Tell me what you know about e cigarettes

Hi all,

Today I've just watched the video linked in this article http://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/203-calif

and seen this flyer from the EU Commission http://ec.europa.eu/health/tobacco/docs/tobacco_mythbuster_en.pdf

I am rarely moved to raise topics (look at my post history), but I can't remain silent and watch people be misinformed by agencies that they should be able to rely on for scientific fact and fairly represented information. Doesn't matter if these agencies are in UK, Europe, or overseas as they are all giving similar messages.

"Right then son, where's the debunking then?"

Glad you asked, i'm not giving any in this post except to say the flyer is terribly misleading.
I don't want to push information at people, I don't believe in the approach and its not my style. I think it is more effective to try and respond to people's questions and address what is important in their eyes.

I'm posting to ask that YOU tell me what you think you know that is negative about e cigarettes. Whether from pre-existing belief/knowledge, the flyer I linked, or somewhere else. I'm not proscribing your source but if its an option feel free to link or cite if it would be helpful.

I will offer a vaper's perspective and hope to show if (from the vaper's perspective) you have been told a half truth, a lie, or had information withheld or misrepresented to leave you a negative view of these products. I hope that you will then have balanced sources from which to determine your final view (which may be to disagree with me)

I do not plan to argue with anyone and hope this can be a thread for cool heads, not impassioned debate. If I have no response or cannot refute a specific point, I'll say so and concede the point.
I'm not going to say these are completely safe, I do hope to show that they are dramatically safer than smoking, and better than NRT as a harm reduction alternative.

In the interests of full disclosure: I may ask fellow vapers to assist with research if I am getting out of my depth in detail, but will not post something I have not personally looked at - I know there are people with greater professional training and education on this forum and don't think this would work well if I can offer no response to such people.

This is a forum full of bright, and curious people, I'm proud to have been, and to remain, a part of it for years. I think you deserve to hear balanced information.

Disclosure/context/about me:
I have been using e-cigarettes instead of smoking for the last 4 years and 3 months. I was a very early adopter.
I did some research, and decided on balance to take a risk as all information I could find pointed at these being less harmful than smoking tobacco. I am neither a scientist nor a medical professional, but I am an informed and educated user, not readily blinded by poor science or persuasion tactics. I guess I'm trying to say I can be an ass sometimes, but I'm not an idiot. [Hopes not to look like one as a result of this]

I am concerned about forthcoming regulation which is poorly thought through, but will pass if people are not given balanced information.

Thanks for reading, please post a response.

So, what do you know about e cigarettes?


Edit: if you read nothing else in this thread, look at this: http://listverse.com/2014/11/12/10-facts-that-everyone-gets-wrong-about-vaping/


16/4/2015 edited in response to feedback

 

Well, since I'm in a writing mood, I'll humour you with a response. As you expect, I haven't done much (read almost none) research into E-cigarettes, so I am operating out of a place of ignorance.

First off, I think you need to know my stance on 'normal' smoking. I don't understand it. I tried it for a couple of weeks when I was 16 and didn't really get it. It didn't make me feel any different and it made everything taste horrible - not to mention the black snot you get as a result. Having said that, on the very rare occasions I go out drinking, I'll partake if someone has cigars or cigarillos on the go as I find them actually quite pleasant compared to cigarettes. Additionally, the health risks are way too bad for my liking. So, in summary, I don't generally like smoking but I'm certainly not an anti-smoking Nazi (let's get Godwin's Law out of the way early shall we).

Onto E-cigarettes.

Quite frankly, I don't like them. If you're going to smoke, go all the way. I don't like the way they can use 'nice' tasting/smelling stuff as in my eyes this makes them appeal to children. I don't like the very artificial way the vapour is produced (i.e. by a filament and battery). I still feel that E-cigarettes are an unknown quantity health wise and HAVE to have bad side effects. Additionally, I see them as a sign of a society that is getting more used to casual drug taking, which is strange coming from someone who think's that weed is a perfectly acceptable drug IN MODERATION.

One thing I wonder about is the effect of frequent vapour inhalation on the lungs. I feel that people could start getting problems with bacteria/algae build up (or something similar). There again, there's probably a counter argument that it could be good for you!

So, I don't think E-cigarettes should have been invented. However, I will defend to the death your right to choose to use them! I'm aware that I have pretty flimsy arguments but I don't feel too strongly against them. Don't expect a decent discussion from me!

 

I'm a little surprised by the notion that people who haven't previously smoked are using them, and some consider them a gateway to tobacco smoking.

Not having used them myself, I used to defend them solely on the basis they helped people quit smoking altogether, but now I see them as a lifestyle choice - an alternative to smoking. You've been on them for four years, so it's I don't think you would still consider your use as an aid to quitting.

I do not think they should be banned, but I do think they need regulating.

 

Thanks for the responses guys.
Let me try to take the points one at a time. In the interests of terminology I'll follow the Oxford dictionary and use the terms smoking and vaping, though I'll be the first to admit I don't like the latter term.

Vaping is an alternative to smoking. NRT is an alternative in much the same way.

Pete J
An important point for me to try and make here is that we have universal agreement across the children or indeed non-smokers, should not be marketed to and there are advertising regulations in place forbid it. An area which I agree with though I feel age 25 stretches the definition of children. http://www.theguardian.com/society/2014/oct/09/e-cigarettes-advertising-restrictions-relaxed

Flavour however is something we enjoy as adults, and has been proven to have an impact in people transitioning from smoking and remaining off tobacco cigarettes. "the number of flavors used was an independent predictor of smoking abstinence." http://www.ecigarette-research.com/web/index.php/research/2013/145-e-cigarette-flavors.
The most recent study I know of regarding use by children was conducted by ASH in Wales and found that use is minimal and almost exclusively by former smokers. The figure of use by 'never smokers' was 0.16%, about 1 in a thousand. http://www.ashwales.org.uk/ash-wales-research/
This is an area of half truth often misrepresented however so I'll call it out here: if you see data on use by any party, look for context. What is the proportion of smokers, what is the comparative value for general population. These figures are typically omitted if they mitigate the concern for children.

I won't try to change your mind on the mechanics but people are smoking, costing health services, and dying as a result, for an behavioural and a chemical (nicotine) addiction. Ecigarettes fulfil both these addictions with a vastly reduced risk to health.
See here for a meta analysis of 41 studies relating to safety http://www.ecigclick.co.uk/farsalin...ntent/early/2014/08/30/ntr.ntu176.short?rss=1

I'm guessing your algae comment is related to steam but in truth, that aspect is no more dangers than spending time in a sauna for steam and a busy kitchen for the vapourisation of food flavourings. I doubt there are health benefits except in comparison to the alternative of smoking, in which case it is undoubtedly better for people.

Your arguments are neither flimsy or strong, I want to know what people think and thank you. If I have at least softened your view or can ask you to think of them as a harm reduction measure perhaps you will feel less negatively about them, and those who use them.

 

Personally I think it's just one addiction replacing another, tbh I wouldn't be surprised if it becomes a fashion item.

Isn't it the tobacco companies that produce the E-Cig / Vapours systems? seems to me they have the best of both worlds.

 

Spreadie
I've linked one study from ASH Wales in my response to Pete, but there are others. Evidence of use my non smokers is lacking. All the numbers show usage by people who previously smoked.
I haven't got research on this point but the non/never smoker use analogy I would draw is how many tee total people tried a non-alcoholic beer when they were new? I reckon you'd find similar figures.

I understand your point on quitting nicotine altogether but you've hit it on the head as an alternative.
Personally I never saw it as a route to quitting nicotine but as a safer alternative.

That said many vapers do actively reduce the nicotine strength of their liquids down to low or even nicotine free levels after moving to ecigarettes
The higher nicotine levels are needed to manage the transition but user then self titrate down through reducing strengths, weaning off the chemical addition without having to battle the behavioural addiction at the same time

In truth I think the behavioural addiction is the harder one to fight and certainly in my own experience of previously trying to quit, the chemical withdrawal and cravings were nothing compared to the discomfort of not having something in my hand or having my natural behaviours/routine disrupted.

Regulation is fine, provided it was informed but the for ongoing but the current proposals are to regulate them as medicines not through trading standards, advertising standards etc which already apply.
Big issues here are:
- I am not sick and these products are not medicinal, they are recreational.
- medicinal regulation carries a vastly high cost overhead unsustainable for small enterprise. This will reduce competition and innovation (in this comment at least, I can be considered a professional opinion). That is fine for the devices you see in the petrol station but these are entry products. I'd make the analogy that those are the xboxes and Wii's of the vaping industry - standardised volume. The devices at greatest risk are the best ones, the custom pc's of vaping. These are what I use and like my rig, I know every component part and build the atomisers myself.
-The regulation proposed for these devices is harsher than that in place for tobacco cigarettes.
- The legislation proposed is drafted in the Tobacco Products Directive. There are not tobacco products, and continued association is harmful to perception and development of them as a harm reduction alternative.

Instead of working with industry self regulation http://ecita.org.uk/ to develop something workable these proposals are being driven by the European commission, and even contradict and undermine the European parliament
http://www.ecigarette-research.com/web/index.php/2013-04-07-09-50-07/2013/140-eu-war

Interested to know if any of this has shown you guys a new side to things?


Anyone else? Keep the comments coming.

 

Fortunately, however much legislation gets in the way of facts, DIY will always be an option.

 

For the device sure, but it seems dangerous to put people in the position of having to mix their own cocktails of liquid which should be using very controlled doses of pharmaceutical grade nicotine, along with vegetable glycerin and or propylene glycol and flavourings. What if someone doesnt read up properly first?

Some will persist, yes, provided the ingredients can be purchased. Many do it now, but the harm done to all those who go back to smoking is unconscionable.

 

Regulation of the liquid formulations seems like a good idea. It is generally made with Propylene glycol and glycerol. Both of which, at least as far as we know are safe to inhale. Propylene glycol is the only kinda iffy one, since if you actually do metabolize enough of it, it makes a fair share of nasty acids in your body. That said it is used in all kinds of foods, including ice cream. The new inhalation vector vs. eating it might be something that should be looked at a bit more carefully.

However there are some low cost substitutes like Diethylene glycol which have been attempted to be substituted for glycerol in other industries before and poisoned quite a few people. The amount of nicotine content is also rather important. Like caffeine a tiny bit goes a long way, and since it is easy to add, it is easy to add too much. The flavor compounds are also a bit of a concern, I do not know what they tend to use for flavoring compounds, and some of them might not be that friendly.

I can see if it gets really popular you will start seeing sub-par manufacturers making stupid shortcuts in order to come out at a lower price to the others. People getting poisoned by it would be some seriously bad press.

So getting some regulations out on what you can put into the vapor liquid might be wise to at the very least, protect the industry from itself. At the very least regulating it somewhat like a food item, and having the contents listed might not be a bad idea.

 

I should add, I'm not fussed about nicotine - I gave up smoking months before I first vaped!

 

This I just don't get, you took up e- cigarettes whilst being a non smoker!
Or was it a means to prevent you from picking up cigarettes again?

 

There have been studies but no material effects that I'm aware of.
http://m.jpet.aspetjournals.org/content/91/1/52.abstract
In fact it can be used as a germicide/air steriliser, read the first post on this thread http://www.e-cigarette-forum.com/forum/health-safety-vaping/1734-germ-killing-vapor.html

Completely agree with avoiding shady practice's and subpar or dangerous ingredients.
Most flavourings are foodstuff flavourings. Would seem an appropriate and relatively simple extension of food regulation to cover these products effectively and proportionately.

That would make sense whilst even the scientific community provided a detailed rebuttal to the EU commission proposals in the Tobacco Products Directive http://www.newscientist.com/article...eus-proposed-ecigarette-law.html#.VSj8-pFwZnF

 

Or was it the behaviour that you enjoyed regardless of the addictive nicotine ?

Genuinely curious to know.

 

Not quite, it's an alternative and safer way to meet the needs of the same addiction, behavioural and nicotine chemical.

Note that nicotine is a poison but the basis for most statements about lethal doses is quite flawed and misleading. Trace back the source and see for yourself in this paper http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880486/. User self medicate and typically inhale less nicotine from an ecig than from a tobacco cigarette.

The big tobacco companies have recently started trying to get into the game, but had no hand in the origin, nor are they responsible to my knowledge for any innovation or development of ecigarette products. The vapers dont want them to be honest but they have the money and are buying their way into the entry level market
http://www.wsj.com/articles/BL-234B-2969

All the innovation and most experienced vapers have moved onwards from these devices but it is a concerning, though unsurprising, development. Keeping regulation at a level where other players can develop products and keep competing would prevent a big tobacco monopoly, which would be bad for everyone.
Medicinal regulation again favours big tobacco.

I don't mind tobacco companies having business in the industry if they offer a good product, diversifying is a better strategy for them to pursue than protection of a dying industry. And surely their money is better spent buying an ecig company and offering a safer alternative, than on some of the dubious tactics reported about their promotion of cigarettes in less developed and regulated countries!
All provided of course that they support and comply with independent self-regulation industry bodies like ecita.http://ecita.org.uk/ecita-members/all-members (Blu is a member and was bought up a couple years back by lorrillard(Camel))

That said, i'd be unlikely to buy from or recommend them myself due to their ethical and moral flexibility shown in past behaviour.

 

In a nutshell.

I never intended to give up smoking, I did it because my partner was pregnant and the last thing I wanted my unborn child exposed to would be cigarette smoke. I fully intended to go back to smoking once the boy was a few months old (never smoked in the house/car/proximity to kids), but picked up some vaping bits instead and they kept me off going back.

I smoked for the best part of 20 years, so the habits were fully ingrained. But I always found it relatively straightforward to stop smoking for extended periods - I just stopped smoking and rode out the week or two of cravings. But I loved the taste and the time wasting properties so much that I always eventually went back again. But the addiction was never strong as it seems to be with many others - despite smoking 15-20 rollies a day for two decades.

Vaping I have found replaces the habitual part of smoking - it fill my lungs with stuff, and it satisfies my hand to mouth muscle memory. It allows me to walk away from my desk for 5 minutes and take stock. The main benefits of it over smoking are that it costs peanuts, my clothes, skin, breath & car no longer smell like an ashtray, I have more flavour choices than I could ever have hoped for from tobacco. Plus I can do it in the bog at work when it's raining

I do still sometimes miss that almost overpowering sensation of a massive lungful of smoke, but then I smell people who've just had a *** and it reminds me why they're no longer a part of my life.

Hopefully that clarifies a bit, even if it makes no sense to some people. I was willing to take the risks for 20 years with cigs, so it's hardly a giant leap to take the risks with vaping.

 

A few months after I switched from smoking to vaping my penis was noticeably harder; Seriously, you could hang a wet teabag on the thing...and that's all anyone needs to know.

 

@jrs77
Thanks, some good points there and well made. Appreciate the evidence context edit too.

Not sure if that's a point for or against... But thanks for joining in the discussion.

 

You're welcome, and might I add that my egocentricity nods to my foundational reasoning to the smoking/vaping debate - People should be allowed to do whatever the hell they want with their bodies, even if it is bad for them. To quote the comedian Redd Foxx - "Health nuts are going to feel stupid someday, lying in hospitals dying of nothing." Everyone has their vices, but we have fetishized long life over other adjectives that could go before life and, as someone to whom dopamine doesn't come easily, I'll take it where I can.

As for putting the two in opposition, vaping feels safer than cigarettes as it has improved my general health in myriad ways beyond the T to the M to the I that I mentioned earlier; Burnt coils or too much voltage feels less safe than regular smoking mainly due to the sensation of fellating the barbed bone of Beelzebub, but the very fact it feels that way ensures users will learn how to properly maintain their equipment.

I essence, I trust what my body tells me and my body tells me

 

I know from multiple failed attempts to quit smoking that I have nowhere near the willpower required to quit for good, it simply is never going to happen.

So the electronic ones have received a very warm welcome from me as with vaping I'm now mostly free of the traditional cancer sticks.

Is it simply replacing one addiction with another? In my case yes it is exactly that.

As for all the lobbying against vaping I bet it is mostly the tobacco industry throwing money at politicians in a last ditch attempt to save their outdated business model.

 

So, from my slightly medical perspective?

I personally believe e-cigarettes/vaping to be less harmful than cigarettes, simple as that. As such, I support them being used as a tool to stop people smoking, as has been said above, part of the smoking habit is the physical aspect of holding a cigarette etc. Would I prefer you to go cold turkey? Yes. Nicotine replacement therapy? Yes. But if what actually works in getting you to stop smoking actual cigarettes is vaping then fine.

So why do I prefer NRT or cold turkey?
Vaping is currently seen as this no harm thing, and as such people will take it up and never ever stop. They're replacing the lifetime vice of cigarettes with the lifetime vice of vaping. Sure, the vaping is probably* better for you, but it's still going to cost you money and ultimately you're still addicted to nicotine. NRT isn't a lifetime thing - the intent is to reduce the dose over time so you're "clean" in the long run. So from a pure health perspective, NRT is "better".

So then we get on to the little asterisk I put above. Probably.
Our evidence base for vaping is minimal. GMC, I know you've linked to a few "studies", but they're not sufficiently rigorous enough at the moment, nor do they span a long enough length of time. Right now, they give us an indication, not absolute fact. There's aspects of vaping that still worry me - namely the fact that chemicals such as acetaldehyde and formaldehyde are still being found in vapour. I'll repeat, it's way way better than cigarettes, but it's still more than nothing.

Simply put, we need more research to form a proper opinion, and it needs to be written up properly rather than partisan authors. It needs to reach the point where proper Cochrane Library meta-analysis can be carried out that is statistically significant. Right now, we don't have that.

Finally, does it need legislating? Yes. Nicotine is a drug, so it needs regulating if only to ensure consumers are not being sold something full of crap it isn't supposed to have. My main concern is with the nicotine and the liquid additives, not the devices themselves that just need to comply with normal safety standards.