New Foulds/Veldheer/Berg study on Philly Vape Fest attendees

[Bill Godshall]

http://www.ncbi.nlm.nih.gov/pubmed/21801287

Electronic cigarettes (e-cigs): views of aficionados and clinical/public health perspectives.
Int J Clin Pract. 2011 Aug 1. doi: 10.1111/j.1742-1241.2011.02751.x. [Epub ahead of print]
Foulds J, Veldheer S, Berg A.
Pennsylvania State University, College of Medicine, Hershey, PA, USA.


Abstract

Background:  Electronic cigarettes (e-cigs) have experienced a rapid growth in popularity but little is known about how they are used. Aim:  The aim of this study was to identify the e-cig products used by experienced e-cig users, their pattern of e-cig use and the impact on tobacco use. Method:  Face-to-face survey of 104 experienced e-cig users. Results:  Of all the e-cig users, 78% had not used any tobacco in the prior 30 days. They had previously smoked an average of 25 cigarettes per day, and had tried to quit smoking an average of nine times before they started using e-cigs. Two-thirds had previously tried to quit smoking using an FDA-approved smoking cessation medication. The majority of the sample had used e-cigs daily for at least a year. Three quarters started using e-cigs with the intention of quitting smoking and almost all felt that the e-cig had helped them to succeed in quitting smoking. Two-thirds used e-cig liquid with a medium to high concentration of nicotine (13 mg +). Only 8% were using the most widely sold types of cigarette-sized e-cigs that are typically powered by a single 3.7 volt battery. Instead most used e-cigs designed to enable the atomizer to more consistently achieve a hotter more intense vapour. Conclusion:  Until we have more evidence on the safety and efficacy of e-cigs for smoking cessation, smokers should be advised to use proven treatments (e.g. counselling and FDA-approved medicines). However, for those who have successfully switched to e-cigs, the priority should be staying off cigarettes, rather than quitting e-cigs.

 

[rolygate]

A set of questions that I would like to see the percentage of answers to are:

1. You should check one of the following three questions only:-

a) Do you intend to use e-cigarettes exactly as tobacco cigarettes, as a replacement for them (wholely or partly), with no real intention to quit at present (although that may be a possibility later)?

b) Do you intend to use e-cigarettes as an aid to quitting all smoking within a finite timeframe (e.g. within the next 3 months), by gradually reducing the amount consumed in one way or another and then quitting, or by just quitting totally when convenient?

c) Not sure.


I believe that a clear majority of e-cigarette users would check answer (a). For this reason I think that statements about 'efficacy for quitting' are at best confusing and at worst irrelevant, as most people don't intend to quit - they simply want a safer way to smoke; and describing any version of the process as 'quitting' is, to me, a mistake (unless we are talking about those who definitely see the e-cig as a route to total cessation within the immediate future - who I believe to be a minority).

I also don't see those who take a year or more to quit nicotine (as some do) or to quit totally as being in group (b). We are talking about a long-term process here and in essence it means, at best, that an e-cigarette is a useful way to eventually quit in the long term. It still means people are using them for extended periods as a replacement.

To me these usages are harm reduction rather than cessation. There is far too much talk of 'quitting' when it has no definition. I have no objection to the word being used when it is defined, whatever that definition might be for the purpose at hand. The trouble is that there are many ways it might be interpreted.

Quitting means (?):
-- To stop smoking cigarettes (but continue as an e-smoker, using an e-cigarette).
-- To stop smoking cigarettes (but continue as a tobacco user, using an alternative tobacco product such as ST).
-- To stop smoking cigarettes (but continue as a tobacco user by using an assortment of harm reduction products such as e-cigs and ST).
-- To stop using tobacco in any form but use an e-cigarette.
-- To stop using nicotine of any type.
-- To stop any activity that is smoking or looks/feels like smoking (but use other products such as Orbs or NRTs or Snus).
-- To cease all tobacco and nicotine (but continue with an e-cigarette with zero-nic).
-- To totally cease any/all smoking, tobacco, nicotine, or any other type of replacement.

And no, there is no 'generally agreed' meaning for 'quit'. If you asked 10 people in the e-cig community you would certainly not get one answer. You might get a single answer from the general, non-smoking population - but from any community that knows something of the issues it is not a simple question with a simple answer.

 

[rothenbj]

I quit smoking period and for all intent and purpose, that should be all that matters from a health perspective. Any more is eugenic nonsense.

 

[GregH]

I quit smoking period and for all intent and purpose, that should be all that matters from a health perspective. Any more is eugenic nonsense.

Yes!

If we don't continue to make the distinction between smoking cessation and nicotine cessation, then no one will. Most of those against us refuse to acknowledge there is a difference. That was the crux of the FDA's argument: that the intended purpose of these devices is to treat nicotine dependence. So, therefore, they must be a drug.

Now, while some have successfully used PVs to wean themselves from nicotine, their intended purpose is to provide a safer nicotine delivery mechanism.

I quit smoking in May of 2009, thanks to electronic cigarettes. I do, however, continue to use nicotine and have no current plans to stop. Whether I get my nicotine from a vaporizer or from Snus, the fact remains that I am no longer a smoker. That's the most important thing.

 

[Placebo Effect]

I'm looking forward to reading the study. I attended Vapefest but I don't remember being surveyed.

This part of the abstract brings up a good question:

However, for those who have successfully switched to e-cigs, the priority should be staying off cigarettes, rather than quitting e-cigs.

Anyone want to take bets on what state's tobacco hotline will be the first to advertise that they can help people quit using e-cigarettes? My money is on Florida.

 

[ByStander1]

...I think that statements about 'efficacy for quitting' are at best confusing and at worst irrelevant, as most people don't intend to quit - they simply want a safer way to smoke; and describing any version of the process as 'quitting' is, to me, a mistake

I agree.

When giving hand-outs to anyone wanting information they can pass on to a smoker, I vehemently say, "Do not say this is about Quitting. Saying, "a way to quit smoking," to a smoker is just like saying "We need to talk to a man." Result: Initial panic, then shut-down. It's about "switching," "changing," or "upgrading," but not "Quitting!"

They laugh, but they also 'get it.'


Whatever works!!!

 

[rolygate]

What I was referring to was an anomaly in the scientific terminology that is obvious even to a lay person - not the experience of the average person. To most people, when they have quit, they have quit - and that's that. But the average person's specious nonsense is the bread and butter of the scientific researcher.

There, you enter a world where every term has a precise definition, which may well be different from that in the everyday world. They have no smokers or non-smokers - they have never-smokers, ever-smokers, and so on. Even a 'non-smoker' means something different to them - an ex-smoker, rather than as we would think of it, just anyone who doesn't smoke.

So the wide mistreatment of the word 'quit' in a scientific context is an obvious anomaly. It has nothing to do with how the average person views it. That is what my comment was directed at - apart from the fact that this is, yet again, a 'scientific' article that ignores the most obvious fact of all: if something has a growth rate of 1000% per year then it obviously works very well indeed and no researcher needs to be paid to validate that fact. The conclusion:

"Conclusion: Until we have more evidence on the safety and efficacy of e-cigs for smoking cessation, smokers should be advised to use proven treatments (e.g. counselling and FDA-approved medicines)."

...is yet another attempt to try and show that researchers know better than millions of people and/or deserve funding to attempt to prove what is obvious and/or that there should be regulations to stop people doing what is obviously going to save millions of lives.

So, I think what my comment says is, "If you are a blind scientist then do not try to tell us that the sky is not blue - and at least try to use science instead of indeterminate gobbledegook".

 

[Bill Godshall]

rolygate wrote

"Conclusion: Until we have more evidence on the safety and efficacy of e-cigs for smoking cessation, smokers should be advised to use proven treatments (e.g. counselling and FDA-approved medicines)."

...is yet another attempt to try and show that researchers know better than millions of people and/or deserve funding to attempt to prove what is obvious and/or that there should be regulations to stop people doing what is obviously going to save millions of lives.

I suspect that sentence was included to prevent the study's authors from being denied future funding, invitations to speak at conferences, and/or other professional advancement.

Please remembers that Jonathan Foulds (who attended the Philly Vape Fest and who was the lead author of this study) published a landmark study in Tobacco Control in 2003 exposing and delineating how many Swedish smokers quit smoking by switching to snus. In response, many anti tobacco extremists (including Matt Myers, Greg Connolly, Scott Tomar and Jack Henningfield) criticized Foulds' study and claimed there wasn't sufficient evidence indicating that snus had helped smokers quit smoking in Sweden.

 

[rothenbj]

.......
Please remembers that Jonathan Foulds (who attended the Philly Vape Fest and who was the lead author of this study) published a landmark study in Tobacco Control in 2003 exposing and delineating how many Swedish smokers quit smoking by switching to snus. In response, many anti tobacco extremists (including Matt Myers, Greg Connolly, Scott Tomar and Jack Henningfield) criticized Foulds' study and claimed there wasn't sufficient evidence indicating that snus had helped smokers quit smoking in Sweden.

Yes, there's nothing like a unified (false) front to keep the TC members in line. Foulds, from the articles I have read, is teetering on becoming another outcast from the gang but it's such a big step. The potential of being run into a funding desert has to have its influence on a TCer.

 

[rolygate]

@Bill
Fair enough - understood.