Vapour trail

THERE are few more reliable routes to an early grave than cigarette smoking. But despite the dangers, nicotine addicts find it almost impossible to kick the habit. Half of those who try to stop “cold turkey” will fail within a week. Fewer than 5% manage to stay clean for a year or more. Crutches such as nicotine patches or gum, which provide the drug without the cigarettes, can help—but only a little.

One reason is that addiction is about more than mere chemistry. The rituals involved, such as holding a cigarette between the fingers or taking a long, luxuriant puff, can be as habit-forming as nicotine itself. So a better way to stop smoking might be a drug-delivery system that mimicked an ordinary cigarette as closely as possible, but had none of the pesky carcinogens and other poisons which come from burning a rolled-up mix of paper, tobacco leaves and additives.

Electronic cigarettes would seem to fit that bill. They use a small electric heater to vaporise a mix of glycerine and propylene glycol (two fairly inoffensive chemicals) in which nicotine has been dissolved, turning it into a breathable mist that can be savoured much as cigarette smoke is. And because some of these devices are designed to resemble traditional cigarettes, they can be held between the fingers and jabbed in the air for emphasis, just like the real thing.

However, the novelty of e-cigarettes (the first of which hit the market in 2006) means there is only a smattering of evidence addressing the question of whether they actually do help smokers ditch the real thing. On December 17th, though, more evidence arrived—in the form of a review published by the Cochrane Collaboration, an international medical research organisation. The review’s authors, led by Peter Hajek of Queen Mary, a college of the University of London, examined results from 13 trials of e-cigarettes. The results, though a long way from being definitive, are encouraging.

Two of the studies the team looked at were randomised control trials. These are the highest form of medical evidence, in which doctors assign volunteers at random to the treatment being studied or to something else, and compare the results. In the cases examined, the something else was a placebo e-cigarette. This resembled the real thing, but delivered no nicotine. About 9% of people using electronic cigarettes in these studies managed to abstain from smoking for six months, as against 4% of those using the placebos. One of the studies also found that e-cigarettes were at least as useful as nicotine patches in encouraging abstinence (the other did not examine this question).

Giving up smoking is the ideal outcome, but puffing less is good for you as well. Both studies suggested that e-cigarettes help those who cannot face giving up completely to cut their consumption significantly. Some 27% of smokers using placebo e-cigarettes, and 36% of those using the genuine electronic article, were able to do so by half or more. One of the trials also compared e-cigarettes with nicotine patches. In that study, 61% of e-cigarette users were able to cut their consumption by half, compared with only 44% of those using patches. These general conclusions were supported by the 11 remaining investigations, known as cohort studies, in which doctors merely monitored people for a time, without attempting to influence their behaviour.

And now for the health warnings

There are, inevitably, caveats. Dr Hajek’s review includes only a small number of studies, each of which involved what was, by the standards of such trials, a small number of people. (Because successfully quitting smoking is a rare event, statisticians need to follow a lot of people to extract a clear signal.) People claiming to have quit were given biochemical tests to make sure they were telling the truth, but those who claimed merely to have cut back on their intake had to be taken at their word. In general, Dr Hajek and his team rated the quality of the evidence as either “low” or “very low”. And the two clinical trials used now-obsolete forms of e-cigarette that do not pack as much of a nicotinic punch as that delivered by more modern varieties.

Moreover, unlike conventional cigarettes, which are made by the zillion by big tobacco companies, using standardised industrial processes, e-cigarettes are manufactured by hundreds of firms of varying sizes, most of which are located in China. Their quality is therefore variable. Some have been found to have heavy metals from the heating element in the supposedly clean nicotine mist. Others have fibres of silica, which could irritate users’ lungs, in the vapour.

Such things will, no doubt, change as more reputable firms displace the less reputable. And more data on the effectiveness of e-cigarettes are now being collected. The study’s authors have identified nine trials now under way. If these, too, come back positive, then grounds for scepticism will be much diminished.


Excellent News As E-Cigarette, Or Vaping, Use Rises

We’ve news from the government that the use of e-cigarettes, or vaping, is on the rise among schoolchildren and teenagers. We might think that this is a health story and it is, but behind it is an interesting little economic point and a guide to public policy. The question really revolves around whether vaping is a substitute for smoking or a complement (yes, complement, not compliment).

Here’s something from the government report:

Daily cigarette smoking has decreased markedly over the past five years (almost 50 percent) across all grades. For eighth graders, it dropped to 1.4 percent compared to 2.7 percent five years ago. Among 10th graders, it dropped to 3.2 percent compared to 6.3 percent five years ago. Among high school seniors, it dropped to 6.7 percent, down from 8.5 percent last year and 11.2 percent five years ago.

“Despite the positive developments this year, we are concerned about the levels of e-cigarette use among teens that we are seeing,” said Lloyd D. Johnston, Ph.D., principal investigator, Institute for Social Research, University of Michigan. “It would be a tragedy if this product undid some of the great progress made to date in reducing cigarette smoking by teens.”


The worry in that second paragraph seems to be that greater e-cigarette usage will lead to greater cigarette usage at some future point. But as the NY Times emphasises from the same report that information in the first paragraph:

E-cigarettes have split the public health world, with some experts arguing that they are the best hope in generations for the 18 percent of Americans who still smoke to quit. Others say that people are using them not to quit but to keep smoking, and that they could become a gateway for young people to take up real cigarettes.

But that does not seem to be happening, at least so far. Daily cigarette use among teenagers continued to decline in 2014, the survey found, dropping across all grades by nearly half over the past five years. Among high school seniors, for example, 6.7 percent reported smoking cigarettes daily in 2014, compared with 11 percent five years ago.

That halving of teen smoking rates coincides with the invention and introduction of vaping (overlaps at least, the first devices really came in 2007). And other studies show very much the same thing. People use vaping equipment instead of smoking, not as a gateway to it nor does vaping increase smoking prevalence. It is thus a substitute, not a complement. As such of course it is to be greatly welcomed. Sure, everyone (adult at least) should be free to chart their own course to the grave and if that includes coughing up their lungs after decades of smoking so be it. And similarly there’s a public health interest in minimising the number of people who do. So tax tobacco until the eyes water (along with the general interest in taxing things with highly inelastic demand) and do discourage the practice.

However, we do have rather a Baptists and bootleggers situation going on here. There are those who, as with the Baptists and booze, think that any drug use, even the inhalation of nicotine, is simply wrong, perhaps even evil. It should thus be entirely expunged from our society. And there’s also those over in Big Pharma who have invested very large sums (it really does cost up to $1 billion to bring a new drug to market) in various pharmaceutical smoking cessation aids. And they would be very interested in being able to market those without having to face the competition of a $3 piece of electronics assembled in a shed in China. It’s this that gives us the background to the discussions about whether the FDA should be regulating e-cigarettes. Should the technology have to support the costs faced by the drugs industry or not? Given that it’s not a drug probably not but that’s the way the debate is being run.

If e-cigarettes were a complement to smoking then the answer would run the other way: sure, their use should be discouraged and so on. Given that all the evidence we have is that they’re a substitute then it runs this way. That vaping, at least so far as we know, is the most successful smoking cessation product any one has as yet invented (and do note that nothing else at all has halved teen smoking rates in only 5 years) means that we really shouldn’t be putting roadblocks in front of further adoption of the technology. A slightly closer look at the details might be appropriate but why one earth would we want to derail what works? Unless we were against the very idea of nicotine on either moral or business competition grounds?


American Heart Association Study Finds Vaping More Effective for Quitting Smoking than FDA-Approved Products

New study shows need for reasonable regulation, says American Vaping Association

WASHINGTON, D.C. -The American Vaping Association, a leading advocate for the benefits of vapor products such as electronic cigarettes, reacted to the release of a new study published in the American Heart Association’s Circulation Journal. The meta-analysis of six previously published studies found an 18% smoking cessation rate (224/1,242) after 6 months for smokers who used vapor products containing nicotine. This compares to an average cessation rate of 7% at six months for FDA-approved nicotine replacement therapy products like the nicotine gum, patch, and lozenge.
Gregory Conley, president of the American Vaping Association, issued the following statement:
“This study demonstrates exactly why e-cigarettes and vapor products have become so popular among smokers looking to quit. For smokers looking to quit, vaping is undeniably a viable option. Additionally, research continues to show that vaping is especially helpful for smokers who have tried and failed to quit multiple times with government-approved methods like the nicotine patch, gum, and lozenge. Genuine public health advocates should cheer this new study.
“We remain very concerned that the public health benefits of vaping could be squashed by improper and excessive FDA regulation. If approved, the FDA’s proposed deeming regulation would act as a de facto ban on over 99% of e-cigarette products currently available on the market. Dramatically decreasing product variety will hinder, not help, the FDA’s goal of reducing tobacco-related disease and death.
“We continue to call on House and Senate leadership to introduce a bill in 2015 that would substantially alter the FDA’s authority over e-cigarette products already on the market.”
About the American Vaping Association:
The American Vaping Association is a nonprofit organization that advocates for small- and medium-sized businesses in the rapidly growing vaping and electronic cigarette industry. We are dedicated to educating the public and government officials about financial and public health benefits offered by vapor products, which are battery-powered devices that heat a liquid nicotine or nicotine-free solution and create an inhalable vapor.


Study: E Cigarette Less Addictive Than Tobacco Cigarettes

A new study from Penn State’s College of Medicine is showing what many had suspected all along — that the addictiveness of electronic cigarettes is distinctly lower than that of tobacco cigarettes. The study looked at the e cigarette and tobacco “dependance scores” of more than 3,500 individuals with histories of using both products. Every individual that exhibited high dependance on electronic cigarettes exhibited a higher dependance on tobacco cigarettes.
According to Jonathan Foulds, Ph.D., professor of public health sciences and psychiatry at Penn State’s College of Medicine:
We found that e-cigarettes appear to be less addictive than tobacco cigarettes in a large sample of long-term users.
He goes on to add:
We don’t have long-term health data of e-cig use yet, but any common sense analysis says that e-cigs are much less toxic. And our paper shows that they appear to be much less addictive, as well. So in both measures they seem to have advantages when you’re concerned about health.
You can read more about the study right here.
The researchers suggest that this reduced addictiveness may be related to the products’ inability to deliver nicotine as effectively. While this is almost certainly true, other researchers and preliminary evidence suggests that, in the absence of smoke (and many other constituents found in tobacco cigarettes), nicotine just isn’t as addictive when delivered via vapor.
The study shows promise not only for those hoping to quit, but also for those that start using electronic cigarettes without using other tobacco produces. There is significant concern that electronic cigarettes may lead the way to a new generation of addicted nicotine consumers. Evidence is already suggesting that a lifetime of nicotine consumption with electronic cigarettes has the potential to be no more harmful that a lifetime of caffeine use. Some experts have even claimed that a lifetime of e-cig use could be no more harmful than 2 months of smoking.
So for those that accept that part of the science, the argument becomes that addictiveness on its own is enough to warrant age restrictions, flavor and usage bans, and counter marketed. If that were truly the case, then caffeine, cheese, and video games would be more tightly controlled too. Now, it appears likely that those consuming nicotine exclusively via e-cigs may be more capable of quitting if they decide to do so. So even that argument is becoming hard to make.


Best choice for holiday season—iTaste MVP 20W

We are proud to be launching the iTaste MVP20W which will be shipped out to official Innokin Authorized Vendors and distributors next week.

The MVP20W is a significant upgrade to the MVP2 which has the same outstanding build quality as the original and improvements in the processor and in the threading is priced very competitively.

The first news release is as follows:

The Innokin iTaste MVP20W: 20 Watts of Intelligent Vaping Power in the legendary 100% Stainless Steel body of the Innokin iTaste MVP!

The MVP20W has been powered up to 20Watts and upgraded with a better chip and a sleeker look.

The iTaste MVP20W now has a high quality flush 510 spring loaded connection that is designed to connect perfectly with all standard 510 tanks. An EGO thread adaptor is packaged with the MVP20W so you can also vape with great tanks like the new Gladius-Vulcan

The MVP20W is variable voltage with a range of 3.3 – 7.5 volts adjustable in .1 volt increments and variable wattage from 6.0 – 20.0 Watts adjustable in .5 watts increments. The easy to use integrated ohm reader will display the resistance of any attached tank and the handy puff counter helps you keep track of your daily vape.

The iTaste MVP20W is smarter with a 32-bit ARM microprocessor which means far faster data processing power and superior vaping performance. The steady VDC power output with an output voltage accuracy of +-1% greatly reduces noise and increases battery life and reliability.

The large capacity of the internal 2600mAh battery means you can depend on the long lasting power of the MVP20W and it’s also a backup portable charger that can power your mobile phone and other electronic devices.

The MVP20W is a smart, powerful and durable vaporizer that’s built with Innokin quality and backed by the Innokin 90 Day Limited Warranty. Very competitively priced the Innokin iTaste MVP20W is the best choice in personal vaporizers this holiday season.