Royal College of Physicians back vaping big time!

Woke up this morning to some great news. The Royal College of Physicians (RCP) have released a 200-page report called "Nicotine without smoke: Tobacco Harm Reduction", that rips several of the ANTZ favourite arguments and theories apart concluding that we should "Promote e-cigarettes widely as substitute for smoking". From the press release:

• E-cigarettes are not a gateway to smoking – in the UK, use of e-cigarettes is limited almost entirely to those who are already using, or have used, tobacco.
• E-cigarettes do not result in normalisation of smoking – there is no evidence that either nicotine replacement therapy (NRT) or e-cigarette use has resulted in renormalisation of smoking. None of these products has to date attracted significant use among adult never-smokers, or demonstrated evidence of significant gateway progression into smoking among young people.
• E-cigarettes and quitting smoking - among smokers, e-cigarette use is likely to lead to quit attempts that would not otherwise have happened, and in a proportion of these to successful cessation. In this way, e-cigarettes can act as a gateway from smoking.
• E-cigarettes and long-term harm - the possibility of some harm from long-term e-cigarette use cannot be dismissed due to inhalation of the ingredients other than nicotine, but is likely to be very small, and substantially smaller than that arising from tobacco smoking. With appropriate product standards to minimise exposure to the other ingredients, it should be possible to reduce risks of physical health still further. Although it is not possible to estimate the long-term health risks associated with e-cigarettes precisely, the available data suggest that they are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure. 

The report acknowledges the need for proportionate regulation, but suggests that regulation should not be allowed significantly to inhibit the development and use of harm-reduction products by smokers. A regulatory strategy should take a balanced approach in seeking to ensure product safety, enable and encourage smokers to use the product instead of tobacco, and detect and prevent effects that counter the overall goals of tobacco control policy.

These are all the things a lot of vapers have been trying to get across to regulators and politicians, and to get the media to report, for a long time now. But not many have listened, and many of those who have listened have dismissed it and told us we don't know what we're talking about. Having this report to back it up will hopefully add quite a lot of weight to our arguments, and the hopefully the report will have as much influence as their report on cigarettes from 1962 which was among the first to show the harmful effects of smoking.

I'm also very happy to see that this has gotten the attention of the media already: Smokers Urged to Switch to E-Cigarettes by British Medical Group (NY Times), U.K. Report Advocates Substituting E-Cigarettes for Tobacco (Wall Street Journal), Doctors: Give E-Cigarettes To Smokers (Sky News). Actually... just google "royal college of physicians e-cigarettes" and see for yourself. Now I'm just waiting for Norwegian media to catch up.

I haven't had the time to read the whole report but they've put up a pretty good summary in the summary of the report that I have to say is bloody great and I recommend reading it... and then bookmark it so you can link it to anyone trying to tell you vaping isn't the best thing for public health since soap.

Dr. Farsalinos asks The Norwegian Institute of Public Health to retract false statements

In response to the report from The Norwegian Institute of Public Health (NIPH) that I wrote about a couple of days ago, Dr. Farsalinos published a post this morning on his blog, demanding that NIPH immediately retract their false statements about passive e-cigarette exposure.

The most significant mistake in the report refers to passive exposure to e-cigarettes. In particular, the report mentions: “… nicotine levels in the environment following passive exposure to e-cigarette aerosols causes similarly high nicotine levels in the blood as that of passive smoking of regular cigarettes. This means that one can expect similar harmful nicotine-related effects of passive smoking from e-cigarettes as for regular cigarettes. This does not mean that passive exposure to aerosols from e-cigarettes causes carcinogenic effects, but that passive smoking may affect the cardiovascular system, have stimulatory effects and contribute to addiction”. Not a single word is true in this statement.

Pretty strong words from Dr. Farsalinos there, but nevertheless completely true. In addition to the fact that the actual levels of nicotine a "passive vaper" will absorb is completely harmless and has absolutely no biological effect, like I pointed out in my previous post, Dr. Farsalinos refers to his own study showing that nicotine levels in the environment are at least 10 times higher during smoking compared to e-cigarette use.

It's great to see that the criticism that vapers here in Norway have directed towards the NIPH report is supported by science. Well of course the criticism has been based on science all the way, but this statement from Dr. Farsalinos makes it a lot easier for us to prove it. Having the support of one of the leading and most respected scientists in the field of e-cigarettes is a huge advantage for us, as we're now working hard to enlighten the politicians and health officials that will soon decide how vaping will be regulated in Norway. A big, big thank you to Dr. Farsalinos for the support. Your statement and support means a lot!

 
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New report from Norwegian Institute of Public Health causes more harm than health

Today the Norwegian Institute of Public Health of published a report called "Health risks associated with the use of electronic cigarettes". The report can be found here and there is also a summary in English.

Norwegian media has been publishing stories today claiming that "second-hand vaping poses health risks", giving the impression that e-cigarettes are as dangerous to bystanders as tobacco cigarettes, which of course is not at all what the report says. The report itself contains quite a few serious mistakes as well, but it concludes that risks associated with all other substances other than nicotine is negligible. It also concludes that cancer risks from nicotine itself, if any, is negligible. 

The biggest problem with the report is that it focuses a lot on potential health risks of nicotine, especially to bystanders. This is all based on a false assumption that the nicotine in second hand smoke poses a risk to bystanders in itself. One of the studies they base this on is this one, that concludes that people who live in smokers homes and e-cigarette users homes absorb statistically similar amounts of nicotine. Now I'm no expert so I'll just have to trust this even though it looks to me from the summary of the study that those in the smokers home gets twice the amount. But that is not the point. The point is that these amounts don't pose any danger to the people exposed to them. Dr. Farsalinos showed us this, with reference to the same study, with some simple maths here. (His numbers seem a bit different than those presented in the summary, but I assume he found more significant numbers in the actual study). The amount of nicotine absorbed by a "passive vaper" is 10 times lower than The European Food Safety Authority say will affect an average human weighing 75 kg (and of course you should not fill your home with vapor if you have babies... but that goes without saying). This also means that the same human being is also unaffected by the nicotine from passive smoking, and this is where the Norwegian Institute of Public Health misses the whole point and causes more public harm than health. Even if passive vapers absorb similar levels of nicotine to what passive smokers do that does not pose any health risks to them. The other particles that tobacco smoke exposes bystanders to is another story. As Dr. Farsalinos points out:

Such a levels is not only harmless but has absolutely no biological effect, even according to the strictest regulatory definitions.

When it comes to the amount of nicotine absorbed by the vapers themselves they also say that these levels are the same as for smokers, which is probably not far from the truth. However, the negative effects of nicotine is also debated. There are some proven, unwanted effects on fetuses which means you shouldn't use nicotine while pregnant but other than that there's not much to be afraid of. In fact there are a lot of positive effects of nicotine use as well (for healthy, non-pregnant people that is). Then there is the question whether nicotine in itself is addictive, to which most serious scientists today would answer no. I've written quite a bit about this earlier: Nicotine - a supersheep in wolf's clothing?

Another big problem with the report is that it is almost 100 pages long, and that a lot of it is used to describe potential problems with substances that are not present in amounts that will cause those problems. This only serves to scare people (or just scare them away from reading the report), which might not notice the last sentence of the paragraph that says this won't be a problem anyway. And apparently both the media and our minister of Health has fallen in this trap. The minister of health said today that he has up until now thought that e-cigarettes are virtually harmless but he is now worried by this report. This shows how much damage this report has already done. The Norwegian Institute of Public Health have caused more harm than health as I said, by writing conclusions that do not reflect the actual content of their report. The conclusion that comes forth is one that is based on a false assumption and an error in the report: Nicotine from passive vaping can cause harm. The contents of the report (even with this error) justifies a conclusion more in the line of this: E-cigarettes are orders of magnitude less harmful to both vapers and bystanders compared to cigarettes. I really hope (and I do believe) that SIRUS and Karl Erik Lund will turn up in the media shortly and minimize the damage. I do feel a bit sorry for them as this probably feels a bit like a punch in the face.

 

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Help spreading the truth to doctors, health care professionals and scientists

Professor Gerry Stimson, Jacques Le Houezec PhD, Professor Riccardo Polosa, Konstantinos Farsalinos PhD and Carmen Escrig PhD are asking doctors, health care professional and scientists around the world to educate themselves on e-cigarettes and vaping and to support their M.O.V.E  manifesto.

We call on our colleagues to sign this declaration in support of the merits of electronic cigarettes based on scientific evidence and ethical debate.

I do believe that the statements and opinions of Doctors and health care professionals in the vaping debate will affect the opinion of the general public, and the politicians, strongly, either directly or indirectly through the media. I expect my doctor to know what he's talking about and trust his advice, and I don't think I'm the only one here. So I really appreciate these guys efforts to reach out and educate those of their colleagues who still needs it, and gathering the signatures of those already educated to create a strong voice that will help educating the general public.

We, as vapers, can help them do this by spreading the word to health care professionals around the world. Give this link to your own doctor, your friends that are doctors or any health care professional you come across:

https://sciencecig.wordpress.com/move/

BIG Surprise: Vaping is LESS addictive than cigarettes

A lot of you have probably read about the new study from Penn State’s College of Medicine that concluded that the addictiveness from e-cigarettes is lower that that of cigarettes. The study was released on the 9th, I think, and was commented quite a few places. Klaus Kneale from ecigadvanced.com has written a great comment that you can read here.

The fact that e-cigarettes seems to be less addictive than cigarettes isn't really shocking to most vapers. I can tell from my own experience that I don't get the nicotine cravings are not as strong as they used to be and I can go a lot longer without my e-cigs than I could without a cigarette when I was smoking. Coincidentally I actually had a go at this this Sunday, when I left was going to a meeting. I was about to put some vaping gear in my pocket as I usually do when I go out, but decided that since it was probably going to be a short meeting I didn't need it. The meeting ended up lasting for 3 hours. Back when I was smoking I would have been trembling anxiously within an hour... but now I didn't even think about it before I got home.

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.

My thoughts exactly, Klaus. When I first read about the study this was the first thing that came to my mind as well. I wrote a couple of posts (here and here) about the addictiveness of nicotine earlier as well, referring to the work of Professor Peter Killeen among others. Killeen has also commented on vaping on youtube, and I highly recommend you watch this and listen to what he has to say about it:


What I personally find quite interesting is this part:

"We know nicotine is a big player in the addiction to cigarette smoke. Inhaled cigarette smoke is very addictive, and it's very fatal to a large proportion of people who use cigarettes or other forms of inhaled tobacco. How about vaping? How about inhaling nicotine? A lot of the assumptions that the scientists have made over these decades about the addictive properties of nicotine are wrong. They are wrong because they are always looking at nicotine addiction in the context of cigarettes and other inhaled tobacco products. Nicotine by itself has never been shown to be addictive. Nicotine by itself has never been shown to be addictive in individuals who have not smoked cigarettes prior to using nicotine"

The reason I put the last part of the quote above in bold is that this is one of the reasons that the gateway theory is invalid. As Steve K's puts it, this is Another Hole in the Gateway.

"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

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

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

Switching from cigarettes to e-cigarettes puts you at less risk from MRSA

After Laura E. Crotty Alexander and her team released a study on how e-cigarette vapour affects MRSA (http://goo.gl/cmQT) on the 18th of May (http://goo.gl/8vsw9Z) the media has been throwing headlines at us that makes it look like e-cigarettes will cause these bacteria to mutate and take over the world. Not very surprising looking at how Crotty Alexander presents her research herself:

Vapour from e-cigarettes makes MRSA bacteria more aggressive

Doesn't look good now does it? The media of course, eager to attract readers by reporting another scandal, makes this even worse. Just have a look at this headline from the Daily Mail:

Are e-cigarette smokers at risk from superbugs? Vapour helps deadly bacteria to thrive, say scientists

First of all there is no such thing as an "e-cigarette smoker". It's just no smoke involved, so stop it! To make it even worse, they add this in the sub-header:

"However new study shows users are more at risk from superbugs"

Looks like we're dead then. Keep vaping and you'll get eaten alive by MRSA, right? NO! Cause there is something missing from the statement in that sub-header. They should have added this: "compared to non-smokers." Because this is what the scientists actually found: E-cigarette vapour makes the bacteria more aggressive, and the human defence system less effective, but smoking cigarettes will have the same effect... only 10 times stronger. So a more reasonable headline would have been something like this:

Are e-cigarettes the solution to fighting MRSA in smokers? Smoke makes bacteria 10 times more aggressive than vapour, say scientists.

You see it all comes down to what perspective you view the data from, and which parts you choose to promote. If you're against e-cigarettes, and like the nicotine gum and patches better, it's pretty obvious that you can present this data to make e-cigarettes look bad. It's all about which findings you focus on and which ones you tone down. The fact that cigarettes are far worse in this matter is just mentioned at the end of the Daily Mail article: "However, the study also failed to give real cigarettes a clean bill of health. In fact, they were found to fuel MRSA even more than the electronic versions." They even fail to mention the magnitude of the whole thing.

Another thing they fail to mention, and that Crotty Alexander just barely mentions herself, is this: "We have not yet pinpointed the components of e-cigarette vapour that trigger these effects, but preliminary findings suggest that the nicotine in e-juice (the liquid used in e-cigarettes that is vapourised and inhaled) is a significant contributor." This would mean that not only cigarettes and e-cigarettes would make MRSA worse, but also nicotine patches and gum... and even tomatoes and eggplant might have an effect. Why don't Crotty Alexander give her lab-mice some nicotine gum instead of letting them breath in e-cigarette vapour if she suspects nicotine is the problem?

The fact that Crotty Alexander, despite the results she has published here, still won't recommend e-cigarettes for her asthma-patients is beyond me. It really makes me wonder if the disclosure statement printed below her author info on http://theconversation.com is even remotely true. We've seen studies lately (http://goo.gl/lEbFpZ) kicking the gateway argument out the window and that makes the really important truth discovered in her research this:  

Switching from cigarettes to e-cigarettes puts you at less risk from MRSA.

photo credit: NIAID via photopin cc

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)

New systematic review by Dr. Farsalinos published

Dr. Konstantinos Farsalinos and his co-author Prof. Riccardo Polosa published a new study in the journal "Therapeutic Advances in Drug Safety" yesterday called "Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarettes substitutes: A systematic review". They have studied 97 other chemical, toxicological and clinical studies on the safety and risk profile of e-cigarettes. The presentation of the study you can find at http://goo.gl/ziJUms and you can read the whole study here: http://goo.gl/kizMY1 (register for free to download the PDF).

They conclude, in short, that even though it is obvious that there may be some residual risk associated with electronic cigarette use, they are far a less harmful alternative to smoking. There has been found some toxic chemicals in e-cigarette vapour but at levels substantially lower than in cigarette smoke and comparable with the amounts found in pharmaceutical nicotine products. They conclude that "Electronic Cigarettes are a revolutionary product in tobacco harm
reduction" and that "Due to their unique characteristics, Electronic Cigarettes represent a historical opportunity to save millions of lives and sgnificantly reduce the burden of smoking-related diseases worldwide".

I'm also glad to notice they have come to the same conclusions as I had (http://vapingiraffe.blogspot.no/2014/01/yeah-yeah-keep-throwing-irrelevant.html) regarding some of the reports used by some anti-e-cig-organizations (and regulatory authorities) to back up the claim that e-cigarettes are a gateway to smoking. They've referrenced a couple of American and also a South Korean study of experimentation with e-cigarettes and say that the findings here does not support the claim that e-cigarettes are a gateway, but rather they are showing that experimentation with e-cigarettes are done by mainly by smokers. "There is no evidence indicating that they could be a gateway to smoking", they write, and continues "It is promising to see that penetration of EC use in youngsters is virtually nonexistent, especially when you take into consideration that there is currently no official regulation in most countries to prohibit the access to ECs by youngsters."

Again Dr. Farsalinos and his co-workers provides us with extremely valuable, thorough and unbiased research. Thank you!

New survey by Dr Farsalinos submitted for publication

I'm happy to see that Dr. Farsalinos announced yesterday that the worldwide survey of more than 19000 users concerning characteristics, side effects and benefits of e-cigarette use, has been submitted for publication. It looks like the results should be very interesting reading. I notice especially that there is also subjects that were not smokers at the time of e-cigarette use initiation participating in the study. The hints he gives us on the results, 81% of the subjects actually managed to quit smoking completely and the rest cut down their smoking drastically, is very interesting indeed. Earlier this week I wrote about a study that reported a 19.9% success rate (http://goo.gl/nRMR2B) for quitting by using e-cigarettes. That is a huge difference, actually their number is close to the 80% I've experienced myself. Of course, as Dr. Farsalinos says as well, the participants in such a survey are expected to be very dedicated so this number is expected to be higher than with the general population, but still I think this shows that if you really want to quit there is a great chance that e-cigarettes will help you. Again, I can use myself as an example of this. I really wanted to quit smoking, and I tried several times, but it was when I discovered e-cigarettes I managed to do it. And it even became the easiest thing in the world.

Really looking forward to reading the complete article when it's published. I also applaud Dr. Farsalinos and his team for their efforts to present the data in an objective way. I know I probably come across as very biased in this matter myself, I find it hard not to be when I look back at my own vaping adventure, so you'll just have to excuse me I guess. However I do try to make an effort at finding unbiased research when writing this blog, and I do believe Dr. Farsalinos and his team provide some of the best unbiased research available. Keep up the good work doctor!

Lots of demonizing misinformation in Norwegian online science magazine

This article was published on the 10th of February on forskning.no: http://goo.gl/r86R7o. It's apparently written by a journalist in the Danish online science magazine videnskab.dk and translated, but I can't find the original article. It seems to be part of an article series called "Ask a researcher", and it's an answer to a reader that sent them an email asking these questions: Is there something in e-cigarettes that is bad for your health? And if so, how dangerous are they compared to regular cigarettes?

Actually what is a bit amazing here is that some of the sources they give us is proof that some of the claims in the article is just not true. I'm not going to go into the whole article, but I just feel I have to comment on a couple of the claims made by a couple of the doctors interviewed there.

Cheif consultant in the Danish health and medicine Authority (Sundhedsstyrelsen), Jørgen Falk talks about the ingredients in e-liquid. He says that PG and glycerin are the main ingredients and these are substances that are related to what is used as antifreeze in cars (!). Well, he's right though. Both has been used as NON-TOXIC antifreeze: http://goo.gl/Btpi6Y, but are not very effective, and not really what it's mainly used for. He does actually mention that it's used in food as well, but dragging this antifreeze purposes into the discussion... that's is just scaremongering as it makes people think it's toxic like methanol. Although he admits that e-cigarettes damages the lungs a lot less than normal cigarettes, he continues claiming that there is not enough research on the long term effect. Again, he want's to close the fire-escape cause the stairs might be a bit slippery, and he has apparently not read the research that is available. 

Then there is this Chief doctor, Charlotta Pisinger, claiming we don't know the long term effect of inhaling PG, which she says is usually about 90% of the e-liquid. How a Chief doctor can say this, and claim there is not enough long-term research is beyond me. The research on inhaling PG started in the 1940s! I mean it is a substance used to clean the air in hospitals, it's actually approved by the FDA for that very purpose. So this is just not the case... we know exactly how inhaling PG works. I'm sorry Charlotta but this statement to me makes me question all the other statements you make as well. Please read this: http://www.vapersclub.com/pg.php.

The last chief doctor, Philip Tønnesen, who is actually a researcher himself (the others are just collecting other peoples research, and are not doing a very good job as you can see), is not that sceptical. He is convinced e-cigarettes are a lot less harmful than cigarettes. He encourages the use of common sense and urges us to look at what e-cigarettes actually contain instead of waiting for long-term research on e-cigarettes in general. So far so good, but then even he manages to make an outrageous claim: "The research that is available to today does not indicate that e-cigarettes are especially effective as smoking-cessation remedies". Ok? One of the sources given in the article is this: http://goo.gl/wV67ia. Lets look what they write in the conclusion of this 24-month prospective observational study: "In conclusion, persistent long-term modifications in the smoking habit of smokers not intending to quit can be attained by using e-Cigarettes. This behaviour could be sustained over a prolonged period of time by advancing to newer more efficient models, which were well tolerated by users. Although not formally regulated, the e-Cigarette can help smokers unable or unwilling to quit to remain abstinent or reduce their cigarette consumption and currently may represent the ultimate tobacco cigarettes substitute.". Maybe the journalist that wrote this article should have shown that to Dr. Tønnesen, just as an example?

Dr Farsalinos' fundraising campaign through the roof

I'm happy to see that the fund-raising campaign launched by Dr Farsalinos and his team to raise money for their study called Electronic cigarette liquids analysis-evaluating potentially harmful ingredients has gone through the roof. They had a goal of collecting $23.000, but now, with still 9 days to go they have collected over $33.000. Now THAT is what I call great news.

The goal of the study is to test more than 100 e-cigarette liquids from manufacturers all over the world to determine what is in them and how safe they are, and they say that the more money they collect, the more liquids they will be able to test. In the study announcement they say that this is a great opportunity for the industry to show responsibility towards health-related issues and the industry is urged to support it. And apparently they have... among the givers announced in the updates section you can see that several Greek e-cig and e-liquid vendors and manufacturers have given their support.

I'm really looking forward to seeing the results of this study, and hope the industry, and vapers will continue to give their support. I applaud Dr Farsalinos for his work and continued reminders that we need to focus on making vaping as safe as possible and in that way make it an accessible and attractive alternative to as many smokers as possible. Great work!

You can read all about the study here: http://www.indiegogo.com/projects/electronic-cigarette-liquids-analysis-evaluating-potentially-harmful-ingredients

Yeah, yeah keep throwing irrelevant numbers at us... where are the vapers that converted to smoking?

After watching the FBI show I wrote about yesterday on NRK (Norwegian government-owned radio and television public broadcasting company) web-tv I read the article mentioned at the end of the show here: http://www.nrk.no/livsstil/frykter-e-sigarettens-pavirkning-1.11502043. (Sorry about all the Norwegian articles guys, hope the google translation is not too bad).

Again I'm baffled by the fact that the Cancer Society seems to be so opposed to e-cigarettes. I really struggle to see why. And to add to that, they keep throwing irrelevant numbers at us. Again it's this new american study that they claim supports the theory that vaping is a gateway to smoking. Well allow me to explain once again why these numbers are at best irrelevant. This is what the "Facts"-box on the side says (I've changed the order here to make things a bit clearer):

• 1379 Americans, average age of 24, smokers, non-smokers and former smokers were followed for a year.
• 7.4% of the ones that hadn't already tried e-cigarettes tried them this year. - What does this really mean? Well, it says nothing about if these were former smokers, smokers or non-smokers. It is hence completely irrelevant and does not support the conclusion at all.
• 21% of the smokers, 11.9% of former smokers and 2.9% of the non-smokers had tried e-cigarettes during that year. - For the smokers this is great, they are trying to quit, for the former smokers it probably prevented a relapse to smoking and for the non-smokers... well it only says they tried it, not that they kept on doing it. I myself have a lot of friends, non-smokers, that have tried my e-cigarettes once or twice. Actually most of my non-smoking friends have, so they would have had to answer yes on this as well. To be honest I'm surprised the number is that low. But as you can see, it gives us no indication on vaping being a gateway to smoking. It's completely irrelevant.
• According to the scientists that did the study, there are indications that the belief that e-cigarettes are less harmful than normal cigarettes can get more young adults to try them. - I actually got to agree with this, but this has nothing to do with the numbers they present. And most of these are probably smokers, former smokers or people who would be tempted to try real cigarettes. This is just common sense. If you believe there is a less harmful alternative to cigarettes you would be pretty stupid not to try it wouldn't you? And IF some of these actually are people who wouldn't have taken up regular smoking, but take up e-cigarettes anyway, WHY on earth would they switch to smoking afterwards. There are certainly NO numbers here supporting that. 

So, why do some people use these numbers as proof that vaping is a gateway to smoking? Wouldn't it be better to refer to a study of vapers who have never smoked for a year and count how many of those that take up smoking? Well, of course this study doesn't exist... you'd have a hard enough time finding enough never-smoking vapers. If you did however I think counting to 0 should be pretty easy. Actually, if someone comes up with ONE vaper who has never smoked a cigarette before starting to vape, and then becomes a regular smoker, I'll eat all my hats, smoke my socks and put a pink background on this blog for a month.

Then there is this other sidebar with a list of potentially carcinogenic substances found in e-cigarettes. The source of this information is given to be the french consumer magazine "60 millions de consommateurs". Well, this so called scientific research has been ripped apart by Dr Farsalinos so I'm just going to give you the a couple of links so you can see for yourself. His analysis of the original article here: http://ecigarette-research.com/web/index.php/2013-04-07-09-50-07/128-60-millions-de-consommateurs, and another answer after they tried to "clarify" what they really ment: http://ecigarette-research.com/web/index.php/2013-04-07-09-50-07/131-basic-science-principles-60-millions-de-consommateurs3. I don't really think I need to comment on that further.

Now I do understand why big tobacco and big pharma would try to spread fear and loathing in this matter, and I do have a sneaking suspicion where funding for some of this "research" can be traced back to. But what I don't understand is why the Cancer Society does it. Why do they keep on ignoring the fact that there IS a lot of science that shows e-cigarettes could dramatically reduce the number of new cancer patients? They keep on saying that this research just doesn't exist. But apparently they do search for studies on e-cigarettes, as they seem to find the reports that conclude e-cigarettes are some kind of new devilry that we need to stop before it's to late. Don't they have the same version of Google that I have?