusion for at least two years.

 

[TropicalBob]

Small aside cause it's funny you bring that up, wmrwl, and I spent much of the afternoon researching vapor and smoke points. I'm becoming more convinced that some very oily e-liquids I'm using are producing smoke, not vapor.

And that would be a game-changer of major proportions!

You're saying the nicotine might not make it from liquid to vapor due to its higher vaperizing point? Maybe one of the researchers can address that. At the same time, can they address whether the temperature of atomizers might "smoke" VG or PG?

+1 Deewal!

 

[Belletrist]

tropical bob, i agree, i'm thrilled to log back in and see this conversation!

dr. e, while i think you'll find in future studies that practice makes perfect with nicotine delivery/e-cigs, i'd also love to see a blind test of 0 mg vs. higher mg juice vs. NRT vs. nothing with naive subjects regarding cravings. (i'm just rambling, obviously studies are expensive and we'd all like to see a boatload of them done). it would definitely have to be naive users/chronic administration, in this hypothetical study because as has been remarked, experienced vapers can 'taste' nicotine. or perhaps if an additive which mimics the mouthfeel/taste of nicotine...

i'd definitely be up for trying that (without knowing it, somehow... to get the full placebo effect). i'd probably vape it like MAD for a few days or a week, but cutting down nic has been problematic for me simply because i miss the feel/hit of nicotine in my mouth/throat. i think it would satisfy conscious cravings... the test would be the physiological withdrawal and whether it would be intense enough that i wouldn't be fooled.

 

[wmrwl]

TropicalBob I guess if the nic didnt get vaporized then it would remain in liquid form unless it builds up as a non-liquid residue on the atty, but this is all purely hypothetical and way beyond my knowledge. It was just a curious thought I had.

 

[Mister]

Whether the nicotine leaves the atomizer as part of the vapor and without breaking down has been well tested by members DVap and exogenesis. It does and does it to a high degree, over 90%, at least from the tested atomizers and liquids. We don't know yet how much nicotine is absorbed into the body from the vapor.

 

[Tom09]

Tom09 asks what sort of results we might expect in our acute testing model if we used a nicotine inhaler. I have never worked with the inhaler and so have no experience with it. In looking at the Bullen et al (2009) SRNT report, it appears to deliver a very slow and low but statistically significant nicotine dose. I'd have to say that would be my prediction, but doing the experiment would be the only way to know. FYI, we HAVE tested the nicotine lozenge (2 mg) in this acute model, and it also failed to increase plasma nicotine levels significantly (Cobb et al., in press).

Thanks, Tom E,

for responding to my question, what results to expect if a study like Eissenberg 2010 would be done on the pharmaceutical Nicotine Inhaler - a delivery device with known and published properties. Though Bullen’s preliminary data is interesting, by indicating where delivery from e-cigs & Inhaler might possibly hit, specifics about their dosing are presently not known to me. Thanks for pointing to the 2-mg lozenge test, will certainly have a read into it.

I’ll try to be a bit more specific and hope on your patience with this non-native speaker:
The review article of Hukkanen et al. 2005 and a cursory ISI search identifies Schneider et al 2001, Clin Pharmacokinet, as the relevant reference on the delivery characteristics of the Nicotine Inhaler. After a ‘single dose’, constituted by 80 deep inhalations over a 20-minute period, plasma nicotine have been determined as Cmax = 8.1 +/- 2.5 ng/ml. If we reduce the nicotine dose - dividing by 8 - by instructing users to inhale ten times, what is the expected outcome?

To re-iterate: Do we expect (as an informed prediction, and for methods of Eissenberg 2010) to find plasma nicotine levels - after 10 inhalations from the Inhaler - that are statistically significant?

Tom09