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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Juice Review: Djinni Range from Decadent Vapors, Part 2

I've got another 4 empty bottles here now, so it's time for Part 2 of my Djinni Range reviews. Again, all the juices I've tested have been 50/50 PG/VG and 12mg/ml nicotine strength, producing quite a lot of vapour and decent throat-hit.

Jelloopy
Tested on: Kanger Subtank (RDA @ 0.4 ohm, 20-25 watts)

The name of this juice suggests it would taste like jelly beans... but then... jelly beans comes in all kinds of flavours, so actually the name doesn't give it all away, but the smell of the juice suggests they've aimed for the fruity ones. Vaping it reveals that they've put a lot of different flavours in here. Almost like they wanted it to taste like all kinds of jelly beans. It actually tastes like you've just put your hand in a bag of mixed jelly beans and picked a few at random, and it kind of taste slightly different every time. Again, Decadent Vapours is spot on with their little slogan on the box: Insanely fruitful. Cause they really have put an insane amount of flavour into this one. I think it might be my favourite in this range so far.


New York 60
Tested on: Kanger Subtank (RDA @ 0.4 ohm, 20-25 watts)

Decadent Vapors describe this juice as vanilla and caramel, with hints of biscuit and coffee. Now I'm not sure I get the biscuit hints, but the vanilla and caramel is definitely the dominating flavours here. As for the coffee it tastes like the same dark, roasted coffee that they've put in the Café au Lait, and I think this really gives this juice a distinctive character. The coffee is by no means as strong as it is in the Café au Lait, but it plays an important role here as well. Kind of reminds me of those Starbucks coffee variants with a lot flavours added, so that there's just hints of coffee left. A great all day vape candidate in my opinion.

San Clemente
Tested on: Aspire Nautilus (1.6 ohm's, 15-17 watts)

Reading the description of this one I was expecting a really heavy cigar flavour with hints of blossom. But vaping it I almost feel it's a bit the other way around. I'm getting quite a lot of floral, almost spicy yet still very smooth flavours from this. When I first tried it it reminded me of the floral taste you get from some kinds of honey that I've tasted actually. The tobacco is still there but for me it's more in the background and it also really leaves an after-taste of tobacco after the exhale. Now I've never been a big fan of floral flavours, so for me I don't think this will be an e-juice I'd start vaping on a daily basis. But there is still something intriguing and very unique with it, and it is still growing on me, and as with all the juices of this range that I've tried so far I keep discovering new tastes even to the last drops of the bottle. The box says it's rolled, robust and original. I'm not so sure about the rolled and robust, but I'll definitely call it original as I've never tasted anything like it. It is quite a difficult juice to describe so I'll just have to recommend you try it out and make up your own mind. Again... don't just write it off if you don't quite like it at first... you have to vape quite a lot of it before you've discovered all of it's flavour notes.


Zingo
Tested on: Kanger Subtank (RDA @ 0.4 ohm, 20-25 watts)

The San Clemente didn't taste quite what I expected. The Zingo on the other hand, tastes, and smells, pretty much exactly as I expected. It's got a strong citrus smell, and an enormous amount of citrus flavour when you vape it. When you mix lime, lemon and oranges I'd expect the lime and lemon to be the dominant flavours and the orange to be more in the background sweetening things up a bit, and that is exactly how I think they've balanced this juice as well. They've done a great job in my opinion. It's really fresh, really zesty, really juicy and you get a lot of delicious citrus flavour from this one. Some of the citrus juices I've tried have had that artificial feeling about them, but this one tastes more like they've actually squeezed and equal amount of real limes, lemons and oranges in there. I imagine it will taste even better when summer comes around and it's time to hit the beach. Great mix again from Decadent Vapours.



Disclosure:

• All my reviews are my honest opinion even if I am affiliated with the company manufacturing or selling the product. 
• The juice was sent to me free of charge for the purpose of this review.
• This review does not contain affiliate links.

Norwegian Department of Health positive to harm reducing e-cigarettes

The Norwegian Department of Health recently published and presented their Public Health Report to the Parliament. According to the Norwegian governments' official web-portal, regjeringen.no, this report presents new policies in areas that the government believes has not been sufficiently prioritized or that require new approaches.

As I've mentioned earlier, The Norwegian Institute for Alcohol and Drug Research (SIRUS), wrote an answer to a request for input by the Department of Health during the process of writing this report. SIRUS' answer focused on harm reduction. After this Public Health Report was published SIRUS' head of research, Karl Erik Lund, was positively surprised by the impact their input:

We prepared a note on the need for harm reduction in the tobacco area but had little hope that the Department of Health would anchor harm reduction ideology in the Public Health Report. Now, however, the Norwegian health authorities for the first time has given the topic discussion in an official, authoritative publication and additionally they've taken a quite positive stance.

I've translated what the report says about harm reduction in the tobacco area:

Harm reduction in the tobacco area

The emergence of electronic cigarettes has intensified the debate about whether harm reduction should be a supplement to the traditional tobacco politics. Smokers who do not manage to quit will be able reduce their health risks by switching to e-cigarettes, even if these are not necessarily completely harmless.

Harm reduction as a political strategy has until now had no place in the Norwegian tobacco policy. The government is open to a rethinking of this area when it comes to e-cigarettes, but have not yet concluded on how the products should be regulated. Traditionally the authorities' policy to reduce tobacco use have had it's roots in three principles of medical ethics: The no-harm principle discourages the use of products which cause harm due to toxic content. The precautionary principle warns against use of products where it can not be excluded that undiscovered harmful consequences may occur in the future, and that these may be irreversible. The loss of autonomy principle warns against use of products which can be addictive.

A comparative perspective implies that the adverse effects of cigarette smoking are used as basis for comparison when evaluating the adverse effects of the use of e-cigarettes. Conventional cigarettes and e-cigarettes are nicotine products in a so-called substitutional relationship, which means that their user functions and users are strongly overlapping. There are still no epidemiological studies of any consequential damage by prolonged use of e-cigarettes. However, a number of studies indicate that the transition from tobacco cigarettes to e-cigarettes will result in a significant risk reduction for the individual smoker. Expert groups have estimated that the overall health risks of using e-cigarettes probably constitute less than 10 percent of the overall risk of cigarette smoking.

Although the transition from tobacco cigarettes to e-cigarettes will be harm reducing for the individual smoker, their effectiveness on community level will depend on the extent to which e-cigarettes may come to recruit non-smokers, postponing quitting, lead to double-use and recruit youth smoking.

Based on current knowledge there is no basis for assuming that e-cigarettes will cause adverse effects on a large-scale population. Users of e-cigarettes is currently almost exclusively smokers or former smokers, and e-cigarettes are used to reduce tobacco consumption, to stop smoking or to prevent relapse to smoking. According to the Institute of Public Health smoking is the single most important cause of differences in life expectancy between people with high and low socio-economic status. The Norwegian Institute for Alcohol and Drug Research has estimated that about 200,000 of the 700,000 daily smokers in this country have characteristics associated with low probability of smoking cessation. The large difference in risk between tobacco and e-cigarettes suggests that access to e-cigarettes will improve the health of the vast majority of users - which is the smokers.There are currently many disreputable manufacturers of e-cigarettes and studies have shown that the content of the products often do not match the content declaration. It is therefore a prerequisite for an eventual repeal of the current prohibition that quality requirements for the products are set, that the sales are regulated and that e-cigarettes in no way will be marketed to young people.

As you've probably noticed there are some points here that are still not concluded on, regulation being the most important one. They do not say much about how much or what kinds of regulation they envision. However, the fact that they seem to have understood the enormous value and efficiency of a harm reduction strategy is a huge step in the right direction.

So, while politicians in a lot of other places seem to work for strict regulations or even bans on e-cigarettes, seemingly unable to grasp the concepts of harm reduction, it looks like we're moving in the other direction here in Norway, where we already have a ban (on nicotine e-liquid that is). This is quite remarkable actually, as we have a strong tradition for over-usage of the precautionary principle here. As I've mentioned before, we even had a total ban on skateboarding from 1978 to 1989 here. So what is the reason that our politicians and health officials seems to have a relatively positive attitude towards the harm reducing e-cigarettes now? Well, we are indeed lucky to have SIRUS on "our side" here in Norway, but a lot of hard work and fighting is also done by the vapers themselves and we must not forget the tireless efforts made by members and the leadership of the Norwegian Union of Vapers (NDS). Here is what Karl Erik Lund wrote in the NDS Facebook group after the report was published:

This must be interpreted as a more sympathetic attitude to harm reduction in general and e-cigarettes in particular. Our note has been important, but it's still all inquiries and activity from you vapers which have prepared the ground for this shift in views on e-cigarettes among the political leadership.

Personally I also believe that the way e-cigarettes have been presented in the media lately have contributed a lot to this. We've seen vapers telling their stories about how the e-cigarettes have affected their lives, stories about how Norwegians travel across the border to Sweden to buy e-cigarettes and liquid, and Karl Erik Lund and SIRUS have done some extremely important work here by quickly debunking the horror stories that hit the media.

Happy Easter!

It's that time of the year again, when we Norwegians fill up our cars with skis, kids and candy and head up to the mountains to see if there's any snow left. After I've figured out how to fit the dog into the car with all the other stuff this evening, we're off to visit family and enjoy a week of good food, lots of candy and hopefully some great long days out in the snow. So next week I'll take a break from blogging as well as work. I do have some cool juice reviews lined up for when I'm back, and hopefully I'll have plenty of time to try out new juices during Easter.

Happy Easter holiday to everyone! Remember to bring enough e-juice on your trip (if you're going on one), and again ... do not try to vape the yellow snow :)