From CNN.com Today/Eissenberg study with feedback
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i also agree that bottles should be clearly marked. as for childproof, well, that would be ideal. i think regardless of how bad they taste, they smell pretty good. if a child decides to take a big swig of a flavored nic liquid, even if he or she spits it out immediately, it's beyond dangerous.
on the other hand, if you have children, and you're leaving bottles of nicotine liquid (or medication, or cleaning fluids, etc.) around where they have any chance of accessing them at all, i'd rather call social services on you than have to deal with my own nic being in childproof bottles.
no kids here, of course, but i am constantly checking and double checking to be sure that i'm not leaving cartomizers or juice where my dogs can get at it. if you can't do more for your children, well.
of course, that's a whole different story.
i'm glad to hear about the potential 5 day test, dr. e.
and on a side note, my nicalert test strips have been ordered... i'm planning to test next wednesday or thursday, and results will be posted on my blog, linked below. i'm striving to do as accurate a test as i can, so hopefully this will greatly reassure potential vapers. or surprise the heck out of all of us.
on the other hand, if you have children, and you're leaving bottles of nicotine liquid (or medication, or cleaning fluids, etc.) around where they have any chance of accessing them at all, i'd rather call social services on you than have to deal with my own nic being in childproof bottles.
no kids here, of course, but i am constantly checking and double checking to be sure that i'm not leaving cartomizers or juice where my dogs can get at it. if you can't do more for your children, well. of course, that's a whole different story.
i'm glad to hear about the potential 5 day test, dr. e.
and on a side note, my nicalert test strips have been ordered... i'm planning to test next wednesday or thursday, and results will be posted on my blog, linked below. i'm striving to do as accurate a test as i can, so hopefully this will greatly reassure potential vapers. or surprise the heck out of all of us.
1) I have 3 children, all grown now.
In my household at various points were: various pleasant flavored children's and other medicines, sweet alcoholic drinks in pretty bottles, (nontoxic) sweet smelling food flavorings, aroma therapy and other oils (I like vanilla, almond and citrus), not to mention the heaps of toxic products that we all use regularly. None of these were "laying about", and none of my children ever ingested anything poisonous. My kids were never tempted to inhale lemon room freshener or eat minty-smelling bathroom bowl cleaning tablets or drink pinesol. When they were young enough that that might be a remote possibility, I, like most parents, kept them up anyway. Careless parents will I suppose always stupidly manage to put harmful substances in reach of children, but no one has banned products on that account. Childproof bottles are certainly very much in order here, but one would have to become hysterical about rather a large number of household items to warrant serious consideration on that one.
2)I've followed this thread and initially somewhat respected the study, which I did read, but at this point the whole thing has become silly. The naivete of the subjects, and the many, many patient explanations offered here by experienced users who have WATCHED beginners fail to "get anything" until instructed or more practiced, and who have experienced the typical light OD symptom (and that one's pretty recognizable to many folks in here - we've had to adjust patch levels), and subsequent absurd speculations just throw the whole discussion into la la land. Placebo is a powerful thing. But it simply doesn't hold water here. Nor does speculation that some other mysterious action in ecigs "replaces" nicotine craving.
I'm sensitive to nicotine, and vomit on 21 level patches, and have certainly occasionally gotten drops of juice on my fingers and lips with no effect whatsoever.
I live in Ithaca, NY, one of the great bastions of Green. Most anyone on the street here will be glad to quote for you numerous studies about the detailed and multitudinous deadly effects of ordinary food preservatives, traditional medicines, magnetic fields, the aluminum in your spoon, meat, and so on. (And pages by Dr. Someone at a prestigious University explaining the harmlessness of arsenic tablets and so on used (legally) in homeopathic medicine. Who knows?)
I was also around when marijuana was going to destroy everyone's brain cells and cause rabid addiction and CNS breakdown and all sorts of horrible things. You want impressive studies? Check THOSE out.
I'm also a psychotherapist, and you really don't want to get me started on all of those "impressive" studies concerning the harmless wonders of psychotropics. We might start with Chantix. Lots of fabulous data upon the release of that one. Huh.
I have had studies up the wazoo. In the end, the data will be skewed in the direction of power, money, or (pray) the blessed common sense of a seasoned judge who knows why it is that my 18 year old daughter has the government's blessing if she picks up a pack of deadly toxic Marlboros, and 10,000 officials crying "Oh no! Nicotine in vapor!" if she chooses to seek a far healthier alternative. With all due respect - Bah.
In my household at various points were: various pleasant flavored children's and other medicines, sweet alcoholic drinks in pretty bottles, (nontoxic) sweet smelling food flavorings, aroma therapy and other oils (I like vanilla, almond and citrus), not to mention the heaps of toxic products that we all use regularly. None of these were "laying about", and none of my children ever ingested anything poisonous. My kids were never tempted to inhale lemon room freshener or eat minty-smelling bathroom bowl cleaning tablets or drink pinesol. When they were young enough that that might be a remote possibility, I, like most parents, kept them up anyway. Careless parents will I suppose always stupidly manage to put harmful substances in reach of children, but no one has banned products on that account. Childproof bottles are certainly very much in order here, but one would have to become hysterical about rather a large number of household items to warrant serious consideration on that one.
2)I've followed this thread and initially somewhat respected the study, which I did read, but at this point the whole thing has become silly. The naivete of the subjects, and the many, many patient explanations offered here by experienced users who have WATCHED beginners fail to "get anything" until instructed or more practiced, and who have experienced the typical light OD symptom (and that one's pretty recognizable to many folks in here - we've had to adjust patch levels), and subsequent absurd speculations just throw the whole discussion into la la land. Placebo is a powerful thing. But it simply doesn't hold water here. Nor does speculation that some other mysterious action in ecigs "replaces" nicotine craving.
I'm sensitive to nicotine, and vomit on 21 level patches, and have certainly occasionally gotten drops of juice on my fingers and lips with no effect whatsoever.
I live in Ithaca, NY, one of the great bastions of Green. Most anyone on the street here will be glad to quote for you numerous studies about the detailed and multitudinous deadly effects of ordinary food preservatives, traditional medicines, magnetic fields, the aluminum in your spoon, meat, and so on. (And pages by Dr. Someone at a prestigious University explaining the harmlessness of arsenic tablets and so on used (legally) in homeopathic medicine. Who knows?)
I was also around when marijuana was going to destroy everyone's brain cells and cause rabid addiction and CNS breakdown and all sorts of horrible things. You want impressive studies? Check THOSE out.
I'm also a psychotherapist, and you really don't want to get me started on all of those "impressive" studies concerning the harmless wonders of psychotropics. We might start with Chantix. Lots of fabulous data upon the release of that one. Huh.
I have had studies up the wazoo. In the end, the data will be skewed in the direction of power, money, or (pray) the blessed common sense of a seasoned judge who knows why it is that my 18 year old daughter has the government's blessing if she picks up a pack of deadly toxic Marlboros, and 10,000 officials crying "Oh no! Nicotine in vapor!" if she chooses to seek a far healthier alternative. With all due respect - Bah.
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Ok. Although I'm confident that factors other than nicotine strongly affect cigarette cravings for many people, I nonetheless view that statement as a faulty generalization. Oh well, so be it.
I do hope that you will do an e-cig study along the lines of study 2 in the Gray et al 2008 paper. The data from such a study would be of great interest.
- Apr 2, 2009
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In posting 376, Tom Eissenberg wrote:
"Bill: The data you cite (i.e., the means and SEMs) are correct of course. What I reject and deplore is your seemingly intentional mischaracterization of the significance testing and its interpretation. Non-significant results are not meaningful differences. They are considered chance results that would likely not recur if the study were repeated. In contrast, significant results are not considered chance results and are likely to recur 95/100 times (or more) that the study is repeated."
While the study consistently found modest increases in mean plasma nicotine levels (albeit statistically insignificant when compared to real cigarettes) after e-cigarette usage, Eissenberg repeatedly told the news media the study found that e-cigarettes emit "no nicotine".
In the study/letter, Tom Eissenberg wrote:
"Importantly, these results were from two specific products tested under acute conditions in which puff number was controlled. Variability in product design may influence vapour content7 and chronic use and/or more intensive puffing (ie, more puffs, greater puff volume) may influence nicotine delivery."
and in posting 417 of this thread, Tom Eissenberg wrote:
"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."
Except the news headlines "Study: 'electronic cigarettes' don't deliver" and "VCU researcher says electronic cigarettes dont deliver the nicotine they promise" and content of the CNN and Richmond Times-Dispatch articles clearly imply the study found that "no" e-cigarettes emit nicotine, and quote Eissenberg as the source of that assertion.
In posting 475 of this thread, Tom Eissenberg wrote:
"In my world, the Ruyan sponsored study is viewed with skepticism by many."
Not sure what world Eissenberg is from, but for three decades Murray Laugesen has been a public health physician and the leading activist in New Zealand to reduce cigarette smoking and to reduce exposures to tobacco smoke pollution. So why the skepticism, and who are many?
As one who encouraged Ruyan to conduct laboratory studies on their products back in 2007 (to defend their products from false allegations by tobacco/nicotine prohibitionists), Laugesen was one of the many respected tobacco researchers (including John Britton, Dorothy Hatsukami, Jonathan Foulds, Mike Cummings) who I encouraged Ruyan to contact.
In sum, while I'm pleased that Tom Eissenberg is now trying to make nice to e-cigarette users, nothing he writes on this forum can begin to repair the damage he caused last week by telling the news media that e-cigarettes emit "no nicotine".
While another published study finding that various e-cigarette products do indeed increase plasma nicotine levels would help, I'm not aware of any tobacco researcher who has published a study that discredits his/her previous assertions to the news media.
Ironically (or not), Eissenberg has rejected my previous efforts to educate him about e-cigarettes by repeatedly telling me to stop sending him e-mails (after I sent him important information about e-cigarettes and other tobacco harm reduction products).
"Bill: The data you cite (i.e., the means and SEMs) are correct of course. What I reject and deplore is your seemingly intentional mischaracterization of the significance testing and its interpretation. Non-significant results are not meaningful differences. They are considered chance results that would likely not recur if the study were repeated. In contrast, significant results are not considered chance results and are likely to recur 95/100 times (or more) that the study is repeated."
While the study consistently found modest increases in mean plasma nicotine levels (albeit statistically insignificant when compared to real cigarettes) after e-cigarette usage, Eissenberg repeatedly told the news media the study found that e-cigarettes emit "no nicotine".
In the study/letter, Tom Eissenberg wrote:
"Importantly, these results were from two specific products tested under acute conditions in which puff number was controlled. Variability in product design may influence vapour content7 and chronic use and/or more intensive puffing (ie, more puffs, greater puff volume) may influence nicotine delivery."
and in posting 417 of this thread, Tom Eissenberg wrote:
"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."
Except the news headlines "Study: 'electronic cigarettes' don't deliver" and "VCU researcher says electronic cigarettes dont deliver the nicotine they promise" and content of the CNN and Richmond Times-Dispatch articles clearly imply the study found that "no" e-cigarettes emit nicotine, and quote Eissenberg as the source of that assertion.
In posting 475 of this thread, Tom Eissenberg wrote:
"In my world, the Ruyan sponsored study is viewed with skepticism by many."
Not sure what world Eissenberg is from, but for three decades Murray Laugesen has been a public health physician and the leading activist in New Zealand to reduce cigarette smoking and to reduce exposures to tobacco smoke pollution. So why the skepticism, and who are many?
As one who encouraged Ruyan to conduct laboratory studies on their products back in 2007 (to defend their products from false allegations by tobacco/nicotine prohibitionists), Laugesen was one of the many respected tobacco researchers (including John Britton, Dorothy Hatsukami, Jonathan Foulds, Mike Cummings) who I encouraged Ruyan to contact.
In sum, while I'm pleased that Tom Eissenberg is now trying to make nice to e-cigarette users, nothing he writes on this forum can begin to repair the damage he caused last week by telling the news media that e-cigarettes emit "no nicotine".
While another published study finding that various e-cigarette products do indeed increase plasma nicotine levels would help, I'm not aware of any tobacco researcher who has published a study that discredits his/her previous assertions to the news media.
Ironically (or not), Eissenberg has rejected my previous efforts to educate him about e-cigarettes by repeatedly telling me to stop sending him e-mails (after I sent him important information about e-cigarettes and other tobacco harm reduction products).
Dear all:
This thread has been very instructive and informative to me. I do not want it to degrade into an argument between Bill and I, as there is no value to anyone in that outcome. Please do not take my silence in response to Bill's comments as agreement. Instead, please understand that the safe bet is that Bill and I are unlikely to convince each other when we differ in this manner, and so I prefer not to tire myself and others by trying.
I apologize if this response is unsatisfying.
Thanks,
Tom E.
This thread has been very instructive and informative to me. I do not want it to degrade into an argument between Bill and I, as there is no value to anyone in that outcome. Please do not take my silence in response to Bill's comments as agreement. Instead, please understand that the safe bet is that Bill and I are unlikely to convince each other when we differ in this manner, and so I prefer not to tire myself and others by trying.
I apologize if this response is unsatisfying.
Thanks,
Tom E.
Bottom line for me, regular hits never did it for me. I had to vape like crazy and then it felt more like too much nic. Of course I was still learning. While Im Vaping and Cig free now I know I couldnt have done it without my eCig.
Not much to wonder about. On my way out the door from work I asked 4 people to describe nicotine. Some said; it's in cigarettes, it's a carcinogen, insecticide, and included other things like flavorless, etc., but All said "poison". And they were all non-smokers.
I'm not saying they were 100% correct in their discriptions, but all said "poison".
My 11 year old told me it was a poison when he was 8 years old. He learned this in school.
Virtually all e-cig users that I know (or have even heard about) used to be smokers and are very aware that nicotine is poison.
Most "vapers" have used at least one or more NRTs. Warnings of nicotine and the instructions for the proper disposal of the product is spread all over things like the patch.
Children are even taught to be wary of discarded patches, gum and cigarette butts if they come across them becuase them might contain nicotine... which is a poison.
Also, some of the first posts I read on this forum warned about mishandling e-juice because nicotine is a poison.
Most of my e-juice comes with warnings either on the invoice, or on the packaging.
JC puts a seal on fresh unopened bottles, Revolvercig ships in child proof containers and sells the empty child proof containers to people who don't have any.
Every bottle I have lists the strength of the nic on them.
All of the parents I know warn their children about the various poisions in their house.
My son has been instructed not to break into my locked tool boxes.
So, as far as regulation, I think wer'e a far cry from needing "serious regulation".
I think most people have been educated well.
And I feel, in general, we are doing a pretty fine job of regulating ourselves.
To me, it's no wonder we haven't had an incident.
Now, say I leave a unmarked 30ml bottle behind at the airport and some guy picks it up. He smells the delicous scent of chocolate truffle and downs the whole thing thinking it's an energy drink.
Of course he'd have to suppress the overwhelming desire to spit this fluid out (that he found in an unmarked container) because it tastes gawdawful and is burning the crap out of him.
But he suffers the insufferable and downs it all.
He dies... maybe.
I'm sorry, but that sort of person is going to do himself in with or without my help.
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Perhaps the study was merely the first step in a series of studies intended to eventually show that all electronic cigarettes should come with an instruction manual that simply says "Go to e-cigarette-forum.com to learn how to properly use this product".
Your earlier statement at Post #426 only said "I did work on a project" so I hope no one would say you conducted it (certainly i did not, and I believe only your own statements on this have been posted here). The point being just that you were paid by Big Pharma on a nicotine research project (designed,co-authored, and stand behind results) about nicotine gum, and found it unlikely to be used (not as prescribed) because of sweet flavor enhancements.
That is incorrect, and could be construed as a semantic spin. I inferred amazement that we are citing "these bottles of nicotine lying around" as huge risks that, thus far, after years of use by likely millions worldwide, do not bear out in real-life experience. And then I pointed to the ACTUAL real-life cited risks that exist in FDA approved product that have been studied and deemed safe for OTC by the FDA - the gum - which resulted in overdose of a child.
I am not implying you have direct responsibility, but do want to point to the techniques of using research data improperly - someone can easily spin facts:
The misuse of the "safe" OTC gum sent a child to the hospital. He could have died, according to his doctor. Big Pharma paid to design and conduct the study you still stand by, clearing the way for marketing flavored nic gum. So someone could argue your work as contributing to misuse, in spite of controls etc.. I DO NOT, and would consider that an abuse of the data
! I don't believe the boy chose to chew the gum for it's flavoring, since, even when flavored, it tastes like cr8-op! Just like the juice.
That's why I feel we have to be careful in over-regulating and over-hyping any position. As to the pet who died, I am truly truly sorry about that - I love animals. But any pet can chew through a Nicorette wrapper, drink anti-freeze, etc. and die as well. The responsibility lies elsewhere, if suitable warning is given.! I don't believe the boy chose to chew the gum for it's flavoring, since, even when flavored, it tastes like cr8-op! Just like the juice.
Let's not spend a great deal of time and tax money warning about the obvious! :
A fact non-smokers often miss (even some credible non-smoker researchers sometimes miss this point): Smokers are very experienced "self-dosers".They self-regulate. Plenty of anecdotal evidence of that here in the forum. And smokers (and ex-smokers) will and do cut back consumption on their own when experiencing the mild initial effects of nicotine "overdose".
And if one thinks a non-smoker will use these devices and get poisoned -try one out, Dr. E! Assuming you do not smoke, see how hard it would be for you to inhale one "puff". After all, no nicotine is transferred
!To repeat my earlier statement, I agree with slybootz - I do support better packaging and labeling of nicotine products. I do not support banning the devices themselves.
and even though it was obvious Dr E would use the "hot-rodding" he discovered while lurking here to support his bias toward increased regulation:
I still say thanks again, many mahalos Dr E for staying with this conversation - good for all that you are here discussing this. I've filled more than my share of this thread and now bow out. aloha to all
kai
PS: Dr E: how do you feel about a "regulated" ecig -properly done, would you approve?
Okay okay, I promise to quit, but after these last 2 questions:
Dr. E -
1. do you drink coffee?
2. Did you know its caffeine is TOXIC, can kill pets, and yourself. And that "users"often concoct and leave highly concentrated drinks of such around where others and pets can get to it, unlabeled, unregulated, etc.
"It is to wonder....." ;-)
Google toxic caffeine
Dr. E -
1. do you drink coffee?
2. Did you know its caffeine is TOXIC, can kill pets, and yourself. And that "users"often concoct and leave highly concentrated drinks of such around where others and pets can get to it, unlabeled, unregulated, etc.
"It is to wonder....." ;-)
Google toxic caffeine
I received my Nicalert kit today to test for cotinine in urine.
My ecig use has been a steady ~2.5 mL/day of 15 mg/mL with a 510 at 3.7 volts.
Result: Level 6 (max reading)
1000+ ng/mL
One thing that we should be aware of, and perhaps Dr. E might be willing to confirm, is that while plasma and saliva cotinine levels correspond 1:1, urinary cotinine is concentrated approximately 5X over plasma/saliva, this suggests my plasma cotinine level is 200+ mg/mL (using plasma conc = urine conc/5).
To put it another way, if you're going to find cotinine with a home test kit, urine is the place to look.
My ecig use has been a steady ~2.5 mL/day of 15 mg/mL with a 510 at 3.7 volts.
Result: Level 6 (max reading)
1000+ ng/mL
One thing that we should be aware of, and perhaps Dr. E might be willing to confirm, is that while plasma and saliva cotinine levels correspond 1:1, urinary cotinine is concentrated approximately 5X over plasma/saliva, this suggests my plasma cotinine level is 200+ mg/mL (using plasma conc = urine conc/5).
To put it another way, if you're going to find cotinine with a home test kit, urine is the place to look.
nicalert also reacts to another metabolite (i'm not going to butcher the name right now, or the science, lol)... but it's also a product of nicotine.
According to Nymox, 3-OH cotinine cross-reacts at 12 - 40%, that is to say that for every 100 ng/mL of 3-OH cotinine, 12 - 40 ng/mL would be added to the result.
I fully agree with you Kauai Kai, I think you are seeing what I'm seeing here.
While I also thank Dr. E. for his participation on this thread (and this message is not directed to him, but to the vaping community), I have a feeling of him giving the media one face and a different one to us, I think his "sound bites" to the media have a connotation against vaping and not a neutral stance like should be for a scientist, looks like he is looking to find specifically only "bad things" and ignoring the possible good ones of vaping.
We all want regulations and studies to make this practice as safe as it can get, but pointing out only "bad things" specially to the media, sometimes without proof at all like this one: "And because they lack the jolt of tobacco cigarettes, users may be modifying the electronic devices to deliver more toxic nicotine, VCU researcher Thomas Eissenberg said yesterday." is not the way I want this to be done.
Remember folks, we have very few friends right now, open your eyes before swallowing everything you read from anybody.
While I also thank Dr. E. for his participation on this thread (and this message is not directed to him, but to the vaping community), I have a feeling of him giving the media one face and a different one to us, I think his "sound bites" to the media have a connotation against vaping and not a neutral stance like should be for a scientist, looks like he is looking to find specifically only "bad things" and ignoring the possible good ones of vaping.
We all want regulations and studies to make this practice as safe as it can get, but pointing out only "bad things" specially to the media, sometimes without proof at all like this one: "And because they lack the jolt of tobacco cigarettes, users may be modifying the electronic devices to deliver more toxic nicotine, VCU researcher Thomas Eissenberg said yesterday." is not the way I want this to be done.
Remember folks, we have very few friends right now, open your eyes before swallowing everything you read from anybody.
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I don't know if you read that other thread, but my recommendation there (seconded by someone else) was that both the KR808d (VaporKing) AND the Joye 510 be used for testing - just like there were two models used in your previous tests. Both models have quite different designs that result in each having it's own different strengths and weaknesses. Comparing and contrasting the results from both could prove to be useful and informative.
If you plan on only using one model, I would agree with the KR808d recommendation due to it being a more simple design that won't present as many potential problems for testing purposes. (no primer issues or concerns over cartridge/atomizer fluid wicking) But, it is my belief that the Joye 510 would show more efficient nicotine absorption due to it's ability to produce a greater volume of vapor comparable to analog cigarettes.
i think, though, lithium, this really is not a matter of dr. e. being two-faced. the issue is that because we have so many "enemies" it seems like anything that isn't "pro" e-cig is anti-e-cig. as has been stated by others, nicotine addicts do self-dose, consciously and unconsciously. i think it's fair to say that some of the ways we modify our use do give us more of an opportunity to absorb nicotine. that said, nicotine isn't really
"recreational"--when we modify to obtain a higher dose, we're likely to stop when it becomes an amount much higher than we're accustomed to. i could see over the course of vaping for a couple years, though, one's nicotine use becoming (more) extreme. hmm, something to think about. even though it seems that many vapers step down their vaping after getting used to it, and some eventually go to 0 nic or quit without much issue.
btw, lithium--i totally understand what you're saying, and i agree to a point. i do wish dr. e's statements had been less subject to negative interpretation, but i don't think they're unfair, and we have no idea how much the media glossed over everything else he said.
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