A little late with this one, but thanks to those who linked to it on FB.
UKNSCC - UK National Smoking Cessation Conference
June 2012, Birmingham UK
UKNSCC - UK National Smoking Cessation Conference
Dr Hayden McRobbie's presentation on electronic cigarettes
Dr McRobbie gave a good presentation on e-cigarettes to this medical conference on smoking cessation in Birmingham, UK in June. He works in NZ and the UK, and may have been involved with Bullen and others (Laugesen? not mentioned though) in the early NZ tests on a Ruyan product in 2006.
He correctly identified that experienced users upgrade to models that perform better than the widely-available entry-level models. He repeated the advice that, "The less it looks like a cigarette, the better the performance will be".
As a medic, in the tobacco control area, he is unusually sympathetic to e-cigarettes, though perhaps not up to date with developments since the early years. In order to provide this medical conference presentation he reports that he had to research the subject on the internet. However, he does have much more knowledge of the subject than most people declaiming on it who researched it on the web. There are some rough edges here that are occasionally amusing, such as the reference to ecig users as 'vappers' (rhyming with rappers).
As a consequence perhaps, there is too much mention of 'smoking' an e-cigarette. They can't be smoked as there is no smoke. If someone were to breathe in steam from a kettle, could it be described as smoking? The product supplies a water-based vapour and therefore can be described as 'being used' or 'using an ecig' or 'vaping' or 'being vaped' - but not 'smoked'. There is no tobacco, no ignition, no combustion and no smoke. A PV can be 'smoked' about as much as Snus can be smoked.
The statement, from surveys, that "People believe that e-cigarettes are less harmful than smoking" - this may be true, but on the other hand current medical opinion is that ecigs are less harmful than smoking, so perhaps this should be mentioned. Even the MHRA have admitted this.
The lipoid pneumonia issue is mentioned, and perhaps some medic somewhere should consult the expert vapers on this. We are well aware that there is likely to be an increase of risk for emphysema sufferers since they are at increased risk for pneumonia, therefore Stage 4 COPD / emphysema patients should NOT use e-cigarettes. Patients with early COPD should only use e-cigarettes with close supervision by their thoracic consultant. As regards lipoid pneumonia vs pneumonia, we would want to see a great deal of pathology on the precise disease implicated and absolute proof that lipoid pneumonia is involved, since this would be the first case recorded where glycerine has been shown to cause a disease normally associated with paraffin. It would be of great importance to the pharmaceutical industry since glycerine is now the preferred excipient for inhalable medicines and is very widely used for this purpose (google for 'dow optim'). As glycerine has taken over from PG as the advised diluent for medical inhalers, evidence that it may be associated with lipoid pneumonia would have significant implications for medical use.
This issue is one reason why it might be a good idea if glycerine-based e-liquid used by those with lung disease caused by smoking contained a small percentage of PG for its bactericidal and virucidal properties (apart from the issue of whether ecig use is advisable or not). Anyone with severe smoking-related lung disease such as late-stage COPD or emphysema must inform their consultant of their ecig use, in order that their health can be continuously monitored, since inhalation of anything at all with these diseases is contra-indicated. If pneumonia develops in someone at high risk of pneumonia due to chronic lung disease, most reasonable people would say that the last thing blame can be attached to is the ecig.
The MHRA was mentioned, but it is worth pointing out that they have no supervisory role with consumer products; they have as much right to regulate coffee and its dosages as e-cigarettes.
Dr McRobbie mentioned that he did not know if ecigs are regulated anywhere. Like virtually all medics he is not aware that the UK is the only country in the world where e-cigarettes are effectively regulated. The Department of Business have a regulatory programme in operation, as is appropriate for all consumer products, though they pay special attention to ecigs currently due to the interest.
The US situation was mentioned but the information seems outdated: ecigs have already been classified as a consumer tobacco product and will be regulated by the FDA as such. The AAPHP letter quoted was probably an old one since ecigs were classified as a tobacco product by 2011.
UKNSCC - UK National Smoking Cessation Conference
June 2012, Birmingham UK
UKNSCC - UK National Smoking Cessation Conference
Dr Hayden McRobbie's presentation on electronic cigarettes
Dr McRobbie gave a good presentation on e-cigarettes to this medical conference on smoking cessation in Birmingham, UK in June. He works in NZ and the UK, and may have been involved with Bullen and others (Laugesen? not mentioned though) in the early NZ tests on a Ruyan product in 2006.
He correctly identified that experienced users upgrade to models that perform better than the widely-available entry-level models. He repeated the advice that, "The less it looks like a cigarette, the better the performance will be".
As a medic, in the tobacco control area, he is unusually sympathetic to e-cigarettes, though perhaps not up to date with developments since the early years. In order to provide this medical conference presentation he reports that he had to research the subject on the internet. However, he does have much more knowledge of the subject than most people declaiming on it who researched it on the web. There are some rough edges here that are occasionally amusing, such as the reference to ecig users as 'vappers' (rhyming with rappers).
As a consequence perhaps, there is too much mention of 'smoking' an e-cigarette. They can't be smoked as there is no smoke. If someone were to breathe in steam from a kettle, could it be described as smoking? The product supplies a water-based vapour and therefore can be described as 'being used' or 'using an ecig' or 'vaping' or 'being vaped' - but not 'smoked'. There is no tobacco, no ignition, no combustion and no smoke. A PV can be 'smoked' about as much as Snus can be smoked.
The statement, from surveys, that "People believe that e-cigarettes are less harmful than smoking" - this may be true, but on the other hand current medical opinion is that ecigs are less harmful than smoking, so perhaps this should be mentioned. Even the MHRA have admitted this.
The lipoid pneumonia issue is mentioned, and perhaps some medic somewhere should consult the expert vapers on this. We are well aware that there is likely to be an increase of risk for emphysema sufferers since they are at increased risk for pneumonia, therefore Stage 4 COPD / emphysema patients should NOT use e-cigarettes. Patients with early COPD should only use e-cigarettes with close supervision by their thoracic consultant. As regards lipoid pneumonia vs pneumonia, we would want to see a great deal of pathology on the precise disease implicated and absolute proof that lipoid pneumonia is involved, since this would be the first case recorded where glycerine has been shown to cause a disease normally associated with paraffin. It would be of great importance to the pharmaceutical industry since glycerine is now the preferred excipient for inhalable medicines and is very widely used for this purpose (google for 'dow optim'). As glycerine has taken over from PG as the advised diluent for medical inhalers, evidence that it may be associated with lipoid pneumonia would have significant implications for medical use.
This issue is one reason why it might be a good idea if glycerine-based e-liquid used by those with lung disease caused by smoking contained a small percentage of PG for its bactericidal and virucidal properties (apart from the issue of whether ecig use is advisable or not). Anyone with severe smoking-related lung disease such as late-stage COPD or emphysema must inform their consultant of their ecig use, in order that their health can be continuously monitored, since inhalation of anything at all with these diseases is contra-indicated. If pneumonia develops in someone at high risk of pneumonia due to chronic lung disease, most reasonable people would say that the last thing blame can be attached to is the ecig.
The MHRA was mentioned, but it is worth pointing out that they have no supervisory role with consumer products; they have as much right to regulate coffee and its dosages as e-cigarettes.
Dr McRobbie mentioned that he did not know if ecigs are regulated anywhere. Like virtually all medics he is not aware that the UK is the only country in the world where e-cigarettes are effectively regulated. The Department of Business have a regulatory programme in operation, as is appropriate for all consumer products, though they pay special attention to ecigs currently due to the interest.
The US situation was mentioned but the information seems outdated: ecigs have already been classified as a consumer tobacco product and will be regulated by the FDA as such. The AAPHP letter quoted was probably an old one since ecigs were classified as a tobacco product by 2011.
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