Latest Health NZ study published

[Oliver]

Murray Laugesen is a prominent physician and campaigner for safer tobacco alternatives in New Zealand. He was one of the first people to get interested clinically in the potential of e-cigarettes, and has conducted a number of studies over the last couple of years.

The latest has just been published in the journal tobacco Control, and makes for some very encouraging reading.

Happily, the paper is fully accessible from here: Untitled Document

From the study's conclusion:

The Ruyan V8 16 mg ENDD reduced desire to smoke more than
the placebo ENDD and during 9 h of use was well tolerated,
acceptable to most users, rated significantly more pleasant to use
than the inhalator, and in the first hour exhibited a pharmacokinetic
profile more like the inhalator than a tobacco cigarette,
without excess adverse events. These findings suggest potential
to help people stop smoking in the same way as a nicotine
inhalator. Our findings should be regarded as preliminary and
need to be confirmed for this and other brands of ENDD. The
nicotine pharmacokinetics of ENDDs should be confirmed in
other studies, and different ways of using these devices need to
be explored. A large, well-conducted randomised trial is needed
to evaluate the ENDD’s efficacy as a quitting aid and to identify
any delayed or long-term adverse effects.

 

[YKruss]

On average, the ENDD increased serum nicotine to a peak of 1.3 ng/ml in 19.6 min, the inhalator to 2.1 ng/ml in 32 min and cigarettes to 13.4 ng/ml in 14.3 min.

It looks like this study once again confirmed that blood plasma nicotine level while using e-cigarettes is effected 10 times less then from analogs.

 

[Tom09]

Good to have yet another peer reviewed publication on the effects of e-cigs. Nice to see that the NZ study comes without the polemic drive that Eissenberg could not resist to splash over his actual findings.

 

[Kate51]

Our suspicions were right, about the 10 times less nic, the study calls for more study, and it calls for consideration as well! A win win in my book.
Thanks for the post SJ!

 

[anim8r]

Fully accessible from here: Untitled Document

From the study's conclusion:

Awesome study!

Good to have yet another peer reviewed publication on the effects of e-cigs. Nice to see that the NZ study comes without the polemic drive that Eissenberg could not resist to splash over his actual findings.

No kidding. I can't express how much that guy irritated me.

 

[Mister]

Our suspicions were right, about the 10 times less nic, the study calls for more study, and it calls for consideration as well! A win win in my book.
Thanks for the post SJ!

Although the study provides some very useful information I don't think it tells us anything significant about relative amount of nic delivery because:

1) Participants were all cigarette smokers not currently attempting to quit smoking or wishing to do so. So probably none had previous vaping experience.

2) "Participants randomised to a day using the ENDD were asked to puff the device as they would their usual cigarette for 5 min." That five minute naiive user consumption was the basis for almost all of the reported results, including the plasma levels.

3) The device used was the rather old Ruyan V8, not favored by anyone on ECF as far as I can tell.

So as with Dr. Eissenberg's study it is a safe bet that the participants didn't get nearly as much nicotine in that five minute session as experienced vapers get. The participants probably took small drags, coughed some, and even with that got less from the Ruyan V8's than they'd have gotten from say a Vapor King.

The good news is that the conditions are clearly stated and no unwarranted conclusions are drawn in this study.

 

[Laz777]

Great clarification Mister.

-Laz.

 

[Kate51]

Mister, all of what you said is very true, my statement was a very generalized one in view of previous testing results. No new news is good news!
Perhaps I'm dating myself by assuming we all are on the same page. I made a mistake by not qualifying my post as I just did.

 

[TropicalBob]

No need to back down, Kate51. Every study is showing far less nicotine delivered. Anyone who thinks nic blood levels from e-smoking are equal to cig smoking must never have smoked cigarettes.

I'm waiting for ANY study that shows elevated blood nicotine levels. And they won't find equal or elevated levels in me after my non-stop daily e-smoking.

But the electronic cigarette is still the most effective alternative to cigarette smoking available. I could not remain off cigarettes without it. Just don't get confused about how much nicotine we're getting. This does not replicate cigarette smoking.

 

[Thulium]

I'm waiting for ANY study that shows elevated blood nicotine levels. And they won't find equal or elevated levels in me after my non-stop daily e-smoking.

8-o Haven't you read the Health New Zealand results?
Here you go: http://www.healthnz.co.nz/ecig_effect-2.pdf

The 16mg EC delivered nicotine
more rapidly (mean tmax 19.4 minutes) than
Nicorette® inhalator (30 minutes) but not as rapidly
as cigarettes (14.3 min), which also gave the highest
cmax of nicotine (13.4 ng/ml), almost ten-fold that of
the 16mg EC (0.9 ng/ml), and Nicorette® inhalator
(1.8 ng/ml).

 

[5cardstud]

Mister, all of what you said is very true, my statement was a very generalized one in view of previous testing results. No new news is good news!
Perhaps I'm dating myself by assuming we all are on the same page. I made a mistake by not qualifying my post as I just did.

I'm with you Kate. I know for myself, and I'm sure many vapers, when I smoked I smoked the whole thing cause for one thing they were to exspensive to throw after a couple of drags. I can vape a couple of puffs or many puffs so I'm not restricted to puffing untill it's gone which should give me a lower nicotine level too. Plus I knew you weren't literally word for word speaking. Woops not speaking, typing.

 

[Mister]

I don't like numbers such as ten percent being presented when the truth is that we just don't know. Numbers like that have a way of getting repeated and turning into commonly accepted wisdom, just as the ten percent number previously made the rounds. AFAIK there hasn't been a study yet which actually tells us anything significant about how much nic vapers do or don't absorb. We have a few tidbits of information which can easily be over-interpreted. (Remember Dr. Eissenberg? ) My guess is that we're getting a fair bit of nicotine, but it is a guess based only on one forum member's post of a measured cotinine level (and it was a puzzling report because the nicotine level didn't line up as expected), a few forum members' posts of NicAlert tests, my own experience with nicotine overdose symptoms from vaping, and the overall vaping success rate which I don't think make sense without nicotine delivery. I won't put a number on it though. I haven't seen enough data to say more than my guess is a fair bit.

 

[Kate51]

Mister, this is the finding...

cmax of nicotine (13.4 ng/ml), almost ten-fold that of
the 16mg EC (0.9 ng/ml),

I don't know what more you need it to show. We're comparing cigarettes to PV and Nicotrol unit.
It is also brand and style specific testing. So user variations in equipment probably would also show variances, if that's your question.

 

[Mister]

Mister, this is the finding...

That is the finding, for new users who have been told to use the device as they would a cigarette, for five minutes only, with a Ruyan V8. With all those qualifications the result tells us next to nothing about what an experienced vaper is getting. Or even someone who has been vaping for a single day. It isn't a useful number and shouldn't be quoted without all of these qualifications (the Dr. Eissenberg error.)

 

[Laz777]

Thanks for the link Bob.

-Laz.

 

[Mister]

Another thing, plasma nicotine levels aren't the best measurement for what we'd like to know ("how much nicotine are we getting?") in any case. Their use even in measuring tobacco products and NRTs is a bit limited because:
1) How much nicotine is in use and how much is stored is not represented by plasma tests.
2) Nicotine metabolizes relatively quickly.

For our purposes it gets a bit fuzzier again because we know little about where and how quickly vaped nicotine reaches the blood supply. All we know is that we think it is a slower process.

The really useful numbers which I hope someone will study sooner or later are the cotinine levels in people who have exclusively vaped (no cigarettes, NRTs, smokeless tobacco) for a week or more. That will start telling us something.

 

[Laz777]

Do these numbers tell us that through vaping we're getting less nicotine then cigarettes? I hope so because I'm slightly paranoid that I'm vaping too much and overloading it on the nicotine. I didn't have much success in finding out if too much nicotine can be dangerous or not. It seems like nicotine is always connected to smoking so it's hard to get a clear picture about the effects of nicotine minus cigarettes.

-Laz.

 

[Mister]

Do these numbers tell us that through vaping we're getting less nicotine then cigarettes?

No, they don't, and we don't know the answer to this yet.

What those numbers tell us is that the blood plasma nicotine level of some people who don't have experience vaping after five minutes of trying to use a 16mg Ruyan V8 as if it were a cigarette was 1/10th as high as the blood plasma level after they smoked one cigarette.

 

[Laz777]

Thanks, that's what I wanted to know.

You wouldn't happen to know if nicotine is dangerous would you? Not ingesting it but by vaping too frequently or actual cigarette smoking as the delivery system? Since smoking is bad in general and smoking too much can cause some physical distress it's tough to tell what effect nicotine has besides addiction.

-Laz.

 

[paladinx]

whenever i read about ecigs delivering much less nicotine than cigarettes, I dunno. I take it kind of as a bad thing. I mean some might suggest thats good because why would you want more of a drug, but to me it would mean it could be less effective for people as a quit smoking device. Plus it might make people use and abuse the device much more than they should. I think people want to feel satisfied at some level, and perhaps that is why we have so many chain vaporers out t here.