Juice review: Steam Sauce - Transdimensional by ePipeMods

Last time I ordered a new batch of one of my favourite juices, the Long Bottom Leaf, from ePipeMods, I included a couple of newcomers as well. I've already reviewed the Piper Mint here: http://goo.gl/SKrdMv. The second newcomer was Transdimensional from ePipeMods fairly new range of non-tobacco juices called Steam Sauce.

"The Marty McFly of eliquids; a grape so intense, it exists in multiple dimensions". 

This is the description ePipeMods have for this Juice on their webpage. It is indeed a pretty intense grape juice, but at the same time, as always from ePipeMods, very well balanced. I was afraid that grape might be a bit too sweet for me, but it's not. You get tons of flavour, perfect amount of sweetness and huge amount of vapour as usual with the ePipeMods juices. Now I haven't tried any other grape e-liquids so I don't have anything to compare with, but my experience is that quite a lot fruit juices have that artificial taste to them. Transdimensional however doesn't have that at all. Another problem with a lot of the fruit juices I've tried is that it really tastes more like a blend of different fruits rather than the fruit they are actually meant to taste like. This as well makes Transdimensional stand out from the crowd, it actually tastes grape. 

This juice, being the second one from the Steam Sauce range that I've tried, have raised my expectations for the rest of them. And I do plan to taste them all. EPipeMods keep on delivering high quality juices that never disappoints me. The problem, however, with this new Steam Sauce range, is that it has no less than 14 juices to choose from. Now I have 12 to go and no idea which one to choose next.

Will the fate of the e-cigarettes be decided in court?

In December last year the New York City council's Health Committee passed a bill that bans the use of e-cigarettes in all places that normal cigarette use is banned (bit.ly/1iJAS9h). E-cigarettes will be included in the Smoke-Free Air Act of 2002, and this will go into effect on the 29th of April, 4 months after the ban was passed. Yesterday, however, e-cigarette advocates led by Citizens Lobbying Against Smoker Harassment (CLASH) filed a lawsuit against the New York City Council, claiming that the ban violates the New York State Constitution (bit.ly/1hnryov). The lawsuit is not based on health claims, but on the advocates says that according to the constitution you cannot edit an existing law to include something that has nothing to do with the existing law. The New York Constitution states: "No private or local bill…shall embrace more than one subject, and that shall be expressed in the title."

The outcome of this will be very interesting, not only because it will decide whether New Yorkers can vape in bars and restaurants, but it also means that a court has to make a decision on whether e-cigarettes and cigarettes are in fact the same subject. But this is not the first time e-cigarette regulations has been discussed in a courtroom. The FDA has been trying to regulate e-cigarettes as drug-delivery devices (together with nicotine patches and gum), but has lost this battle in court: bit.ly/1g1hVuH. The courts ruling was that they could not regulate them as such unless health claims are made, and the court said that the FDA should regulate them as tobacco products. As far as I know, the FDA is expected to propose regulations for this but has still not done this. Why they haven't yet, I don't really know, but they are probably struggling to find any good reason to, as the majority of scientific evidence shows that there is none. The fact that the FDA wanted to regulate e-cigarettes as a pharmaceutical product, I think shows that they really do know that the e-cigarettes are helping people quit smoking and are virtually harmless. And then... what will happen if the New York court decides that e-cigarettes and cigarettes are not the same thing?

Other countries has also tried to regulate e-cigarettes as pharmaceutical products. In France, before the TPD was approved though, a court decided that e-cigarettes are tobacco products (f24.my/NUxNbv), a German court has ordered that e-cigarettes cannot be restricted (bit.ly/1gCz4B1) and in Hungary a court also ruled that e-cigarettes are not pharmaceutical products (bit.ly/1jvmNjU). Earlier I've also written about a court in Sweden that ruled against Swedish customs who wanted to classify e-cigarettes as a pharmaceutical product (bit.ly/NUH7MK). There are probably more examples as well. The courts around the world at least seem to agree that e-cigarettes cannot be regulated as medicines. But are they tobacco products? It'll be very interresting to see what the New York court decides on in that matter.

Here in Europe I also expect that we'll see that e-cigarette regulations will end up in court. French consumer organization Aiduce (www.aiduce.fr) say that the provisions in the TPD "are unjust, incoherent and detrimental to public health", and "As soon as it (the TPD) is transposed into national law, it will be challenged before the Courts" (bit.ly/1f08ACW).

It can look like the fate of vaping and e-cigarettes will be decided in courtrooms around the world. And that, I hope, will be a good thing for vapers and smokers who wants to quit. Most courts, have high evidence requirements. This means that they will look at all the scientific evidence, and the ones that provide the evidence might be dragged into the courtrooms to witness. It will be very hard for the regulators to provide scientific evidence backing up their regulations, and hopefully they will not be able to. And I look forward to see what happens if Aiduce go through with their plan, and the scientific data to support the 20mg/ml limit on nicotine content is examined by a court...

photo credit: SalFalko via photopin cc

Nicotine poisoning; the anti-e-cig-movements new favourite argument?

Responsible adults is the key to avoid nicotine poisoning.
photo credit: lindsay-fox via photopin cc

The gateway argument has been the anti-e-cigarette-movements favourite argument for a while now, urging us to think of the children that would doubtlessly start using e-cigarettes and then move on to traditional cigarettes, or even worse, according to some of the most delusional anti-e-cig advocates, to harder drugs. However, this argument has been properly ripped apart by people like Clive Bates and Dr. Michael Siegel (read http://www.clivebates.com/?p=2053 and http://goo.gl/tYS7Gb) lately. In my opinion Dr. Glantz himself is kind of responsible for destroying the credibility of this argument totally by publishing his infamous report that, as I've written about earlier (http://goo.gl/AvS6T8), despite failing to provide data to support the argument, claims to prove it by deliberately misusing the data they actually did have.

Now, however, I'm a bit worried by a new kind of propaganda emerging in the media. Yesterday this headline was screaming against us from the New York Times: Selling a Poison by the Barrel: Liquid Nicotine for E-Cigarettes. To be fair, however, the article itself is not as bad as the headline would suggest. It does recognize that most of these poisonings are due to the lack of proper regulations and careless adults, and it has some statements that supports reasonable regulations. However I am afraid such headlines, and the scaremongering cited in there, will be picked up by the anti-ecig-movement and used to support their crusade against vaping. It might very well become the anti-e-cig-movements new favourite argument.

I did some google searches on the topic and I noticed several newspapers and websites have published stories on the topic last week. A press release from Minnesota seems to be a favourite source of information. Read about it here (among other places): http://www.wdaz.com/event/article/id/23361/. The case in Minnesota is that the number of reported incidents of nicotine poisoning by e-liquid among teens and children has jumped from 5 to 50 from 2012 to 2013. Sounds bad huh? Well, first of all we see e-cigarette use booming around the world so an increase in poisoning cases are not unexpected, and e-cigarettes are not even close the the number of poisoning cases from other household products. But does that mean we shouldn't worry about this? Not at all... we need to take this seriously of course. We should start out by trying to figure out the reasons why kids get poisoned, and what we can do about it.

On thing I notice is that 50% of the cases are children younger than 3 years. These kids are not capable of opening a child proof bottle, so all these cases are caused irresponsible adults, either leaving childproof bottles opened in reach of children, or leaving bottles that are not childproof in their reach. 9 of the cases were teenagers meaning that 16 we're kids older between 3 and 13 years old. The reasons for these poisoning could very well be the same as for the ones under 3 years, but it could also be that these children actually had bought the e-liquid, as there is no age limit. Other reasons for poisonings could be unsafe bottles (leaking), unsafe equipment, and that people are really not aware what is in the bottles and how to treat them. The solution to all of this is reasonable regulation, with emphasis on reasonable. That means labelling and information requirements, reasonable nicotine concentration limits and age limits on sales.

Over-regulation or banning will on the other hand lead to more cases of poisoning. I've earlier written about the consequences of over-regulation, and in addition to forcing a lot of ex-smokers back to cigarettes and denying heavy smokers the option of e-cigarettes, over-regulation or banning will have negative impacts on the safety of e-cigarettes. Some examples:

• One of the worst consequences is a thriving black market. A black market is by it's nature not at all regulated and will supply a lot of unsafe equipment, unlabelled e-liquid bottles with nicotine concentrations off the chart and no information to the customers whatsoever. 
• Regulating the sizes of bottles and cartridges, like the TPD does, will also have negative consequences on safety. It will lead to more bottles and cartridges around the house (easier to loose, misplace), or carried around. Filling will also need to happen more often, leading to even more risk.
• Limiting the nicotine content too low (like 20ml/mg in the TPD) will have a couple of negative effects as well: It will force a lot of people to get their products from a black market, which is as I said above not good, but it will also lead to more filling, more frequent use and more e-liquid around children.

Nicotine poisoning from e-liquid is a matter we really do need to take into consideration. And the e-cigarette industry (well most of it anyway) and vapers do take this seriously and most important, they do know what measures need to be taken to ensure safety in this matter. This brings further support to the claim that vapers should write the laws on vaping, because the regulators have shown that they do not understand this. The EU rules on nicotine concentration and bottle and cartridge sizes are perfect examples of over-regulation that will work against its intention. The rules were put there to enhance safety (at least that is what the EU claim), but will in fact lead to less safety. Another example is that the EU (and the American Cancer Association) is against age limiting, while the the e-cigarette industry is currently self regulating and the great majority of vendors enforce an age limit on e-liquid and vaping equipment. Almost all the e-liquid I buy also has good labelling with ingredients and health warnings. In conclusion, the e-cigarette industry, and the vapers do need to worry about the children... and they do that today. And, unlike the regulators, they do understand the safety aspects of vaping and e-cigarettes.

Review: Mini Aspire BDC Clearomiser and 390mAh ECig Tank Batteries from Smokers Angel

A couple of weeks ago my wife asked if I could get her something smaller to bring out and about than the Kanger Evod she has been using for a while now. I thought that I'd ask around a bit and find a decent cig-a-like for her. So I did, and James, who runs the excellent Ashtray Blog as well as the Smokers Angel web-shop told me that they had some new Mini Aspire BDC Clearomisers exclusively made for them. Match this up with a cool mini ego-style battery and you got a really small combo, perfect for bringing out and about. My wife was pretty set on a cig-a-like, but she also loves skulls, so when I saw the skull-batteries I thought why not give it a shot.

Now, I got the package about a week ago, filled it up with Long Bottom Leaf and gave it to my wife. She absolutely loved it and the Evod has been collecting dust since then. The size is perfect for bringing around, the batteries have the classic 5 click locking feature so you can safely keep it in your pocket and the clearomiser is pretty solidly built and we've had no leaking yet. In other words, this is perfect for bringing around, if you're going out just a short trip or you just don't vape that much, like my wife. I think she goes through like 1 ml a day if not less. As for myself, I go through around 3-5 ml a day so for me this would be more like an extra device to bring when I'm just going out for a couple of hours or to a party or something where I wouldn't want to bring the more expensive devices. Cause it's also quite affordable, the atty is £7 and the batteries £8 and you can buy a strip of 5 replacement coils for £8.

Size matters. Shown beside an Evod on
a VV 650mah battery, an Evod 650mah
and a 10ml juice bottle.

Now to the performance of this little thingy. I'm used to my genesis atomizers, and of course this doesn't give you the same flavour and vapor-production as the high end atties and mods. And I wouldn't expect it to either. That said, the first thing that hit me was that I thought it performed a lot better than the Evod. Fresh out of the box the flavour was clean and vapour-production was pretty great. Now my wife has been hugging it for a week and I just gave it a taste again and I can notice the difference of course, but it's still performing pretty well. Personally I would change the coil after a week, but that of course also depends on how much you use it and the juices you use. The Long Bottom Leaf is pure VG and tends to build up a bit on my genesis coils and muting the flavour pretty quickly, so I'd actually say I'm quite happy with the Mini Aspire coil lasting a week with that juice.

This is an awesome little combo, and I do actually think I'm going to get myself one as well when they get back in stock. For a medium to heavy vaper the battery size (and tank size if you don't want to bring a juice bottle) makes this an affordable extra device to bring out and about. For a light vaper it might be a main device. Looking at the different decorations available on the batteries I'd say some of them would definitively appeal to the ladies, and they also have their handbags with them at all times so it wouldn't be a problem to bring an extra battery and a small bottle of juice for a night out. This would also be a combo I'd recommend as a first device for a smoker who wants to try out e-cigarettes, due to the ease of use.... unless it's one of those who wants a cig-a-like no matter what. For those I'd let them get their cig-a-like and then offer to try this one out and I bet they go buy one as well. Thanks to James from The Smokers Angel who recommended this.

Lots of cool batteries to choose from, and something for the ladies as well

On vaping in Norwegian media today: "E-cigarettes create smoking boom"

This morning I was reading the online version of one of Norway's biggest newspapers, VG, and spotted some pictures of people blowing some pretty decent clouds of vapour. "E-cigarettes create smoking boom" was the headline accompanying the pictures and the ingress was something like this: "They smoke on the bus, in the cinema and inside nightclubs. The "Vapers" are heading full speed to become generally accepted. The new trend takes Norway by storm". The article was released in VG.no's premium service so I had to pay for a week of this service to be able to read it. It is also in today's paper version of VG. (The article can be found here, in Norwegian of course, and you'll have to pay for at least 1 week, which is 35 NOKs: http://goo.gl/fv99nu).

The article is kind of a life-style piece, describing everyday situations where e-cigarettes are seen more and more often. Pretty amusing reading actually. After describing a situation where someone vapes in the cinema the article sums up the situation (freely translated): "New winds is blowing into nicotine hungry lungs. In nursing homes old farts are using hyper-modern smoking equipment. In a crane, a polish worker is sucking on his plastic mouthpiece. Hip girls blow clouds of vapor in bars".

It moves on to explain what an e-cigarette is and gives us a list of vaping celebrities (Johnny Depp, Leonardo DiCaprio, Paris Hilton, Ronnie Wood, Lindsay Lohan og Lady Gaga), before summing up the legal status here in Norway. And of course, our friend Karl Erik Lund is mentioned here as well, when the consequences of the new TPD is mentioned: "It looks like e-cigarettes containing nicotine will also be legal in Norway" says Lund, and explains: "There are few reasons to maintain the existing ban, now the debate will be about regulations, health warnings, declaration of contents, flavours, age restrictions and so on."

The article continues to give examples of how smoking is replaced by vaping. It mentions the Kik launch party, where Helen Flanagan arrived in a white Lamborghini, puffing on a blue e-cigarette, and that the main character in the Netflix series "House of Cards", Frank Underwood, replaces the old analogs with e-cigarettes. "A vice precident can't smoke cigarettes" it is pointed out. The word "smoking" is replaced with "vaping" and Big Tobacco is of course involved, states the article.

"Norsk Dampselskap" (Norwegian Union of vapers) is also mentioned and Jacob Hauge from the organization says that they exist mainly for people that wants to replace smoke with vapour. It's great to see that the journalist behind this article (Olav Brekke Mathisen) has done his research. He even mentions the modding sub-culture, describing how some users modifies their e-cigarettes, or making new "mods" with the intention to maximize the vaping experience, experimenting to create as much vapour as possible. American vaper Brian Ott is described as a human vapour machine, capable of filling a room with vapour in just a couple of puffs.  

"Statistically it is more dangerous taking the bus through the capitol, than to fill your lungs with electronically generated vapour. The big question in 2014 is maybe not what long term harms that lurks in the fog, but how socially acceptable it will be to vape", the author states towards the end of the article. And then he has gone out and asked around in a lot of public places if vaping is accepted there. The answers are quite interresting:

• In a mall in Sandvika they are worried it will trigger the fire alarm, but they have it on the agenda to discuss it.
• In Oslo Airport they were asked if they would stop an old lady from vaping in the terminal, to which they answer that they do not have any restrictions on vaping in the terminal. (That's good news, I've always stealth vaped in the toilets in there)
• The head of the taxi-company in Tromsø says a lot of his colleagues have switched to vaping, but not in the car. He really doesn't see why a customer would do that. (This one really surprised me to be honest, as the car is one of the places I vape the most)
• Peppe's Pizza (one of the larges pizza restaurant chains in Norway) does not allow vaping in their restaurants for the sake of their customers. (Clearly they don't know a lot about it)
• You can't vape in a group workout session at SATS (a big fitness center chain). (Well, why would you need to do that :P)
• Then what about inside bars and nightclubs? Kaman Leung, responsible for social media communication at Jæger in Oslo, says they do not allow vaping at this time, but that a lot of their DJ's are very exited about vaping cause it allows them to vape at work. (Uhm... how does this work actually? The DJ is allowed to vape but not the guests... sounds pretty strange, and a bit hard to justify to a guest that starts puffing on an e-cigarette)
• And in the university reading rooms? HSE-advisor at NTNU (Norwegian University of Technology and Science), Arve Johansen, says he has actually never seen an e-cigarette. He seems unsure, but concludes that if there is smoke coming out of the device, the one using it would probably be asked to leave. (I'm not so sure about this... would be interesting to check)
• Finally, on the bus home? Svein-Arne Vik from Nettbuss Express says they do not have any rules against it as of now. (I think this varies from bus company to bus company to be honest).

Very interesting answers indeed. And I suspect some of these will change during 2014, when vaping gets more known to people, and people understand more what it is. It's pretty obvious from these answers that some people are still totally unaware of it's existence.

I think this article is a good piece of work, putting vaping in a positive light, and it will be read by a lot of people, as VG sells more than 600k papers every day in addition to all the people reading this online via their premium service (which they claim is the fastest growing premium newspaper service in the country). And it's good to see a journalist actually do some real research on vaping, and talk to people about it, rather than just writing whatever the health authorities feed them. Good work.

Vapers: Your stories can save millions of lives!

Vapers fighting for their rights
photo credit: #VAP_IN_LIBERTY via photopin cc

After the TPD was approved on the 26th of February, a lot of vapers probably ask themselves: What now? Is the war over, or is there still something we can do? Do we have to live with and adapt to article 20 and accept the fact that we had a chance to save millions of lives, but the greed and ignorance of the EU Parliament effectively smashed the snowball we had rolling?

The short answer is: Yes, there is still something we can do. The battle was lost but the war is not over. The e-cigarette-industry and user-organizations are still fighting and people like Clive Bates and Dr. Michael Siegel continue their hard work, ripping the anti-ecig-movements arguments and so called "science" apart. And to me it seems like a lot of their fighting is paying off, slowly. I've got a feeling they are getting to the media and we're gradually seeing more reasonable journalism now than we did some months ago. The feeling I'm left with is that the media used to swallow everything the anti-ecig-movement fed them whole, and most media coverage of e-cigarettes we saw was focused around "scientific" reports that "proved" the dangers of e-cigarettes and stories of pets dying from chewing on e-liquid bottles. But I do feel that the tireless efforts of Dr. Siegel, Clive Bates and a lot of others, criticizing these articles, writing letters to the people appearing in the media and publicly proving them wrong has forced the media to dig deeper and report if not the whole story, at least more of it. I'm not saying we're there yet, but in my eyes, there is a positive tendency. And having the media reporting the whole story and not just the propaganda from the other side, will be incredibly important to win the war in the end. As it stands now, "normal" people (people that don't spend hours on the internet searching for information like yours truly) cannot turn to the health organizations for reliable information about this matter, so what is written in the media will be one of their strongest influences when they make up their opinion.

Another, maybe just as important, source of information about vaping is YOU! Well, most of you at least, as I think the poll I had some weeks ago told me that around 99% of my readers are vapers. In the heading of this post I asked the question: Can we, as vapers, still do something? Sharing your story is one of the most important things you can still do. I don't expect all vapers to spend a lot of time searching the internet for scientific data, writing long letters to politicians to convince them to do the right thing and engage heavily in the online debate. And we don't need to do that either. But share your story to the people around you. As I've stressed several times before: You are proof that vaping works, so go show people that. Your story matters. And once you've told your story, you might get some questions from smokers who wants to try this out. Make it easy for these people to take the step. You can make sure you already have a web-page and a starter kit recommendation for them, or even better (if you can afford it) buy a small starter kit you can give away or lend to them. For you, as a vaper, this requires minimum effort, but I bet most of you used some time researching before you bought your first kit and that might be what is stopping a lot of smokers from trying. The more smokers that switch to vaping before 2016 comes and the TPD is to be implemented into the laws of the member states, the more stories will be told, and the better the data collected regarding the efficiency and security of e-cigarettes will be. Your story is important to keep the snowball rolling. Have a look at what the EU writes in their press release after the TPD was approved:

Can the rules on e-cigarettes be revisited at a later date?

Monitoring and reporting on all developments relating to e-cigarettes – including market and health related developments – has been built into the new Directive. The information collected will provide a good overview of what additional legislative action, if any, is required, and the Commission will revisit the issue if necessary.

This means that the TPD can be changed if we can make sure health developments are shown to be very positive, and the market develops in a healthy way. And to do that we, the vapers, can make sure the market grows by telling our stories which will in turn show the EU the huge impact this will have on public health. And when this data emerges, I'm pretty sure well have Dr. Siegel and Mr. Bates here to make sure it appears in the media, making it VERY hard for the EU to ignore. Vapers: Your story can save millions of lives!

Another thing we can do, is to support and sign the European Free Vaping Initiative. As a Norwegian citizen I can't do this myself, since Norway is not a member of the EU, but I can help spreading the word. And so can everyone else, which is just as important as signing it yourself. It is very important to note that his is not just another petition. The EFVI is a European citizens' initiative, which means that if 1 million people sign this EFVI will have the opportunity to meet Commission representatives in person and to present their initiative at a public hearing in the European Parliament. This means the EU is forced to listen to the vapers in this matter, something they have not been willing to do voluntarily. So if you're a EU citizen and haven't signed this, I urge you to do it now (sign here:  http://www.efvi.eu/), and then spread the word to as many people as possible... along with your vaping story.

Juice Review: Pipe Sauce - Piper Mint by ePipeMods

Piper Mint is the newest addition to the Pipe Sauce range from ePipeMods. I've been a fan of the Long Bottom Leaf from the same range from the moment I first tasted it and I always seem to have one of my atties filled with LBF wherever I go (and my wife vapes LBF exclusively now).

Piper Mint tastes like it's based on the same tobacco tastes that I know from Long Bottom Leaf and Shire Malt, but this time with a hint of mint/menthol on top. It's a very subtle hint that doesn't kill the tobacco tastes but adds a nice slightly cooling sensation on the inhale and the mint comes a bit more to the front on the exhale. Fantastically well balanced juice that gives you kind of a gentle mint and a slight cooling sensation on top of what I suspect might be a mix of Long Bottom Leaf and Shire Malt (try out these 2 as well if you haven't yet... they are fantastic). This is definitely a juice I would recommend you try out, especially if you're already a fan of the range.

Piper Mint fits very well into the range with the other juices as well. The whole range has some common elements that tie them together, so you're instantly able to tell that they are from the same range without ever having tasted the juice before. Now I have only tried one of the juices from the new Steam Sauce range (which is ePipeMods new non-tobacco range); the Airship (read my review here: http://goo.gl/ruFEvM). But... I have a new bottle of Transdimensional here that I'm now really looking forward to try out. I wonder if they have managed to make the Steam Sauce range as constantly awesome as the Pipe Sauces?

You can get the Piper Mint and all the other fabulous juices from ePipeMods in their own webshop or from one of their many vendors:
http://www.epipemods.com/vendors

ECF Interviews Dr Konstantinos Farsalinos

ECF has done an excellent interview with Dr. Farsalinos that was posted yesterday. I highly recommend reading it as the good Dr. Farsalinos makes some excellent points, as usual. You can read it here: http://goo.gl/FlDYzN

I'm happy, but not very surprised, to see that he as well is ripping the latest studies that claims to prove the gateway argument apart, criticizing the questions asked, and saying the data really doesn't support the conclusions, like I discussed here yesterday. I got some comments on twitter yesterday, after my post on Dr. Obvious and his latest achievements, that it's good to see a normal vaper dismantling "scientific" journal papers. To be honest, the fact that "normal vapers" are able to, says a lot about the quality of this so called "science". As Dr. Farsalinos says: "You only need to check the numbers to see that the public statements they make after these studies are nonsense."

Another great point I'd like to mention is his answer to the people that are not happy with the e-cigarettes unless they are 100% risk free: "Do you know any medication that has no side effects? For example: Paracetamol is used the world over, but it’s the number one cause behind people ending their own lives. If you take just 10 tablets at once, you can develop acute liver necrosis." This is a very important point that I think needs to be made as often as possible in this debate. The medications, when used correctly, would help a lot of people, but could harm people (or even kill them) if you use them wrongly. The same thing goes for e-cigarettes, it is quite possible, although close to impossible unless you really try, to harm yourself with them. But that doesn't mean they shouldn't be available to the people they are intended for, the smokers. This is is again just common sense, something Dr. Farsalinos, unlike certain other "scientists", has a lot of.

Dr. Glantz proves that e-cigarettes and cigarettes are associated with each other in some way. Thank you Dr. Obvious!

Dr. Glantz wants us to believe e-cigarettes will
turn young more people into smokers, but his
numbers are totally irrelevant
photo credit: Scott Charlesworth via photopin cc

Last Thursday (6th of March) Dr. Glantz and his co-author Lauren M. Dutra published their study that they claim finally proves the gateway argument: http://goo.gl/ez6nSP. Their conclusion was probably written a long time before that, most likely it was the first thing to be written in the report. Because, as Dr. Michael Siegel has pointed out as well (http://goo.gl/y3J7qE), the data collected in the study doesn't support that conclusion. The report even admits this: "This is a cross-sectional study, which only allows us to identify associations, not causal relationships. Our results are also limited by the lack of information about motivation for using e-cigarettes (eg, popularity, trendy, smoking cessation) and the fact that they only apply to middle and high school students, not all US youths." In other words: This study can't prove the gateway argument. But then in the conclusion they write: "While the cross-sectional nature of our study does not allow us to identify whether most youths are initiating smoking with conventional cigarettes and then moving on to (usually dual use of) e-cigarettes or vice versa, our results suggest that e-cigarettes are not discouraging use of conventional cigarettes. Among experimenters with conventional cigarettes, e-cigarette use is associated with established cigarette smoking and lower rates of abstinence from conventional cigarettes." Oh... so what you're saying is that there is no way this study, by it's nature, can tell us whether e-cigarette users tend to move on to smoking or if it's the other way around, but you conclude that this is the case anyway?

Dr. Glantz obviously has no intention of actually trying to find out IF the gateway argument is valid, I'd say he already knows that it's not, cause, as I have written before, it makes no sense. So his goal now is to find a way to make the public believe it's valid anyway, and this time, apparently confusion is his tactic. Just have a look at the some of results published. Pretty confusing stuff, lots of numbers and percentages, but he is Dr. Glantz, so we would assume all these numbers are actually put in there to support the conclusion right? Well, after reading it several times let me try to clarify: 

• "Among cigarette experimenters (≥1 puff), ever e-cigarette use was associated with higher odds of ever smoking cigarettes (≥100 cigarettes; odds ratio [OR] = 6.31; 95% CI, 5.39-7.39) and current cigarette smoking (OR = 5.96; 95% CI, 5.67-6.27)."
  This tells us that e-cigarette experimenters have a higher odds of being smokers or at least have tried a cigarette. If anything this suggests smokers experiment with e-cigarettes, probably as a healthier alternative, trying to quit.
• "Current e-cigarette use was positively associated with ever smoking cigarettes (OR = 7.42; 95% CI, 5.63-9.79) and current cigarette smoking (OR = 7.88; 95% CI, 6.01-10.32)."
  The same association is shown for current e-cig users. So e-cig users are either smokers (probably trying to quit) or former smokers (congratulations on the switch guys).
• "In 2011, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR = 1.53; 95% CI, 1.03-2.28)."
  Smokers that had tried e-cigarettes intend to quit smoking within the next year. Good. Don't give up guys.
• "Among experimenters with conventional cigarettes, ever use of e-cigarettes was associated with lower 30-day (OR = 0.24; 95% CI, 0.21-0.28), 6-month (OR = 0.24; 95% CI, 0.21-0.28), and 1-year (OR = 0.25; 95% CI, 0.21-0.30) abstinence from cigarettes. Current e-cigarette use was also associated with lower 30-day (OR = 0.11; 95% CI, 0.08-0.15), 6-month (OR = 0.11; 95% CI, 0.08-0.15), and 1-year (OR = 0.12; 95% CI, 0.07-0.18) abstinence. Among ever smokers of cigarettes (≥100 cigarettes), ever e-cigarette use was negatively associated with 30-day (OR = 0.61; 95% CI, 0.42-0.89), 6-month (OR = 0.53; 95% CI, 0.33-0.83), and 1-year (OR = 0.32; 95% CI, 0.18-0.56) abstinence from conventional cigarettes. Current e-cigarette use was also negatively associated with 30-day (OR = 0.35; 95% CI, 0.18-0.69), 6-month (OR = 0.30; 95% CI, 0.13-0.68), and 1-year (OR = 0.34; 95% CI, 0.13-0.87) abstinence.".
  These initially look like they prove Glantz's theory, but actually they don't, because this only talks about total abstinence from cigarettes: "Abstinence from conventional cigarettes for 30 days, 6 months, and 1 year was based on responses to the question "When was the last time you smoked a cigarette, even 1 or 2 puffs?". So this actually just tells us e-cigarette users, or experimenters, have a higher chance of being smokers, or still smoke from time to time, than people that haven't tried e-cigarettes. Why? Well as the first 3 statement tells us, e-cigarette users are probably former smokers or still smokers. And these last statements says nothing about whether e-cigarette use lead to smoking, but combined with the 3 first statement it might suggests that not all e-cig experimenters or users are able to completely stop smoking.

As you can see, the data collected in this study does not support the conclusion at all. He references several other studies as well, that I can't access without paying, and to be honest I doubt they are worth the money going by the quality of Dr. Glantz's study. The relevance of these references also needs to be questioned, seeing the conclusions that are presented from them: "A cross-sectional US study also found that unsuccessful cigarette quitters were significantly more likely to have ever tried e-cigarettes in comparison with individuals who had never tried to quit." So people who have failed to quit smoking has a greater chance of having tried e-cigarettes than people that have never tried quitting. How on earth is that even remotely relevant? This is just another example of how he is just throwing irrelevant numbers and data at us, trying to make them look like they support his invalid argument.

The reason the data in this study is irrelevant is of course the questions that have been asked when collecting the data:

• "Have you ever tried cigarette smoking, even 1 or 2 puffs?"
• "About how many cigarettes have you smoked in your entire life?"
• "I plan to stop smoking cigarettes for good within the next…"
• "During the past 12 months, how many times did you stop smoking for 1 day or longer because you were trying to quit smoking cigarettes for good?" 
• "When was the last time you smoked a cigarette, even 1 or 2 puffs?"
• "Which of the following tobacco products have you ever tried, even just 1 time?" (E-cigarettes were one of the answers)
• "During the past 30 days, which of the following tobacco products did you use on at least 1 day?" (E-cigarettes were one of the answers)

Remember what they're trying, or rather should be trying to find out here: Do e-cigarette users that have never smoked before, start smoking? So why didn't they ask all the smokers in the survey this question: "Did you start using e-cigarettes before you started smoking?" Isn't that the obvious question? To me it is. So why wasn't it asked? Because Dr. Glantz already knew what answers he would get, and they really don't help his case. Dr. Glantz concludes that e-cigarettes are encouraging young people to start smoking, and smokers to keep smoking, rather than discouraging them. This means we should see an increase in tobacco consumptions. But the numbers are showing quite the opposite, here presented by Dr. Siegel: http://goo.gl/bHZY1s. Despite the fact that more and more young people are trying e-cigarettes, the decline in tobacco consumption is accelerating. This also supports my post from a couple of days (http://goo.gl/KZEHnK) ago where I argue that vaping replaces smoking, both by enabling current smokers to quit or cut down and by giving young people an alternative so they don't start.

By collecting a bunch of irrelevant answers, and turning them into irrelevant numbers, Dr. Glantz has successfully shown that vaping and smoking is associated with each other, cause people use e-cigarettes to quit smoking, or as an alternative to smoking... nothing more. Thank you Dr. Obvious.

(Dr. Glantz is not the first one to do this by the way: http://goo.gl/4gR10M)

Vapers create vapers, smokers create smokers: Think of the children!

Would you rather see your kids smoking?
Photo credit: James Alby via photopin cc

Another one of the anti-e-cigarette movements favourite arguments at the moment is that we need to think of the children. They seem to be loosing a lot of sleep worrying about kids taking up vaping, believing this is a safer alternative to smoking. So let's do that for a moment shall we, think of the children I mean. First lets start with looking on the main reasons young people start smoking:

• Their parents are smoking
• Peer-pressure 
• Stress relief
• Rebellion and showing independence
• Mimicking the behaviour of people around them
• Smoking to look cool
• Smoking to look older
• Experimenting and adventure

How will the availability of e-cigarettes and vaping affect this? Well actually they can all be applied to vaping as well. So if parents are vaping, there is a chance their kids will, peer-pressure from other young vapers will exist, they might use vaping as stress relief, to rebel against parents and so on. So we will have young people that start vaping without smoking first. But think about this... if a teenager starts vaping because his or her parents are vaping, wouldn't the same teenager have started smoking if the parents were smoking? If stress relief was the main reason for starting to vape, wouldn't the alternative be smoking? If your kids wants to experiment, would you rather have them experiment with vaping or smoking? The point is that these reasons will not go away if you remove vaping, but vaping will be an alternative for young people that would otherwise start smoking. By demonizing vaping, young people would start smoking instead. Cause their parents would be smokers instead of vapers, their friends would experiment with smoking instead of vaping, they would use smoking to fit in socially instead of vaping or they would light up a cigarette to look cool instead of pulling out their e-cig.

The important point here, that seems to be missed by most anti e-cigarette advocates, is that e-cigarettes and vaping replaces smoking. Not only for smokers but also for young people that would otherwise have started smoking. If a teenager is mimicking other vapers around them, it is because there are less  smokers around them to mimic. So yes, we will have young people that starts vaping without smoking first, but most of these people would have gone straight to smoking instead if vaping wasn't an alternative. I say most people, because there might be people that wouldn't have started smoking, but starts vaping because of the reasons above combined with their belief that vaping is safe. But this won't kill them! However restricting e-cigarette use and advertising will kill a lot of people. So what is most important? Making sure that no-one picks up a relatively harmless habit of vaping unnecessarily or making sure that as few as possible picks up the deadly habit of smoking?

Not only does vaping replace smoking but in most cases it gives the user something more in addition. And that is what makes them more effective than any other smoking cessation product (read my post on this here: http://goo.gl/Sf0Cn6), but also what makes the gateway argument invalid. The reason people struggle to go from smoking to nicotine gum, is the same reason that people would "struggle" to go from vaping to smoking. It would take something away.

To all the e-cigarette sceptics out there: Vaping adults will lead to kids vaping, smoking adults will lead to kids smoking. What would you rather have your kid doing, vaping or smoking? Think of the children!

The Norwegian Heart and Lung Patient Organization (LHL) asks employers to ban e-cigarettes

The Norwegian Heart and Lung Patient Organization
don't want me to vape at work.

In this article in Norwegian publication "Dagens medisin" ("Daily medicine") The Norwegian Heart and Lung Patient Organization (LHL) asks employers, and other owners of premises where people gather, to ban e-cigarettes in the same way smoking is banned. The Norwegian Health Department wanted e-cigarettes to be part of the Norwegian tobacco law when it was revised last year, but the suggestion was left out by a mistake. Turns out they forgot to ban e-cigarettes. This means that it is up to the employers themselves to decide whether or not e-cigarettes is permitted indoors. And now, LHL is asking employers to act as if the tobacco law included e-cigarettes. Their arguments for doing this? Not surprisingly they pull out their precautionary principles and that "we don't know enough about the e-cigarettes yet", which I agree with them on. They don't know enough about e-cigarettes yet, because the haven't taken the time to ask someone or just google it.

General secretary of the LHL, Frode Jahren, says that even though e-cigarettes are assumed to be far less harmful than normal cigarettes, there is people that will react to it and that one shouldn't need a law to tell us to use common sense show respect for others... but still he wants employers to implement rules to ban e-cigarettes everywhere indoors even if no-one reacts to the vapor. Where is the common sense in that?

Jahren is then asked this question: "Some will react to the use of perfume in public spaces as well. Should we ban everything we don't like?" Seems like the journalist might have caught the point here. Jahren responds saying that we don't know enough (editor: Wrong Jahren, you don't), and then he pulls out the normalization argument, which I wrote about yesterday: http://goo.gl/dYjyJk.

But, luckily, we have SIRUS here in Norway. Again, Karl Erik Lund comments on the case and tells the readers of "Dagens medisin" what we do know about e-cigarettes, and how "dangerous" they really are. He argues that if we should ban e-cigarettes because of the health risks, we also need to ban theatrical smoke. Lund also says that a lot of people have learned to hate smoke and their resistance towards e-cigarettes are based on feelings rather than reason. He concludes that the arguments for banning e-cigarettes by including them in the tobacco law is "pretty weak".

After reading the article I'm left with the feeling that a lot of these organizations are just the victims of ignorance. I really do think that LHL doesn't know enough about e-cigarettes and vaping, and that they do believe the gateway argument and the normalization argument. It's not that strange really, cause these arguments are the same as thos used by the Health Department here in Norway. And this is potentially a big problem. If the patient organizations stop thinking and just adopts whatever argument the health department give them, they become rather useless. A lot of these organizations have done a lot of great work, fighting for their members patient rights, but in the case of the e-cigarettes, I say they haven't done their job at all. And I'm sad to see that.

E-cigarettes and vaping will normalize quitting, not smoking

Can you tell if she's smoking or vaping?

One of the favourite arguments of the anti-e-cigarette movement these days seems to be that vaping and e-cigarettes will "re-normalize" smoking. This argument has no proof to back it up, and seems to be constructed due to the lack of good arguments.

First of all smoking is not at all de-normalized as some of these guys claim. This is just not true. In 2012 18.1% of the adult population in the US was smoking (http://goo.gl/EWmCM), in the UK the number is around 20% (http://goo.gl/ZUoj0B), and European Region countries have rates varying from 20-40% mostly (http://goo.gl/FhhkTr). I would say that something that 20% of people does is pretty normal. In fact it's more normal to smoke than to be left-handed (around 10%: http://en.wikipedia.org/wiki/Handedness), or having blue eyes in the US (around 17%: http://www.ask.com/question/eye-color-percentages). So to look at smoking as abnormal behaviour is just narrow-minded and wrong.

Then there is the question of why vaping and e-cigarettes would make smoking more normal. Why? Cause it look like smoking and has the same ritual? I don't think so. With the exception of some of the cig-a-likes that the TPD allows, it is pretty easy to see that someone is vaping, not smoking. It's also pretty easy to tell by the smell. There is also no scientific evidence at all that people go from vaping to smoking. Cause why would they? There is just no reason that someone would want to do that, except for ex-smokers who for some reason like the taste of normal cigarettes so much better (because of limited flavours in e-liquid due to the TPD maybe?) that they are willing to kill themselves for it. Vaping will not normalize smoking. In fact as more and more people start vaping it will become more normal to vape, it will normalize vaping, and smoking will finally be de-normalized.

Think of it, when you see someone using an e-cigarette, do you think that "this is someone who is trying to start smoking"? No-one in their right mind would think that, not even kids if told once what it is. You'd probably think that "this is someone who used to smoke, and has now quit, or is trying to". So vaping and e-cigarettes will in fact normalize quitting, and in the end de-normalize smoking.

However, there are some things that can be done to make the anti-e-cigarette movements "normalizing-argument" a tiny bit more plausible. One could, for example, try to make sure that e-cigarettes look as much as cigarettes as possible, try to limit the range of flavours or maybe put a limit on nicotine content to make sure smoking becomes the only way to get a sufficient nicotine hit for some... oh wait... this is starting to look familiar.

photo credit: alexanderferdinand via photopin cc

New years resolution update: Completed!

When I started this blog in the beginning of this year I wrote that I'd give you some updates on my new years resolution: running a half marathon in less than 2 hours. 2 years ago I couldn't walk up one flight of stairs without getting out of breath, and my kids could tell that I was coming home 3 minutes before I was actually home... cause they could hear me coughing my lungs out a long way down the street. As I've said before, we vapers are the best proof that vaping works (http://vapingiraffe.blogspot.no/2014/02/you-are-proof-that-vaping-works.html), and I've encouraged you to challenge yourself a bit and try to do something you couldn't do before. In that way you can show people what you can do now that you've done the switch. This is one of the reasons I set this goal for myself, and hopefully I could inspire others by writing about it here.

So this morning I went to the gym to do a 10k run, but after 10k it felt pretty good so I decided to keep on running. And it helped a bit that they had put a sticker on the treadmill announcing they had a competition going on where 21.1km was one of the exercises and I could win a bag of goodies if I completed. I have no idea what is in that bag... yet. It's just raffled among everyone entering I think, so with my luck I'm never going to either :) Anyway, after 112 minutes I was done, in all possible ways, and very happy that this years new years resolution is completed. I think this might be the only new years resolution I've ever completed as well.

So again, hope I've inspired some of you to challenge yourself a bit. It doesn't have to be running a marathon (or a half one), but find something you couldn't do when you were smoking and show people around you that vaping does work. Cause YOU are the best proof of this.

Norwegian Institute for Alcohol and Drug Research (SIRUS) comments on the approval of the TPD

Norwegian Institute for Alcohol and Drug Research
- Sirus supports Norwegian vapers

After the TPD was approved SIRUS and their head of research, Karl Erik Lund, received a lot of requests for comments on this. Not very surprising as SIRUS has been one of the biggest supporters and advocates for e-cigarettes here in Norway. Due to the amount of requests, Karl Erik Lund and SIRUS chose to write a public response on the Norwegian Union of Vapers' (Norsk Dampselskap) Facebook page. We are indeed lucky here in Norway to have SIRUS to support us vapers. Karl Erik Lund is usually the one speaking on their behalf in the media and I've got to say his statements always appears well though out, well formulated and convincing, which is really helping the case here in Norway. (Lund also spoke about the TPD and what it means for us here in Norway in an article on nrk.no on the 28th of February: http://goo.gl/zYdu0e, in Norwagian but google translate might work)

On the before mentioned facebook page Lund writes that it is appropriate to consider two different aspects of the TPD: The procedures that has been followed, and the result. He says that from his point of view the results are much better than the procedures, but that does not necessarily mean the results are good. The procedures have been close to a scandal, he says, with allegations of corruption leading to John Dallis resignation as Commissioner (read more about the "Dalligate" scandal here: http://goo.gl/Hkwnug), absence of consultations with scientific groups, abuse of research results, skullduggery concerning the voting procedures and so on. He refers to Clive Bates' blogg (http://www.clivebates.com) for more information on this. The results are not optimal either, according to SIRUS: The 20mg/ml limit has no scientific foundation, the option for members state to regulate them as medicines creates openings for over-regulation (read my post on the consequences of over-regulating here: http://goo.gl/mrE4bS) leading to less product variety, higher prices and standardized products that have as little appeal to smokers as the nicotine inhalers of the pharmaceutical companies have today, standardized nicotine delivery that requires technology that is not available yet, refill limitations, and so on. So as you can see, SIRUS really gets the point, which is a very good thing for Norwegian vapers.

Now, regarding the situation in Norway, Lund says that the health authorities and the Cancer Society are still clinging to their precautionary principles, but as the scientific results are starting to get to the people in charge, the ban here in Norway is loosing support among them, and the reasoning for keeping the ban is pulverizing. Lund, and a lot of the vapers I know, including myself, is especially disappointed in the Cancer Society. In my opinion their arguments have been based on speculations, not science and they appear to just take everything the EU say as the truth. The smokers could really have benefited from having this organization supporting them in the fight for a harm reducing nicotine alternative and the design of a strategy for increased product safety, Lund says.

"Norsk Dampselskap" (Norwegian Union of vapers)
fights for vaping in Norway

Despite it's many deficiencies, article 18 (editor: now article 20) will have more positive than negative consequences - in Norway, Lund writes. Norway is not part of the EU, but we are part of the EEA, which means we implement most EU directives anyway. So here in Norway, if the TPD is implemented in it's current form, the ban we have today will be repealed and we'll have regulations (although totally over-regulated) to ensure product safety. Now it is still uncertain how the Norwegian health authorities will regulate e-cigarettes but now, with the TPD the debate has changed from being focused on whether or not a ban should be in place to being a debate on how to regulate them. This is progress, says Lund. The demonizing of nicotine (for example in the anti-tobacco movement) is an inappropriate approach to the regulation question, he adds. 

I've seen some positive feedback on the TPD among Norwegian vapers lately, stating that it will actually better situation for vapers in Norway. And they are right about that, as SIRUS also points out here. But I'd like to stress, again, that we are not fighting this fight only for our own sake, but for all the smokers whose lives could be saved, not only in Norway but all over the world. And I think it's important for Norwegian vapers to be aware that even though this means a step in the right direction for Norway, it's a long step backwards for the countries where we buy our vaping equipment and e-liquid today. And thus it is very important that we continue the fight here in Norway as well, and try to get our politicians to take science and facts into consideration when the laws regarding e-cigarettes in this country is written, and not just adopt the EU directive directly. As I said yesterday: Vapers should write the law on vaping. If we do win that fight we would be a good example for the EU on how it should be done as well and might be able to help others.

Why vapers should write the law on vaping

Do the EU know how these work?

It's very clear to us vapers that the parts of the TPD that concerns e-cigarettes is written by people with limited knowledge of vaping, e-cigarettes and e-liquid. I doubt that any vaper was ever close to helping out writing that text and the science that is referenced to support the directive is picked to fit the text, not the other way around like it should be. The EU claims that the directive will make sure that e-cigarettes and vaping is as safe as possible, but as I mentioned yesterday, some of it will actually work the other way around, making it less safe. Less effective equipment, smaller bottles and smaller cartridges will actually lead to more bottles and more cartridges that can get into the hands of children ... or eaten by pets. And then there is the issue of a black market that will thrive as long as restrictions are unreasonable. Why can't they see this?

Yesterday I read some news article where some health authority again was asked about why they want restrictions on e-cigarettes. Don't really remember who or what but it's not that important cause we have all seen this statement a million times by now: "We don't know enough about it yet". As usual I was a bit angry at it at first. But after thinking a bit about it I realize this person was absolutely right. They (the health authorities) don't know enough about it. Seeing how the TPD was written the EU don't know enough about it either. Writing to the Norwegian Cancer Society on Twitter yesterday I tried to ask where they got their information from as well... the answer was: "The EU has calculated this". So the Cancer Society don't know enough about it either. Turns out they were right all the time... they don't know enough about vaping yet.

So who are the experts on vaping then? The answer is pretty obvious: vapers and scientists that has actually done research on vaping. And who are the people that benefits the most, and has the most interest in making vaping as safe as possible? Vapers. Who knows what e-cigarettes are the most effective, and which aspects of vaping that keep people from reverting back to cigarettes? Again... vapers ... of course! This means that to ensure a directive that will make vaping as safe and effective as possible, vapers should be the authors, or at least co-authors, supported by scientists that has done research on vaping. Because vapers are the experts on vaping and e-cigarettes, and it is in their interest to make vaping as safe as possible. But instead the EU has chosen to let Big Tobacco and Big Pharma dictate the directive. That's like having a farmer writing a directive on fishing. I'll leave it up to my readers to make up their own opinions on the reasons the EU has for doing this, but the point is: Vapers should write the law on vaping, simply because they are the experts on vaping.