"2014 worst published study award" - The nominees are

Looks like Clive Bates managed to find another canditate for the "2014 worst published study award": www.clivebates.com/?p=2426. Quite an amusing post by Clive pointing out how utterly useless this "research" really is.

There you go - problem solved

The topic at hand now is "3rd hand exposure" to nicotine, and you can read the whole study here: http://goo.gl/o0BkK9. The authors of the study found out that nicotine is actually left on walls, windows and so on in a chamber, and from that they conclude that people will be exposed to it "3rd hand". But, as Clive points out, there is a quite important difference between deposition of nicotine and exposure to nicotine. This is Clive's response to our dear Dr. Glantz's praising of the study on his blog:

The main risk appears to be to people who lick windows – or ‘window-lickers’ as they are known on the Internet.  However, even these people, who have other problems and priorities, would have to lick the deposition from 38 square meters* of glass in this chamber to be exposed to 1mg of nicotine (47/6*1000/205).

I don't really think there is anything else to say about this. Go read Clive's post if you haven't yet. Oh, and I've put up a poll on the right hand side so you can vote on which of the 3 studies I've written about lately that you think should get the "2014 worst published study award". Who will win this prestigious award? The nominees are:

• "3rd hand exposure" by Goniewicz and Lee
• "Scary warning labelz" by Popova and Ling 
• "Creative Cancer research" by Borderud, Li, Burkhalter, Sheffer and Ostrof

"2014 worst published study award" - a new contender

On Wednesday I wrote about a study that I thought would win the "2014 worst published study award" quite easily. But reading Clive Bates' blog today I'm glad I didn't put any money on that: http://www.clivebates.com/?p=2418. I'm not going to go through what's wrong with this study, as Clive does an excellent job at that. So please read his article.

I must say that it surprises me a bit that someone actually manages to get such an article published. First of all the the numbers they present shouldn't really surprise anyone with just the tiniest bit of common sense. Of course a label telling you that something is risky would, unless you have any other information to go by, make you think that something is more risky than before you saw the label. I mean... doh! And then there is the conclusion:

In conclusion, this study provides the first evidence against allowing “reduced harm” or “lower risk” labels on alternative tobacco products. While further data should be collected to validate our results, our findings provide initial evidence that endorsements such as the one proposed by RJ Reynolds may have similar effects to the prohibited “FDA Approved” label. Warning labels may be an effective way to decrease interest in e-cigarettes among non-users of tobacco. Regulatory agencies should consider implementing graphic warning labels for smokeless tobacco and investigate use of warning labels for e-cigarettes.

This pretty much shows why this so called study is done: They're trying to figure out how to label e-cigarettes to make them the least attractive. So actually their data (for once) supports their conclusion 100%. Because if you hate e-cigarettes, and you don't care how much you'd have to lie to get rid of them, and you don't care one tiny bit that you're actually preventing people from getting rid of their smoking habit, then yeah... telling people they'll get cancer from e-cigarettes is probably a good way to start. However, the fact that someone needed to do a study to figure this out proves that they are unable to use any kind of common sense and hence their statements should be considered totally useless and ignored in every possible way.

There are bad studies, really bad studies - and then this

On Monday this week a study claiming e-cigarettes are not helpful for smoking cessation among patients with cancer, was published online ahead of printing in the journal "Cancer". You can view the abstract of this study here (or the whole study if you have access): http://goo.gl/qCyHPs. This of course triggered a lot of headlines:
- Study: E-cigarettes do not help people trying to give up (Telegraph.co.uk)
- E-cigarettes 'not helping cancer patients to quit smoking' (Medical News Today)
- E-cigarettes 'make cancer patients more nicotine dependent' (Daily Mail)

Thankfully there has also been more balanced headlines, that also includes some criticism of the study, like this one from Reuters for example:
- Study of smoking cancer patients fuels e-cigarette debate 
 
Dr. Siegel has (once again) done a great job analyzing what's wrong with this study: http://goo.gl/58sXkL. And of course there is something very, very wrong with it. The conclusion that e-cigarettes don't help smoking cancer patients quit just makes no sense at all. We know that e-cigarettes help a lot of normal smokers quit (http://goo.gl/17Ocyn), why the hell shouldn't it help cancer patients? I suggest you read Dr. Siegel's analysis. It explains pretty well what exactly they did wrong, or more likely what they failed to cover up. I don't have access to the full study, so I'll have to trust the comments of (more competent) others that I assume have read the study:

Dr. Robert West, director of tobacco research at University College London:
"the study was not able to assess whether or not for cancer patients who smoke using an e-cigarette to try and quit is beneficial "because the sample could consist of e-cigarette users who had already failed in a quit attempt, so all those who would have succeeded already would be ruled out."

Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary, University of London:
"The authors followed up smokers who tried e-cigarettes but did not stop smoking, and excluded smokers who tried e-cigarettes and stopped smoking. Like smokers who fail with any method, these were highly dependent smokers who found quitting difficult. The authors concluded that e-cigarette (use) was not helpful, but that would be true for any treatment however effective if only treatment failures were evaluated."

So in other words, they haven't counted the ones that successfully quit by using e-cigarettes, when trying to figure out whether e-cigarettes work or not. One user commenting on Dr. Siegels blog has this to say about it: The methodology used reminds me of High School chemistry labs. Everyone knew what the results were supposed to be and you fudged the numbers doing the experiments so it came out "correct". I couldn't agree more. How is it even possible to get such a study published? I'd like to quote a fellow blogger, James from the Ashtray blog:

There are bad studies, really bad studies - and then this

Vaping areas - a good idea?

A vaping area could be a great place to meet
other vapers, or recruit new ones.

This weekend I spotted someone posting an article about the U.S. Military opening a vape deck on USS George Washington (http://goo.gl/16EZHe). I was pretty excited about this "news" and set out to write a blog post about it. In fact, I almost finished the whole post before I suddenly noticed the date.... 23rd of July. Damn that's old news, but still really good news though. Anyway, seeing that a lot of people have blogged about this already, I'm sure I'm the only one in the whole world of vaping that missed it, so I'm not going to bother you with that post now.

However, reading the article I especially took notice of something Aviation Maintenance Administration-man 3rd Class Zachary Dixon (damn, that is some title) said:

“I think having an E-cigarette smoke pit is a great idea and I believe it is a step forward, not just for the George Washington, but for the U.S. Navy as a whole,” said Dixon. “People like myself now have the option to avoid being exposed to cigarette smoke, and still enjoy our E-cigarettes in a similar environment.”

Thinking of it I don't see this argument too often: making vapers go to the smoking areas, or outside with the smokers, to vape, will in fact expose them to cigarette smoke. Of course I've seen it mentioned before, but I do feel it's not emphasized enough.

The most obvious negative effect of this is the exposure to secondhand smoke. The reason smokers have to go outside or to a designated area is to protect non-smokers from this. Well, a lot of vapers are also non-smokers now so why shouldn't they be protected?

Another negative effect, that in my opinion is just as bad, is that I do believe this will cause quite a lot of people relapsing and start smoking again. I think new vapers, or people that are on the verge of making the switch will be very vulnerable to this. A lot of people start out with poor performing cig-alikes. If they were allowed to vape inside, without exposure to cigarette smoke, this might just have been the one advantage that keeps them from switching back, and might encourage them to search for better performing equipment. If forced to vape with the smokers, the way back to cigarettes at this stage is not very long. I know this was the case with myself, as I started out with a crap set from Deal Extreme, and I have to admit that when I went outside with the smokers at work the cigarettes were very tempting. And yes, I had a cigarette once in a while... and it was great. At home, I didn't cause I used the crap set inside, and this inspired me to search for something better. Now I'm pretty much immune to this effect, since I've been vaping for so long and I've got equipment that makes vaping so much better than smoking. Cigarettes now taste so awful that I'd never go back.

Then there is the fact that vaping in non-smoking areas could encourage more smokers to try it out. Now this one is a bit tricky though. Making vapers "hang out" with the smokers could also get some more smokers interested. But then again, there is one less advantage for the vaper to boast of. To be totally honest I'm not sure whether forcing vapers to use the smoking areas or allowing vaping in non-smoking areas will trigger the most smokers to try it out, but I do think allowing vaping in non-smoking areas will increase the success rate of those who try.

I don't see any good reason that vaping needs to be banned in any non-smoking area. Of course there are some places I don't vape. In general I'd say I try to avoid vaping openly where there is a lot of kids. It's all about vaping responsibly, and using common sense. But I also think having special vaping areas, for example on ships or in airports, preferably combined a vape bar, is a good idea. You could do this without banning vaping in other areas, and I think it would still attract a lot of vapers. Such areas, especially if it offers smokers the opportunity to try it out, could be great for gathering vapers, sharing experiences and convincing smokers to switch. And it is certainly a lot better than forcing vapers to go vape with the smokers.




photo credit: lindsay-fox via photopin cc

Public Health vs. Vapers

This week has been quite a busy one for me. Feels like I haven't been standing still for a minute, with quite a lot to do at work and even more to do when I get home. But even though there haven't been much time for writing, I've managed to squeeze in some reading, and some of the stuff I've read has been fantastic. So, today, I'm just going to recommend 3 of the best pieces I've read this week on the relationship between Public Health and Vapers. Enjoy! And have a nice weekend :)

• http://www.redheadfullofsteam.com/its-different-when-they-do-it/
• http://theindefatigablefrog.blogspot.no/2014/09/the-indefatigable-frog-or-why-this-wont.html?spref=fb
• http://www.clivebates.com/?p=2391

Two important critiques of the WHO report that you should read

Since the WHO published their report on e-cigarettes last month it has been criticized by a lot of people. Many of the critics point out the fact that WHO focuses on every little trace of harmful substances found in e-cigarettes and cherry-picking scientific reports that supports this. They fail completely to compare the potential risk of using e-cigarettes to the risk of smoking cigarettes, and they haven't even looked at the potential positive effects of e-cigarettes.

I want to highlight a couple of very well written and thought through critiques that pinpoints the errors made in the WHO report and the consequences they have on public health:

• Earlier this month Ann McNeill and others (among them our dear Dr. Farsalinos) published their critique in Addiction Journal: http://goo.gl/3kqBR3
• On Sunday, Clive Bates published his critique: http://goo.gl/qwuyDk. Remember the WHO tried to shut him up not long ago? I'm happy to see they failed.

I highly recommend reading both of them, as they explain very well why the WHO report does more harm than good. I don't really see the need for me to comment any further on those, but I noticed that the McNeill critique was responded to by one of Dr. Glantz's friends, David W Bareham. The response was published by Glantz here: http://goo.gl/8LZ5e8. What I found very interesting was Dr. Farsalinos comments on this response, published here: http://goo.gl/5GJszv. Now I realize I've given you guys a lot to read, but trust me, it's worth it. If you don't have the time to read it all, go straight for the last couple paragraphs in the comments by Farsalinos. It makes a couple of very good points:

• He points out that the possible negative effects of vaping is highlighted without even taking the positive effects into consideration. If this was done with other smoking cessation medications they wouldn't sell much of it.

"Would any smoker ever try an oral smoking cessation medication if the only information provided would be that they can cause seizures, depression and suicidal ideation?", Farsalinos asks.

• Vaping is not compared to smoking, like it should be, but to not smoking:    

"Of course we continue our research efforts because we need to learn more about e-cigarettes. Of course we are concerned about some issues, such as e-liquid composition (despite the lack of combustion and the absence of cured tobacco) and temperature of e-cigarette use (despite being almost 5 times lower than smoking), not because e-cigarettes may be more harmful than smoking but because we want to find ways to make e-cigarettes even less harmful than they currently are."

•  The last one speaks for itself I guess: 

In fact, our position concerning e-cigarettes is identical to the recommendation of the American Heart Association (AHA): “If a patient has failed initial treatment, has been intolerant to or refuses to use conventional smoking cessation medication, and wishes to use e-cigarettes to aid quitting, it is reasonable to support the attempt”. What AHA and other scientific associations fail (or avoid) to admit is that this group represents the majority of smokers.

As I said, I highly recommend reading the articles and comments mentioned above. If you're a fast reader and still hunger for more, I'm going to go ahead and recommend reading my own article about this from late last month (http://goo.gl/qE8FNC) if you haven't read it yet.

Juice review: Steam Sauce - Deadeye by ePipeMods

The Steam Sauce range from ePipemods consists of no less than 15 different flavours. Some of you that has been following my blog for a while now has probably noticed that I'm trying to work my way through testing all of them and I've been quite impressed so far. I've already reviewed 4 of them (Airship, Transdimensional, Snozzle and Chrononaut) and every time I order some more Long Bottom Leaf I add a couple of new samples from this series to try out.

Now the turn has come to Deadeye, a juice the guys at ePipemods just describe as The Chololate Mint concoction! First of all, let me tell you that I absolutely love the After Eight chocolate, I could easily eat a whole box without taking a break. So of course I've tried my share of chocolate mint e-liquids as well... and I've been disappointed every time. I've actually come to the conclusion that even though I love chocolate, I simply don't like it very much in e-liquids. But, having only had positive surprises so far with the Steam Sauce range, I decided to give Deadeye a chance anyway. 

The main reason for this rather long introduction is that the actual review part of this review is going to be quite short. It took me about one second after I tasted this juice to realize what has been wrong with all the others: To much chocolate and not enough mint. Again, ePipemods proves they are masters of balancing tastes to perfection, adding enough mint for the chocolate to become delicious rather than slightly sickening. I guess most people have tried mint filled chocolate like After Eight so I'm not going to bother trying to describe the taste too much. I'll only say this: If you like mint filled chocolate (or love it, like I do), and are looking for an e-juice with the perfect balance of the two: This is it! Period! Pair it with a cup of coffee and it gets even better.

Scary substances found in e-liquid... and in everything else we eat, drink or inhale

Lately we've gotten some reports and studies about the dangers of vaping. Apparently the vapor produced by our e-cigarettes are not completely free of dangerous substances after all. A friend of mine told me a couple of days ago that he had read they were even more dangerous than real cigarettes. I didn't get to the bottom of exactly where he had read it but I am guessing there has been some article in Norwegian media related to the findings of diacetyl in e-liquid. Probably about as scary as this one from Metro: http://goo.gl/WBUugk. Or it might have been some article about the WHO report and their unsupported claims of dangerous substances in e-cigarette vapor.


The article from Metro is a typical example of how this has been covered in the media lately. What happens is that someone studies or just tests the vapor from a bunch of e-liquids with a bunch of different devices, and ends up managing to find trace levels of some kind of dangerous substance in it. Some times it's not even very dangerous, but has a long and scary sounding name. Then it's published in a way that makes it look like all e-liquids and e-cigarettes produces deadly vapor that will fuck up your lungs and it's probably best to keep smoking cigarettes.

The big problem is that they leave out a very essential piece of information: The amount of the substance found. When it comes to the diacetyl-case the articles focus on what happened to people that got the ‘popcorn worker’s lung’-condition. But what they fail to mention is that the levels found in one flavour of e-liquid, that the manufacturer has already withdrawn from the market, was much lower than the levels found in cigarettes. And cigarettes haven't caused any popcorn worker's lungs yet. But still Metro came up with this headline: "Butterscotch e-cig liquid ‘has links to serious lung condition’". Kind of misleading don't you think? My friends at the Ashtray Blog has written a great article about this (I even stole their graphics to illustrate this post by the way).

We've also had similar cases where someone has found traces of metals in vapor. Like this study for example: http://goo.gl/mOHXxR. Here the case is that vapor contains even more of some metals than cigarette smoke. But what they don't mention is that the levels found are below the levels of Big Pharmas nicotine inhalers, and also way below the USP Standards for Metals in Inhalation Medications (http://goo.gl/eqmfFh).

There are a lot of scary sounding substances in the food we eat, the water we drink and even the air we breathe (http://goo.gl/e34ZDD). Many of them will kill you if you get too much of them. So why are we still alive then? Obviously this has to do with how much of these substances you get into your system. Even pure water will kill you if you drink to much of it (http://en.wikipedia.org/wiki/Water_intoxication). This is just common sense. Leaving out such essential information, and just focusing on what scary substance they've found and what it can do to you is as bad as lying about what they've found. It will only serve to scare people back to cigarettes and an early death.

I'm not saying that we should not care that these substances are found in our e-liquid. We most definitely should care, and we should take action to enhance the safety. And the vaping industry does care. The e-liquid in question was already withdrawn from the market when the story hit the media. The problem is how these findings are presented in the media. Every day elevated levels of dangerous substances are found in food, drinks and air, but we usually don't go around crying out for bans. We try to make the products better instead. And this is the focus we need to have when it comes to e-liquids and vapor as well, even if the levels found are far from dangerous. There is no need for diacetyl in e-liquid, but there is also no need for this scaremongering over some trace levels found in an already withdrawn flavour.

New study claims ecigs are a gateway to cocaine(!), CASAA responds

The poor mice got hooked on cocain just to
realize they had proved... well nothing actually

Every morning, well almost every morning at least, I do a quick search on Google news to check for interesting headlines about e-cigarettes and vaping. This morning this headline caught my attention:  

"E-Cigarettes Are Gateway to Substance Abuse and Addiction"

The article is about the study published by "doctors" Denise and Eric Kandel here: http://goo.gl/VlblK8. The first thing that came to my mind, before I even read the article was: "Oh... another one of these studies with a pre-written conclusion and data that doesn't support it... at all". Turns out... I was right. Here we have a bunch of mice that are fed nicotine one day and cocaine the next day and it turns out they react differently to the cocaine. And what can we conclude from this? Of course this shows that e-cigarettes will make people addicted to cocaine... *sigh*

I was going to sit down and write an article about how wrong and this is and why the data doesn't support the conclusion at all. But I was just made aware that CASAA had already done that, so I'm just going to leave you with the link to their response on Anti-THR Lies: http://goo.gl/qQFuIL
 


photo credit: Nils J. via photopin cc

Review and sweepstakes: Zamplebox, win a free month of Vaping

It's been a while now since I received a little green box filled with goodies from Zamplebox to do this review. I think the guys at Zamplebox have experienced a pretty good growth lately and have been busy as hell shipping out juices, talking to juice-makers and doing updates to their website. So it has taken them a little while to get the competition I promised ready for you guys to enter, but now we're good to go. Enter the sweepstakes before the 15th of September, and it might be you that gets the chance to try out Zamplebox for free.

I got my box right before I went on a weeks vacation this summer. Found the notice in the mail while I was loading the car with loads of stuff we probably wouldn't use (I was right), and some small things we actually did use. Luckily I had the time to pick it up before I went away or it would probably have been returned to sender. But, as I left it at home I had to wait over a week before I opened it. I must admit that when I got home and finally got to open the box, I kind of got that Christmas feeling from when I was a kid.

Inside the little green box there is no less than 11 samples, of varying sizes. Some of them I've read a about, some of them I've never heard of, but I've not tried any of them before. Zamplebox has two options when it comes to how much juice you want: Standard and Gold. The one they sent for this review is the gold version that will cost you $44.99 per month. The standard will cost you $24.99 and you'll get 6 samples every month.

So... to the juices... from left to right in the picture above I've got:

• A pretty large bottle of Frankenvape from The Standard. It's not labelled with how much is in there but I'm guessing it's at least 20 ml or maybe even 30 ml. The bottle at least looks like the standard 30 ml bottle they use for this juice.
• 10 ml of Tico Tico from Strix Elixirs that is labelled with "Zamplebox exclusive flavor". 
• 17 ml of 555 from hotvapes.com (Big Heart Flavors)
• 10 ml of Love Berry Blue from Puff-U
• 10 ml of Peachy Keen from Rocketfuel vapes
• What looks like 15 ml of Santeria by Omega Vape
• A bottle of People's vape Kremlin. Looks like at least 20 ml, maybe 30.
• 15 ml of Cherry Bomb from 503eLiquid.com
• 10 ml of Snake Eyes from Seduce Juice
• 10 ml of Vanilla Ice from evaporhut.com
• And what looks like 15 ml of Sunburst from Victory Liquid

All together that's around 160ml, give or take 10ml, of e-juice at the cost of $44.99. I'd say that is a lot of juice for your dollars. You also get some coupons (if you want) giving you discounts if you really like some of the samples and want more.

Now I haven't really had the time to try out all the samples yet, but I've gotten through a few of them. I started out with the Peachy Keen and the Santeria. The Peachy Keen I kind of like and it's still growing on me. The Santeria I'm still trying to figure out if I like or not. Kind of getting some of the same tastes as from Mothers Milk by Suicide Bunny to be honest with some berries added. It's not an all day vape for me as it's too sweet for that, but good once in a while.

I could of course review all the juices here but I doubt any of you would manage to get to the bottom of this post if I did. But, as I said, you'll get to try out a lot of premium e-liquids with the Zamplebox service.

When I first heard about Zamplebox I tried out their ordering procedure and I think I got asked only 3 questions back then, regarding if I wanted coupons, strength and how much liquid I wanted. Now they have added a couple of more questions, but the whole procedure is still really simple. Just click through the simple questions, give the your address and pay. Right now they 5 questions:

• Do you consider yourself a beginner, intermediate or expert vaper?
• Do you like tobacco or menthol flavors? 
• Do you want coupons in your box?
• Which subscription do you want (Gold or Standard)?
• And finally what strength you prefer (18,12,6 or 0mg/ml)?

I like that they have a limited number of choices. To me on of the main reasons that I think these subscription services are a good idea is that you get to try out a lot of different juices, and I try to keep an open mind. It has happened more than once that I've really liked an e-juice, even though I didn't really like the sound of it before I tried it. The Coquette that Epipemods sent me as a bonus when I ordered a sample pack is one example I can think of. Rum and coke e-liquid? Didn't like the sound of that, but when I tried it I actually liked it a lot.

I think the whole idea of a e-liquid sample subscription service is kind of great. If you're like me and like trying out a lot of different flavours, you should definitely try it out. I know there are several of these services out there, and I've only tried Zamplebox yet so I can't really say if it's the best one. Actually I don't think any of them could claim to be the best one, as it would be a matter of the tongue that tastes the liquid. But I would definitely recommend trying out Zamplebox as it's great value for the money, really simple ordering procedure and from what I can see they have an exciting juice line-up. And, as with most of these services, you can cancel any time you like. 

Another thing I just noticed, and that is worth checking out is their shop area on the website. In addition to some t-shirts and stickers they now sell some basic vaping equipment as well. Again, there is not many options, which is a good thing again in my opinion. Zamplebox stick to their idea of a service that gives you the opportunity to taste a lot of juices at a reasonable price. So in their shop you can buy a dripping atomizer, a Stainless Steel & Pyrex Glass tank that looks very much like a Kanger Aerotank, a starter pack (containing 2 ego twist batteries, a carrying case, a tank with atomizer and charger) and now even a DNA30 mod that kind of looks like a Hana Mod. I would love to try out that DNA30 mod some time. This limited selection of vaping gear I think reflects Zamplebox's motto very well:

We exist to make vaping simpler, more fun and more accessible.

If you want to try it out their web-page is of course... wait for it...  www.zamplebox.com. Zamplebox also say they take pride in being a community first, and a product second, so be sure to check out their facebook page as well: www.facebook.com/zamplebox.


Disclosure:

• All my reviews are my honest opinion even if I am affiliated with the company manufacturing or selling the product. 
• Zamplebox sent me the products free of charge for the purpose of this review.
• This review contains affiliate links.