Latest Health NZ study published

[DVap]

Figure 2 of the NZ study is trying to tell us something that the study fails to address.

Cigarettes produce a very quick reduction in desire to smoke (approx -5.3 units at ~15 minutes).

Ecigs produce a lesser reduction in desire to smoke (approx -3.3 units at ~15 minutes).

Now look closely at what happens to the desire to smoke between 15 and 60 minutes: The desire to smoke increases from approx -5.3 to approx -2 for cigarettes, and increases from approx -3.3 to approx -2 for Ecigs.

Desire is identical after one hour.

After use, desire increases far more rapidly with cigarettes than with ecigs. It's there in black and white: After one hour, cigarette = 16 mg ecig = inhaler (with the desire being dramatically greater than the rest when using the 0 mg placebo ecig).

Why? For the technically minded, the studies focus on maximum height, not on total area. This is, in my opinion, the glaring oversight that is being missed entirely.

Or to put it more simply:

Cigarettes stop delivering nicotine as soon as the smoking stops, but ecigs continue to deliver nicotine even after the vaping has stopped.

It's the tortoise and the hare.

Forget peak nicotine, measure cotinine at t=8 hours and I'll bet the results will be very similar cigarette vs ecig vs inhaler.

If anyone can offer a better explanation as to why the desire for another cigarette increases far more rapidly than the desire for another vape, I'd like to hear it.

 

[TropicalBob]

In this respect, e-smoking might be more like snus use than like cigarette smoking. In an earlier report, Murray Laugesen said nicotine from vapor was primarily absorbed in the mouth and throat, not the lungs. Something about vapor molecules being bigger than smoke molecules and not reaching the depths of the lungs, etc. I was taken aback.

But if mouth absorption is true, then nicotine takes the long road to the blood system. It does reach the brain, but not like the 7-second kick after inhaling cigarette smoke. Nicotine from e-smoking or snus use takes about 10 minutes to kick in.

As you say, at the end of an hour, the levels might be identical. It is how those levels rise and fall that differeniate the nicotine delivery and its impacts.

That is why e-smoking cannot be said to replicate cigarette smoking.

I know that I can achieve what I call a "steady state" of nicotine after an hour or so, and maintain that steady state with snus, dissolvables and e-smoking the remainder of the day. But nothing I do, or have done since I quit cigarettes, equals or replaces that spike 7 seconds after I inhaled tobacco smoke. To my mind, this missing pleasure has nothing to do with nicotine levels in liquid, either.

 

[Laz777]

Interesting post Bob. Good information.

-Laz.

 

[Kate51]

As discussed now and in other threads, the MAOI issue has much to do with physical satisfaction of smoking...something e-cigs can't address for many trying to quit tobacco smoking. Nicotine may moreso be the catalyst for that issue. I truly don't think it is totally about nicotine. I've been able to cut my intake with no/very little effect. Lots of people seem to need the snus and dissolvables as the kicker. Dvap has a good point, reading cotinine t=8 hours, but I think this study still has basically corrolated earlier bench testing by machine inhalation to a fair degree. Clinicals are always subject to human fault, this subject more than most MHO. TBob was fun to go back into the old threads when the first testing came out. I do miss those times, sadly!
But sure glad to see testing continuing. And I still think my personal track is born out yet again by this Publishing. I don't know where I'd be now without e-cigs. Something was making me totally dependant on cigarettes, to the point of almost being non-functional and terribly unhealthy. Maybe DVap is touching on that aspect on what's not able to be addressed. Or maybe it's just the nature of the beast.
Scares me to think about it.

 

[Mister]

Figure 2 of the NZ study is trying to tell us something that the study fails to address.

Cigarettes produce a very quick reduction in desire to smoke (approx -5.3 units at ~15 minutes).

Ecigs produce a lesser reduction in desire to smoke (approx -3.3 units at ~15 minutes).

Now look closely at what happens to the desire to smoke between 15 and 60 minutes: The desire to smoke increases from approx -5.3 to approx -2 for cigarettes, and increases from approx -3.3 to approx -2 for Ecigs.

Desire is identical after one hour.

After use, desire increases far more rapidly with cigarettes than with ecigs. It's there in black and white: After one hour, cigarette = 16 mg ecig = inhaler (with the desire being dramatically greater than the rest when using the 0 mg placebo ecig).

Why? For the technically minded, the studies focus on maximum height, not on total area. This is, in my opinion, the glaring oversight that is being missed entirely.

Or to put it more simply:

Cigarettes stop delivering nicotine as soon as the smoking stops, but ecigs continue to deliver nicotine even after the vaping has stopped.

It's the tortoise and the hare.

Forget peak nicotine, measure cotinine at t=8 hours and I'll bet the results will be very similar cigarette vs ecig vs inhaler.

If anyone can offer a better explanation as to why the desire for another cigarette increases far more rapidly than the desire for another vape, I'd like to hear it.

Excellent discovery DVap! I think you've found a real eye-opener here.

Edit: Removed some thoughts about inhaler data. The inhaler users in the study were instructed to use the inhaler for 20 minutes, so comparing the first 20 minutes of their usage to the other data in figure 2 is not meaningful..

I think your observation here shows more than ever that nicotine from vaping is following a longer path to the brain. And as a result I distrust nicotine plasma tests to determine how much nicotine is being delivered even more. We either need a better marker which tests how much is in-use in the brain at a given moment, or out of the known markers must rely on cotinine tests to determine total usage over a period of time.

 

[mwa102464]

Good post Smokey,

I really believe Smokeyjoe, you should have a thread of your own called Smoky's Thread where you post more for all of us ECF Memebers. We would like to here from our founder more often since your post are always so intoitive and in the forfront of the E-Cig world. You always seem to have some great information, first hand, direct, and post some great stuff for all of us to read.

Thank You
MWA102464

 

[Kate51]

to Mister, just fyi
This is a copy of a partial plasma test report: by an ECF member:
you'll notice cotinine is used as a metabolite. Cotinine, just to verify, is the metabolised factor of nicotine. Test subject used average of 3ml of 36mg juice/day.
* not sure what the nicotine number represents, we could not verify but seems to reflect absorbed (through mucosa) but not yet metabolized. Same measures would be used for any testing, whether plasma, urine, or saliva. Testing effects of nicotine in the brain at time of use would be a whole different ball game.

nicotine and cotinine metabolite
test status......final
nicotine...13
cotinine...247
3-oh-cotinine S/P....66
all units are ng/ml
NOTE: Test information..Nicotine and metabolites, serum/plasma analysis performed by liquid chromatography-tandem mass spectrometry
reference intervals ng/ml
Nicotine unexposed user level would be less than 2........active tobacco user would be 30-50 (mine is 13)
Cotinine unexposed user would be less than 2.....active tobacco user 200-800 (mine is 247)
3OHcot unexposed user would be less than 2.....active tobacco user 100-500 (mine is 66)

 

[DVap]

This study from 1976 monitors plasma nicotine between 9 AM and 4 PM. It compares smoking a cigarette hourly with chewing a 4 mg piece of nicotine gum hourly (back then, nicotine gum was not yet approved but it was the same principle used currently...nicotine bound to an ion exchange resin with a buffer).

The second page (page 1044 of the journal) shows a very interesting table comparing plasma nicotine concentration for the cigarette versus the gum.

We can see the rapid plasma nicotine spike after each cigarette is smoked, and the equally rapid plasma nicotine drop as the acute dosing ends after 5 minutes of smoking. The effect of what appears to be about a one hour half-life is dramatically illustrated.

With the gum, plasma nicotine starts up slowly and just keeps rising through the day without the dramatic drop off seen with cigarettes. By the end of the day, the gum has built up a plasma nicotine level comparable to the cigarettes, but without the dramatic drop offs.

Simply looking at the data between 9 and 10 AM gives a deceptive picture. The cigarette appears to beat the gum handily. But keep monitoring throughout the day, and the tortoise... I mean the gum... catches up with the hare... I mean the cigarettes... and provides a comparable peak plasma nicotine level, but without the deep dropoffs between doses.

I'm glad I found this study, it really illustrates what I've been trying to get at. I believe the behavior of ecigs would approximate the behavior of the gum as demonstrated in this study.

Bottom line, you can't just test for an hour and get the whole picture.

 

[Kate51]

DVap, very interesting! I snitched a copy, hope that's ok!
I found it amazing that the gums really did a tortoise race. And was amazed at the progressive raise in nicotine levels. Even considering the 1/2 life of nicotine there was still an overall rise. Which explains how long a person has to abstain from smoking/vaping in order to 'test' clean.
The 1976 date also struck me, when that was done I had already been smoking for 10 years. That was also the year my Dad died at 63 from heart failure (infarction). They blamed it on smoking, but he smoked a carton of Lucky Strikes per month, not considered excessive even then. He was a hard working farmer, ate well, but worried a lot, that was more his make-up. But I do believe this is about the time that rumors ran rampant about the BT companies fudging with nicotine levels in cigarettes. I hope more will come out someday about that, for instance adding formaldehyde to effect free-basing nicotine, I've seen numbers of up to 27mg per cigarette. I think we've been very mislead for a very long time. Dare I say lied to! But, cigarettes have been blamed for pulmonary and heart problems since late 1800's.
I see your point about plasma sampling over a longer period of time, but for sake of argument the two tests vary a great deal in general purpose:
The NZ testing was to determine the benefit of using e-cigs or inhaler as NRT's as opposed to cigarette smoking and effectiveness, level of satisfaction, craving, etc.
The test you posted was to obtain Plasma nicotine levels after cigarette smoking and chewing nicotine gum. I believe that would explain the difference in sampling times and procedures.
More in depth testing has to be done, that's for certain. There are more that should be published soon, hopefully.
I just read through a quick read, will have to study it some more, but nice work finding it!
Kate

 

[DVap]

DVap, very interesting! I snitched a copy, hope that's ok!
I found it amazing that the gums really did a tortoise race. And was amazed at the progressive raise in nicotine levels. Even considering the 1/2 life of nicotine there was still an overall rise. Which explains how long a person has to abstain from smoking/vaping in order to 'test' clean.
The 1976 date also struck me, when that was done I had already been smoking for 10 years. That was also the year my Dad died at 63 from heart failure (infarction). They blamed it on smoking, but he smoked a carton of Lucky Strikes per month, not considered excessive even then. He was a hard working farmer, ate well, but worried a lot, that was more his make-up. But I do believe this is about the time that rumors ran rampant about the BT companies fudging with nicotine levels in cigarettes. I hope more will come out someday about that, for instance adding formaldehyde to effect free-basing nicotine, I've seen numbers of up to 27mg per cigarette. I think we've been very mislead for a very long time. Dare I say lied to! But, cigarettes have been blamed for pulmonary and heart problems since late 1800's.
I see your point about plasma sampling over a longer period of time, but for sake of argument the two tests vary a great deal in general purpose:
The NZ testing was to determine the benefit of using e-cigs or inhaler as NRT's as opposed to cigarette smoking and effectiveness, level of satisfaction, craving, etc.
The test you posted was to obtain Plasma nicotine levels after cigarette smoking and chewing nicotine gum. I believe that would explain the difference in sampling times and procedures.
More in depth testing has to be done, that's for certain. There are more that should be published soon, hopefully.
I just read through a quick read, will have to study it some more, but nice work finding it!
Kate

It's pretty clear by now that if one wants a quick hit, nothing beats a cigarette... but by the end of the day mouth/throat absorption is no slouch. I think it's important to better understand how vaping is like smoking (nicotine-wise) and also how vaping is not like smoking.

The data shown in this study extending well beyond one hour serves well to suggest why some folks handle vaping fine and others don't. I, for example, never was a "first thing upon waking up smoker". I didn't need a dramatic spike, but for those who do, one might expect the morning to be the worst part of the day when vaping instead of smoking. It's interesting that some vapers report using a higher nicotine level in the morning than later in the day. This anecdotal data "lines up" with the study.

 

[Dillinger]

What you guys are discussing makes perfect sense to me now that I think about it.

When I was on nic patches, I would wear them overnight and have lucid dreams. I've also seen a thread here on ECF where, after heavy vaping before bedtime, posters have also experienced lucid dreams.

I have never once had this experience with normal cigarettes alone.

Just thought I'd mention another piece of anecdotal "evidence" in support of this subject.

 

[DVap]

What you guys are discussing makes perfect sense to me now that I think about it.

When I was on nic patches, I would wear them overnight and have lucid dreams. I've also seen a thread here on ECF where, after heavy vaping before bedtime, posters have also experienced lucid dreams.

I have never once had this experience with normal cigarettes alone.

Just thought I'd mention another piece of anecdotal "evidence" in support of this subject.

Dillinger, precisely.

Nicotine patches messing with dreams is a well-known phenomenon. This happens, of course, because the nicotine keeps on delivering through the night instead of dropping off precipitously.

So why would vaping mess with dreams (I've experienced this as well) but cigarettes don't? Because, with cigarettes, nicotine drops off precipitously after the initial spike while ecigs keep on delivering long after the last vape.

 

[Kate51]

Actually the dreams are most likely happening from reduction of MAOI's ingested from cigarettes, not found in e-juice. A withdrawal symptom. Can also cause insominia, itching, muscle twitching, weird dreams, digestion problems including heartburn, ........, heart palpitations. People with severe sypmtoms usually use snus or dissolvables to replace MAOI's. These are the component for the euphoric effect we crave. Nicotine may prove less an integral part of NRT's, MAOI's moreso. Or a balance of each gradually reducing amount of ingestion. Careful use of anti-depressants??
Anyway, if there's any truth to MAOI, then I refer back to the theory that it isn't all about the nicotine. Why would it be so easy to alter your nic intake if that was not the case.

 

[rothenbj]

Actually the dreams are most likely happening from reduction of MAOI's ingested from cigarettes, not found in e-juice. A withdrawal symptom. Can also cause insominia, itching, muscle twitching, weird dreams, digestion problems including heartburn, ........, heart palpitations. People with severe sypmtoms usually use snus or dissolvables to replace MAOI's. These are the component for the euphoric effect we crave. Nicotine may prove less an integral part of NRT's, MAOI's moreso. Or a balance of each gradually reducing amount of ingestion. Careful use of anti-depressants??
Anyway, if there's any truth to MAOI, then I refer back to the theory that it isn't all about the nicotine. Why would it be so easy to alter your nic intake if that was not the case.

I believe there's a lot off truth to the "it's not all about the nicotine". Actually that might be the least addicting aspect of smoking. What explains the many long term smokers on heer that start to vape and stop smoking entirely? They are replacing the hand to mouth strong habit and that subliminal "smoke" visualization message, but are they getting anywhere near the same level of nic from vaping? Many quickly appear to also drop to zero nic very quickly with little complaint.

Then there is that other group that are totally missing something, the ones that Zyban and Chantix were supposed to address, the depressive aspects of our personality. If asl I had was E Cigs, I may have fallen back into full analog usage again, had I not found snus. Those tobacco alkaloids, for me and I think many like me, plus the habit beater E Cig are a lot more important that the nicotine. I vapor for the habit, I snus to keep away the cravings.

All is good, especially the dreaming.

 

[Kate51]

Jfyi..................

"In Defence of Smokers", by Lauren A. Colby / Chapter 11

http://www.drugabuse.gov/Nida_notes/NNVol13N3/tobacco.html

There are many more. I question the use of the term alkaloids being used in reference to MAOI's, I think there is a discrepancy there. They seem to be different things. Chinese have done testing regarding Alkaloids.

http://www.springerlink.com/content/p08101327vt767xg/

 

[rothenbj]

Thanks Kate, that research certainly correlates to experience with trying to quit smoking and explains how easy it was to quit smoking for me after limited success with E Cigs, but instantaneous success after my first portion of snus in conjunction with it.

To think that it took FSC added to smokes, a television report on E Cigs and the amazing help this forum provides to get me totally off cigarettes after all these years. I had given up hope to ever be where I am today, I can't stop researching and advertising these products to anyone that asks and, believe me, a lot of people ask.

 

[D103]

Figure 2 of the NZ study is trying to tell us something that the study fails to address.

Cigarettes produce a very quick reduction in desire to smoke (approx -5.3 units at ~15 minutes).

Ecigs produce a lesser reduction in desire to smoke (approx -3.3 units at ~15 minutes).

Now look closely at what happens to the desire to smoke between 15 and 60 minutes: The desire to smoke increases from approx -5.3 to approx -2 for cigarettes, and increases from approx -3.3 to approx -2 for Ecigs.

Desire is identical after one hour.

After use, desire increases far more rapidly with cigarettes than with ecigs. It's there in black and white: After one hour, cigarette = 16 mg ecig = inhaler (with the desire being dramatically greater than the rest when using the 0 mg placebo ecig).

Why? For the technically minded, the studies focus on maximum height, not on total area. This is, in my opinion, the glaring oversight that is being missed entirely.

Or to put it more simply:

Cigarettes stop delivering nicotine as soon as the smoking stops, but ecigs continue to deliver nicotine even after the vaping has stopped.

It's the tortoise and the hare.

Forget peak nicotine, measure cotinine at t=8 hours and I'll bet the results will be very similar cigarette vs ecig vs inhaler.

If anyone can offer a better explanation as to why the desire for another cigarette increases far more rapidly than the desire for another vape, I'd like to hear it.

Thanks for the info. DVap - to me this explains why I've been able to reduce my nicotine intake effortlessly. I was a 2-pk a day tobacco smoker. I started e-cigs on Jan. 21, 2010 and haven't gone back since. What I didn't understand was how, without any effort or intent on my part, I have been totally content to vape only one 16mg cart. per day (equivalency of one pack of analogs) This is a reduction in nicotine intake by almost two-thirds and I've not experienced cravings or periods of dissatisfaction. The info you provided I believe explains this, at least in part.

 

[paladinx]

I cant read through this whole thread, I literally got a headache trying. the back and forth and all the figures and studies. Jesus.

Can anyone write a bottom line or something that you all kind of agree on? In regular english? So ecigs give less nicotine, but accumulate over time? I hate things that accumulate, I feel like its kind of a loss of control of how much you are using. i like the idea that when your done the nicotine stops. lol

Why isnt there any studies that just show a users blood nicotine after 24 hours of heavy vaping and compare it to a cigarette smoker with the same usage. Why all these half ... facts and pieces of information that always pop up.

 

[jiff]

Good news in this thread's beginning (didn't read the whole thing, not enough time.)

 

[Laz777]

Actually the highs and lows are what cause people to smoke so much, one of the main reasons anyway. A steady stream of nicotine is better then the ups and downs that analog cigarettes are designed to cause. You might not get the rush in the morning but once your blood-nicotine levels are stable you're good to go, no crazy mood swings or freak outs to deal with.

-Laz.