Real public health research on e-cigarettes?

by Carl V Phillips

A funny thing appeared in the abstracts for the upcoming meeting of the Society for Research on Nicotine and Tobacco (SRNT).  Buried amidst the few dozen abstracts about e-cigarettes from the “public health” people is some actual public health research (i.e., research that could inform messages and regulation that would help people be healthier).

Most of the abstracts on e-cigarettes are just dumb make-work projects, presumably by people trying to justify their employment.  There are numerous surveys of attitudes, which mostly just reflect how the questions were asked and are changing by the month, and other variations on how to provide no useful information other than perhaps a historical record about the social dynamics of THR adoption (I will probably try to mine them for that).

Not surprisingly, many of the supposed social science projects violate the ethical norms of social science by using the concocted term “ENDS” rather than using the population’s preferred terminology for e-cigarettes.  This offers absolutely no scientific benefit (e.g., it does not more precisely define the behavior) and was clearly designed to be somewhat derogatory, but most of all it is designed to assert researcher primacy over a population’s own self-identity.  Some types of scientists can make up words when they are helpful, and political actors can have some fun with it when describing the powerful (e.g., “ANTZ”); people doing sociological research are ethically obliged to respect the populations they are studying.  Imagine researchers making up a patronizing name to refer to a self-identifying ethnic/cultural group; their writing would generate serious deserved backlash and be refused by any respectable journal or research organization.  This alone says a lot about these “researchers” and SRNT.

Most of the abstracts contain disinformation and, indeed, the one that I am highlighting has disinformation built into it (see below) despite its possible value.  It is by Alan L. Shihadeh and Thomas Eissenberg, who unlike their SRNT colleagues seem to be trying to do useful work and have some inkling of what useful science looks like.

(However, in spite of his increasingly valuable contributions, I believe the latter still owes the world an apology and/or retraction for his widely-cited publication that claimed that e-cigarettes do not deliver nicotine.  Politicians and activists make errors like that all the time and then pretend it never happened; scientists who make the mistake of epistemic immodesty need to rise to a higher ethical standard.  In science, the phrase “our one-off limited empirical study found something contrary to what all the previous evidence suggests” should always be followed by “so we probably did something wrong, so please ignore this result until we do additional research” rather than by “and therefore what everyone knew before was wrong” (or, better still, they should do the additional research to explain the discrepancy before publishing).  He does however get credit for trapping the ANTZ into starkly illustrating that science is just window-dressing to them and they do not really care what it shows:  When they were foolish enough to believe his claim, they condemned e-cigarettes as failures because they do not provide nicotine.  After it became clear that his claim was wrong, they condemned e-cigarettes because they effectively deliver evil evil nicotine.)

The abstract (or just skip down to my observations about it if you are in a hurry – there is really just one important point in it):

Background: “Electronic cigarettes” (ECIGs) heat a nicotine-containing solution to produce a vapor for inhalation. There is considerable variability in device characteristics and puff topography and each of these factors may be related to vapor toxicant content.

Method: We investigated the role of device voltage and puff duration on vapor toxicant content. We examined total particulate matter, nicotine, and volatile aldehyde emissions from 15 consecutive puffs of V4L™ ECIG cartridges (18 mg/ml nicotine) while varying device voltage (3.7 vs 5.2 volts) and machine-produced puff duration (1.8 vs 3.6 s). We used a puff velocity of 38.8 ml/s and 10 s interpuff interval (Goniewicz et al., 2012). In another study, we investigated a non-cartridge ECIG use method that involves dripping nicotine containing liquid directly onto a heating element and inhaling the resulting vapors. We measured aldehyde emissions from dripping 3 drops of e-liquid (16 microL, similar to the amount of e-liquid consumed in 15 e-cig puffs) onto a 300 C heater surface.

Results: The higher voltage tripled vapor nicotine content, and doubling puff duration doubled nicotine content. We also found that longer puffs resulted in greater cartridge temperatures, and that, for a given puff duration, higher puff velocities resulted in lower temperatures. Dripping liquid onto a heater surface produced more than 200 micrograms of formaldehyde, compared to 0.03 micrograms for 15 puffs of an ECIG cartridge (V4L™cartridge, topography of Goniewicz et al., 2012). We also measured 2-20 fold greater emissions of other aldehydes (9 species in total).

Conclusions: Overall, these results demonstrate that device characteristics (e.g., voltage), puff topography, and use behavior (i.e.,“dripping”) can influence vapor toxicant content. Indeed, these findings suggest that ECIG aficionados who take longer duration, slower puffs (Hua et al., 2011) are working to obtain higher nicotine doses and that those who drip liquid directlyon the heater (McQueen et al., 2011) risk significant exposure to formaldehyde that is a human carcinogen and is associated with COPD in conventional tobacco product users.

Most of the results fall into the “incredibly obvious” category:  Faster puffs result in lower temperatures (because more cool liquid moves across the atomizer, cooling it faster than it can heat).  Longer puffs extracted more nicotine, approximately proportional to the length of the puff (anyone surprised by that?).

It was interesting to see how much delivery (reported as nicotine quantities, but that is obviously just a measure of how much total liquid was aerosolized) increased with the increase in voltage.  This, of course, is not some universal finding for the ages, like something that might be discovered about the behavior of a molecule (though undoubtedly countless naive readers will interpret it as such).  Every result in this research depends heavily on the exact variables of the equipment and other methods they were using, and every device and every user is different.  But the authors get credit for actually varying a few of the variables a bit.  Reading most of the research on e-cigarettes would give the impression that there are no such variables, so actually the authors get a lot of credit for starting to correct that error.

The result that is potentially real health-affecting knowledge (unlike, as far as I can tell, every other bit of research on e-cigarettes in the SRNT abstracts) is the result of dripping e-cigarette liquid onto a heater at 300C.  This result is, unfortunately, also the germ of more disinformation because this is far hotter than what actually occurs (except, perhaps, with a seriously ill-advised novelty mod).  This presumably explains why the concentration of formaldehyde they found is enormously higher than that observed in analyses of real e-cigarette vapor.  Even if you preheat an atomizer to that temperature before dripping on it, it will rapidly cool toward an equilibrium temperature.  I am guessing that the “heater surface” they used was a piece of lab equipment that has a much larger mass than an atomizer filament, and thus maintained close to the original temperature rather than rapidly cooling when the first bit of liquid touched it.

We can safely assume that some people will spin this result as showing that e-cigarettes generate this quantity of formaldehyde, and thus the way the information was presented is a gift to the liars.  (Perhaps such an offering to the liars is the price of admission to SRNT.)  Still, this might offer a genuine contribution to health.  It does suggest that using very-high-temperature mods or a high preheating of the atomizer (by holding the switch on for too long before starting to draw) might increases vapors’ health risks.  Even if most of the liquid would not be heated to 300C, a bit of it might.  That is intuitive if you think about it:  higher peak temperature = more pyrolysis = more nasty chemicals.  But it is not clear there has been much thinking about it.

There should be more.  Good scientists who have more knowledge than I about the chemistry should really think this through — a little bit of theory and existing general knowledge would be worth for more than a series of one-off experiments on particular equipment.  If there is going to be any actual health-improving research about e-cigarettes, it obviously will not be the attempts to demonize them out of existence, but it also cannot be the attempts to claim everything about them is always just fine.  Real public health researchers do not behave like “public health” people who just look for an excuse to say “never do this, no matter how much you want to”; they figure out how to advise “if you are going to do this, you are better off doing it this way….”  This is, of course, the reasoning behind THR in the first place, and also describes what real health research about nicotine inhaler technologies should look like.  I suspect that most of this public health learning will have to wait until the tobacco companies report what they are doing, but it is good that at least one independent research team is headed in that direction.

Advertisements

45 responses to “Real public health research on e-cigarettes?

  1. Konstantinos Farsalinos

    Very interesting studies, however i have some serious objections. For example, how did they define that 10sec interpuff interval is a realistic measure? In my opinion, and based on research i have done by observing and recording real e-cigarette users (currently preparing a manuscript for it), it is completely unrealistic. Additionally, 15 puffs from 16microL liquid is also non-realistic. My observations have indicated that the mean puff consumption in experienced e-cigarette users is approximately 4-5mg of liquid per puff. Taking into account that the specific weight of liquid is at least 1.1, we get a measure of 4.4-5.5microL per puff. For these measurements, we used a commonly-available eGO battery with a common atomiser (type CE).

    • Carl V Phillips

      I am not sure the inter-puff time matters much at all, so long as it is enough to allow a few seconds of cooling. Right? I think it is an artifact of people not realizing that the methods for cigarettes do not necessarily apply.

      Your observations about quantity, though, are definitely not easily dismissed, and is good to keep in mind. What do you think the ramifications of that is for what was reported in the abstract (realizing, of course, that we have limited info from it)?

      Thanks for the input.

      • Konstantinos Farsalinos

        I must say that the interpuff interval plays a major role, depending on the device you use. For example, i used an eGO-C atomiser for a clinical study and asked users to use it intensively (at least one puff every 30 seconds). Most of the experienced users reproduced the “dry puff” phenomenon (unpleasant burning taste due to insufficient cooling and liquid supply to the wick) and device overheating. Some of them managed to destroy the resistance (so i had to replace the atomiser), while in others the device did not produce any vapor due to overheating. And this was not due to a defective device; i had 3 different eGO-C devices for the trial and i experienced similar things with all of them.
        Concerning the issue of consumption, once again it has to do with the phenomenon of “dry puff”. Most probably, during this phenomenon some toxic substances are produced. Although in the laboratory setting you can never detect it, it is detected by the users. So, if you reproduce this phenomenon in the experimental setting you are in fact performing an experiment with conditions that are never applicable in real use. This has significant implications for the quality of the study. In fact, every atomizer has different functional characteristics and the user adjusts the way they use it according to these chracteristics. I have plenty of examples from our laboratory studies evaluating the cytotoxicity of e-cigarette vapor on cultured cells on how misuse of the device can produce bad results that however do not represent real-use conditions.

        • Carl V Phillips

          Thanks. That is really useful to know. Well, I suppose it is not that critical for me to know, since I will not be doing the lab work. I hope that Eissenberg et al. read this blog (or otherwise learn from you).

    • “My observations have indicated that the mean puff consumption in experienced e-cigarette users is approximately 4-5mg of liquid per puff.”

      Wait, what ? 4-5mg of liquid PER PUFF ??? Shurely shome mishtake.

      Try 4-5mg of liquid PER 24 HOURS. That’s if you puff all day and half the night too and easily includes that sneaky puff when you get up in the middle of the night for a pee.

      This, for me, with an EGO-T standard 1100mah battery – 2.0 ohms atomiser – 16mg (nicotine content) e-liquid in a 2.4ml Kanger tank filled up to twice a day.

      “…. misuse of the device can produce bad results that however do not represent real-use conditions.”

      Yep. A simple fact is that smoking using an e-cig or atomiser is completely different to smoking a cigarette and you’ll have to retrain your habit to mimic old ways. Longer, measured draws on your chosen device are needed to produce vapour resembling a ciggy-like amount of smoke.

      Hence the enormous disparity in manufacturers claims of pre-filled cartridges being equivalent to X amount of cigarettes to what you’ll actually get for your cash.

      • Tatty, please have a look once again to what i wrote. I suppose you understand that 4-5mg (milligrams, that is weight) are completely different from the 4-5ml (milliliters) that you probably imply in your comment. 4-5mg is about 0.0044-0.0055ml (milliliters) of liquid.

  2. ” Imagine researchers making up a patronizing name to refer to a self-identifying ethnic/cultural group; their writing would generate serious deserved backlash and be refused by any respectable journal or research organization.”

    Very true, as is your point about needing to add the proper “window dressing” to get your results accepted. Note the abstract of Bofetta’s 1998 WHO study: the ONLY statistically significant finding of the entire study, that children of smokers got 22% *LESS* lung cancer than children of nonsmokers, was formally dismissed as showing “no association.” Meanwhile the non-significant findings were shown as supporting the secondhand smoke theory.

    As for the tobacco companies… I can only expect that the hard core Antis out there are drooling for the hope that Big Tobacco will jump heavily into e-cigs. Right now the Antis have very little in the way of a coherent enemy or villain to fight in the e-cig area. As soon as BigT is heavily involved they’ll be able to dismiss all ameliorative research as “typical tobacco company propaganda.”

    It will be interesting to see how things develop. Meanwhile, let’s hope some of the more honest and clever researchers find ways to continue to sneak touches of honest good research past the fanatics.

    – MJM

  3. Jonathan Bagley

    I’m touched that so many people are concerned about my health. If I was living in a malarial swamp rather than puffing an ecig in a warm house, this concern would be worthwhile. Some days I start to think they have an ulterior motive. But I am a bit of a cynic.

    • Konstantinos Farsalinos

      I have noticed that you always make that kind of comments. I suppose you undestand that besides you there are several millions of people that are using e-cigarettes. Most of them are probably more interested than you in knowing all the facts about their use and the related benefits and risks. You should also realize the possibility that some researchers may also be e-cigarette users, so they might work for their personal interest. Finally, you are free to not follow all the work done by Prof Phillips and many others.

      • Carl V Phillips

        Just for the record, I did not interpret Johnathan’s comment as being aimed at me (but can be corrected if I am wrong). Recall that my point was that true public health research is about improving health and the best public health research discovers how to do that without making people less happy. Discovering that particular variants on vaping methods produce higher risk (*if* that is really done — the caveats in the text and the many comments to notice how big an “if” that is in this case), and thereby suggesting other methods instead, seems totally unobjectionable. It is the pretend scientists doing “attitudes and knowledge” research that you should complain about.

  4. Dr. P;
    First, as a vaper now coming up on four years smoke-free, please accept my thanks and my gratitude for the work you’re doing. To the extent it keeps–or at least slows down–the attempts of those sanctimonious $%*bags to get their hands on our harm-reduced nicotine delivery mechanism of choice, you’re saving lives.
    Now to my real question–any chance those formaldehyde levels could be put in perspective? I checked the OHSA standards (http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=10075&p_table=STANDARDS) and the discussion was all about parts per, rather than raw weights. Apples, oranges. The MSDS I was able to find linked from the Wikipedia page (https://www1.fishersci.com/ecomm/servlet/msdsproxy?LBCID=08350875&productName=F75P1GAL&productDescription=FORMALDEHYDE+POLY+1GAL&catNo=F75P1GAL&vendorId=VN00033897&storeId=10652) was a bit more helpful, and the PEL numbers there sound to me as if amounts in the mcg range would likely be trivial. Perhaps comparable to most THR nitrosamine levels? So… is 0.3mcg a significant amount from a health standpoint? Is 200? The dose makes the poison, as we all know, particularly with regard to a natural chemical like formaldehyde.
    Warmest regards, and keep the faith!
    — Brian Scherrer

    • Carl V Phillips

      Good questions, and I am going to punt them down the road a bit, hoping that the expert report we commissioned will give a better answer than I can, especially for the lower numbers. You are right that inhalation standards are almost always based on “if you breathed some relatively low quantity all day” rather than “you had a few highly concentrated puffs”, and the same quantity does not necessarily have the same health implications under those different scenarios.

      It is reasonable to say that if anything remotely similar to the process that generates 200 micrograms from just 3 drops is occurring sometimes [UPDATE: and do not forget that I pointed out in the post that this seemed to not represent real vaping], that is definitely worth making some effort to avoid. It could conceivably push into the range that is no longer generally considered “safe enough to not worry” in terms of non-cancer effects and the cancer risk increases with dose (even if it remains small compared to smoking). Unfortunately, we need to know a bit more (like what actual dripping in various ways generates) before this can translate into concrete advice.

  5. Couple of points:
    #1: The puff interval is relevant in real-world applications because a short interval does not allow liquid to wick to the heater coil and re-load it. Enough time needs to be allowed for full wicking by capillary action, otherwise the coil will be dry to a greater or lesser extent, therefore hotter, therefore more pyrolysis will occur. The problem is that all heads (the heater/reservoir devices) and liquids (because they have differing viscosities) – and especially combinations thereof, obviously – require a differing minimum interval. This is very simply determined by the user. It cannot be determined by a machine. For purposes of safe measurement, uniformity, and repeatability, and especially for the purpose of establishing protocols, a minimum puff interval of 20 seconds should be used. This will always be sufficient; a shorter interval may conceivably not be.

    This basically points up that a technical expert should always be asked to consult. They never are. This tends to open researchers to allegations of incompetence, since so many trials are incompetently managed. This isn’t just an accusation, I can show you photographs they themselves have provided of erroneous protocols in use.

    #2: Carl is right to point up the issue of the 300C heater coil. Since a red-hot coil at this temperature is never employed in practice, and the highest normal temperature seen is around 70C and unlikely to exceed 100C, it raises questions, again, about the researchers competence, and their agenda. No vaper would dry-burn a coil then drip onto it – that just doesn’t make any sense. An atomiser is a liquid-cooled immersed heating element like a kettle’s; trying to make out it is something else is going too far. The user will easily determine that the atomising function is not correctly managed; a machine cannot do that. A machine will happily accept vapour that basically includes smoke, whereas a real user would choke. A machine will accept vapour with melted plastic compounds in it from extreme overheating (as has been offered previously in such poorly-managed trials), when a user certainly won’t.

    What exactly is going on here?

    • Konstantinos Farsalinos

      I agree with almost everything Chris said,, however i disagree that 20 seconds interval is fine with every device. It is not fine with Ego-C and 510-T atomizers. And i mention these two because i have done experiments (clinical and laboratory) with these atomizers. And i know that even 30 seconds may not be enough in real situations. Unless the time of activation is just 1 or 2 seconds, which is then unrealistic compared to the real e-cigarette use by experienced users.

      • That is interesting, Konstantinos. I haven’t tried that type of atomiser/tank. Useful to know. It sounds remarkably inefficient.

        There is also the point that some systems require the user to tilt the device occasionally, in order for it to re-load correctly. Perhaps that atomizer tank system is one of those. I don’t think these kinds of head (atomiser/reservoir fitting) can be used in lab tests, although they may well be.

        • Interesting. Anyone else get the feeling that the vaper community is in some ways in a stage similar to that of early ham-radio enthusiasts? Always trying different things to make it work better, reading and talking and discussing, etc etc?

          But eventually, it will probably work out the same way it went when radio became standard and the big choice was between the blue transistor radio or the red one. :> I think the real future with e-cigs lies in the eventual development and spread of the the “Blu-Cig” model: no thought involved… just buy and use them like cigarettes. Of course the Antis will magnify the environmental impacts of disposables unfortunately — eventually we’ll need some honest evaluation of such things.

          – MJM
          P.S. Ever hear the Antis sqawling about “toxic butt pollution” killing all the cute little fishies? I did some calcs on it with the 1.35 sextillion liters of water on earth and found that yep, if

          1) everyone tossed their butts in the ocean
          and
          2) there was no biodegrading so the “poisons” just built up over time

          that it would take the world’s smokers roughly 250 million years to kill half the little fishies in the ocean. Seriously.

    • Carl V Phillips

      More good points. It is amazing how much an experiment can be improved by asking people who know things. Kind of like how someone might figure out how to make sure vaping is being done in a way that actually gets nicotine out of the e-cig. Thanks for pointing that out about interval time. It is one of those things that is obviously right as soon as you hear it, but did not occur to me like it would a regular user. So basically let it wait a long time between puffs would never do any harm, so the interval time might as well be a minute or two, but getting it too short would produce something that does not represent real vaping.

      • Konstantinos Farsalinos

        Exactly Carl. However, it would be interesting to see if some toxic substances are produced even before this is detected by the user. However, the problem with such studies is that the only way to check for this phenomenon is to have an e-cig user test it. If for example he identifies dry puff after 5 seconds of device activation, we could test in a laboratory what happens at 3 seconds and at 4 seconds, before dry-puff is detected.
        It is not only a matter of interpuff interval, it also depends on puff duration. And of course, it also depends on the energy (wattage) applied to the atomizer (let’s not forget that mods are becoming popular).

  6. It is absolutely necessary to see photographs of their testing set-ups, procedures, and protocols in use. Otherwise the most amazing cock-ups can be overlooked.

    As an example we have seen several photos of a mini ecig being operated upside down. All this does is create smoke from internal melted plastic and sealants. How do we even know that their testing involved operating the hardware at a constant 45 degree downward angle, as it must be in order to simulate real world use?

    Testing such as that loosely described in the paper is useless and irrelevant without proof of the precise protocols used. They have demonstrated that they don’t know anything about the technical basics by using a 10 second puff interval and not precisely describing the head type and model and the liquid type and viscosity. What other screw-ups are concealed? Why not just dispense with any pretence of accuracy and just heat some liquid in a furnace?

    • Konstantinos Farsalinos

      The issue of e-cigarette orientation is also EXTREMELY important. It was a very overlooked mistake during the first cytotoxic studies performed in Italy on Flavourart liquids. Their other big mistake was that they made an extreme number of puffs from each atomizer, which was not consistent with the amount of liquid present in the atomizer. These are very common mistakes that can produce different (and unfavourable) results. But they would not represent real conditions. In order to perform our cytotoxic studies we had to find a way to predict if the time of activation or interpuff interval could produce the dry-puff phenomenon. The only method we could find was to assign an e-cigarette user to test the device with the time-settings and interpuff intervals we wanted to use in the laboratory, in order to make sure that no dry-puff occurs.

    • Carl V Phillips

      I agree that inadequately reported methods are a serious problem and a video should be required. In fairness, this was just a conference abstract so better reporting would not fit and the lack could still be corrected. However, you can bet that no journal will require proper reporting of the methods, and most paper journals will not even allow it) so it will only happen if the author gets this message and insists that the journal let him publish enough info or acts in a way that is typical for better sciences but vanishingly rare in health, and publishes complete information online.

      What absolutely boggles the mind is that so many people presume to do this research without even talking to skilled vapers first, let alone recruiting them to help with the methods. What an amazing combination of stupidity and arrogance.

      • “What absolutely boggles the mind is that so many people presume to do this research without even talking to skilled vapers first, let alone recruiting them to help with the methods. What an amazing combination of stupidity and arrogance.”

        Kind of like the Antismokers who took twenty years to “discover” that people who switched from Camel nonfilters to Carlton Ultra Lights tended to take bigger or more frequent puffs.

        – MJM

  7. Thomas Gleeson.

    Thing is ‘dripping’ is never done onto a hot coil, vapers drip into the atomizer then heat the coil. not the other way around. I would translate this as more of a concern about the end portion of a puff which is liquid coming into contact with a hot coil. Though even then the coil gets cooled a bit as new juice hits it.

  8. Pingback: Real public health research on e-cigarettes? | Vaping | Scoop.it

  9. Pingback: Real public health research on e-cigarettes? | VapeHalla! | Scoop.it

  10. Actually it is probably the right time now to construct a set of protocols for testing ecigs in the lab. These exist for tobacco cigarettes, and due to the complexity of and variation between ecigs, are even more necessary. I might knock something up and post it to the ECCA site, then ask for input. What do you think?

    • Carl V Phillips

      Could I recommend that you work actively with someone who does such research work on e-cigarettes (Konstantinos seems like an obvious candidate) as well as someone with long-term expertise on cigarette research standards who understands the process of creating standards (I could probably introduce someone). My recommendation is that you do that before posting a draft for public comment — it will increase the value of the exercise substantially, IMO. It is one thing to do a blog post like this one and then proceed to enjoy the dramatic increase its value due to comments, but I think a proposed standard needs to be closer to a final version out of the gate.

      • Konstantinos Farsalinos

        I am currently writing a manuscript that will describe the patterns of use of an e-cigarette device and atomizer, meaning puff duration, inhalation duration and exhalation duration. It will also have data on average consumption, based on weighting the atomizer before and after use. These data are based on recordings of more than 40 experienced vapers when they vape. Additionally, i have included a group of smokers that smoked and vaped at 2 different days, to show the difference between experienced and novice users. All data have been analyzed and i am currently writing the manuscript. This will provide insights on the methodology that should be followed in exoerimental settings. However, once again i should stress that the results could not be generalized because different kind of atomizers may have different functional characteristics and could be used by experienced users in a different way (puff duration and interpuff interval).

  11. I think we should try to co-operate on this, as Carl has suggested. I believe it is possible to create a benchmark protocol. The hardware, refill, and puff parameters all ideally need agreement. I’ll email you, Konstantinos.

    • Konstantinos Farsalinos

      Sure Chris, i am always open to any kind of cooperation.

      • There are two different kinds of parameters to try to set, each with their own difficulties:

        1) the machine puff, one in which you’re trying to duplicate the “average human puff” and in which the vapor is taken directly into a chamber of some kind for analysis and quantification. Schripp (among others) has done this kind of thing: Schripp T, Markewitz D, et al. “Does e-cigarette consumption cause passive vaping?” Indoor Air, Volume 23, Issue 1, pp. 25–31. doi:10.1111/j.1600-0668.2012.00792.x

        and

        2) the human exhaled puff: This would be a bit tricky, as it’s hard to have someone vaping in any form of “normal” pattern if they are being asked to exhale directly into a tube of some kind. It would also be difficult to backtrack it from a chamber because the quantities of elements involved are so small that even several vapers sitting close together in a small air-tight chamber would be unlikely to produce much that is measurable (again, see Schripp with his 8 cubic meter chamber and fairly squishy results.) There’s also the question of the value of measurements of the direct exhaled puff for other than antismoking/antivaping propaganda purposes since no one will ever be exposed to a full human exhaled puff (unless you’re giving someone a “Vape Kiss” which would hardly be likely to represent an average puff!)

        and

        3) which is really just an extension of (2) where you do proper chamber analyses. I asked Dr. Schripp about his study and why they didn’t do a more extended analysis of exhalations from nonsmokers over longer periods in his chamber and the answer seemed a bit confusing: something about the chamber being too noisy to ask people to sit in for longer periods? In any event, there appeared to me to be a real question about how much of the measured amounts in the chamber portion of his experiment may have been due to normal human metabolic activity.

        The third option doesn’t need strict standardization as the results, ideally, would yield the same type of information regardless of such things as initial chamber size, number of vapers, and rate of air changes. Ultimately you’d want to get figures indicating such things as the concentration of vaping-produced formaldehyde per about a hundred cubic meters of air after one hour of average vaping. (100 m3 would probably be a reasonable first draft ball-park estimate of an average likely “vaping encounter” whether it be from one or two vapers in your living room, or a half dozen or dozen in a decently ventilated small restaurant or bar.) (An hour of “average vaping” would be the roughest variable there as there are so many subvariables to deal with: nicotine liquid concentrations, individual vaping behavior in different environments, different types of e-cigs, etc. The range would probably at least two to three hundred percent for commonly encountered situations.)

        (1) would seem to be the most important measurement, BUT, just as with ETS, there’s the whole additional question of “aging” to consider, both chemical and physical

        – MJM

        • I was able to find more than ten analyses of e-cigarette vapour when I last looked. Some are listed here:
          http://www.e-cigarette-forum.com/forum/technical-research/149160-analysis-electronic-cigarette-vapor.html

          In general the analyses offer very different profiles, in fact of such substantial difference that it is hard to work out which of the vastly different major ingredient profiles might be correct (for example, one analysis gives water @66%, another PG @68%). Also, they all failed to operate the ecig correctly, and used it in a way that would likely provide melted plastic smoke as well as or instead of vapour. Photos were commonly provided and all looked similar to the one on page 5 of this report (with the device incorrectly operated inverted):
          http://www.e-cigarette-forum.com/forum/attachments/technical-research/26458d1293903856-analysis-electronic-cigarette-vapor-16-3.pdf

          It is worth making another practical observation: machine testing as used for tobacco cigarettes has failed previously in ecig vapour analysis, due to the fact that the water-based mist, containing materials which adhere to the equipment, clogs the internals of a machine and renders it useless until thoroughly cleaned (which has to be carried out according to set protocols). In one ecig vapour test performed with one of these machines, for instance, the first sample adhered to the machine internals and contaminated all further tests.

          Therefore an ad hoc flask-based testing arrangement must be used, not a machine. Luckily this is much cheaper, and also faster, since otherwise the machine needs to be cleaned after every single test. However there are numerous practical issues with using an ad hoc flask and syringe-created vacuum. Protocols are particularly difficult to follow under this type of arrangement. It means that different results will be obtained every time, for tests carried out everywhere including in the same lab.

          Ecig vapour testing is exceptionally difficult compared to cigarette smoke testing, for all sorts of reasons.

        • Konstantinos Farsalinos

          In our latest study evaluating cytotoxicity in cultured myocardial tests, we used a vacuum pump. In order to have a realistic experimental setting, we previously tested the e-cigarette device we used (eGo battery and 510T atomiser) so that each “puff”n(4-seconds duration) would consume 4-5mg of liquid.
          I agree with Chris that using smoking machines to test e-cigarettes is almost impossible.

        • What’s with these 4 second duration puffs? I’ve been smoking nonfiltered cigarettes for over 40 years. I just recently began experimenting with vaping. I just watched the clock and found that I tend to puff for perhaps 1.5 to 2 seconds at most. A full four seconds completely filled a distended mouth and practically choked me when I inhaled it!

          From what I’ve read on here and elsewhere it would seem that a 4 second draw might very well heat up (?) the element that makes the vapor to an abnormal level and produce vapor that might (?) be worse (?) than what one would get from a more reasonable 2 second puff.

          It’s possible I’m just really atypical, but I don’t think so. My smoking history would indicate that I’d be more likely than most to take longer, stronger puffs.

          – MJM

        • Konstantinos Farsalinos

          4 seconds is the average puff duration measured on 45 experienced e-cigarette users that were asked to use an eGo battery with a CE4-type atomiser. This is the data i have and i use. You may probably take short puffs, but i have seen vapers take 6-seconds (or even more) puffs.

        • Look at some YouTube videos and find the correct mode of use for the different types of equipment. Of course, no one else’s version really matters, only what works for you, so if a 2-second inhale works for you (on your choice of rig and refill) then that’s fine, naturally. Some draw for 8 seconds (when using a mini ecig) but that is their preference. It needs to be pointed out, though, that an ecig is not used like a tobacco cigarette: the vapour is first drawn into the mouth, held for a second or two, then inhaled. Some smokers use a direct lung inhale with cigarettes – this is *not* used with an e-cigarette. (It will choke many people, as vapour does not have the anaesthetic effect engineered into cigarette smoke.)

        • I have recorded approximately 40 people using an e-cigarette (eGo battery with CE4-type atomiser), using a 9mg/ml nicotine liquid. I am currently preparing the manuscript for publication. In fact, only a very small minority of people held the vapor to the mouth before inhaling it. Of course, all of them were experienced vapers. As with the case of tobacco cigarettes, everyone uses the e-cigarette in a different way, that is why we need a lot of people to get the average values and thus the average use pattern.

        • And don’t forget that the exhalations of a person not vaping may also contain formaldehyde.

  12. Pingback: Real public health research on e-cigarettes? | Tobacco Harm Reduction | Scoop.it

  13. Pingback: Real public health research on e-cigarettes? | vapeforlife

  14. Addendum: And, actually, in terms of antivaping activities/sentiments, (3) would be as important, or possibly even more important than (1) … particularly since the measurements would almost certainly show that no sane people would ever worry about such exposures. E.G. I would expect that sitting in a room with a vaper for 1,000 hours might yield roughly the same exposure to formaldehyde as hanging around the kitchen for one hour while Thanksgiving dinner is being prepared with a gas range/oven.

    – MJM

  15. I have offered this kind of advice to a number of e-cig resarchers… some ASKED for it… others got it unsolicited. Some listened, some didn’t. I met with Maciej Goniewicz at SRNT this past weekend. He has been recruited by Roswell Park to do NIH funded research on e-cigs. He seems very open to advice and help and also seems unbiased. I could be wrong… but I have some faith he will do his homework before he does his research and could produce some additional worthwhile studies instead of wasting everyone’s time doing research that is not real world.His most recent paper was confirmation of the air quality study we published last year. It was nice to know the results could be replicated and has been helpful with indoor bans. It is better to say “we have 2 studies that show” instead of “there is A study that shows”. So thanks to him and his colleagues for their work.

    • Carl V Phillips

      That is good news. Just to clarify, though, we have a dozen or so studies now of e-cig chemistry, dating back a while now. All tend to support the same conclusions (though we will wait for the review for a more precise assessment of that point). It is true that the new Goniewicz et al. study might well be the best of the bunch — or at least the one least likely to be ignored, so is a welcome addition.

  16. Sometimes Dr. E is a bit more savvy than we give him credit: Since the experiment completely vaporized 16microliters at 300C in a completely unrealistic scenario, the 200mcg of formaldehyde measured is basically the maximum possible exposure–perhaps Tom was measuring a lifetime risk of 200mcg? A far more realistic measurement was cited next with the .03mcg detected in 15 “puffs” off a V4L e-cig meaning that it takes 100,000 Goniewicz puffs to be exposed to all the formaldehyde that can be produced from 3 drops of e-liquid.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s