posted by Carl V Phillips
I am going to keep brainstorming this (clearly related though somewhat tangential) subtopic that I started here, which has produced some useful feedback.
Based on numerous conversations I have had two different meetings since making that post, as well as the comments on that post, I think there is a need to dramatically increase the emphasis on the hardware specs and conditions, as compared to my original portrayal. That is, I mentioned that we need to study the mapping from e-cigarette liquid chemistry to vapor chemistry as a function of the hardware used. But I did not put enough emphasis on the latter bit.
While we are not going to be able to test every possible configuration, we should at least carefully examine the effects (on the liquid->vapor relationship) of different heat and power levels, as well as such things as what happens when the atomizer is heated dry. We should also want to know what changes as components get old. As noted in the previous comments, there are too many variables but if we can see what happens to a high-quality, pure, relatively typical liquid under varying circumstances, that would be useful.
The next step after that — dramatically more expensive and harder to do, but useful — is to look for human biomarker changes. A bit of this had been done, but it is very limited. It should also be tied back to the chemistry — given how much more expensive human subjects research is, it should always be combined with a chemical analysis of what is being vaped. Perhaps we will have to wait until very large companies want to test their specific highly standardized products this way, perhaps to please regulators, but the results will also offer useful general knowledge.
Moving on from chemistry, I will branch the conversation into other areas of research. We really need to collect the many personal testimonials about quitting smoking using e-cigarettes and analyze them. In this case, by “we” I mean not a vague “the scientific community” or “humanity”, but CASAA in particular. We have been planning to do that, and will start on that soon.
It would likewise be nice to have more of the data about how much product is actually being sold and how many people are consuming it. This is not all that difficult to know, in theory, but there is remarkably little public information.
Finally, going beyond the relatively easy observations in the social science situation to actively create information, it would be valuable to understand more about users who fall in between trialers/beginners and the category I call “aficionados” (basically anyone who uses mods). They are most of the users, almost certainly, and growing. But are they really happy with the products they are using? Are they at risk of relapse to cigarettes? What would improve their vaping experience? We have some good guesses about those, but learning more could improve THR efforts.
That is what I have for now. I open the floor to comments, which are most welcome.
Tobacco harm reduction, anti-THR lies, and related topics 
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In a comment a made on the first post of Prof Phillips about the research agenda, i mentioned the fact that different voltage/wattage vaping is an important issue that should be investigated. “Dry burning” also can give us valuable information, but i think that they will not be applicable to real situations because users can understand dry buning almost immediately. I also agree that testing the huge variety of products currently available to the market is impossible.
I would like Prof Phillips to expand his view about biomarkers. In smoking,. studies evaluating biomarkers are focused on markers of inflammation, thrombosis and oxidative stress. Is this what you mean by talking about biomarkers or you refer to measurements of vapor components in blood (like formaldehyde, acrolein etc)?
Puzzled as to why you wouldn’t want to find out more about ‘trialers/beginners’ and their experiences also. Particularly the paradox that most people are going to start with the most prevalent product (the disposable cig-a-like types) because of superficial similarity to cigarettes, price and availability but they are the lowest performance product (though this seems to be improving) that will be least likely to satisfy as an alternative to smoked cigs.
There’s lots of potentially useful stuff that you could get from a first time users – how their experiences matched to expectations, what were the barriers to use, reasons for giving up and going back to smoked… and so on. Obviously, everybody started off at this stage first, so it makes sense to try and minimise barriers to use at this stage rather than one step on?
Was thinking of a (necessarily limited in scope) MSc project for myself that looked at that, a small qualitative case series maybe. The problem I kept on coming back to was recruitment – it’s pretty easy to recruit enthused vapers to tell you about their experiences and what worked for them, ‘normal’ first time users not so much. Best I have come up with so far is recruiting a small number of first time users at purchase from a friendly local shop that would let me, initial interview, then a follow up. However ceasing use after initial trial seems pretty common, so I’m not sure that even this is feasible…
Rory, maybe you could interest one of the e-cig manufacturers in providing some minimum no-strings support for your research if you outlined the project well. E.G. maybe they’d be willing to supply you with a couple of dozen “starter kits” at cost or even a bit below cost (since your research would likely be beneficial to them in the long run).
You could then devise a survey aimed at people who’ve never tried e-cigs but have thought about it or had some interest in it. From the respondents, you could select those who seem most sincere/interested/responsible and offer them a free (or very low-cost, covering perhaps your own basic cost) kit with the understanding that they’d respond to two or three future surveys over the next six months or a year. (Actually, you’d probably want to do the first part of your surveying before contacting the e-cig folks for the samples.)
There’d be a lot of good research that could be done out there with this sort of model, but the big hangup is probably funding. The 500 million dollars + per year that the “Tobacco Control” folks is unreachable for any “heretics” and obviously tobacco companies wouldn’t be interested. Is the e-cig industry large enough at this point that you’d be able to get enough sample kits to run at least a trial research project? Dunno, but maybe some of the people here would.
Michael J. McFadden
Author of “Dissecting Antismokers’ Brains”
hmm, would rather not go down the ‘offer incentive of free stuff’ route to secure recruitment, introduces some bias in the kind of participant you’d get and would prefer to get a more naturalistic group of people, if at all possible.
also an area of interest is to what degree cost of the replacement product is a barrier/facilitator. a lot of introductory e-cigs make pretty extravagant claims in terms of cigarette equivalence that might not be borne out in reality. (there are tales of people getting through many more cartridges that the manufacturers’ ‘cigarette equivalence’ suggests so the degree to which switchers actually save costs could be overstated and disappointing to the switcher). can’t do that if you give out the stuff for free.
If you watch the recent statement by John Dalli, he mentions that his intentions were to regulate the amount of nicotine in the electronic cigarette cartridges. See : http://www.youtube.com/watch?v=vwOJNrenKxo
This is simply not feasible. In Australia and New Zealand, the Elusion Electronic cigarette brand has failed to maintain many people that I have talked to, to stay off tobacco smoke simply because their pre-filled cartridges are both extremely expensive and do not contain enough nicotine to simulate the sensations of smoking. Most vapers mix their own liquids purchasing the nicotine, flavour and base (PG/VG). I myself vape at 2% nicotine (20mg/mL). I use a range of batteries (Provari, eGo), and a range of cartridge types (Boge, CE# variants, and Genesis).
The Boges are a vertical coiling device wrapped in a coil cloth , and are extremely popular in the vaping community world wide. See my schematic : http://i.imgur.com/asYfh.png
The convential atomisers and CE varients (CE2,CE3,CE4,Stardusts,ViviNovas) have a similar design consisting of a horizontal coil, with a silica wick passing through it. See this schematic ; http://i.imgur.com/yNOgP.jpg (this diagram is not mine)
The Genesis cartridges (or tanks) use an oxidized stainless steel mesh as a wick. See this photo : http://i.imgur.com/VBwxv.jpg (not mine).
There are many cartridges out there, but all have the basic design type of the three above. See : http://i.imgur.com/9dBz2.jpg
What you also have to remember is that the transfer to vaping is very much a lifestyle change. Most people who are willing to take the leap and change lifestyles often want variety and choice involved. The availability of different types of batteries, different types of cartridges, different types of propylene glycol/Vegetable Glycern ratio mixes, different concentrations of nicotine, and of course the thousands of different flavors, has been a very strong factor in attracting lifetyle changers who are open to new experiences and crave diversity and individuality – something that the electronic cigarette industry offers.
There are some batteries that have a puff counter function – which is useful. However, attempting to normalize cartridges to pump out an exact amount of nicotine per puff could be very damaging for the ecig industry, as the very well known VTF (Vapour-Throat Hit-Flavor) factor preferences for every individual is different. It would however, be valuable, not only for industry regulation, but for pro-consumer choice, if manufacturers of the cartridges were able to test and describe how much nicotine and total vapour comes out of a cartridge in relation to how much electricity is pumped into it. The consumers of e-cig products would actually love that, as it provides more choice and specifications, and those manufacturers who first get onto this factor will definitely see an increase in sales – just another way Capitalism solves problems.
I have another idea for helping promote personally responsible nicotine usage. And it is quite simple. On almost all e-cig vendor websites, there are “Do it Yourself” (DIY) products that often display the ejuice mixing bottles, for which we mix our three components of e-liquid (PG/VG, Nicotine, Flavour).
While I do believe in individual freedoms and choice, I do have a strong opinion that all vendors should be selling ejuice mixing bottles with measuring gradients on them. Currently, these bottles are very hard to attain. Currently, I use a measuring cylinder to empty my ejuice into at the end of each day and I calculate the amount of e-liquid I consumed throughout the day before dispensing it back into my bottle. Since I know my nicotine concentration, I know my exact nicotine intake to the milligram. Selling volume gradient marked bottles to vapers would be very helpful in helping people know how much nicotine they are taking in each day.
I also only buy my nicotine from places that quality control certify their nicotine liquids, and measure the level of nitrosamines. I also test my liquids when they arrive with a nicotine titration test kit. There have been talks on the forums about people setting up a nicotine testing services, where you could send a sample of your newly arrived bottle of stock nicotine and receive an accurate measurement of it’s nicotine content (if you are not willing to trust the company you bought it from).
I do believe that this industry can self regulate.
As Rory implies, there are no cost savings to be made by a smoker switching to a mini e-cigarette with pre-filled cartomisers, since the ‘cigarette equivalence’ for these products is usually vastly overstated. Example: a regular pre-filled carto, in reality, contains the ‘equivalent’ of around 6 cigarettes, not the 20 or more frequently claimed. At the usual £2.50 or $2.50 purchase price (or more), it is actually more expensive to vape than to smoke, in many locations. (I place the term ‘equivalent’ in inverted commas as it is not a defined descriptor.) The UK price of many consumer products is the US price with the currency changed, i.e. about 33% or so higher.
Ecig users make their 1st-level savings when they learn how to refill cartos, their 2nd-level savings when they buy in bulk to refill tanks etc., and the 3rd-level savings (if desired) are achieved by DIY mixing.
And in connection with the above, it also needs to be recognised that a clinical study of ecig users that utilises minis with pre-filled cartos (a sub-optimal methodology, now, though) would need to provide sufficient materials to replace the smoker’s previous habit. A 20-a-day smoker consumes 3 or so cartos per day.
Clinical studies are better performed using modern technology, not the obsolete models of 6 years ago – assuming that successful transition is the desired objective, or at least useful during the trial. 92% of smokers who started with a mini upgrade to a mid-size model or larger.
yep, I think the large trial ongoing in NZ comparing e-cigs with a patch uses minis (reports of battery failure being a big prob), so less then optimal.
of course, in time and given the right conditions the technology will trickle down to improve the experience for those dabbling with minis also. really, it *needs* to, because minis seem the point of entry.
you mention 92% of smokers who started with a mini upgrade to a mid-size device, but I suspect a larger number don’t persist with use (who are obviously unseen when you look at the vaping community, because they never form part of it). trial rates could be high, conversion rates could be low (or at least that is my suspicion from some limited data I’ve seen).
a slightly tangential issue, but something that occurred from Mav’s longer comment above, is that we can’t expect the ‘average’ new user to be as interested in the details of the tech and how to optimise as are today’s current committed vapers. all the technology stuff has a nerdy attraction for me, but certainly not for everyone – some people will just want it to work well immediately, with minimal knowledge of the working systems, as people expect from most other consumer items.
I bought a small cigarette type ecig about three or four years ago. It was useless. this year the Raconteur section of the Times featured ecigs and this persuaded me to give them one last go. I bought a Jac VGO, which does deliver sufficient nicotine. All the talk about doses of nicotine is scaremongering propaganda by the anti tobacco industry. You put 25 drops in the cartridge, and that’s the maximum which goes into your body. It’s impossible to put a harmful dose in the cartidge. It won’t be absorbed. I don’t think it is a good idea to engage in a debate with these people on their terms. Better to point out that for years, nicotine gum has been less regulated than paracetamol, that there is nothing to stop someone chewing ten pieces at a time, and that nobody has died – although there was a case of a school child being sick when gum was handed out at his school by anti tobacco campaigners. If nicotine were harmful, it would be sold like paracetamol.
I’ll go further. As a drug, nicotine is on a par with caffeine. Whether or not people use ecigs or snus is an irrelevance. Busybody anti tobacco (actually now, they have shown themselves to be anti nicotine) and tax money research troughers should be told at every opportunity to wind their necks in and spend their years on this earth doing something useful.