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10-21-2008, 10:14 PM Anonymous Electronic Inhalation Devices Hi there, First of all I would like to compliment the website. It contains a lot of very interesting and useful information, thank you for your time and efforts in putting it on the web. I was interested to note that there seems to be no mention of Electronic Inhalation Devices such as the Electronic Cigarette. What are your thoughts on these ? Although they cannot (yet) be classed as a 'Smoking Cessation Device' (as not enough research has been done on this yet), from personal experience I would class it as a 'Tobacco-smoking Cessation Device' as I have stopped using tobacco altogether since discovering this device (completely cigarette free for five months and counting !), even though I had no intention to do so when I first started using it, it was so easy ! Smoking tobacco is actually not an option for me anymore as I now intensely dislike the taste, but of course I cannot state that I no longer have an addiction. I am addicted to the use of the E-cigarette, although I have brought my nicotine usage down considerably compared to when I was still smoking cigarettes by using cartridges with Low to Non nicotine content. This proved to me that, for me at least, it's not the nicotine habit that's so hard to get rid of, it's more the action of smoking itself. The e-cigarette allows me this action of smoking with less risks than smoking tobacco. Needless to say, I am very happy with this excellent alternative ! Would love to hear any thoughts or opinions on this device. Cheers, Silver New Zealand

10-22-2008, 7:18 AM admin Joined on 12-06-2005 Posts 114 Re: Electronic Inhalation Devices Stay tuned.  We have just started researching these devices and right now they seem like genuine additions to the list of alternatives for smokers.  If they are as good as they appear to be we will be modifying our website to include information on these.    Report

10-22-2008, 6:59 PM Anonymous Re: Electronic Inhalation Devices That sounds great, I'm very happy to hear that ! A word of caution though, please make sure you test a good brand as the experience can otherwise be quite disappointing and contrary to what is actually achievable with these devices. There are various E-cigarette forums on the net where you can read/view excellent (video) reviews about various brands and generic E-cigarettes of different shapes and sizes (E-cigarette Penstyle, mini E-cigarette, E-cigar, E-pipe etc.). Please let me know if you'd like to be pointed in the right direction, would be glad to be of help. Cheers, Silver PS I registered right after posting, but have yet to received my confirmation e-mail. Should I be worried, or just a bit more patient ;-) ?

10-24-2008, 7:35 AM admin Joined on 12-06-2005 Posts 114 Re: Electronic Inhalation Devices We are just in the process of gathering samples and are keeping an eye out for reputable analyses which are just starting to come out. As to the registration.....I'll take a look though I think that might have been related to a previous forum that was discontinued.  You can communicate with us outside the forum by using the admin@tobaccoharmreduction.org address.  Thanks.    Report

11-26-2008, 6:44 PM Anonymous Re: Electronic Inhalation Devices Recent Clinical Journal of Medicine article states two cases of adult men experiencing psychosis from use of propylene glycol used in phenytoin injection USP. Both patients had to be switched to Cerebyx (Fosphenytoin Sodium) in order to avoid propylene glycol co-solvent.( Wikipedia Search "propylene glycol ") E-cigarettes contain propylene glycol. I'll stick with the snus.  Also tobacco contains the MAOI anti-depressant Harmine.

11-27-2008, 9:33 AM admin Joined on 12-06-2005 Posts 114 Re: Electronic Inhalation Devices I would not be too concerned about two cases that seem to involve circumstances quite removed from e-cigarette use.  However, it does bring up an interesting point.  As good as these new products appear to be, they are too new to have amassed the same kind of evidence that supports the logic of switching to smokeless tobacco from cigarettes.  For that we have evidence from decades and decades of use by thousands of people so we can be pretty confident about that strategy.  With e-cigarettes, almost all the harmful elements seem to be removed but we just don't have that crucial long term data.  However, despite that, and partly because smoking is so harmful, we would not discourage anyone from switching from smoking to e-smoking.      Report

12-24-2008, 11:01 PM Anonymous Re: Electronic Inhalation Devices This article about psychosis from polyeth glycol injection - is there a real citation anywhere?  It is mentioned on wikipedia but without a citation.  I put it as being every bit as correct as Wikipedia's announcement of the 750th anniversary of the United States Constitution.  (http://www.theonion.com/content/node/50902) There is a 4g/l serum concentation PEG dose cautioned about in the literature, but that is immense and a chronice dose (Food and Cosmetics Toxicology, Apr. 1972, 10(2), pages 151 - 162.)  It is far more than you'd get from ecigs, even should you drink the cartridge fluid.  A bottle of e-cig juice is 30 ml;  PEG weighs a bit more than water, (1 g /ml) - for the sake of argument, let's say it weighs 1.2 g/ml.  So that would be 36 g of PEG in the e-cig juice.  Drink all of it and assume all of it partitions into the 7L or so blood space right away.  That would indeed get you past 4g/l of PEG,  briefly.  You'd be violently ill from all the nicotine you just drank, and just barely over that 4g / l number before you heave.  (If you've never had so many cigarettes at a setting as to induce nausea, it's not fun.  I once kicked for a few months by doing just that.)   Realistically, the cartridges hold about 2 ml of liquid, I believe, and most people use 1-2 carts a day from what I'm reading. PEG is not an issue with these devices, as far as I can see.   The best research on them I've seen is from an anti-smoking group in New Zealand, who identify a number of compounds of concern in the vapor and suggest that as manufacturing processes improve, these compounds may be eliminated. The research was funded by an ecig maker, but it's the closest thing to "real" research I've seen yet.  PEG is not a compound the researchers ID'ed as being of interest;  acetaldehyde and benzene were.  Right now, most e-smoke refills are made in China.  If the FDA recognized the devices and the solution and its formulations, it could be manufactured in factories that would be inspected.  I expect that doing so would eliminate the actually somewat dangerous compounds  from the "juice."  The "juice" might, however, scream up in cost.  One of the reasons Nicorette is unsuccessful is that it's very slowly absorbed and not remotely useful in replacing the fast freebase nicotine hit from smoking, and another is that a box of the gum is stupid expensive.   Let's face it: it is just nicotine in high quality chewing gum.  It should not cost as much as a carton of smokes for 110 pieces of gum.  It should save you money and be as effective as what it replaces.  Since nicorette accomplishes neither goal, there are a lot of folks it just doesn't work for.  The nasal spray looked to be  of marginal interest to me, but I never did get a prescription for it - it did look as if I could control my own dose, but I've had bad experiences with nasal sprays triggering horrendous sinus complications before.  The chance that this would do so made me unwilling to give it a go. Let me be honest:  I actually like smoking quite a bit.  There is a transgressive social signal behind a cigarette that is very interesting.  Being able to control my own dosing is great.  I am someone who notices - and benefits from - the improvement in attention and IQ that comes with nicotine intoxication.  (Don't believe me on the IQ thing?  Take a read through the chapter n Goodman and Gilman on nicotine, get back to me.  I believe we're talking Chapter 8, but my copy is in storage.)  I am, however, increasingly aware (24 years in) of decreasing lung function and dental issues.  The ecigarette looks to me to be a drug delivery system that might actually help alleviate these symptoms.  I fully intend to maintain my addiction to nicotine itself for as long as I find the effects rewarding, quite possibly until I die.  And at this point, odds are I will die a few years early because of my indulgence.  So be it.  It might be nice if the emphysema were less intense, though.  (As you've probably already figured out, I could give you a lecture with footnotes on why people should not smoke, from an epidemiological or a biochemical standpoint.  I can discuss the morbidity associated with smoking in some detail, but I can also explain quite a bit of the reward mechanisms engaged by smoking.)  http://www.healthnz.co.nz/coynews.htm is the site of the NZ group testing one brand of e-smokes.

01-25-2009, 6:36 PM Anonymous Re: Electronic Inhalation Devices There are now 4 English speaking forums. e-cigarette.com, e-cigforum.com, righttovape.com, and e-cigcentral. E-cignews.com collects the latest news.

02-11-2009, 1:17 PM admin Joined on 12-06-2005 Posts 114 Re: Electronic Inhalation Devices Just to follow up on the propylene glycol concerns.   It is quite safe as long as it is not ingested.  See the following excerpt from a Material Safety Data Sheet.. sourced from http://www.ertco.com/msds_propylene.html Potential Health Effects ---------------------------------- Inhalation: No adverse health effects via inhalation. Ingestion: Relatively non-toxic. Ingestion of sizable amount (over 100ml) may cause some gastrointestinal upset and temporary central nervous system depression. Effects appear more severe in individuals with kidney problems. Skin Contact: Mild irritant and defatting agent, especially on prolonged contact. Eye Contact: May cause transitory stinging and tearing. Chronic Exposure: Lactic acidosis, stupor and seizures have been reported following chronic ingestion. Aggravation of Pre-existing Conditions: Kidney disorders.    Report

02-15-2009, 3:00 AM Anonymous Re: Electronic Inhalation Devices I smoked for 30 years, but only had serious health deficits in the last 5. Got to where I could not climb a flight of stairs without gasping and I was coughing up nasty gunk 24/7. I'd quit and just go nuts--rage, desperation, you know. Anyway, the last time I quit smoking, in 2005, I tapered down to zero on nicotine replacement therapy (NRT), went nuts, and this time, went back on NRT, instead of back to the cigarettes. So far, this is working for me--I don't need a prescription for the nasal spray because I live in the UK. I use a high-dosage patch (21-mg) every day, and nasal spray as needed (this is called "combination therapy"). This is very expensive, so I'm trying to find out more about the e-cigarettes. Sometimes, you get busybody pharmacists who give you a hard time, but this stuff is available, usually cheaper, on the internet, Advantages of nasal spray include: (1) you control the dose and (2) it is the only NRT product with a "kick"--not quite like a cigarette, but near enough. Disadvantages include (1) it burns the first few days you use it, (2) it is way, way too expensive, (3) pharmacists and other medical health professionals are still stuck with the old quit nicotine or die false treatment dichotomy, so any time you have to deal with them, you get harassed for absolutely no good reason, and (4) it does not provide the same level of cognitive benefit as cigarettes do--in fact, it took me over two years on NRT to get back to levels of intellectual functioning even close to those I had when I smoked. Is anybody aware of any studies on the pharmacokinetic properties of e-cigarettes? You can find data on NRT products easily enough, but I haven't found any data on e-cigs. We're going to have to wait a decade or so for longterm safety studies, I think.

02-17-2009, 8:48 AM admin Joined on 12-06-2005 Posts 114 Re: Electronic Inhalation Devices You are right in that we do need a few decades of use to be better certain of long range effects.  As to studies, see our references on what there is so far at Research Bibliography - Electronic Cigarettes.  We will keep adding to this.    Report

02-23-2009, 12:06 AM Anonymous Re: Electronic Inhalation Devices <BLOCKQUOTE><table width="85%"><tr><td class="txt4"><img src="/Forum/Themes/default/images/icon-quote.gif">&nbsp;<strong>admin wrote:</strong></td></tr><tr><td class="quoteTable"><table width="100%"><tr><td width="100%" valign="top" class="txt4">You are right in that we do need a few decades of use to be better certain of long range effects.  As to studies, see our references on what there is so far at <a href="http://www.tobaccoharmreduction.org/bibliography.htm">Research Bibliography - Electronic Cigarettes</a>.  We will keep adding to this.<br></td></tr></table></td></tr></table></BLOCKQUOTE> Hi admin, Not sure if you are aware of this, but there is a slightly newer version of Dr. Murray Laugesen's report. It can be found here: http://www.healthnz.co.nz/RuyanCartridgeReport30-Oct-08.pdf. Kind Regards, Silver

02-23-2009, 10:37 AM admin Joined on 12-06-2005 Posts 114 Re: Electronic Inhalation Devices Thanks...missed that somehow.    Report

04-01-2009, 11:32 AM Anonymous Re: Electronic Inhalation Devices Admin, Has there been any further developments or opinions in your studies ? Especially now since Health Canada has taken the stance of putting a stop to all electronic cigarette's (presonal vapourizers for the purpose of inhaling nicotine) importing, marketing or sales there of. See Link: http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2009/2009_53-eng.php Any insite or response from you would be greatly appreaciated considering I'm about to become a blackmarket supporter as opposed to a dead duck by returning to my old "analog" tobacco cigarette habbit. Respecfully, Greg Stark, Ottawa

04-06-2009, 7:53 AM admin Joined on 12-06-2005 Posts 114 Re: Electronic Inhalation Devices If you looked at our electronic cigarettes FAQ you will see that we did post links to the Health Canada advisories. As we already have stated, we suspect that at least part of their response is practical, that is that they are dealing with a product that has little quality control and also does not perfectly fit into their preordained categories.  Part of the job of Health Canada is to help determine risks associated with new products even if those products are obviously safer than others already on the market.  That being said, we do not think this is fair to nicotine users.  And accepting that Health Canada's actions are bureaucratically appropriate, their actions are still encouraging unhealthier alternatives. There is little doubt that esmoking or vaping is much safer than smoking and ultimately you have to make your own health decisions.  Put it another way, their job is to see if a product will make anyone ill and then communicate that (like the warnings on cigarettes) but it is not their job (though it would be better for everyone if it were) to communicate which alternatives were safer.  This is one of those cases where it is so obviously safer than smoking, that it would be better for them to do their testing while leaving the product on the market.  They could simply communicate their concerns that it is not perfectly explored and then let consumers decide whether they want to choose a product that is known to be very dangerous or one that might have some little harm attached.    Report

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