Abstinence-only approach to nicotine has created undue fears about alternatives

from The Journal – http://www.thejournal.ie/readme/abstinence-only-approach-to-nicotine-has-created-undue-fears-about-alternatives-3652593-Oct2017/

by David T Sweanor

DEATH, MOST OF us can agree, is best delayed. But cigarette smoking is a major impediment to achieving such a delay. Indeed, cigarettes kill over 100 people in Ireland on a weekly basis, or about 30 times the still horrendous toll of Irish road deaths.

With cigarette smoking being by far the leading cause of death in the country, rushing such a product towards its own doom should be a national priority. All the more so if we could do so relatively easy while empowering rather than punishing people who currently smoke.

Well, the time to begin to finally stub out cigarettes might have arrived. It is based on three very straightforward facts and the application of some of the political vision that has brought us a host of past public health revolutions.

People smoke for the nicotine but die from the smoke

First, people smoke for the nicotine but die from the smoke. Cigarettes are a very dirty delivery system for a relatively low risk drug. They are the equivalent of getting caffeine by smoking rather than brewing tea leaves, or heating a building with an open fire but no chimney. The repeated inhalation of smoke, not the pursuit of nicotine, caffeine or warmth, ultimately kills.

Second, it is now entirely possible for people who currently smoke to get their nicotine from consumer acceptable products that obviate the inhalation of the products of combustion.

Vaping, also known as electronic cigarettes, is already very popular as a substitute for lethal cigarettes. These products are getting constantly better, and are used by ever growing numbers of people who seem to appreciate the advantages in saving both money and years of life. But there are many other options that could also be available.

Read full article at http://www.thejournal.ie/readme/abstinence-only-approach-to-nicotine-has-created-undue-fears-about-alternatives-3652593-Oct2017/



Flawed study and questionable PR becomes news

from IVVA (Irish Vape Vendors Association) – http://www.ivva.ie/latest-news/flawed-study-and-questionable-pr-becomes-news/

It is unfortunate that ‘negative’ media stories about vaping garner a lot more clicks and shares than ones which tend to be more balanced and accurately reported. One thing most casual readers would hope however, is that what is contained in the press release which gets sent out to journalists does indeed reflect the study findings, and that the data and its  implications have been communicated honestly and accurately.


So it certainly disappointing that a study which came to light on Tuesday has elicited some highly alarmist headlines. Although the research was conducted in November, its release this week seems to perfectly coincide with the exact time of year that many smokers will perhaps be thinking of looking for an alternative as part of their new resolutions.


‘Scientists warn e-cigarettes could cause cancer’

‘E-cigarettes may be ‘no better’ than smoking regular cigarettes, warn scientists’

‘E-cigarettes are not safe! They can cause cancer too’

‘E-cigarettes are ‘no better’ than traditional cigarettes, say scientists’


So what lies behind the headlines, what was the study looking at, and was the media frenzy warranted?

According to the press release,

…a lab team at the Veterans Affairs San Diego Healthcare System tested two products and found they damaged cells in ways that could lead to cancer. The damage occurred even with nicotine-free versions of the products.

“Our study strongly suggests that electronic cigarettes are not as safe as their marketing makes them appear to the public,” wrote the researchers, who published their findings in the journal Oral Oncology.


The researchers

…created an extract from the vapor of two popular brands of e-cigarettes and used it to treat human cells in Petri dishes. Compared with untreated cells, the treated cells were more likely to show DNA damage and die.

Dr. Jessica Wang-Rodriquez, one of the lead researchers concludes:

“Based on the evidence to date,” she says, “I believe they are no better than smoking regular cigarettes.”


The study tells us that ”E-cigarette vapor was pulled through media using negative pressure, and the resulting extract was filter-sterilized with a 0.2µm pore-size filter before treating cell cultures.”

However, as Tom Pruen, Chief Scientific Officer for ECITA points out:

Here’s what is not described in the method:

  1. Hardware – No mention is made of what hardware was used to generate the vapour. No mention of what design the hardware was, its resistance, or how much power was supplied to it.
  2. Topography – How long were the puffs? How long between puffs? How many puffs were taken per cartomiser/tank? Was the number of puffs plausible for the design?
  3. Were the emissions generated in a sensible, realistic way, or was there dry burning (leading to huge emissions of carcinogens – an effect described in the literature back in 2013)? This could have been easily established by conducting an analysis of the vapour condensate for carbonyls, but this was not done.


Effectively, this leaves us with no information at all on the sampling methods, making this research incomplete and unrepeatable. That is not how science is supposed to be conducted.


As regards the fact that this particular type of cell was used, there has been some criticism of the use of cell studies to look at whether results can be directly translated into similar effects in humans. Dr Farsalinos from the Onassis Cardiac Surgery Centre in Athens said when looking at a different study that: ”In the majority of cases, the protocols and experimental procedures are irrelevant to human effects.” 

So in comparing the effects of tobacco smoke and e-cigarette vapour, were the two protocols of exposure to the cell cultures comparable, so that an accurate comparison between the amount or rate of cell death observed could be made?

Not at all.

From the study itself:

“Treatment media was replaced every three days with 1% e-cigarette extract. Because of the high toxicity of cigarette smoke extract, cigarette-treated samples of each cell line could only be treated for 24 h.”


Tom Pruen looks at this more closely:

So the cells were being constantly exposed to the vapour condensate for periods of multiple days, with the solution refreshed every 3 days, but only for 24 hours to cigarette smoke condensate because it was too toxic.

Despite the massive difference in exposure, the cigarette smoke extract scored as high or higher on most of the measured outcomes:


Read full article at http://www.ivva.ie/latest-news/flawed-study-and-questionable-pr-becomes-news/

NHS Greater Glasgow and Clyde lifts e-cigarettes ban

from BBC – http://www.bbc.com/news/uk-scotland-glasgow-west-35102530

Scotland’s largest health board is to allow the use of electronic cigarettes within its hospital grounds.

Tobacco smoking was banned in all health grounds in Scotland in April, but health boards were given discretion over the use of vaping devices.

NHS Lothian was the only one of the 13 health boards at the time to allow restricted use of e-cigarettes.

NHS Greater Glasgow and Clyde has said it will do so too, after new evidence that they help tackle tobacco smoking.

Dr Emilia Crighton, NHS GGC’s director of public health, said: “It is clear from research carried out by Public Health England, ourselves and others, that e-cigarettes do have their place in the fight against tobacco and are being used effectively to help people stop smoking altogether.

“In NHS GGC we have carried out our own research which has revealed that some 32% of smokers in our health board area intend to use e-cigarettes in their next quit attempt and that 18% of recent ex-smokers used them to help give up tobacco in the past 12 months.

“It is therefore very important that we organise our services to ensure that that we can safely and effectively manage the use e-cigarettes as part of suite of services to help people give up tobacco.”

Read full article at http://www.bbc.com/news/uk-scotland-glasgow-west-35102530

Should we switch from tobacco to e-cigarettes?

from BBC iWonder – http://www.bbc.co.uk/guides/zyb7tyc#z3cxnbk

21st Century choice
As of 2015, there are 2.6 million current or ex-smokers in the UK who now use e-cigarettes – almost four times as many as in 2010.
Cigarettes burn tobacco to release smoke containing nicotine and other chemicals. On the other hand, e-cigarettes heat liquid nicotine directly to make an inhalable vapour.
Although this method has become popular, not everyone’s clear if vaping should be recommended. Some healthcare experts think it has the potential to eradicate smoking-related diseases, while others worry widespread vaping could create unknown problems in the future. Take a look at the evidence to help you decide.

How tobacco causes harm

Read full article and see infographics / videos and more at http://www.bbc.co.uk/guides/zyb7tyc#z3cxnbk

What to Advise to Respiratory Patients Intending to Use Electronic Cigarettes

Author: Dr. Riccardo Polosa

Full article available at http://www.discoverymedicine.com/Riccardo-Polosa/2015/09/what-to-advise-to-respiratory-patients-intending-to-use-electronic-cigarettes/

Abstract: Electronic cigarettes (ECs) are being increasingly used as an attractive long-term alternative nicotine source to conventional tobacco cigarettes. This substitution is likely to improve health in regular EC users, and more and more respiratory patients using or intending to use ECs will be seeking professional medical advice. Unfortunately, the public’s view of ECs is far from being clear with a great deal of ambiguity around the product and its intended use. Moreover, health-care professionals themselves do not seem to use an evidence-based approach when it comes to informing respiratory patients about ECs and many advise against their use. Evidence-based advice about ECs is provided here with the goal of improving counseling between physicians and their respiratory patients using or intending to use ECs. Regular EC use is unlikely to raise significant health concerns and can lead to health improvement in the respiratory patient who makes the switch from tobacco smoking.


Switching from cigarettes to e-cigarettes has significant health benefits, according to a survey of more than 19,000 users

via ecigarette-research.com

Many health benefits are reported by e-cigarette users, according to a new study published today in International Journal of Environmental Research and Public Health. The study was a worldwide survey, with a questionnaire available in 10 different languages, to assess the experience, patterns of use, side effect and benefits observed by e-cigarette consumers.

In total, 19,441 vapers participated to the study. More than 80% had completely substituted smoking with e-cigarette use, while the rest reduced smoking consumption from 20 to 4 tobacco cigarettes per day. The main findings of the survey were that vapers use e-cigarettes in order to reduce or completely substitute smoking for health reasons. They initiate use with high levels of nicotine, with more than 1 in 5 participants starting with higher than 20mg/ml nicotine concentration. E-cigarettes were effective smoking substitutes even with those with high-dependence on smoking, with most consumers using 2nd and 3rd generation devices. More than half reported side-effects; they were mild and temporary in most cases, with the most common symptom being dry mouth and throat. Importantly, significant benefits were reported for physiologic functions (such as better breathing, gustatory and olfactory senses), as well as improvements in pre-existing disease conditions (mainly respiratory disease, hypertension and hypercholesterolemia).

“This is by far the largest survey of e-cigarette users ever published until now” said leading researcher and main author of the manuscript Dr Konstantinos Farsalinos from the Onassis Cardiac Surgery Center in Athens-Greece. He noted: “Although the study evaluated the experience of dedicated users only, it is important to examine how this group is using e-cigarettes so that we can instruct smokers on how to successfully use the devices in order to switch from tobacco to e-cigarette use.”

The study found that those who completely substituted smoking were more likely to experience health benefits compared to dual users. “This is an expected finding”, said Dr Farsalinos. “E-cigarettes do not have therapeutic properties, but using them instead of tobacco is definitely expected to result in substantial health benefits. This is supported from all research performed until now on the safety profile of e-cigarettes. However, we should wait for long-term follow-up studies to define the overall health impact of e-cigarette use.”

A very small minority (0.4%) reported not being smokers at the time of initiation of EC use. They were consuming less liquid and were using lower nicotine levels; more than half of them were using non-nicotine liquids. “This is a very small minority of e-cigarette users, consistent with other studies showing minimal adoption by non-smokers”, said Dr Farsalinos. “It should be emphasized that none of them became a smoker after initiating e-cigarette use, debunking the theory of gateway to smoking”, he added.

Click Here to read full study.