The results of a study of 19000 E-Cigarette users

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The Ministry

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I considered myself a non-smoker before starting to vape. I had quit cigs 10+ years ago. What I want to know is... Why do so many vapers seem to treat people like me as a sort of enemy? "They" don't want things regulated as medical quit smoking devices yet "they" insist that vaping is for quitting smoking or harm reduction. "They" see non-smokers who vape as fuel for the "ANTZ". Why? This is a serious question and I'm not trying to start anything. (I welcome PMs if anybody wishes to keep it out of this thread. I'm bringing it up because the 88 non-smokers statistic was pointed out, and I'm curious.) I've only been around here for about a month and was ignorant to all the political drama around vaping before I started.

Of course I am extremely happy for anybody who can quit smoking. I sure wish vaping had been around when I quit because I really suffered. I don't have many smokers in my life, but I'm sure going to try to introduce any I can to vaping.

My personal view is I'd rather you vaped than smoked. Honestly. :) Vape on I say
 

tommy2bad

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This study maks no difference anyway, their minds are set against ecigs. If they were not a study like this would make them go, "send this guy some money, we need to know what makes these new fanged things work so well!" Instead they will say "send Stan and Pru some money, we need a study to counter this one"
Joking aside, you would think some one would be curious as to why ecigs work so well (even if it's half what's reported here it an amazing success).
 

Rickajho

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Despite the selection bias, this study should fuel the pressure to initiate scientifically rigorous studies. As in doctors recommending smoking cessation, and patients placed in various interventions, one being those selected for the e-cig (beyond cigalike) intervention. That intervention would also include on-line support, and financial assistance for hardware and juices. Such a study would be expensive, BUT we see plenty of justification for such a study, based on this research.

Some of us HAVE taken graduate-level coursework in research, and understand the importance of fully controlled studies.

The dilemma I see applying "controlled studies" is... you can't. Or rather you can, but every time you "control" something you could get pretty much select the end result you want to see before you even start the study. The very reason for the success rates reported in the survey is the lack of control we have. Success with e-cigarettes means you change as needed - change the hardware, change the PG/VG ratio of the liquids, change the nic level - up or down - some times several times a day... Hell, buy a solar powered charger if that fits your needs or floats your boat.

If a controlled study is only going to study the quit rate of people using, for example, nJoy King Gold disposables or perhaps only 100 PG liquids... What is the point of a controlled study proving "X" number of people cannot quit using 100 PG liquids because they have an allergic reaction to PG or cannot tolerate the fixed nic level in an nJoy King? Our lack of control allows a switch to 100 VG when needed to get to a success. A controlled study maintains... control and says "don't do that, report adverse reaction and a fail."

A Chantix is a Chantix, a box 'o patches is a box 'o patches. Even with gum - lot's of control if you follow the instructions - the only flexibility is the number of pieces you use. (Wonder if there will be a controlled study now that usage restrictions for gum have been lifted?) How does one form a controlled study that incorporates the very flexibility which allows so many people to achieve their goal of switching? The number of controlled studies required to take into account all the real variables of both hardware and liquids to successful switching to e-cigs would be daunting. Then you would end up with a pile of statistics. Lack of control works. Is there a point to rigid control studies that show "A" liquid at "B" nic level made with "C" PG/VG ratio results in "X" quit rate when used with "D" battery attached to "E" device but all that changes when "B" nic level changes. Or "B" nic level stays the same but "C" P/VG ratio is... Or "A" and "B" when used with this "D" and "E" produce one quit rate but when you change "D" and E" to FGHIJKLMONOPQRSTUVYXYZ you will definitely get a different controlled study end result.

We like our lack of control. Controlled studies? Not so much.
:2c:
 
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3mg Meniere

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Nice try, but no Provari.

A controlled study means that there is a control group, and a single experimental group or multiple experimental groups. In the simplest form, one group gets no treatment or a placebo treatment, the other gets e-cigs. Then, at the end of the experiment, the success outcomes are compared.

In some studies, the experimental group is obviously far better than the control group. In such a case, in the interest of ethics, the control group is given the treatment, and their progress is then also monitored.
 

CabinetGuyScott

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With respect, there are two things I feel compelled to point out:

1) This isn't an entirely proper use of the word "addiction." Addiction means the compulsive repetition of a behavior despite the behavior resulting in demonstrable harm. Since smoking causes demonstrable harm to nearly everyone who does it on a daily basis for an appreciable length of time, it is perfectly accurate to call smoking an addiction. However, addiction and dependence are not the same thing. Dependence simply means you'll have withdrawal symptoms if you discontinue intake of something. Countless millions of people are physiologically dependent on coffee, tea or energy drinks, but aren't doing themselves any harm provided their intake is not unusually excessive. Similarly, it's possible to be dependent on nicotine without doing one's self any harm, so long as the delivery system doesn't involve tobacco.

2) Nicotine dependence has never been observed in any individual who never used tobacco. Numerous clinical trials have attempted to induce it, but even when never-smokers are given high doses on a daily basis for six months or more (using gums, patches, inhalers, or some combination thereof), withdrawal symptoms have never been observed in any subject on the cessation of nicotine intake. Hence, the main reason we shouldn't be concerned about non-smokers becoming nicotine-dependent through the use of e-cigs is because there's no scientific reason to believe it's even possible.

Well stated Nate!

Back in February I had proffered the idea of retiring the word 'addiction' in association with nicotine use.
Words matter - time to retire the use of "addiction"?

In the meantime I've come across Rollygate's great site: E-Cigarettes Politics, , Discover magazine article ("Nicotine-A Wonder Drug?"), the recent Tampa Bay newspaper article, and numerous other discussions on these, and your very points.

I bristle everytime I see the addiction/nicotine association, and to be honest, I catch myself about to use it in a sentence every now and then too :ohmy:

Back to topic - I'm excited to see Dr. F's survey study has been released, and look forward to getting time to read it!
 
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NorthOfAtlanta

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This wasn't a study, it was a survey of e-cigarette users:

Dr Fs title:
(Bold is mine)

Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers

The only real control on it was do you use e-cigarettes, if so please answer these questions.

It is a great snapshot of e-cigarette use in the western world with a lot of good info.

:2c::D:vapor:
 

DrMA

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Nice try, but no Provari.

A controlled study means that there is a control group, and a single experimental group or multiple experimental groups. In the simplest form, one group gets no treatment or a placebo treatment, the other gets e-cigs. Then, at the end of the experiment, the success outcomes are compared.

In some studies, the experimental group is obviously far better than the control group. In such a case, in the interest of ethics, the control group is given the treatment, and their progress is then also monitored.

Randomized controlled studies (RCT) are a fallible tool extensively used by BP to inflate both the safety and effectiveness of most (if not all) drugs currently on the market). I certainly hope that serious ecig researchers (such as Dr. F) will be very careful in considering the applicability of this experimental paradigm.

As stated by others, the group assignments and experimental conditions can be easily manipulated to obtain whatever pre-determined result is desired, while maintaining the appearance of a "gold standard" double-blind RCT. This is especially true with treatments for addiction, where, for example, people assigned to the "placebo" group would very soon realize the treatment they receive does nothing to alleviate cravings.

Here's a recent publication discussing the pitfalls of control groups in RCTs: Clinical trials: specific problems associated with the use of a placebo control group - Cleophas - 2003 - British Journal of Clinical Pharmacology - Wiley Online Library
An the famous example (at least in clinical circles) of the massive failure of RCT in dozens of studies for vitamin E: Vitamin E Trials 'Fatally Flawed' -- ScienceDaily
 

AndriaD

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It's my job anyway. Not anyone else's.

GOD, I wish more people understood this! I took so much crap for so many years because I was a stay-at-home mom, for that simple reason: my child was MY job, not anyone else's, and no one but that child's parents have any interest in how that child turns out. Yeah we were broke, even poor, for most of that time -- but when my son got home from school, mom was always there; when he got sick at school and had to call to come home, mom was there. Anytime, anything, even for no reason at all -- mom was there. And that's exactly as it should be -- even if mom is the breadwinner and DAD is there -- SOME PARENT is always available when that child needs. I think that's a LOT more important to a child's wellbeing than having a nice house, nice car, nice clothes (though his grandparents helped a lot with the clothes so he was always "in style" to his peers!). Money is NOT everything, despite the current popular belief that it is. He's even told us that he's quite sure that his dad and I are the "sanest parents" he's ever heard of! Considering the usual level of insanity in a home with 2 recovering alcoholics, that's really saying something! :D

My son is presently out of state, and currently a non-smoker, though he's mentioned a few times that when he smells it lately, he's powerfully tempted to go back to smoking. Would I urge him to vape? YOU BETCHA!!!! And he's so amazed and thrilled that MOM no longer smokes, when that's all he's known of me for his whole life, he knows it really will work, to keep him from smoking again. So my lil eRoll is here awaiting his return home. He may decide that no matter how it smells, he's not tempted enough to go back to smoking, and if so, great! But if that temptation returns... the eRoll is waiting. ;) Then of course he'll probably steal one of my iTastes. :D

Andria
 

Uma

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Yes, yes, yes! Thank you, Jake, for posting the link to Dr. Farsalinos et al's survey results.

There were soooo many interesting facts and figures based on the survey respondents' answers to the well designed questions. Yeah, I took the survey last year. :)

I also loved the extra little tidbits, as when Dr. Farsalinos wrote this (regarding the population of non-smoking teenagers) and cited the CDC's own survey.

There is currently no evidence of adoption of EC use by such a population, with the CDC reporting that only 0.5% of non-smoking adolescents had tried EC in the past 30 days [28].

28. Centers for Disease Control and Prevention (CDC). Notes from the field: Electronic cigarette use
among middle and high school students—United States, 2011–2012. MMWR Morb. Mortal. Wkly.
Rep. 2013, 62, 729–730.


I suppose most teens who are non-smokers in the first place aren't even interested in trying an e-cigarette. And, I'd be willing to bet that most of that tiny bunch of non-smoking kids who decided to try an e-cig, probably took one tentative puff and went, "ewwwwwww!!!"

Hey, cig-alikes may have an important role to play in protecting the children from themselves during their experimental years! :laugh:

^^^ this ^^^!
 

3mg Meniere

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Randomized controlled studies (RCT) are a fallible tool extensively used by BP to inflate both the safety and effectiveness of most (if not all) drugs currently on the market). I certainly hope that serious ecig researchers (such as Dr. F) will be very careful in considering the applicability of this experimental paradigm.
I come from an educational psychology background, which may actually be more relevant in the technical aspects of experimental design in this case. I agree that a true placebo control group would be nearly impossible to engineer. It might be more practical to compare groups of people assigned to the three different NRT strategies, and chuck the idea of a true control altogether.

My point is that user surveys are only an exploration. True experiments must follow, if we are to determine if vaping is more effective in helping people quit smoking than other interventions.

In education, the effectiveness of many programs was more dependent on the teaching style of the teachers and learning style of the students, than on what actual instructional materials were used. This fits the observations about the effectiveness of "whatever and however the vaper prefers."

conditions can be easily manipulated to obtain whatever pre-determined result is desired, while maintaining the appearance of a "gold standard" double-blind RCT.
Yes, I already know about the wickedness of BP. :evil:
 

Katdarling

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With respect, there are two things I feel compelled to point out:

1) This isn't an entirely proper use of the word "addiction." Addiction means the compulsive repetition of a behavior despite the behavior resulting in demonstrable harm. Since smoking causes demonstrable harm to nearly everyone who does it on a daily basis for an appreciable length of time, it is perfectly accurate to call smoking an addiction. However, addiction and dependence are not the same thing. Dependence simply means you'll have withdrawal symptoms if you discontinue intake of something. Countless millions of people are physiologically dependent on coffee, tea or energy drinks, but aren't doing themselves any harm provided their intake is not unusually excessive. Similarly, it's possible to be dependent on nicotine without doing one's self any harm, so long as the delivery system doesn't involve tobacco.

2) Nicotine dependence has never been observed in any individual who never used tobacco. Numerous clinical trials have attempted to induce it, but even when never-smokers are given high doses on a daily basis for six months or more (using gums, patches, inhalers, or some combination thereof), withdrawal symptoms have never been observed in any subject on the cessation of nicotine intake. Hence, the main reason we shouldn't be concerned about non-smokers becoming nicotine-dependent through the use of e-cigs is because there's no scientific reason to believe it's even possible.

Well stated Nate!

Back in February I had proffered the idea of retiring the word 'addiction' in association with nicotine use.
Words matter - time to retire the use of "addiction"?

In the meantime I've come across Rollygate's great site: E-Cigarettes Politics, , Discover magazine article ("Nicotine-A Wonder Drug?"), the recent Tampa Bay newspaper article, and numerous other discussions on these, and your very points.

I bristle everytime I see the addiction/nicotine association, and to be honest, I catch myself about to use it in a sentence every now and then too :ohmy:

Back to topic - I'm excited to see Dr. F's survey study has been released, and look forward to getting time to read it!

Nate and CGScott, excellent posts. To add to this discussion, and for those who have not yet heard him, there is a wonderful video by Fr. Jack Kearney (instructor, pastor, and Certified Addiction Treatment Counselor) titled: There's No Such Thing as "Addiction" to Electronic Cigarettes!

(I'm not sure whether or not I can post the link. I'm terribly afraid of Sonic... ;))
 

sonicdsl

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Nate and CGScott, excellent posts. To add to this discussion, and for those who have not yet heard him, there is a wonderful video by Fr. Jack Kearney (instructor, pastor, and Certified Addiction Treatment Counselor) titled: There's No Such Thing as "Addiction" to Electronic Cigarettes!

(I'm not sure whether or not I can post the link. I'm terribly afraid of Sonic... ;))

:lol: no, please, post the link! Fr. Kearney is a friend of vaping (and a vaper)!
 

FireDragon1138

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Yes, and I personally had the experience of *asking* my doc for the Nicotrol inhaler, when it came out, because I'm already accustomed to receiving medicine from an inhaler, and I thought the use of it might be somewhat analogous to actual smoking -- and being told that he couldn't prescribe it to an asthmatic. I asked him, would it be worse for my lungs than smoking? He said no, but he couldn't legally prescribe it to an asthmatic. That's just asinine
Andria

That's pretty dumb considering the nicotine inhalator is actually designed to be puffed like a pipe, not inhaled. I think it's just a fig leaf to protect themselves from liability.
 
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FireDragon1138

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Lexic... I'm a libertarian so I have no problem with it., but some vapers are only a hair away from being ANTZ themselves. The idea that an adult could make an informed decision to actually want to use nicotine or tobacco is baffling to them. Smoker's guilt becomes vaper's guilt and pretty soon vaping is just "the lesser of two evils", with the emphasis on evil.
 
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AndriaD

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Lexic... I'm a libertarian so I have no problem with it., but some vapers are only a hair away from being ANTZ themselves. The idea that an adult could make an informed decision to actually want to use nicotine or tobacco is baffling to them. Smoker's guilt becomes vaper's guilt and pretty soon vaping is just "the lesser of two evils", with the emphasis on evil.

So right. My answer of "never" when idjits ask me when I'm going to quit "that,"(vaping) *absolutely* baffles them; they get this stereotypical "dumb look," like they've never heard such heresy. :facepalm: Then my mom says "well so-and-so's daughter-in-law used them to quit smoking, and then quit vaping." As if because ONE person used it that way, well EVERYONE MUST! I still want to know when that young lady starts smoking again, because it's NOT a "cessation device," it's a REPLACEMENT. If you remove the replacement, it's only logical that the original addiction will still be there, waiting.

Andria
 
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