Important for the campaign?

[katink]

I would like to ask the ECA and any other people that want to help keep the e-cigaret on the market, to help me think along in what I am writing here.

Please take note, that I am not questioning ECA's good will or faith or integrity with this writing: I fully believe they have taken numbers from reports and studies that do have standing as serious reports/studies, leading to it being quite logical and truthful that these numbers were taken, used and spread; however, I think I may have been able to lay a finger on where numbers went wrong earlier, in studies - while these numbers being wrong simply didn't alert us, e-smokers and ECA the like, enough to put all of us to thinking about reasons or backgrounds of what might be wrong or why (Kate being the exception, clearly - but our onlook on, and subsequently our road in to trying to solve, the real problem we are facing here are different ones as to 'who to blame' - hence this seperate thread going another route of approach) (the problem being, that e-smoking will not be seen as a viable alternative [too low nicotine-level to work] for smokers to have succes with e-smoking - while practice of course is showing the opposite).


In response to a medical blog at Better Health Does The e-Cigarette Deliver Nicotine? , I wrote (and believe this to be quite probably true, though I am open to other thoughts on this matter from anyone here) the following comment:

Please take a look at http://www.e-cigarette-forum.com/forum/ - the biggest e-smoking forum around; and read a bit in the comments accompanying the petition concerning e-smoking: http://www.thepetitionsite.com/1/keep-life-saving-electronic-cigarettes-available
You will learn, that e-smoking does indeed help many, many smokers, including quite a few real heavy smokers (2 to 3 packs a day) to abandon tobacco completely - what is really amazing is, that quite a few of these people even refer to themselves as 'accidental quitters': while looking at e-cigarets for the reason of lowering their tobacco-intake somewhat, or for being able to smoke at places where tobacco-smoking has been banned, they actually found themselves to not meet their goals but instead far exceeding them - some don't even remember when exactly they stopped completely with using tobacco, but just found themselves, after days, weeks, sometimes months... to simply prefer e-smoking so much that they in fact 'just forgot to take any tobacco anymore'! Now that is one amazing accomplishment for a product, in relation to a heavy smokers big friend tobacco, if ever there was one!

While I am not a scientist like dr. Laugesson, I have been thinking a lot about the discrepancy between everyday-evidence, and his findings that a puff of an e-cigarette nets a lot less nicotine then a puff off a tobacco-cigarette, and I think I might have found where that discrepancy is to be found. I don't question the outcomes of the scientific research that dr. Laugesson has done - it is being confirmed by other studies now underway, plus his record does not point to making faults in his scientific work.

I do think however that he made a (considerable) mistake where it came to applying the found results to the practice of people actually smoking the e-cigarette. He used methods derived from tobacco-smoking, plus I think his own expectation that people would handle e-cigs as they would handle tobacco-cigs entered here; and those two together led to expectation that the daily intake of people smoking e-cigarettes would amount to about 68 to 70 puffs a day. And that is a far, far cry from what daily practice from e-smoking is showing. This figure, 60-70 puffs a day, is in fact what most e-smokers will be consuming per HOUR - probably even more.

And as you can see, this gives a totally different outcome as to nicotine-intake, including blood-levels of nicotine-intakers using the e-cigarette. I believe that, once this one wrong assumption/assertion gets rectified, that then the story gets clear why e-smoking IS working, working in a fantastic way even, for so many (heavy) smokers for whom none of the current methods like patches, gums, pills, hypnosis or anything else has shown to work - while e-smoking did do the trick for these people.

Please give your thoughts on my picking apart the real problem we are or hopefully were facing here (by far too low nicotine in blood to be seen as a viable solution to get people changing from tobacco to e-smoking).

(Next step, on agreeance, will of course be: how can we get this rectified asap...)

 

[LaceyUnderall]

Katink -

I think you have picked this apart pretty well... and while I agree that some do actually vape more than the suggested study by Laugesen, there are a couple of things that need to be kept in perspective.

1. It is my estimation that Ruyan will enter the US market as an FDA approved quit smoking device. In order to achieve FDA approval, they will need to compare apples to apples (ecigarettes to cigarettes) and that will be based on puffs.

2. All of those who are against the ecig have worked within the boundaries of per puffs for decades. Many groups have even done studies to discredit the amount of nicotine in a puff from a tobacco cigarette as put forth by the tobacco industry. This is the language in which they speak.

 

[TropicalBob]

the main conclusion is that although the e-cigarette CONTAINS a reasonable amount of nicotine it actually DELIVERS very little nicotine to the user, and certainly much much less that can be obtained from smoking. To my mind this relegates the status of this product to that of a very nice and cleverly designed theatre prop, and unfortunately not a product that is likely to be highly effective in helping smokers to quit smoking.

I cannot argue with this conclusion, based on my experience in e-smoking for 16 months. And I think the e-cig could avoid regulation by being an ineffective nicotine delivery device, thus not a "smoking cessation" or "medical" device. This is not NRT. Our e-liquid is too ineffectual to be a "drug".

But, no, I cannot explain accidental quitters, nor do I understand them. In my case, it took tremendous willpower not to return to tobacco cigarettes. For me, the e-cig is not a miracle. It's a crutch, not a cure for anything. I'd market it that way. Have fun with it. Blow vapor rings. Just don't claim it replicates cigarette smoking (it doesn't), delivers comparable nicotine (it doesn't) or will help everyone quit (I still want to know the FAILURE rate among those who try e-cigs, because this forum attracts only fanboys).

 

[katink]

Agree on 2 (and largely on one) Lacey, as to 'what they expect'... BUT this might well lead to e-cigarettes not being seen as viable alternatives (and thus being ousted as 'a whim, a novelty without meaning') - and that of course isn't factual. And while I may see the attractiveness of this at first sight - I am guessing that this will lead to a few different undesirables:
- tobacco-smokers will go along with the articles telling them this, so much less smokers then would be possible will even take a look at e-smoking (hurting their own health that way);
- those that do e-smoke, could find a reason in these 'findings' to go get 50, 60, 100 mg and smoke that ('hey I need my level, right') while we know that in practice 36 is allready too high for quite a few users; so this could lead to real and awful accidents;
- FDA might well take this 'proof of not being effective' as a reason to not be worried about banning them (don't forget, even a trace of nicotine CAN lead them to declare it drugs so still under their jurisdiction; and without proven effectiveness there will be little opposition to them then banning them anyhow).

Difficult, I agree... but perhaps it would be neccessary to teach them, if we can, that the wanted way is in fact nót comparing apples to apples, but is comparing pears to apples instead? (so that's even a factor of difficulty added, sigh... agree..)

 

[ladyraj]

Katink -

I think you have picked this apart pretty well... and while I agree that some do actually vape more than the suggested study by Laugesen, there are a couple of things that need to be kept in perspective.

1. It is my estimation that Ruyan will enter the US market as an FDA approved quit smoking device. In order to achieve FDA approval, they will need to compare apples to apples (ecigarettes to cigarettes) and that will be based on puffs.

2. All of those who are against the ecig have worked within the boundaries of per puffs for decades. Many groups have even done studies to discredit the amount of nicotine in a puff from a tobacco cigarette as put forth by the tobacco industry. This is the language in which they speak.

I respectfully disagree. It appears the labeling of tar and nicotine yields per cigarette have been based on average intake or puffs via smoker or smoke machine. But the studies do not go beyond light, moderate, or heavy smokers..meaning cigarettes per day not puffs per day. The comparable figure then would be carts per day or liquid per day. Some vapors are light, moderate, and heavy. Don't scare off the non-smoking world by the image of someone sucking on a tube hundreds of time a day (although it may be true!). Just my humble opinion.

 

[katink]

Thanks for your thoughts Bob. I am thinking though, and sorry for saying... do you consider yourself to be an average representative of a smoker? Have you ever calculated (I bet you have) what your daily intake is in mg nicotine? Perhaps that is so very very high, that for you indeed the e-cig is insignificant - without making it such for 'more normal users'?
Not trying to put your arguments to the side, but honest questions... can you comment on that side perhaps?

 

[Kate]

Ruyan research says we get 300 puffs from a cartridge (1ml?).

A forum poll shows that most voters get less than 60 puffs from 1ml - http://www.e-cigarette-forum.com/forum/general-e-smoking-discussion/6525-draws-puffs-per-ml.html

Commercial brand nicotine potency varies from zero - 48mg per ml

Ruyan research suggests that a cartridge (1ml?) lasts 1-4 days

A forum poll shows 2-3ml per day being more usual

Initial results from 9 participants in blood nicotine level tests by Ruyan show that five minutes vaping of 16mg eliquid gives about a tenth of the blood nicotine level as smoking a cigarette. http://www.e-cigarette-forum.com/fo...5034-nicotine-absorbtion-vaping-research.html

Some people think they can overdose with vaping and some don't.

Some people have been diagnosed by medics with nicotine overdose from vaping.

Tolerance levels seem to vary a great deal, making subjective comparisons difficult.


http://www.e-cigarette-forum.com/fo...thread-anyone-has-nicotine-ml-conversion.html

http://www.healthnz.co.nz/RuyanCartridgeReport30-Oct-08.pdf

Politics has nothing to do with accurate measuring.

 

[katink]

I respectfully disagree. It appears the labeling of tar and nicotine yields per cigarette have been based on average intake or puffs via smoker or smoke machine. But the studies do not go beyond light, moderate, or heavy smokers..meaning cigarettes per day not puffs per day. The comparable figure then would be carts per day or liquid per day. Some vapors are light, moderate, and heavy. Don't scare off the non-smoking world by the image of someone sucking on a tube hundreds of time a day (although it may be true!). Just my humble opinion.

Thanks for commenting Ladyraj. On first sight I think you have a valid point, about not scaring people away with the 'hundreds of drags a day' scenario (but that it is true, for many... guess we do both know that). But I think this can be easily translated into a number that is not scary at all (and pretty true, for my feeling). Lets say 400 a day - and let's give people 8 hours sleep.
That amounts to 400/16 = 25 puffs per hour (and puffs can be taken in for instance two sessions of 12 or 13 puffs each). Now that is not scary at all... and looks to be quite realistic also - can you agree?

 

[TropicalBob]

Sure, Katink. As a cigarette smoker, I was about 30 mgs nicotine per day. As an ex-cigarette smoker, I'm north of 60mg per day (and beginning a slow, painful process of cutting nicotine dependence and tolerance).

I have indeed tried to calculate absorption from snus, dissolvables, e-smoking and four pipes. There is no way I can get an accurate figure, but the non-stop craving for tobacco cigarette smoke keeps me using some form of nicotine every waking hour.

No, I'm not your typical social smoker. And every experience here is personal, so I relate mine, knowing others are different and some are similar.

P.S. I think those figures in your last post are dead-on accurate. 62 is laughable.

 

[katink]

You don't think, or see the possibility, that Laugesson might have injected a wrong number due to expectation (and translation from known way of tobacco-usage-treatment of results), probably without realising it, Kate?

 

[LaceyUnderall]

I respectfully disagree. It appears the labeling of tar and nicotine yields per cigarette have been based on average intake or puffs via smoker or smoke machine. But the studies do not go beyond light, moderate, or heavy smokers..meaning cigarettes per day not puffs per day. The comparable figure then would be carts per day or liquid per day. Some vapors are light, moderate, and heavy. Don't scare off the non-smoking world by the image of someone sucking on a tube hundreds of time a day (although it may be true!). Just my humble opinion.

I completely agree that the statistics up until now have been skewed based on all of the variables that should be taken into consideration, like you have pointed out light, moderate or heavy smokers being just one set of variables.

To further your point, that is why there are discrepancies between the cigarette equivalency in a cartridge. Originally, the manufacturer tested them (my assumption) via a smoke machine and was taking quick short puffs which many smokers simply do not do. I have heard of people getting what they feel to be 20 cigarettes out of a super mini cartridge, but for the most part, smokers don't get that and yield 3 at most.

You do make a good point, non-smokers would be confused by hearing 15 ml per day vs. 300 puffs per day and would automatically think 15 ml was yielding less than puffs, even if the math didn't add up.

 

[katink]

Well Bob, you aren't even as high as I had expected then (I would have given you to be around 100 mg or so)
Still, 60 mg is, I think, a fair bit higher then your average smoker too (not talking about real social smokers, they will of course be the very lowest, but aren't really the group we see e-smoking all that much).
I think we agree that you are one of the smokers heavily longing for that missing factor in your brain - which undoubtedly will have lead you toward raising your nic-intake after leaving the tobacco. But the result is that you can now not really be seen as 'average', indeed... do you have any idea of a percentage here that would have gone the same way as you? Considerable, or small?

 

[Kate]

I don't know where the 300 puffs per ml have come from Katink, we'd really have to ask Dr Laugesen how he came up with that number. Maybe he is equating a draw of a cigarette as the same volume as a vapour draw It doesn't even come close to real life for most people if our poll results are reasonably reliable. It's never made sense to me and it skews all the other maths completely.

Another number that's come up recently is one Lacey says she was given that apparently came from a poll Njoy did with customers on daily puff counts. That one says 64 (or something around that) is average. That doesn't add up to me either (maybe Njoy users can't afford the cartridges to puff any more than that, ha ).

 

[TropicalBob]

Not too many e-smokers seem to jump to other alternatives, as I did. But the ones who did are uniformly happy with their decisions. I would be lost without the alternatives.

Long ago, I saw a trend that didn't look good and asked what I would do WITHOUT e-cig supplies. I found my answers, but I think most folks don't want to believe the government might actually continue actions to shut down our practice.

I don't advocate my approach to staying off tobacco cigarettes. I just note it and the fact that, so far, it's worked for me. (And it's insane that the EU bans Swedish snus!)

 

[LaceyUnderall]

Another number that's come up recently is one Lacey says she was given that apparently came from a poll Njoy did with customers on daily puff counts. That one says 64 (or something around that) is average.

******
This is one question we asked in a survey sent to 3000 of our users in March
of 2009.

On average, how many times each day do you take a puff of your NJOY
electronic cigarette?

25.3% Less than 20 puffs
33.3% 20 to 50 puffs
22.1% 50 to 100 puffs
11.3% 100 to 150 puffs
3.6% 150 to 200 puffs
4.4% More than 200 puffs

62.8 Average puffs per day
******

 

[katink]

While I believe this is the outcome the survey gave, I can't actually believe the numbers to be right either... it sounds like 'answering the way you think the other party will desire to hear' or something... unless Kate is right of course, that those people just can't afford using their e-cig any more then that due to Njoy cartridge-prices (do you know Lacey, if there was an accompanying question as to if these people were using just Njoy-devices, or if they were using either other e-smoking devices, or tobacco-cigs, next to this amount they gave?)

 

[LaceyUnderall]

While I believe this is the outcome the survey gave, I can't actually believe the numbers to be right either... it sounds like 'answering the way you think the other party will desire to hear' or something... unless Kate is right of course, that those people just can't afford using their e-cig any more then that due to Njoy cartridge-prices (do you know Lacey, if there was an accomanying question as to if these people were using just Njoy-devices, or if they were using either other e-smiking devices, or tobacco-cigs, next to this amount they gave?)

I do know there were other questions asked in the survey but I do not have them.

 

[katink]

Do you (or others) know if that survey is viewable anywhere on the net?

 

[LaceyUnderall]

Do you (or others) know if that survey is viewable anywhere on the net?

It is my understanding that it is not. Will it be? Hopefully. I am working on Jack to make it available in it's entirety

 

[katink]

Good! (for your trying)
If they were indeed using other means of nicotine-intake next to this number, it would be a lot more believable (but then, using those numbers as a total for other studies or means to reach results wouldn't be correct of course).
Thanks for trying, hope you succeed.