Research Agenda
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This abstract begins by labeling e-cigarettes as a nicotine delivery device, but who exactly is marketing as "delivering nicotine"? Some e-cig manufacturers market their products as containing "ZERO, low, medium, or high" levels of nicotine, but I've never seen anybody bragging about how much nicotine they deliver. Even when making truthful health claims that haven't been proven by clinical trial they say things like "you can use them to help quit smoking" not "you'll get a great nic buzz!"
ETA: Also notice that it defines them as marketed "to deliver nicotine AND sometimes other substances". This is a logical fallacy e-cigarettes have been marketed that do NOT purport to deliver nicotine or anything other than a visible vapor and/or flavoring.
How safe do they need to be demonstrated? Is Chantix safe or does its continued marketing constitute an uncontrolled experiment?
Here's the rub. Here you see that the intention of this research effort is to withdraw "dangerous" products, but they don't define what constitutes a dangerous product. Is it valid to withdraw Electronic Nicotine Delivery Systems while more dangerous Nicotine Delivery Systems (ie. CIGARETTES) are allowed?
Thomas Eissenberg's own study shows that e-cigarettes that do NOT deliver nicotine still have value as smoking cessation devices. The fact that Chantix continues to be sold worldwide with a black label warning of deadly side effects shows that products that are provably dangerous still have value as smoking cessation devices. This research agenda is fatally and fundamentally FLAWED.
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Thad, I couldn't have said that better. OT, you forced me to finally do an acronym search as I'v seen you use ETA before and just let it go. However, I kept going to "estimated time of arrival" and I knew that wasn't right. "Edited to add" certainly made a lot more sense. LOL
And in local news the American Lung Association has said that they would like to see sales of e-cigarettes suspended until research proves them safe. How safe is safe enough? How much research? Are we talking keeping them experimental for 20 years to prove there are zero long-term negative effects before we allow smokers to buy them and switch away from smoking? Frankly, I'm pretty sure that my lungs would not have lasted another 20 years with smoke going into them. The wheezing was keeping me awake at night.
So the point is not that research is a bad thing. What's the bad thing is insisting on getting and keeping them off the market until the scientists have done all the research their little hearts desire.
- Apr 2, 2009
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I was especially disappointed with this article, as a more accurate title (that actually represented the article's content) would have been:
It appears that Etter, Laugesen and Bullen (and obviously Eissenberg) are more interested in studying banned e-cigarettes than in allowing smokers to reduce their health risks by having legal access to e-cigarettes.
It appears that Etter, Laugesen and Bullen (and obviously Eissenberg) are more interested in studying banned e-cigarettes than in allowing smokers to reduce their health risks by having legal access to e-cigarettes.
It might be better to wait before accusing them all of taking the pharma dollar. Who knows what scheme is being proposed here? It might be a punt for research funding phrased in a way to attract establishment money. That doesn't necessarily mean the results will suit the establishment.
You have to sympathize with their position: their oath is to do no harm, and their inclination is to help people. But their wages directly or indirectly flow down from the pharmaceutical industry, whose agenda is to make money at any cost. So - do what the man says and see thousands die, or go out on a limb, see your salary fall, see your future job prospects shrinking. Difficult.
One or two of them will do the right thing, at great personal cost.
You have to sympathize with their position: their oath is to do no harm, and their inclination is to help people. But their wages directly or indirectly flow down from the pharmaceutical industry, whose agenda is to make money at any cost. So - do what the man says and see thousands die, or go out on a limb, see your salary fall, see your future job prospects shrinking. Difficult.
One or two of them will do the right thing, at great personal cost.
- Apr 2, 2009
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rolygate wrote
Except that their regulatory recommendations for e-cigarettes have already caused harm (in countries that have banned e-cigarettes) and may cause harm (in the US, UK and elsewhere depending upon what specific regulations are ultimately applied to e-cigarettes).
The so-called precautionary principle that has been widely adopted by many government agencies in Europe and old British colonies is realy a prohibitionist principle.
Except that their regulatory recommendations for e-cigarettes have already caused harm (in countries that have banned e-cigarettes) and may cause harm (in the US, UK and elsewhere depending upon what specific regulations are ultimately applied to e-cigarettes).
The so-called precautionary principle that has been widely adopted by many government agencies in Europe and old British colonies is realy a prohibitionist principle.
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Unfortunately, it actually goes even deeper than just pharma dollars--you could almost call it a pharma "sensibility" that is at work. It illustrates the "dirty little secret" that many scientists don't want to admit: Science is constantly on the edge of a slippery slope into the depths of morally questionable areas like weapons technology and eugenics...
that is how groups with an agenda can intentionally or accidentally come to conclusions based on fundamentally flawed premises like the one above.I didn't object so strongly to the term "ENDS", for example, simply because its not quite the best description for e-cigarettes, but because the term demonstrates the fundamental misunderstanding of the issue from looking at the issue from a pharmaceutical point of view first, and Harm Reduction second. The problem with the agenda is that by looking at e-cigs as a "drug delivery system" first and examining its effectiveness as a smoking or nicotine cessation therapy is that is completely BACKWARDS: There is no inherent advantage of e-cigarettes as a drug delivery system over any other delivery systems UNLESS e-cigarettes prove to be more acceptable than other methods. In other words, if an product is good or bad at delivering nicotine or other substances doesn't necessarily mean it will be an acceptable reduced harm alternative...but if e-cigs are acceptable reduced harm alternatives for people who are otherwise unable or unwilling to quit, THEN we might look to see if e-cigarettes are a good way to deliver nicotine or other substances.
I encourage Dr. Eissenberg to craft a research agenda that examines e-cigarettes as a reduced harm CONSUMER product first and examine possible pharmaceutical applications second. Attempts to quantify effective nicotine delivery in a product are worthless without data showing that the delivery mechanism is acceptable to users who would otherwise be unwilling or unable to completely stop using tobacco or recreational nicotine.
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We are on the same wave length, Thad. I wrote this response to the article and submitted it to Tobacco Control:
If they really feel the need to do a long term clinical trial, that's fine, no problems there, and as Vocalek said - who cares if there is also an uncontrolled experiment going on at the same time? I'm struggling to imagine how it could affect whatever controlled experiment they wish to do.
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