Dr. Farsalinos Challenges Published Misinformation on Formaldehyde in Electronic Cigarettes

konstantinos-farsalinosA misleading statement regarding levels of formaldehyde in electronic cigarettes has made news. According to Naoiki Kunugita, a researcher at the Department of Environmental Health-National Institute of Public Health in Japan, e-cigarettes have “more than ten times the level of carcinogens contained in one regular cigarette”. Kunugita and his colleagues submitted their report on Thursday and understandably it has alarmed the public.

Amidst the media frenzy, Dr. Konstantinos Farsalinos interjects with scientifically accurate information. While the media presented this story as a comprehensive analysis of all carcinogens in cigarettes, the Japanese researchers only reported on one such carcinogen: formaldehyde. The findings described formaldehyde as “a substance found in building materials and embalming fluids”. In his response, Dr. Farsalinos informs readers that in reality formaldehyde is present in all of our surroundings.

Armed with factual data, Dr. Farsalinos manages to poke holes in the claim that electronic cigarettes contain formaldehyde at “ten levels higher than cigarettes”. In his rebuttal, Farsalinos compares the list of published studies in which Prof. Kunugita sourced his results to a Canadian study conducted on the levels of formaldehyde in cigarette smoke. On average a single cigarette contains 200mcg of formaldehyde. This is six times higher than the highest amount (34mcg) found in the e-cigarettes reported by Kunugita.

The average level of formaldehyde found in the e-cig samples was 4.2mcg per 10 puffs. This is an average of 50 times lower than levels found in tobacco cigarette smoke.

Fortunately, there are scientists and doctors dedicated to providing the public with factual information. These findings reinforce the need for scientifically correct information. In the pursuit of science, we will continue to publish only accurate research.

Sources: http://bit.ly/1xM0uYf



Are Electronic Cigarettes Effective Tools for Craving and Smoking Reduction?

Any smoker who has attempted to quit knows that cigarette addiction is so much more than nicotine dependency. It is because of this that nicotine replacement therapies (NRT) have such low success rates (usually around 10% or lower). Expecting smokers to completely abstain from nicotine and all forms of tobacco may be unrealistic, as many people enjoy the act of smoking and are seeking a less harmful way to do so. Tobacco harm reduction (THR) may give smokers a better chance at giving up cigarettes.

The goal of THR is to provide smokers with a substantially less harmful way to consume nicotine and/or tobacco. Electronic cigarettes not only deliver nicotine in a satisfying way; they address the behavioral aspects that play such a huge role in cigarette addiction. A new study was conducted to examine the potential of electronic cigarettes as an effective THR tool.

Participants who were unwilling to quit smoking were placed into three groups to assess the effectiveness of  electronic cigarettes as they relate to acute cravings and smoking reduction in an eight month Randomized Controlled Trial. The groups consisted of two experimental/e-cig groups and one control group who continued to smoke tobacco cigarettes exclusively during the first eight weeks of the study.

Three lab sessions took place over a two month period. Forty eight participants abstained from smoking for four hours and then vaped/smoked for five minutes. Next, they were monitored for cravings and withdrawal symptoms. In between lab sessions the two experimental/ecig groups were permitted to use e-cigs or smoke tobacco cigarettes as desired. The control group was only allowed to smoke cigarettes. Questionnaires were supplied to monitor craving and the perceived benefits and complaints reported by participants. Additionally, breath carbon monoxide measurements (eCO) and saliva cotinine levels were taken. Cotinine is a metabolite of nicotine that binds to nicotine receptors and can be found in tobacco.

The results are as follows:

Beginning with the first lab session, use of an electronic cigarette was equally as effective as smoking a tobacco cigarette in terms of craving reduction. Cravings were monitored after four hours of abstinence.

After two months, 34% of the e-cig groups had stopped smoking cigarettes. 0% of the smoking only, control group had stopped.

After five months, the e-cig groups showed a total quit rate of 37%. Once the use of e-cigs was permitted to the control group, a quit rate of 38% was demonstrated after three months of initiating e-cig use.

After eight months, 19% of the e-cig groups and 25% of the control group were completely abstinent from smoking. Compared to initial intake, an overall reduction in the number of cigarettes smoked was 60%.

ijerph-11-11220-g007-1024Cotinine levels remained the same in all groups and eCO levels decreased.

The study concludes that “…e-cigs were shown to be immediately and highly effective in reducing abstinence induced cigarette craving and withdrawal symptoms, while not resulting in increases in eCO. Remarkable (>50 pc) eight-month reductions in, or complete abstinence from tobacco smoking was achieved with the e-cig in almost half (44%) of the participants.”

Source: http://bit.ly/1yQbg25




E-Research Foundation Launches Website

erf-logo,The electronic cigarette industry is growing exponentially without any signs of slowing down. Unfortunately, misinformation and baseless opinions continue to spread. There are also doctors and politicians who claim there simply isn’t enough information to back e-cigs. Consumer protection along with impending FDA regulations increase the need for scientific data and credible studies.

There is now a foundation whose mission is to “collectively fund and advance independent medical/scientific research [as it relates to electronic cigarettes] targeted for peer-review and publication.” The E-Research Foundation consists of active individuals in the electronic cigarette industry. Included in ERF’s team is Vapor Shark CEO, Brandon Leidel, serving as a board member.

The E-Research Foundation is a nonprofit, collective funding structure aiming to provide consumers, suppliers, law-makers and the general public with factual information. All studies funded by ERF must undergo a process of peer-review to ensure transparency and availability to all. Previous independently published research is also available in the Existing Studies portion of the site.

The use of electronic cigarettes continues to be a polarizing issue. With so much conflicting information it’s difficult to decipher fact from fiction. E-Research Foundation has provided the public with one reliable source where only credible studies are published.

For more information visit e-researchfoundation.org


Study Examines Electronic Cigarettes and Smoking Cessation

Quit-Smoking-CigarettesA population-based survey of smokers was conducted to assess electronic cigarette use and its connection with abstinence rates. At baseline 1,374 adult smokers from the Dallas and Indianapolis areas were surveyed and agreed to be contacted two years later. Of this group 695 were re-contacted in 2014.

After the initial interview of the surveyed smokers’ tobacco use, the follow up interview assessed their smoking rates and electronic cigarette use. Those surveyed were categorized as one of the following: intensive users (using electronic cigarettes every day for at least one month), intermittent users (using e-cigarettes regularly, but not every day for more than one month), and non-users/triers (using e-cigarettes once or twice at most).

The results of the follow up interview categorized the 695 re-contacted respondents as 23% intensive users, 29% intermittent users, 18% triers, and 30% non-users. According to the results, intensive users of electronic cigarettes were six times more likely than non-users/triers to quit smoking. In this study smoking cessation was defined as abstaining from cigarettes for at least one month.

Only intensive users of e-cigs were successful in terms of smoking cessation. For this reason more research is needed to determine why many smokers do not become intensive users.

The study concludes that “daily use of electronic cigarettes for at least one month is strongly associated with quitting smoking at follow up. Further investigation of the underlying reasons for intensive versus intermittent use will help shed light on the mechanisms underlying the associations between e-cigarette use, motivation to quit and smoking cessation.”

Sources: http://bit.ly/1rH5KZX



Groundbreaking Clinical Study to Assess the Temperature of E-Liquid Evaporation

Latest-E-Cig-StudyDr. Konstantinos Farsalinos is a Greek cardiovascular specialist. In recent years he has devoted most of his time to clinical research on electronic cigarettes and the effects of their use. His work is important because it arms the public with scientific data on the safety and efficacy of e-cigs.

An important, new study is in the works. The main objective is to evaluate the temperature at which e-liquid evaporates. A significant difference between tobacco cigarettes and electronic versions is combustion. Electronic cigarettes do not burn material to create vapor. However, heat is required to convert e-liquid into the vapor that is inhaled by its users. This may cause decomposition and release of e-cigarette chemicals.

Until now, no study has evaluated temperatures inside the wick. In addition to gathering data in a lab, this research will be conducted under real life conditions. Natural patterns of electronic cigarette use, including duration of inhalation and wattage settings, will be analyzed for the release of potentially harmful chemicals. Hazardous emissions will also be evaluated in “dry hits” and sub-ohm vaping. All results will be compared to exposure from tobacco cigarettes.

The data gathered through this study will provide electronic cigarette users with valuable information needed to make informed decisions on the safest methods to vape. Manufacturers can also use the results to ensure safety with the release of new devices. As popularity of e-cigs continues to grow, this exciting study will shed light on possibly the most crucial factor of electronic cigarette safety and new development.

Source: http://bit.ly/1p9x9Un





Study Finds E-Cigs are not a Gateway to Tobacco Cigarettes

A study that has yet to be published, was presented to the American Association for Cancer Research. This study, conducted by Dr. Ted Wagener from the University of Oklahoma Health Sciences Center, examines the fear that electronic cigarettes lead young people to cigarette addiction.

College students, with an average age of nineteen, were surveyed on their nicotine and tobacco use. Of the 1300 students, 43 students reported their first nicotine product was an electronic cigarette. Researchers found only one person who started using nicotine through an electronic cigarette who then went on to smoke tobacco cigarettes.

The recent CDC article on teen usage of electronic cigarettes left people fearful that e-cigs could be a gateway for youths to lifelong cigarette addiction.

According to Dr. Wagener, “It didn’t seem as though it really proved to be a gateway to anything.”  The vast majority of those who started with e-cigs reported they were not currently using any nicotine or tobacco.

In an online column Jacob Sullum of Forbes magazine agrees, “…the survey data [CDC data] provided no evidence that e-cigarettes are a gateway to the conventional kind.”

I think everyone can agree that electronic cigarettes are not intended for and should not be used by minors. It is an issue that should not be taken lightly. The assumption that e-cigs lead to tobacco cigarettes is a serious one, but it’s just that: an “assumption.” Parents should talk to their kids about smoking and e-cig vendors should sell responsibly. Let’s not allow ideological fear get in the way of the millions of adults who have benefited from electronic cigarettes.

Sources: http://bit.ly/17tcXJT




European Parliament Makes Decisions on Tobacco and Electronic Cigarette Regulations

European parliament in Strasbourg-1448437

After months of debate, the European Parliament voted in Strasbourg on tobacco regulations. The tobacco industry used a strong lobbying campaign arguing against regulations because the vote would “limit consumer freedom.”

Ultimately, Parliament agreed on scaled-back versions of tougher tobacco regulation. The World Health Organization (WHO) and EU health officials are viewing the tobacco vote as an important milestone, but will continue the quest to get smokers to quit and keep nonsmokers from picking up.

Regulations include phasing out menthol cigarettes over eight years, as opposed to the three years agreed by EU governments. An agreement was made to include health warnings in pictures and text on 65% of each cigarette pack. There will also be a ban on packs of cigarettes containing 10 cigarettes. Slim cigarettes will not be banned.

As far as electronic cigarettes are concerned, the European Parliament approved restrictions on advertising, sponsoring, and sales to minors.

They rejected proposals to regulate e-cigs as medical devices. This regulation would have made it very difficult for electronic cigarettes to be viewed as an accessible alternative to tobacco.

“Armando Peruga, tobacco control expert at WHO in Geneva, said regulating e-cigarettes wouldn’t necessarily be a bad thing and that WHO is currently evaluating their safety and effectiveness. “We do think e-cigarettes could be useful, but we need more information. We have not yet ruled them out. We do think they could be helpful for some smokers.”

This is a very big change from WHO’s previous stance on electronic cigarettes. In the past, WHO has strongly advised against using e-cigs. The EU Parliament’s decision to allow electronic cigarettes to compete with tobacco cigarettes is a huge one.

The vaping community is a passionate group of individuals who are not blinded by ideology. The countless testimonials and success stories of e-cig users in the face of anti-smoking groups is impossible to ignore. There are tens of thousands of people benefiting from the use of electronic cigarettes and health officials are taking notice.

Sources: http://www.bbc.co.uk/news/world-europe-24439474







Study Finds Electronic Cigarettes are as Effective as Nicotine Patches at Helping Smokers Quit

An early online publication of The Lancet medical journal explores the possibilities of electronic cigarettes as smoking cessation tools. The study investigates the effectiveness of e-cigs compared to that of nicotine patches.

A randomized controlled study was conducted in New Zealand between Sept 2011 and July 2013. Of the 657 participants, 289 received nicotine e-cigarettes, 295 received nicotine patches, and 73 received e-cigs without nicotine (“placebo e-cigarettes”).

At six months, the verified abstinence rates were as follows:

  • 7.3% abstinent with nicotine electronic cigarettes.
  • 5.8% abstinent with nicotine patches.
  • 4.1% abstinent with placebo electronic cigarettes

There were no significant differences in adverse effects among the different products used.

According to the CDC, tobacco is the number one preventable cause of disease and death in the US. Tobacco kills 443,000 annually. The American Cancer Society estimates that 4-7% of people are able to quit smoking with any given try.

The study found that electronic cigarettes, with or without nicotine, achieve similar rates of abstinence as nicotine patches.

Sources: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61842-5/abstract?rss=yes


Comprehensive Review on the Chemistry of Electronic Cigarette Vapor

imagesA study conducted by Dr. Igor Burstyn assess the chemistry of contaminants in electronic cigarettes. “Both peer-reviewed and “grey” literatures were accessed and more than 9000 observations of highly variable quality were extracted.” According to Dr. Burstyn, “The existing literature tends to overestimate the exposures [of contaminants in electronic cigarettes] and exaggerate their implications.”

The question is, why are there so many discrepancies when it comes to the “facts” on electronic cigarettes? Dr. Burstyn believes the differences in opinions are partially due to rhetoric. He describes the reported isolated instances of “highest level of chemical detected” as “clear bias.” … average exposure that can be calculated are higher than true value because they are missing all true zeros.”

When compared to tobacco cigarettes, e-cigs are generally recognized as safer. This paper goes a step further in attempting to analyze health risks to both users of electronic cigarettes and bystanders.

According to this study further research is needed on the long term effects of inhaling propylene glycol and glycerin in regards to respiratory distress. However, “exposure of bystanders to the listed, let alone the contaminants, does not warrant a concern as the exposure is likely to be orders of magnitude lower than exposure experienced by vapers.”

In regards to contaminants, “An analysis of current state of knowledge about the chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces.”

The key conclusions are as follows:

  1. “Even when compared to workplace standards for involuntary exposures, and using several conservative (erring on the side of caution) assumptions, the exposures from using e-cigarettes fall well below the threshold for concern for compounds with known toxicity. That is, even ignoring the benefits of e-cigarette use and the fact that the exposure is actively chosen, and even comparing to the levels that are considered unacceptable to people who are not benefitting from the exposure and do not want it, the exposures would not generate concern or call for remedial action.”
  2. “There is no serious concern about the contaminants such as volatile organic compounds (formaldehyde, acrolein, etc.) in the liquid produced by heating. While these contaminants are present, they have been detected at problematic levels only in a few studies that apparently were based on unrealistic levels of heating.”
  3. “Tobacco-specific nitrosamines (TSNA) are present in trace quantities and pose no more (likely much less) threat to health than TSNAs from modern smokeless tobacco products, which cause no measurable risk for cancer.”
  4. “Contamination by metals is shown to be at similarly trivial levels that pose no health risk, and the alarmist claims about such contaminants are based on unrealistic assumptions about the molecular form of these elements.”

Source: For the full story click here: http://publichealth.drexel.edu/SiteData/docs/ms08/f90349264250e603/ms08.pdf

24 Month Study Reports 40% Success Rate With the Use of Electronic Cigarettes

A study was published in the journal Internal and Emergency Medicine. Many of the doctors who conducted this study were involved in the research I covered in July 2013 entitled 12 Month Clinical Study Confirms E-Cigs are Effective Smoking Cessation Tools.

The latest findings were gathered over a two year follow-up period. The study included 40 participants who were disinterested in quitting at the time of the initial study. Electronic cigarettes were provided for six months. Cigarettes per day (cig/day) and exhaled carbon monoxide levels were measured at 18 and 24 months. The results are as follows:

12.5% of smokers with no desire to quit at baseline completely quit cigarettes. 27.5% cut their cig/day intake by more than half. Of the participants who cut back on smoking, the average cigarette consumption significantly decreased from 24 cig/day at baseline to 4 cig/day at 24 months. This brings the combined smoking reduction and abstinence rates to 40% at 24 months.

Three participants relapsed back to tobacco cigarettes, four upgraded to higher performing products, and five participants stopped using e-cigs altogether and stayed quit.

The study concludes, “Long-term e-cigarette use can substantially decrease cigarette consumption in smokers not willing to quit and is well tolerated.” Take that skeptics!

Source: http://link.springer.com/article/10.1007/s11739-013-0977-z