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References: Vaping, Ecigs

A page of references related to vaping and e-cigarettes.

 

E-Cigarettes - commentary

1. Molimard - ecigs (FR):
http://www.formindep.org/Avec-la-cigarette-electronique-est.html

2. Restaurateur talks about ecigs at local uni:
http://dimisphere.com/point-of-view-university-of-tn-chattanooga/

3. How children know that ecigs = not smoking:
http://www.ncbi.nlm.nih.gov/m/pubmed/24238406/

4. Huge increase in UK vapers forecast by SaveEcigs:
http://saveecigs.wordpress.com/2014/02/08/40625-smokers-are-switching-to-e-cigarettes-each-month/

5. Public health leadership and electronic cigarette users
G Stimson 2014
http://eurpub.oxfordjournals.org/cgi/reprint/cku049?ijkey=WwzSqMwg8VvIF22&keytype=ref
Points out that public health orgs need to support ecigs.

6. Remarkable rise in e-cigarette use in Britain
G Krol 2014
http://nicotinepolicy.net/g-krol/1535-remarkable-rise-in-e-cigarette-use-in-britain

7. Farsalinos and colleagues refute any potential for ecigs to elevate risk for CVD:
https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0034-1375702


 

E-Cigarettes - regulation

UK
1. Prof P Hajek:
http://thesmokersclinic.blogspot.co.uk/2013/06/mhra-regulation-of-electronic-cigarettes.html

2. Cabinet Office business regs blocking:
http://www.redtapechallenge.cabinetoffice.gov.uk/themehome/disruptive-business-model/

3. ASH UK:
http://www.ecigarette-politics.com/ash-uk-e-cigarette-regulation-pdf.html

4. MHRA ecig licensing:
http://www.mhra.gov.uk/home/groups/comms-ic/documents/websiteresources/con297583.pdf

5. ARI regulator guidance:
https://www.gov.uk/government/publications/regulator-impact-accountability-guidance

6. Viscount Ridley argues very cogently for less ecig regulation:
http://www.youtube.com/watch?v=Y06D-ithidY&feature=youtu.be

7. Achieving appropriate regulations for electronic cigarettes
Polosa et al 2014
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3926346/
http://taj.sagepub.com/content/early/2014/01/31/2040622314521271.full.pdf
The penultimate paragraph contains the most honest (and only correct) interpretation of the ecigarette regulation issue ever written by any medical professional - the incredible naivety of the medical profession is, unusually, not seen here.

8. POSTnote ecigs PDF:
http://www.parliament.uk/briefing-papers/POST-PN-455/electronic-cigarettes

9. Lords Q on ecigs:
http://saveecigs.wordpress.com/2013/12/18/transcript-of-viscount-ridleys-debate-on-e-cigs-in-the-house-of-lords-how-it-should-be-done/


USA
1. Analysis of the FDA deeming regulation possibilities:
http://www.khlaw.com/webfiles/What_To_Expect.pdf?utm_content=buffer8bc3d&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

2. FDA nicotine licenses:
http://www.usatoday.com/story/news/nation/2013/04/01/fda-nicotine-gum/2042175/

3. Bill Godshall pre-release presentation, before publication of the FDA deeming proposals:
http://www.ecigarette-politics.com/fda-proposal-for-deeming-regulation.html

4. FDA proposals for a deeming regulation:
http://www.ofr.gov/OFRUpload/OFRData/2014-09491_PI.pdf
https://www.federalregister.gov/articles/2014/04/25/2014-09491/sale-and-distribution-of-tobacco-products-and-required-warning-statements-for-tobacco-products
https://s3.amazonaws.com/public-inspection.federalregister.gov/2014-09491.pdf

5. ECF forum on FDA regs:
http://www.e-cigarette-forum.com/forum/fda-regulations/

 

E-Cigarettes - research

1. Electronic cigarettes pose no health concern for users or bystanders:
Prof I. Burstyn, Drexel USPH
http://www.biomedcentral.com/1471-2458/14/18/abstract
http://publichealth.drexel.edu/SiteData/docs/ms08/f90349264250e603/ms08.pdf
http://publichealth.drexel.edu/~/media/Files/publichealth/ms08.pdf

2. List of ecig studies:
http://tobaccoanalysis.blogspot.co.uk/2013/08/even-mayo-clinic-is-spreading-lies.html

3. ASH UK ecig survey:
Use of e-cigarettes in Great Britain among adults and young people (2013)
http://www.ash.org.uk/files/documents/ASH_891.pdf

4. Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes?
Cahn Z, Siegel M. - 2010
http://www.ncbi.nlm.nih.gov/pubmed/21150942
notable points:
- ecigs are ~1,000 times less toxic than cigs
- 8.2ng/g carcinogens detected, same level as NRTs

5. Evaluating Nicotine Levels Selection and Patterns of Electronic Cigarette Use.....
Farsalinos et al 2013
http://www.la-press.com/evaluating-nicotine-levels-selection-and-patterns-of-electronic-cigare-article-a3858
65% of ecig users in this study reduced their nicotine level over the time period of the study.

6. 1 in 3,000 vapers is a never-smoker:
Etter, Bullen 2011
http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2011.03505.x/abstract
3,307 ever-users of e-cigarettes responded; 187 used the devices without nicotine (5.6%); of 2,850 who used an e-cigarette that does contain nicotine, one (1) was a never-smoker (0.03%); indications are therefore that about 1 in 3,000 ecig users were not previously smokers.

7. Survey of enthusiasts at a vaping event in Philadelphia:
Foulds, Veldheer, Berg 2011
http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2011.02751.x/full
54% of experienced ecig owners use an APV model, 38% of experienced ecig owners use a mid-size model, 8% of experienced ecig owners use a mini (92% of enthusiasts have upgraded from a mini).

8. A longitudinal study of electronic cigarette users.
Etter, Bullen 2014
http://www.sciencedirect.com/science/article/pii/S0306460313003304
Ecigs are effective for maintenance of non-smoking status.

9. Electronic Cigarettes As a Smoking-Cessation Tool: Results from an Online Survey
Siegel, Tanwar, Wood - 2011
http://www.ajpmonline.org/article/S0749-3797(10)00792-0/fulltext
31% quit smoking with Blucigs @6months.

10.a. Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers
Farsalinos et al 2014
http://www.mdpi.com/1660-4601/11/4/4356
Large survey of enthusiasts. Median use 10 months; 81% had quit smoking; ecigs work for highly-dependent smokers; 21% use >20mg strength refills; 3.5% use 0-nic (note variance with all other surveys, which generally report ~7% 0-nic).

10.b. ACSH commentary:
http://acsh.org/2014/04/large-online-survey-shows-users-e-cigarettes-smokers-trying-quit-succeeding/2013/

11. What you need to know about electronic cigarettes
Britton, Bauld, Bogdanovica
Royal College of Physicians, 20 March 2014
http://www.rcplondon.ac.uk/commentary/what-you-need-know-about-electronic-cigarettes
"Switching completely from tobacco to e-cigarettes achieves much the same in health terms as does quitting smoking and all nicotine use completely."
"...any gateway risk should be assessed in the context that nearly one in five 16-19 year olds in Britain has already become a regular tobacco smoker."
"...first generation cigalike products ..... are about as effective - but no more effective - as cessation therapy as are transdermal nicotine patches."
"E-cigarettes will save lives, and we should support their use."
The comment about ecig effectiveness for smoking cessation is correct in terms of some clinical trials but a wildly inaccurate underestimate of real-world success, because ecigs are unlike medicines in that they work better outside the lab. A success rate as poor as that referenced here would be impossible to find in any real-world scenario, for multiple reasons. People just buy a better model or a stronger refill or a nicer flavour, when using consumer products with free choice - they don't give up on the attempt abruptly as in trial situations. There are many ways that ecigs are something entirely new in smoking cessation/substitution, for example there is no other product that gradually causes a smoker to use it more frequently, to the exclusion of smoking; or that causes a smoker to quit when they have absolutely no intention of doing so. This indicates that academics are completely out of their depth when trying to compare the consumer effects to that of other products - clinical trials have never been so irrelevant. In effect, researchers are unable to evaluate their own lack of competence in this area.

12. Current US ecig clinical trials:
http://clinicaltrials.gov/ct2/results?term=electronic+cigarette&Search=Search

13. 31% success in smoking cessation at 6 months using Blucig
Siegel et al 2011
http://www.ajpm-online.net/webfiles/images/journals/amepre/AMEPRE3013.pdf
Of the respondents, 31% had successfully ceased smoking; however few responded from the overall number polled.

14. The Cochrane Review of Electronic Cigarettes
http://www.cochrane.org/CD010216/TOBACCO_can-electronic-cigarettes-help-people-stop-smoking-or-reduce-the-amount-they-smoke-and-are-they-safe-to-use-for-this-purpose

 

E-Cigarettes - research - junk science

1. E-Cigarettes: A Scientific Review
AHA / Grana, Benowitz, Glantz 2014
http://circ.ahajournals.org/content/129/19/1972.full.pdf+html
An attempt by the tobacco control industry to produce a document similar to the Burstyn/Drexel review, but instead of being neutral it is funded by and written to the WHO/pharma agenda, ignoring any positive or neutral data, and cherrypicking only negative data from studies funded by the pharmaceutical industry, and featuring only the CDC's corrupted statistics. Glantz specifically denies any COI while his university is for all practical purposes owned by pharma and enforces its agenda, and his salary is in effect paid by pharma. Agenda-based junk science in its purest form.

There is a ton of this kind of junk to choose from: search 'prue talbot' or 'glantz' for multiple examples. This example is included as it is typical, by one of the most consistent offenders, and outrageously protective of cigarette sales for a purely commercial purpose and to ensure continued employment of the authors by pharma.

 

E-Cigarettes - statistics

2012 US ecig users:
total US pop @Mar1 2012 = 313.1m
http://www.census.gov/popclock/
1.4% in survey at Mar 2012 were ecig users.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0079332
Assuming the survey was of adults only, then adults are 77% of the population
http://datacenter.kidscount.org/data/Tables/99-total-population-by-child-and-adult-populations?loc=1&loct=2#detailed/1/any/false/868/39,40,41/416,417
77% of 313.1m = 241m
1.4% of 241m = 3.3m
So, at Mar 2012 this survey appears to demonstrate that there were 3.3m ecig users in the USA.

 

E-Cigarettes - technical

1. It has been known since late 2009 that only around 50% on average of the nicotine in e-liquid is transferred into the vapour, due to the work of the professional chemists on ECF:
http://www.e-cigarette-forum.com/forum/nicotine/45843-some-notes-nicotine-absorption-addictiveness-maois.html

2. The first published study to address ecig nicotine transfer efficiency. The study found that on average, approximately 55% of nicotine in e-cigarette refill liquid ('e-liquid') is transferred to the vapour. We refer to this study as 'Goniewicz 1'.
Nicotine Levels in Electronic Cigarettes
Goniewicz et al 2012
http://ntr.oxfordjournals.org/content/early/2012/04/21/ntr.nts103.abstract

3. This study examines the topic again, in more detail and with more measurements; it shows that, on average, 50% of the nicotine in e-liquid transfers to vapour (though there is an extreme range of efficiency from around 10% - 80%). We refer to this study as 'Goniewicz 2'.
Nicotine content of electronic cigarettes, its release in vapour, and its consistency across batches: Regulatory implications
Goniewicz, Hajek, McRobbie 2013
http://onlinelibrary.wiley.com/doi/10.1111/add.12410/abstract

4. Dawkins, Corcoran 2014
E-Cigarette use raises nicotine plasma measurement to 7ng after 10 minutes, 14ng/ml average at 60 minutes, with a small sample of experienced users with 1st-generation hardware (minis) and average/low strength refills (18mg):
http://www.ncbi.nlm.nih.gov/pubmed/23978909
http://link.springer.com/article/10.1007%2Fs00213-013-3249-8

5. Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices
Faralinos et al 2014
http://www.nature.com/srep/2014/140226/srep04133/full/srep04133.html
Demonstrates that 2nd-gen hardware (mid-size models) with average/low nicotine strength refills (18mg) raises plasma nic level to 6ng in 5 minutes and 23ng in 65 minutes; nic delivery from 1st-gen hardware (minis) is lower. A refill strength of about 50mg would be needed to replicate the faster and greater nic delivery from cigarettes. (The current max retail strength is 45mg and would probably suffice.)