By Paul Bergen from tobaccoharmreduction.org
A recent study by Jean-Francois Etter and Chris Bullen, Saliva cotinine levels in users of electronic cigarettes, concludes that vapers ingest about the same amount of nicotine as smokers. Since it is often difficult to mimic the real world, Etter and Bullen used cotinine levels to compare nicotine acquisitions. Vapers were asked to chew on a small cotton roll less than 30 minutes after vaping, place these saliva samples in a vial, and mail them in.
We conclude that cotinine levels in ENDS [electronic nicotine delivery systems] users were similar to levels observed, in previous reports, in smokers and higher than levels usually observed in NRT users. This finding has important implications for ENDS use by smokers who want to quit, for future research, and for the regulation of these products.
Forgiving the fellows for the use of the anti-tobacco folks’ term ENDS (maybe they are trying to make you think of butts or imply death), this comment makes sense about the implications in that if smokers know that there is better nicotine delivery in vaping than in using NRTs, then they know which alternative is most likely to result in cessation. And, of course, it is always good to know more than less about these things.
There is an implication that this will somehow prove to vapers that vaping is a good way to quit smoking. It is quite funny because if there is anything vapers know, and knew quite some time ago, vaping is one of the best ways of getting off tobacco cigarettes.
There is often this disconnect between research and real world experience. Research beats anecdotal easily but when it comes to behaviors in which millions of people are engaged in, the real world manifestation can tell you more than any lab tests as to what is actually going on at the user level.
That vaping delivers adequate nicotine certainly contributes to its success as an alternative but so does the fact that it mimics smoking. There are quite a few ex-smokers who are happily vaping away on nicotine-free versions. What that tells us is that while nicotine levels might make a difference for some (and possibly for most) users, for others it is something else.
Many vapers have successfully switched from smoking. They knew within puffs that this was a reasonable substitute and a research article residing behind a pay wall is not going to alter their experience one way or the other.
My criticism is not so different from when I wrote about research which had argued that there was not enough nicotine in alternative products to satisfy smokers (see here). Whether the research finds too little or too much nicotine in these products, and whatever conclusions they draw about suitability, the real evidence lies in the growing population of ex-smoking vapers.
If it did not work, they would not exist.