From CNN.com Today/Eissenberg study with feedback

[Mister]

Here's my "take-away" from this thread.

There is a real possibility that the study's data is fatally flawed. No one knows whether the subjects were inhaling primer fluid or 16mg fluid. DVap has shown that primer fluid does not contain nicotine.

The study conditions are insufficient to draw generalized conclusions.

The study's results were surprising to the researcher yet he took no action to confirm them before publishing.

Even if the data were correct (which is unknown) the conclusions which could be inferred from the data would be that:
1) When a person tries their first electronic cigarette, no significant amount of nicotine is absorbed from the first 10 puffs.
2) The NPRO e-cig slightly reduced the subjects' cravings.

Yet Dr. Eissenberg stands by the following quotes to the media regarding this study:

"They are as effective at nicotine delivery as puffing on an unlit cigarette,"

“Consumers have a right to expect that products marketed to deliver a drug will work safely and as promised. Our findings demonstrate that the ‘electronic cigarettes’ that we tested do not deliver the drug they are supposed to deliver. It’s not just that they delivered less nicotine than a cigarette. Rather, they delivered no measurable nicotine at all. In terms of nicotine delivery, these products were as effective as puffing from an unlit cigarette.”

"What we have here is a product which seems to contain nicotine but in fact is unable to deliver it to the people who are using it"

"If people are reporting what they are reporting about cravings, the data suggest it's not because of the drugs in the device"

"These data scream out for the need for regulation of these devices“​

Dr. Eissenberg has failed to address the chasm between the study and the generalizations he stands by, nor the possibly flawed data. I perceive his responses in this thread as arm waving and semantic dances. The chasm between the data and his representation of the data remains.

Throughout this discussion I had hoped that Dr. Eissenberg would provide convincing arguments, or refute some of the quotations attributed to him, or retract or modify them. It has become clear that the latter two will not happen under any circumstance. Perhaps this is necessary in his world. Does the research environment make it a practical impossibility to say "I was wrong" even when it happens?

After the discussion on this thread I can only conclude that the media (in most cases) was not at fault here and that Dr. Eissenberg did frame his statements to maximize their attention grabbing potential at the expense of the message which would forseeably be delivered to readers.

I find it hard to imagine that after all this he will do an oral presentation of this study to a group of his peers. If he does so I hope that there will be a capable speaker in the audience who has read this thread. That could be interesting. Does anyone have some appropriate email addresses? People outside this forum may find this thread an interesting read.

 

[Kilroy]

I've said it before, and I'll probably say it again. Right on Mister.

We didn't learn how to sustain ourselves in 10 puffs or 20, or 40. Day one for me was the .....s. It got better after that, as I learned. In a way I'm a lab rat, but in a better lab. Vape on forum. Vape on.

 

[JoJoBaby]

If we post enough stuff they will be forced to pull the article

Where exactly would I post on cnn? Could you post the link?

 

[DC2]

So it appears that Tom Eissenberg is actually urging the FDA to continue down its already chosen policy of e-cigarette prohibition.

That certainly seems to be the case, not that the FDA needs any urging.
They appear more than willing to take my life if need be.

 

[Vocalek]

Where exactly would I post on cnn? Could you post the link?

When a news story is being discussed, as a rule you will find a link to it in the OP (original post -- #1 in the thread). In this case, the link is Study: 'Electronic cigarettes' don't deliver - CNN.com

 

[anim8r]

Here's my "take-away" from this thread.

There is a real possibility that the study's data is fatally flawed. No one knows whether the subjects were inhaling primer fluid or 16mg fluid. DVap has shown that primer fluid does not contain nicotine.

The study conditions are insufficient to draw generalized conclusions.

The study's results were surprising to the researcher yet he took no action to confirm them before publishing.

Even if the data were correct (which is unknown) the conclusions which could be inferred from the data would be that:
1) When a person tries their first electronic cigarette, no significant amount of nicotine is absorbed from the first 10 puffs.
2) The NPRO e-cig slightly reduced the subjects' cravings.

Yet Dr. Eissenberg stands by the following quotes to the media regarding this study:

"They are as effective at nicotine delivery as puffing on an unlit cigarette,"

“Consumers have a right to expect that products marketed to deliver a drug will work safely and as promised. Our findings demonstrate that the ‘electronic cigarettes’ that we tested do not deliver the drug they are supposed to deliver. It’s not just that they delivered less nicotine than a cigarette. Rather, they delivered no measurable nicotine at all. In terms of nicotine delivery, these products were as effective as puffing from an unlit cigarette.”

"What we have here is a product which seems to contain nicotine but in fact is unable to deliver it to the people who are using it"

"If people are reporting what they are reporting about cravings, the data suggest it's not because of the drugs in the device"

"These data scream out for the need for regulation of these devices“
​

Dr. Eissenberg has failed to address the chasm between the study and the generalizations he stands by, nor the possibly flawed data. I perceive his responses in this thread as arm waving and semantic dances. The chasm between the data and his representation of the data remains.

Throughout this discussion I had hoped that Dr. Eissenberg would provide convincing arguments, or refute some of the quotations attributed to him, or retract or modify them. It has become clear that the latter two will not happen under any circumstance. Perhaps this is necessary in his world. Does the research environment make it a practical impossibility to say "I was wrong" even when it happens?

After the discussion on this thread I can only conclude that the media (in most cases) was not at fault here and that Dr. Eissenberg did frame his statements to maximize their attention grabbing potential at the expense of the message which would forseeably be delivered to readers.

I find it hard to imagine that after all this he will do an oral presentation of this study to a group of his peers. If he does so I hope that there will be a capable speaker in the audience who has read this thread. That could be interesting. Does anyone have some appropriate email addresses? People outside this forum may find this thread an interesting read.

Absolutely Agree!

Though you said it much kinder fashion than I would have.

 

[DVap]

DVap has shown that primer fluid does not contain nicotine.

Keep in mind that I did not test the atomizers used in the study, but a different model entirely.

Dr. Eissenberg has failed to address the chasm between the study and the generalizations he stands by, nor the possibly flawed data. I perceive his responses in this thread as arm waving and semantic dances. The chasm between the data and his representation of the data remains.

As I discussed previously, I believe that a combination of 1) subject inexperience, 2) equipment selection, and 3) ecig nicotine level combined to create a serious bias against the ecig vs tobacco with the ecig nicotine delivery being limited to perhaps 1 cigarette puff worth of of nicotine.

While the study discussion is generally cautious, I do believe the doctor has over-stated his case via some of his outside comments.

If the study discussion is heavily qualified, then so too should be the doctor's comments relating to the study, but it seems the doctor is "running with it", I must agree that there is a "chasm" between the data and it's representation, and data (not words) must bridge that chasm.

 

[Heed]

Well said Mister and DVap -- accurate and fair.

 

[TropicalBob]

I just can't get all bent out of shape over this: He got what he got from his tests involving 16mg standard carts used by neophyte smokers for 10-puff sequences. Is anyone really surprised at those results? I certainly am not.

The problem that is worth fretting is the blanket indictment about e-smoking that seems to have resulted from those limited tests.

Our test would be: Can nicotine sufficient to satisfy a smoker's urges be provided by vaporizing a nicotine-containing liquid and inhaling that vapor? Given very different circumstances for that test, the answer would be a resounding "yes."

But instead of accepting the researcher's results after learning his test protocol, many here jumped all over him. And virtually demanded future test subjects drip 36mg or higher liquid and test with high-voltage stuff and ..

And turned him off. And turned on all anti's, likely including an FDA that should read this test and think again about whether our vaping creates the required physical and psychological respones of a "drug".

Thankfully, Bill Godshall took a high road and his post stands out from all the others, especially his summary paragraph at the end. E-smoking needs more of those .. and fewer BS shouts.

 

[Cancer]

Yet i know from experience that 36mg liquid delivers nicotine and 24mg does as well. Yet without thinking i have grabbed various 11mg and 16mg bottles by accident and within a couple of hours realized i am not getting my fix. So unscientifically i can assert that the lower mg juices probably do not elicit enough nicotine to pass testing muster. Just my opinion

 

[DC2]

Yet i know from experience that 36mg liquid delivers nicotine and 24mg does as well. Yet without thinking i have grabbed various 11mg and 16mg bottles by accident and within a couple of hours realized i am not getting my fix. So unscientifically i can assert that the lower mg juices probably do not elicit enough nicotine to pass testing muster. Just my opinion

I smoked on average about 5 cigarettes per day.

The 16mg liquid I got gave me a slight headache and made me a little nauseous.
I dropped to 12mg liquid and I have no problems.

So while I agree with your premise, the actual numbers depend on the individual.

 

[ChipCurtis]

But instead of accepting the researcher's results after learning his test protocol, many here jumped all over him. And virtually demanded future test subjects drip 36mg or higher liquid and test with high-voltage stuff and .. turned him off.

I feel certain that Dr. E's position on things was not going to be changed by anything going on in this forum. He received enough reasoned responses so that the few brazen ones shouldn't have mattered much. After all, it is an internet forum!

I'm pretty sure he simply used this as a source to pick up more "negative memes" wherever he could find them, and then carry on his studies/campaign/whatever.

 

[kristin]

Whether they failed to do so (under the conditions in which we tested them) because the product came to us with no nicotine (very difficult to believe that each of two manufacturers managed to send us separate shipments of 16 mg cartridges that actually contained no nicotine!) or because the product cannot vaporize nicotine (but FDA and Laugesen both show that at least some of these types of products do vaporize nicotine, albeit in very low doses), or because the nicotine-containing vapor does not allow absorption of the drug to the user will not change the conclusion that they failed to do so under the conditions in which we tested them. In this study I wanted to know what the first-time user of the off the shelf product is likely to experience, not what the expert in the field who modifies the device and/or drips liquid directly onto the atomizer experiences. Again, that study is an interesting one, but a different one.

Thanks,

Tom E

Your testing conditions failed to meet real life applications. Someone is not going to spend $100 on an electronic cigarette, take 10 puffs and then put it down. Most people won't turn into modders, but they will usually look for guidance - whether through an online search or contacting the retailer for advice. In short order, they would learn that 10 shallow puffs is not the right technique. I doubt new tobacco smokers get much nicotine, either, until they train themselves to inhale properly.

Give those 16 people the ecigs to take home and practice with for a week and you'd have vastly different results. Expecting them to work at 100% out of the box is like expecting someone who has never owned Microsoft Excel to start tossing out spreadsheets as soon as they pop it in the DVD drive. Completely unrealistic expectation.

Your study conditions were specifically designed for electronic cigarettes to fail in nicotine delivery and you should be ashamed of yourself for putting thousands of smokers at risk by implying, on the Virginia Commonwealth site, that smokers would be better satisfied by staying with tobacco smoking over electronic cigarettes. Better satisfied, maybe - but also filling their bodies with much more deadly toxins and carcinogens.

Think of how many smokers will read that and die from cancer or other lung diseases because your "study" made them think ecigs wouldn't cut it for them.

You must be so proud.

 

[curiousJan]

I just can't get all bent out of shape over this: He got what he got from his tests involving 16mg standard carts used by neophyte smokers for 10-puff sequences. Is anyone really surprised at those results? I certainly am not.

Not surprised at all, actually.

The problem that is worth fretting is the blanket indictment about e-smoking that seems to have resulted from those limited tests.

Agree again ... although it appears that we disagree as to where Dr. E. falls into this aspect of the current climate.

Our test would be: Can nicotine sufficient to satisfy a smoker's urges be provided by vaporizing a nicotine-containing liquid and inhaling that vapor? Given very different circumstances for that test, the answer would be a resounding "yes."

Again agree.

But instead of accepting the researcher's results after learning his test protocol, many here jumped all over him. And virtually demanded future test subjects drip 36mg or higher liquid and test with high-voltage stuff and ..

And turned him off. And turned on all anti's, likely including an FDA that should read this test and think again about whether our vaping creates the required physical and psychological respones of a "drug".

But here's where your position, imho, falls flat. I think that Dr. E. has picked and chosen which of our questions to answer. Rightly so in some instances as some questions were mere bait from someone looking for a fight. There have been more than a few thoughtful questions from other members that have been overlooked or ignored, though. This concerns me due to Dr. E's acceptance of the media's negative spin. I agree with his comments that he cannot force a reporter to clarify unless he was directly misquoted ... but his lack of outrage is unnerving. If he were truly interested in helping us gain access to effective harm reduction products, I believe he would be more careful in his wording and more vocal with his distaste for the negative conotation regarding e-cigs that he himself is helping to plant in the mind of the public.

Thankfully, Bill Godshall took a high road and his post stands out from all the others, especially his summary paragraph at the end. E-smoking needs more of those .. and fewer BS shouts.

The vast majority of the 'shouts' weren't BS in my opinion. They disagreed, yes, but most did so in a very mature, analytical, and respectful manner.

If Dr. E. has been turned off by the discussion here, the problem lies with him and not the manner in which he was treated.

Jan

 

[Belletrist]

I just can't get all bent out of shape over this: He got what he got from his tests involving 16mg standard carts used by neophyte smokers for 10-puff sequences. Is anyone really surprised at those results? I certainly am not.

ditto; and being given the opportunity to read the summary of the methodology/etc. explained away the media hype. for me.

The problem that is worth fretting is the blanket indictment about e-smoking that seems to have resulted from those limited tests.

quoted for emphasis. and that problem is not really dr. e's job. would i have preferred he not be so good at providing sound bites that can be used by the media to hype things up? yeah, but it's not really on list of top one-thousand-things-i'd-change-if-i-could. if i'd done the research, would i have been able to resist trying to spin it in a more positive way? i don't know. but i do know that in the letter dr. e does a pretty fair job of outlining possible biases.

Our test would be: Can nicotine sufficient to satisfy a smoker's urges be provided by vaporizing a nicotine-containing liquid and inhaling that vapor? Given very different circumstances for that test, the answer would be a resounding "yes."

and i think (hope) we will see those types of circumstances included in further studies.

But instead of accepting the researcher's results after learning his test protocol, many here jumped all over him. And virtually demanded future test subjects drip 36mg or higher liquid and test with high-voltage stuff and ..

And turned him off.

well, i hope that the doctor knew that the potential for that reaction was there. maybe not quite as vehemently as it came out, but this is the internet... i was pleased that there were as many reasonable posts as there were, and not at all surprised by the number that were purely reactionary. (and i don't really have anything against those people either, because a string of four letter words came out of my own mouth when i read the CNN article.)

And turned on all anti's, likely including an FDA that should read this test and think again about whether our vaping creates the required physical and psychological respones of a "drug".

yes... this is hard to address though. i mean, it's almost impossible not to be extremely passionate (which usually leads to not-always-thoughtful) about something which has had such a profound and positive impact on many of our lives (by serving as a viable alternative to smoking).

i think if i hadn't been eyeball deep in academia for most of my (not very long ) life, i probably would have reacted a lot like some of our more passionately upset posters. granted, i don't have experience in the hard sciences but i am familiar with the apparent complete lack of common sense displayed in academia. that's not a criticism of it, it's just that clinical studies aren't real life, any more than anna karenina is a good summer beach read. (okay, maybe for me, because i'm tedious. though if you've gotten this far you know that.)

being a little tedious and proving the obvious (like the unfortunately useless results of puffing 10 times on a crap brand of PV) really does lay a foundation for future work, and could, really, go a long way towards helping all of us. dr. e didn't have to join and spend his time chatting with us to get 'material' for blasting vaping to the media. he could have simply read the thread about the article--i'm sure we would have .....ed plenty enough with or without him.

he came out of the laboratory, though, and engaged in discussion. the point isn't that he's right or wrong or that you should agree with the statements he makes, the point is just that he took the time to do it. he shared information with us that he didn't have to. he has no reason to be 'two faced' to get our help; he could have made an account without announcing himself.

he has nothing to gain from coming here and enough to lose--even if just his time--but he did it anyway. by all means disagree with him, but calling him a clown or implying he's got some malicious intent behind joining is... showing a lack of common sense on our parts. if anyone has made the vaping community look bad as a result of his discussing things here, it's the vaping community itself. but i think we've had a good showing of constructively critical debate, and reasonable curiosity, too, which we can be proud of.

okay, wake up, i'm done. *gets off high horse*

 

[Kate51]

I do hope a lot of people posted to the article, because Kristin's concern is mine also...people reading "studies" like that may just be discouraged into not trying to quit, or going the Pharm route to quitting.
And I also agree that "studies" of any ilk are pretty subjective, they really don't get to the crux of the problems in any measured way, which of course is not really a nicotine issue my opinion, but a behavioral issue. With an ecig I had withdrawal symptoms for a couple months in the form of excessive HUNGER, but the behavioral part is probably something I'm not really addressing right now. I have cut back on nicotine and vaping frequency, but I am prepared to continue vaping until I'm just ready to stop. And I'm loving this! I have found nicotine density very easy to cut down with no symptomatic uptick at all.
In fairness, I'm going to give it another 43 years and 2 weeks and 7 hours to figure it out, since I smoked cigarettes for 44 years! I deserve at least that.

 

[RIMP]

I do hope a lot of people posted to the article, because Kristin's concern is mine also...people reading "studies" like that may just be discouraged into not trying to quit, or going the Pharm route to quitting.
And I also agree that "studies" of any ilk are pretty subjective, they really don't get to the crux of the problems in any measured way, which of course is not really a nicotine issue my opinion, but a behavioral issue. With an ecig I had withdrawal symptoms for a couple months in the form of excessive HUNGER, but the behavioral part is probably something I'm not really addressing right now. I have cut back on nicotine and vaping frequency, but I am prepared to continue vaping until I'm just ready to stop. And I'm loving this! I have found nicotine density very easy to cut down with no symptomatic uptick at all.
In fairness, I'm going to give it another 43 years and 2 weeks and 7 hours to figure it out, since I smoked cigarettes for 44 years! I deserve at least that.

I have posted several times to that article. Just posted a little while ago and put my name at the end of it. When you comment at the cnn site please add your screen name at the end of your post so we can know who wrote it Hi Kate
RIMP

 

[Heed]

IGNORE: Nevermind.

 

[JoJoBaby]

When a news story is being discussed, as a rule you will find a link to it in the OP (original post -- #1 in the thread). In this case, the link is (won't let me post a link yet)

I don't see where to post on that cnn page

 

[yvilla]

I don't see where to post on that cnn page

Down the page, at the very top of where the comments start, you will find toward the right side of the column an icon and the message to "Log in or sign up to comment". If you have not commented on CNN before, you need to register (sign up) with them first, and then you will be able to post a comment.