From CNN.com Today/Eissenberg study with feedback

[mpetva]

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.

How about using the 2 piece KR808D-1 and cartomizers???? Perhaps 24mg or such? Many are using the 2 piece e-cig no instead of the 3 piece e-cig.
No primer and very reliable! Long slow drags instead of quick puffs though.

 

[DVap]

Also +1 for manual batteries, and +1 for a minimum of 24mg carts, with higher being better for naiive users who are unlikely to puff well.

Mister, there's something in your comment here that I alluded to previously. While I keep my ecig to myself, my wife has a compulsion to let here friends down at the local give her ecig (24 mg) a try. The crowd there are largely inveterate smokers and heavy smokers at that. I've noted their behavior when taking their first puffs from the ecig, and several items are notable, 1) they're extremely tentative, 2) they tend to attempt to "direct draw" instead of holding the vapor in their mouth, then inhaling, 3) their duration is low, and 4) they cough hilariously if they attempt to get a good full puff.

Honestly, I still can't get along too well with automatic batteries, they're simply a pain in the ....

One piece of information that would interest me greatly would be finding the 1:1 ecig vs cigarette correspondence among individuals who are both experienced vapers and experienced smokers. I'd want to see a standardization of puff duration as well as a standardization on the cigarette used as well as the ecig used (with my preference being a stock manual battery 510), also the ecig would have to pass the subjects subjective evaluation through the 10 puffs (the subject would have to agree that the ecig puffs were "good" puffs). The 1:1 correspondence that I mentioned would then simply be the eliquid nicotine concentration that would result in the same cotinine concentration at t=8 hours for both the cigarette and ecig.

 

[anim8r]

Personally... I think they're dealing with a bunch of n00bs as test subjects who thought they were sucking on poison carts. If they had some experienced and successful users toking on their e-cigs, they'd get different results.

My wife and I weren't getting the proper "fix" off of our first e-cigs and had to swap to better models and higher mg rated liquids.

Hell, I get a buzz from the liquid I encounter every Friday night when I refill carts and then clean the equipment and parts I used thoughout the prior week. Maybe that's the placebo effect too

 

[jiff]

Yes, clearly everyone who has bought and uses an e-cig is secretly craving cigarettes.

Yes, clearly all of us are under a mass placebo effect.

Yes, clearly CNN is full of .....

 

[Belletrist]

mister, yup, i started with the kr8 (a bumpy start with autos, made 100X better by manuals)... and i am still sucking happily away at my V4L PlaceboD-1 i have done a ton of research on the 510, and plan to try it soon (not cause i'm unhappy with the kr8 but just for kicks since it's the 'other' best e-cig).

i must say, though, i've gotten a taste for 5V, and plan to continue in that direction, so i'm mod shopping. or i'm going to somehow implant a USB port into my body that will run off of my personal bioelectricity so i can PT it up 24/7... that would be more convenient, i could charge my cell, too.

now that i've established myself as a calm, rational being... let us proceed.

 

[Kilroy]

The study showed what it showed but I think that the acute model may be something that just doesn't work. I think that most of us vape more like a fog machine. The chronic model. I know that I'm getting nicotine. The cotinine test bears that out. But I am a chain vaper.

 

[Belletrist]

yup, a chain vaper here too. but, having said that, i can go a few hours longer w/out vaping if i am otherwise occupied than i ever could go without smoking.

 

[anim8r]

This is Dr. Tom Eissenberg.

I have no conflicts of interest associated with e-cigarettes. The e-cigarette study was funded by the National Cancer Institute. My work has *never* been funded by the tobacco industry: anybody who says differently is not telling the truth and should be asked to provide evidence. My pharmaceutical industry funded research has *never* involved either nicotine or tobacco and, in any case, the last such study I conducted was back in ~2001 or ~2002. VCU (the university where I worked) had an unfortunate contract with Philip Morris a few years ago that has since been terminated; I knew nothing about it, was never part of it, and protested it when I learned of it. I repeat: I have no conflicts of interest associated with this study.

As for the CNN report, CNN released their story before the study was ready for release by Tobacco Control. I was as surprised as you to see the story this morning -- CNN had agreed to wait for publication. I am trying very hard to get a final PDF copy of the study from Tobacco Control so that I can share it. Right now all I have is uncorrected galley proofs.

Finally, you should understand that one of the purposes of the study was to determine how much nicotine the products I was testing delivered to naive users under acute dosing conditions. Of course their are other studies that can be conducted and I can assure you I noted the study's limitations (these products, these cartridges, these conditions) in the discussion. Frankly, I was interested in the nicotine delivery, whatever it was, and had no preconceived notions or agenda. Indeed, that is why the two control conditions (own brand cigarettes, sham smoking) are included -- I wanted the two extremes (efficient nicotine delivery, no nicotine delivery) to see where the e-cigs ended up: more like a normal cigarette or more like sham smoking. I am sorry if the results are not agreeable to some of you: I don't control the data, I report them.

Finally, I saw another thread on here where people describe vaping and using snus at the same time, and someone else on this thread noted (as have others elsewhere) that they vape more frequently than they used to smoke. One person reported smoking normal tobacco cigarettes when stressed, but vaping at other times. All of these observations are all consistent with a product (e cig) that may not be delivering the nicotine dose to which the user has become accustomed.

Thanks for your attention. When the PDF is available, you'll hear about it.

Tom E.

(I found the Doc's post)

To the Doc,

You'll also read (in this forum) about several brands of e-cigs that are almost useless, as well as, get a chance to see a video from someone who is vaping... poorly.

So, if some members are using these weak and/or ineffective brands of e-cigs (and couple that with the possibility that some of them may also be using the improper strength of e-liquid), I can believe some people on this board need to supplement their nicotine intake.

Personally, I'd have focused on the OVERWHELMING documentation provided by the vast majority of this forum's members, instead of using the fringe elements to support your findings.

I'd have looked at the reviews for the best, the good, and the poorest versions of e-cigs and included samples of each in my test.

I would have had at least half of my test subjects be current and successful users of e-cigs. You know... to use them as controls, since they are, well, successful users.


I imagine if you hadn't been focused on the fringe elements, and instead, studied the causes for the phenominal success of these products (that is posted here on a daily basis) you would have had a much different type of study.

One with useful and pertinent data.

Just my 2 cents and I'm just a simple Animator.

 

[voltaire]

So, if some members are using these weak and/or ineffective brands of e-cigs (and couple that with the possibility that some of them may also be using the improper strength of e-liquid), I can believe some people on this board need to supplement their nicotine intake.

It's generally believed that those who supplement their vaping with other tobacco related products do so in an effort to obtain the tobacco alkaloids (not present in eliquids) that have MAOI-like effects. It's not about getting more nicotine, it's about getting something that's not present in ecigs.

 

[Tom09]

Hello Tom E,

my previous question, here, might have been missed in this rapidly evolving thread. I’ve now scanned through the suggested VCU paper of Cobb et al. (Tob. Control, online first). It’s interesting to read that the tested Commit Lozenge (2-mg), among other non-combustible nicotine products (i.g., some snus), failed to deliver a significant dose of nicotine, relative to the experimental conditions of that study.

Now, there’s the paper of Choi et al. (Nicotine & Tobacco Research, 2003), the authoritative reference on the pharmacokinetics of lozenge (judging, again, from Hukkanen’s review and ISI search). Among other results, Choi et al. 2003 presented nicotine plasma concentration profiles following 2-mg lozenge vs. 2-mg gum administration, single dose. The authors determined virtually identical plasma nicotine profiles for both commercial products [Cmax (ng/ml) 2-mg lozenge: 4.4 (1.7); 2-mg gum: 4.0 (1.5)].

My question, expanding on the still open one: Would the Nicotine Gum (2-mg) deliver a statistically significant amount of nicotine (for methods applied in Eissenberg 2010)?

Tom09

 

[DVap]

It's generally believed that those who supplement their vaping with other tobacco related products do so in an effort to obtain the tobacco alkaloids (not present in eliquids) that have MAOI-like effects. It's not about getting more nicotine, it's about getting something that's not present in ecigs.

voltaire, I actually am under the impression that since I (along with others) started pushing the "nicotine is over-rated" belief, that it's still generally believed that nicotine is the be-all, end-all of addiction/satisfaction. The realization that nicotine is simply the most abundant psychoactive component but not the only relevant component has helped more than a handful of folks find that they can improve their quality of life by supplementing vaping with snus (instead of simply giving up and falling back to smoking). Still, all in all, I think that perhaps less than 10% of the forum is familiar with this. (and if a person doesn't need to supplement vaping, then it's best not to). As a fairly loose guess, perhaps 1 in 4 has a persistent problem with using nicotine alone that might either drive them back to smoking or ahead to snus supplementation)... and with thanks to the Swedes, we have plenty of hard scientific data on both the safety and efficacy of snus.

 

[anim8r]

It's generally believed that those who supplement their vaping with other tobacco related products do so in an effort to obtain the tobacco alkaloids (not present in eliquids) that have MAOI-like effects. It's not about getting more nicotine, it's about getting something that's not present in ecigs.

I can agree that is a contributing factor for others in this forum. But my main points, that some vp's are better than others, and that experienced users are more proficient than absolute beginners, has some merit which was utterly neglected in the test.

It boggles my mind that someone would test for nicotine ONLY in inexperienced e-cig users that are also ONLY accustomed to smoking real cigarettes (which is an entirely different beast altogether).

I would have liked to have seen at least SOME people allowed to sign up and bring their own vp's, as well as sample several other brands of vp's and test multiple brands (and strengths) of juice. The test would've had entirely different results.

And it would've been so freakin cheap to test.

A lot of us here would be more than eager to be tested and to supply our own equipment and juice.

 

[voltaire]

Your concerns, and other recently voiced ones, were brought up and addressed by Dr. Eissenberg earlier on in this thread. If it seems nobody is responding to those concerns now, it's because the thread has moved on from there. The study "is what it is" and Dr. Eissenberg has expressed willingness and intent to address many of the those concerns in future studies. If anything can be taken away from the study, it is that some manufacturers have a lot of work to do to make PV's more new-user friendly - something that I don't think anyone here would disagree with.

P.S. I'm not trying to suggest you shouldn't voice your concerns. I'm just trying to explain why they might appear to go unanswered.

 

[kai kane]

now that i've established myself as a calm, rational being... let us proceed.

I have sign by my desk "PLEASE REMAIN CALM!"

 

[kai kane]

If anything can be taken away from the study, it is that some manufacturers have a lot of work to do to make PV's more new-user friendly - something that I don't think anyone here would disagree with.

good summary

 

[SMILIN]

V4L would be very happy to supply Dr. Eissenberg whatever he needs to conduct a proper study. As most of you know, I used to smoke 5 packs a day, and am just shy of 1.5 years tobacco free. I have used every single method available in the united states, as well as eastern remedy's to quit. I have Asthma, and begginning stages of COPD.

I am a walking example, of the benefits of Vaping vs. smoking, and that Vaping, is the ONLY thing which has helped me to kick the habit of 40 years.

I have buried my grandparents, parents, and was still not able to quit.

Funny post on my forum a day ago, the women in the Chantix commercial is a friend of a customer of mine, whom he ran outside of a store smoking, is now planning on being a V4L customer, after trying my product.

V4l will not stop till we help to prove these are a far better alternative than smoking.

Thank You

Steve

 

[brooke.bradford]

Did anyone notice the part about diethylene glycol? It is toxic, but It's not in antifreeze, it's a humectant for tobacco which is probably how it showed up in the mix. Ethylene glycol is used in toxic antifreeze, and propylene glycol is used in the non-toxic variety for machines in the food service industry, & other places. But we all know that...

 

[Jimmy_2k9]

Its good to know I can sign up for the military, grab a gun and head off into a desert. I can't however, smoke a liquid that may harm me potentially. I sure as hell can smoke Tobacco that has killed millions, or destroy my liver with booze. This country needs to use some logic and stop pretending its looking out for us and not their wallets, it quite obvious.

 

[teissenb]

Tom09:

You asked:

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?

and then I think you are asking the same question about the 2 mg nicotine gum.

I thought I answered the first question already: my answer is I have not worked with the inhaler, though I have read the data, and I would guess it would deliver a low, slow, but statistically significant dose under the conditions described in Eissenberg, 2010 and elaborated in more detail in Cobb et al., in press. However, the only way to know is to conduct the study and I am uncertain that it has been conducted. I also should note that my response is only a prediction, and I am rarely surprised when my predictions are wrong.

As for the gum, I have worked with it and am very confident that it would deliver statistically significant increases under the conditions described. In fact, I am so confident that when we conducted a study with it a few years back, we did not even measure plasma nicotine levels -- we used heart rate as a proxy measure and saw significant heart rate increases after 2 and 4 mg gum doses (See Blank et al., 2007). Others of course have measured blood nicotine levels in the laboratory and I am sure you can find those papers if you want them.

I would like to address Anim8r's comment:

"And it would've been so freakin cheap to test."

No, it would not. This work is never cheap. The plasma nicotine analysis for the work described in Eissenberg (2010) is over $25,000.

 

[kai kane]

One piece of information that would interest me greatly would be finding the 1:1 ecig vs cigarette correspondence among individuals who are both experienced vapers and experienced smokers.

Perhaps a forum Poll can be conducted, specifically as an offering to members, to assist in our own forum's research into actual "real" life usage.

I'd guess the results might have significant impact for all members as well. This dialog has certainly brought a lot to light!

aloha
kai