as for the lozenge... I'm not surprised. Ugh, those things are awful, lol, and taste like paste. And the side effects... user error, but still. couldn't help ingesting some of the nic/saliva mix and... let's just say i was an unhappy camper.
From CNN.com Today/Eissenberg study with feedback
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Tom09 is hitting on something here that's been bothering me throughout this whole discussion.
The use of an ecig simply cannot be compared to the use of a cigarette on a puff per puff basis. 10 puffs on an ecig is in no way the equivalent of 10 puffs of a cigarette. We all know that Dr. Laugesen estimates the ecig puff renders about 1/10th the nicotine as a cigarette puff. If he is anywhere near correct, the study subjects would have had to take up to 100 puffs on the ecig to fairly measure nicotine intake as compared to the 10 puffs on a cigarette they were taking.
Further, from several of Dr. E's posts, I wonder if he realizes the amount of nicotine an ecig cartridge is even supposed to contain. He's mentioned a cartridge containing "16 mg" - but I believe his study used only super-mini type ecigs (certainly the Npro is a super-mini), the cartridges for which can only hold around .3 of a ml. Thus given 16 mg liquid, which is 16 mg per ml, the cartridges he used, when full, probably contained only around 4.8 mg of nicotine. The nicotine content of prefilled cartridges is measured and stated the same way as is the nicotine content of eliquid - in mg per ml. So a big 801 cartridge filled with 16 mg eliquid will contain close to 16 mg of nicotine, as it holds close to a full ml, but those super-minis certainly do not!
And, it's generally accepted here that around 20 to 25 drops of eliquid approximate 1 ml. Wouldn't one drop on your atomizer get you at least 10 puffs, if not more? So if we use 25 drops as the measure, and assume 10 puffs is going to actually consume 1 whole drop of eliquid (but which it probably won't), then the most nicotine you could likely expect to get from those 10 puffs off an ecig, with 16 mg eliquid, is .64 of a mg. And that's only if 100% of the nicotine is vaporized (and does not begin to take into account the likelihood that not all of it will be absorbed by the user).
Tom, an excellent excellent question.
This addresses the use of a product. The inhaler instructions tell the user to take those deep inhalations over 20 minutes, so the manufacturer has defined the proper use of the product. If a study was done with the inhaler and ten inhalations, the immediate response would be "You're doing it wrong".
With the ecig, the 10 puff comparison to tobacco cigarettes is necessary since the researcher must attempt to compare apples to apples, even if.. and this is important, the devices being compared are apples and oranges.
Cigarettes != inhalers != snus != ecigs, etc.
(!= is a commonly used symbol for does not equal)
We know empirically that if one uses an ecig like in the study, that "you're doing it wrong". But if the ecig instructions themselves do not define "doing it right", then there's no standard against which to evaluate "doing it wrong".
With Dr E's study, I've come to believe that there are those things that the study demonstrates and those things that it does not demonstrate. It, to put it simply, is what it is.
4.5 million puffs....that really makes me think about how much time I spent puffing on a cigarette, such as leaving my desk for a few minutes, walking out of the house for a smoke, etc. Whereas right now I can enjoy a vape indoors and continue my everyday tasks while vaping, unlike when I was smoking due to the smoking bans.
Definitely agree with the points you made: e-cigarettes were the 'real deal' when it comes to all of the available NRTs...e-cigs replaced not only my source of nicotine, but also provided all the physical stimulation that gum/patch/lozenge/others could not. I definitely believe that I have found a way to replace both the habit and the addiction by using e-cigs, and I definitely consider it to be a healthier practice than smoking(although I'm not a doctor, and no long term side effect e-cig studies have been performed.)
yvilla, pretty decent math there.
The way I've come to a result very similar to yours was slightly different. I determined experimentally (several times) the weight difference of a good ecig after 10 puffs of 5 second duration (with a rest between each). The control was a before and after weighing of an unvaped ecig. For every second of puffing, ~1 microliter of liquid is vaporized. So if we have 10 puffs, and assume a 4 second puff duration, that's 40 microliters of liquid vaporized. At 16 mg/mL, that 40 uL represents 0.64 mg of nicotine (same number you got), I simply selected a puff duration to most closely match your figure, and that duration is certainly within the "normal" range.
That being said, full flavor cigarettes are generally believed to deliver to the system about 1 mg of nicotine, though we know that some smokers are capable of getting more by manipulating their smoking technique. To assume around 0.64 mg of nicotine delivered from 10 puffs of an analog is not unreasonable. Viewed this way, Dr E's data suggests that the analog does work much better than the ecig at delivering nicotine... but we must ask if the naive users were indeed vaporizing 1 microliter of liquid per second, and we must also ask about the puff duration. (Dr E doesn't have to ask these things, we do, because we're interested in the answer).
Another factor that comes into play is "hold time". With analogs, we tend to inhale the smoke in and exhale it immediately. Vapers tend to inhale and hold for a bit, then exhale. We create this longer dwell time as part, I believe, of our "self-titration" of nicotine. Obviously a naive ecig user would not have yet developed this technique.
Bottom line, I am quite looking forward to receiving the nicalert test strip I ordered so I can see if my 15 mg liquid is giving me anything.
Whether or not I am getting anything, my smokefree banner (below) says it all.
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Dr. E.,
*If* such a thing could be arranged and paid for by a fundraiser here, would you be willing to have someone(s) come to your lab and submit to testing?
Of course, this wouldn't qualify as a rigorously constructed study to be published in the journals - we probably couldn't afford something at that scale, and I'm sure the method of selecting the participants wouldn't be up to standards. This would simply serve to help everyone involved gain some insights into the subject that's been covered at length here.
Assuming that such a thing were possible, I'd let you and the much more qualified of those among us flesh out the best methodology. But in it's most simple form (one test subject) I envision something *very* roughly like this:
-Subject arrives at facility and sits in isolation (no nicotine products) for x hours
-Subject then submits to blood and urine testing
-Subject then begins use of a standard (effective) ecig at whatever appropriate intervals
-?Blood taken at certain intervals?
-Subject submits to final blood and urine testing
So what do you say - would something like this be doable? Without having to worry about funding, you could possibly gain some insights that would help you plan your future (much) more rigorous studies. How could you say no to that?
*If* such a thing could be arranged and paid for by a fundraiser here, would you be willing to have someone(s) come to your lab and submit to testing?
Of course, this wouldn't qualify as a rigorously constructed study to be published in the journals - we probably couldn't afford something at that scale, and I'm sure the method of selecting the participants wouldn't be up to standards. This would simply serve to help everyone involved gain some insights into the subject that's been covered at length here.
Assuming that such a thing were possible, I'd let you and the much more qualified of those among us flesh out the best methodology. But in it's most simple form (one test subject) I envision something *very* roughly like this:
-Subject arrives at facility and sits in isolation (no nicotine products) for x hours
-Subject then submits to blood and urine testing
-Subject then begins use of a standard (effective) ecig at whatever appropriate intervals
-?Blood taken at certain intervals?
-Subject submits to final blood and urine testing
So what do you say - would something like this be doable? Without having to worry about funding, you could possibly gain some insights that would help you plan your future (much) more rigorous studies. How could you say no to that?
Isn't this in part good news? How can they regulate it as a nicotine delivery system if it does not deliver nicotine, and if it does not contain nicotine, how can the regulate it as a tobacco product? I see it as good news.
Voltaire:
I really appreciate the idea and, even more, the implied confidence in me that lies behind it.
I fear that such a project would open me up to the same types of criticism that are made at the beginning of this thread. Instead of "bought and paid for by the tobacco industry" it would be "bought and paid for by the vapers". Even if the study were not published, the project would necessarily involve a contract of some sort between a vaper (or group of vapers) and VCU, and money woudl change hands. At that point, there would be the appearance of a conflict of interest associated with all of my subsequent e-cigarette work.
I hope you can appreciate this position.
I really appreciate the idea and, even more, the implied confidence in me that lies behind it.
I fear that such a project would open me up to the same types of criticism that are made at the beginning of this thread. Instead of "bought and paid for by the tobacco industry" it would be "bought and paid for by the vapers". Even if the study were not published, the project would necessarily involve a contract of some sort between a vaper (or group of vapers) and VCU, and money woudl change hands. At that point, there would be the appearance of a conflict of interest associated with all of my subsequent e-cigarette work.
I hope you can appreciate this position.
rkh3, the liquid does contain nicotine; that's not really being debated. it's whether or not it's being absorbed. and if (this is a wild worst case scenario, mind you) the powers that be read this study and said, "hey, they're not absorbing nicotine anyway, let's just ban nicotine liquid" there would be a LOT of unhappy vapers.
that makes complete sense.
i'm going to do the nicalert test as well, just to share here/at the blog/and for my own curiosity... dr. e, do you think there's any difference in accuracy between the saliva/urine test or any factors other than steering clear of even passive exposure to cigarette smoke/any non-vaping tobacco product that we should know about?
Belletrist:
Make sure you read the instructions for reading the strip carefully and be prepared to dip more than one strip if necessary. It would be interesting to hear results of:
first urine of the day
mid-day
last urine of the day
Tom E.
Make sure you read the instructions for reading the strip carefully and be prepared to dip more than one strip if necessary. It would be interesting to hear results of:
first urine of the day
mid-day
last urine of the day
Tom E.
thank you! i will follow the instructions to the letter. another member suggested that i repeat my test after a few weeks. after that (i'm still considering this part, ha, it's distasteful) i may switch back to smoking for a week (if i can) and repeat it. just once though, i'm not going to smoke for a month, no way. 
*also, i'm going to photograph the strips. i know, i know, you all can't wait. it'll be a very different "Puff's Pic of the Day".
*also, i'm going to photograph the strips. i know, i know, you all can't wait.
it'll be a very different "Puff's Pic of the Day".
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I do appreciate and understand your position - and also somewhat expected it, but figured I'd try. It wouldn't have been a lot of money, and certainly no profit, just expenses paid.
But if you can't take our money, could you just take one of us and our ecig to do testing on VCU's dime?
Just a couple of blood and urine tests couldn't be too hard to get funded, could it?P.S. Even if the results of the testing couldn't be made public (including to us), I'm sure that someone around here would be willing to be your guinea pig for a day just to advance science. (And, of course, to convince you that ecigs can in fact deliver appreciable nicotine.)
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nice find jamie
Dr. E. - funny comment on the "light addiction"!
Could that part be better defined as a "dependency" or ?
mahalo
kai
After reading the CNN piece I ordered two COT brand one step cotinine test devices off eBay. They arrived Friday, I tested positive for cotinine. Negative results would have been great a real game changer. I use 48mg Tasty Vapor juice and vape about 3 milliliters per day with a 510 device. Nicotine is getting into my system even though I have no exposure to second hand smoke and don't currently use any other tobacco or nicotine replacement product.
Thanks RVC. I'll note the result.
And Voltaire (and others) I hope you'll recall that I never said under no circumstances would any e-cig at any strength liquid deliver any dose of nicotine. My published study does not address that statement at all.
So can you folks agree on one unmodified device and one marketed cartridge that you are as certain as you can be (without a blood test) delivers nicotine? If you can, I'll get it and see where we can go from there. I can tell you that there is no way an IRB is going to allow device modifications and/or this "dripping" procedure, so it would have to be off-the-shelf stuff. I doubt everyone is going to want to read each person's individual reply here so that may NOT be the way to go -- is there some way to organize your thoughts (perhaps a new thread)?
I look forward to your considered reply.
And Voltaire (and others) I hope you'll recall that I never said under no circumstances would any e-cig at any strength liquid deliver any dose of nicotine. My published study does not address that statement at all.
So can you folks agree on one unmodified device and one marketed cartridge that you are as certain as you can be (without a blood test) delivers nicotine? If you can, I'll get it and see where we can go from there. I can tell you that there is no way an IRB is going to allow device modifications and/or this "dripping" procedure, so it would have to be off-the-shelf stuff. I doubt everyone is going to want to read each person's individual reply here so that may NOT be the way to go -- is there some way to organize your thoughts (perhaps a new thread)?
I look forward to your considered reply.
I just completed the same test. I've not smoked a cigarette, used any tobacco product or any other nicotine product since November 21, 2009. I use 24mg strength liquid, mostly in a 901. The test reading is clearly positive. It is a simple yes/no test so there is no other data to be gained from it. This is the test that I used Drug Test Outlet
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Full on TB. Well said.
And the same to Mister and everyone else posting here. Amazing process - big thanks to the Forum for providing this opportunity.TropicalBob - I'm more than confident you are getting some nicotine from ecigs. And I find it impressive you were able to combine "safer than smoke" alternatives to satisfy your higher tolerance (man you could smoke me under a table!).
I'm confident that further scientific testing will bear this out. (oops I see one OTC test returned positive already) EDIT: make that two now.
Really important to make sure ecigs stay available to smokers!
aloha
kai
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I do realize this, as I'm sure others do - I didn't mean to suggest otherwise. Though, it's my belief that the majority of people who are able to fully transition from cigs to ecigs use much more efficient devices and probably slightly stronger eliquids than the ones used in your study.
The two most popular devices recommended on this board are the 510 manufactured by Joye, and the KR808 manufactured by Kanger. The 510 is a 3-piece (battery, atomizer, cartridge) and the KR808 is a 2-piece (battery and "cartomizer" - which is the cartridge and atomizer integrated into 1-piece).
The 2-piece KR808 would carry the advantage of not having any "primer" for you to deal with. But as has been pointed out previously, it would be advantageous to fill empty cartridges from a bottle of (off the shelf) e-liquid that could be tested in advance for nicotine levels. In that case, the 510 would probably be the better choice for it's more easily filled cartridge design. (The KR808 isn't intended to be filled, so that would probably violate the "off-the-shelf" rule) The 510 is also known for more cigarette-like vapor production, and is really the gold-standard and the most often recommended model on this forum.
Maybe another thread should be created to discuss this further, but I just wanted to give you an idea of some issues to consider for now. And I'm confident that the consensus here would be one of those two models.
P.S. Here are the websites of the two manufacturers:
http://www.joyetech.com/ProductsView.Asp?id=65
http://www.szkanger.com/product_show.asp?id=8
Of course, both models could be more easily obtained form any number of vendors here on this forum.
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