E-Cig Advocates Respond to Misleading Stanford Research

Robert Jackler Stanford British Medical Journal

FOR IMMEDIATE RELEASE, 11/30/15, 9:00 AM Eastern.

E-Cig Advocates Respond to Misleading Stanford Research

Paper published in British Medical Journal contains significant factual errors.

Oakley, CA – A new research paper from Stanford Research Into the Impact of Tobacco Advertising, published in the British Medical Journal, raises serious questions about the university’s use of research funds. The paper, authored by Stanford professor Dr. Robert Jackler, makes accusations of “brandalism” – manipulating an existing work to convey a different message, a tactic often used in anti-tobacco advertisements over the past two decades.

Dr. Jackler asserts in the paper that Not Blowing Smoke, a California-based e-cigarette advocacy group, engaged in a deliberate effort to modify advertisements created by the Centers for Disease Control and Prevention as part of their Tips From Former Smokers campaign. In addition, Jackler accuses Not Blowing Smoke of having “close ties to the e-cigarette industry” and being founded by “four creators, including an e-cigarette company marketing manager (Apollo) and vape store employees.”

“I was completely confused by this research. Two of our three board members have no affiliation with the vaping industry and none of our team members work in a vape store,” said Stefan Didak, founder and president of Not Blowing Smoke. “Stanford’s research team clearly missed a few things in their review, most importantly that we didn’t create any sort of counter-campaign to CDC.”

In fact, the originator of the edited images is a graphic designer named Shawn Rego, who created the modification based on a poorly-worded CDC advertisement he felt was misleading the public. The ad, featuring a woman with a scar from surgery, implies that e-cigarettes were somehow responsible for a collapsed lung despite the clear statement that ‘Kristy’ continued use of combustible tobacco products. Ironically, Stanford’s paper makes note of the fact that identifying the author of a knock off advertisement may be challenging.


“Jackler alleges that the modified work infringes on CDC copyright, but as part of the federal government, it’s unlikely that copyright protection applies,” adds Didak. “We certainly shared images via social media. The backlash against CDC’s misleading campaign was completely a consumer-driven effort that we were happy to support.”

Of particular note is Stanford’s bizarre accusation of industry ties. Not Blowing Smoke’s board is comprised of three people, two of whom have never been employed by the e-cigarette industry in any capacity. “At any given time, a majority vote is controlled by consumer advocates,” says Jason Downing, the organization’s treasurer and communications director. “We operate with complete independence from any e-cigarette manufacturer, wholesaler or retailer. We believe this paper falls far short of Stanford’s long history of producing and publishing fine research both in the tobacco control field and many other areas of medicine.”

Not Blowing Smoke has sent formal letters in response to the research to Dr. Jackler as well as leadership at both Stanford and the British Medical Journal calling for a retraction.

About Not Blowing Smoke:

Not Blowing Smoke is a nonprofit corporation formed in response to the California Department of Health’s misleading anti-vaping campaign, which to date, has spent upwards of $15 million dollars of taxpayer money. The organization was founded in March 2015 by Stefan Didak, a nationally recognized consumer advocate for vapor products with assistance from Jason Downing. Shortly after founding, Danielle Bloss, a brand manager at Apollo, joined the team and the three now form the board of directors.

We are dedicated to providing the public and government officials with the truth about vaping. Not Blowing Smoke operates completely independent of industry influence, although we do receive limited funding from strategic partnerships.

Jason Downing, Director
(507) 416-9632

Misleading Research by Robert Jacker at Stanford

Robert Jackler Stanford British Medical Journal

Dr. Robert Jackler
Stanford University School of Medicine
801 Welch Road
Stanford, CA 94305

Re: Ramamurthi D, Fadadu RP, Jackler RK. Tob Control Published Online First: [11/06/2015] doi:10.1136/ tobaccocontrol-2015-052661

Dear Dr. Jackler,

In reviewing your recent paper, published in the British Medical Journal, Not Blowing Smoke (hereafter referred to as NBS) felt it important to reach out to Stanford to address portions of the document directed toward the organization.

We wish to address allegations regarding the so-called brandalism of CDC’s Tips From Former Smokers campaign. “Identification of the original author of the knock off may be challenging, as it has become very easy for even those with minimal digital graphic skills to create derivative advertisements.” In fact, the originator of the edited images is a California-based graphic designer named Shawn Rego. The catalyst for the original modification was an image created by CDC (Fig. 1) intended to mislead the public about e-cigarettes. The implication from CDC is that e-cigarettes were somehow responsible for the subject’s illness, despite the clear statement that ‘Kristy’ continued use of combustible tobacco products.

Mr. Rego’s image (Fig 2) was republished by Not Blowing Smoke via our social media channels and other individuals used the template created by Mr. Rego to express their own views. The image noted in the paper was created by Geoff Brathwaite (Fig 3), who has no formal association with NBS. One such image was created by NBS founder Stefan Didak in his individual capacity and several dozen individual consumers who were able to cease combustible tobacco use as a result of vapor products. As these images were created and shared prior to NBS’ incorporation date of August 4th, 2015, the assertion of an advertising campaign created by NBS is blatantly incorrect.

Further, despite having immediate and direct access to one of the most respected law schools in the United States, the paper fails to recognize that works of the United States government do not qualify for copyright protection . All the same, we believe the transformative works created by individual consumer advocates fall squarely inside the bounds of fair use. The images utilize less than 3% of the original source material, are wholly intended to provide both criticism and commentary and do not use the CDC logo. The paper willfully ignores United States copyright law while simultaneously praising identical efforts by the tobacco control industry and calling for censorship of dissenting viewpoints.

The paper also alleges that “NOTBlowingSmoke is an advocacy group for e-cigarettes, with close ties to the e-cigarette industry. Their website lists four creators, including an e-cigarette company marketing manager (Apollo) and vape store employees.”

In effect, by stating that one current Director is an employee of Apollo, the study authors demonstrate a more comprehensive understanding of the persons involved in the leadership of NBS, yet fail to cite their evidentiary source(s). NBS was created in March 2015 by Stefan Didak with assistance from Jason Downing, two of the three current board members. Neither Mr. Didak nor Mr. Downing has been employed by the e-cigarette industry in any capacity whatsoever.

To reiterate, a two-thirds majority of NBS’ Board is controlled by consumers without industry ties and the organization acts with complete independence from any e-cigarette manufacturer, retailer or wholesaler. Camille Winans volunteers her time and does not act in a decision-making capacity. Unfortunately, the authors made no attempt whatsoever to contact NBS prior to publishing and instead relied on false assertions unsupported by evidence. For the above reasons, the paper demonstrates a bad faith effort to defame and libel Messrs Didak and Downing and Not Blowing Smoke as an organization under the guise of legitimate research.

It is our opinion that this paper falls far short of both BMJ and Stanford’s long history of producing and publishing fine research both in the tobacco control field and many other areas of medicine. Due to myriad inconsistencies, significant factual errors and material misrepresentations, Not Blowing Smoke requests that this paper be retracted in its entirety.

  1. Ramamurthi D, Fadadu RP, Jackler RK. Tob Control Published Online First: [11/06/2015] doi:10.1136/ tobaccocontrol-2015-052661
  2. https://www.usa.gov/government-works
  3. http://fairuse.stanford.edu/overview/fair-use/what-is-fair-use/
  4. Ramamurthi D, Fadadu RP, Jackler RK. Tob Control Published Online First: [11/06/2015] doi:10.1136/ tobaccocontrol-2015-052661


Jason Downing
Director, Not Blowing Smoke
(651) 785-3355

Important Update

Dear Vaping Community,

I am thrilled that NotBlowingSmoke.org has taken on a life of its own.  To ensure that our campaign maintains and grows its momentum we are working feverishly to formulate our ongoing strategic plan.  We will be calling upon members of the community to give us input in this process.  We expect our initial plan to be completed within two weeks.  We hope you will be open to helping now and in the future.


Stefan Didak
Jason Downing

Immediate Call To Action : SB140 and SB24, April 8th in the Senate Health Committee

Senate Bill 140 (SB140) would make California the fourth state to pass regulation that treats vaping the same way as smoking. This will severely hinder current smokers from having easy accessibility to a vapor based alternative and likely putting most industry stakeholders out of business.

The bill IS scheduled for its first hearing in the Senate Health Committee on Wednesday April 8th at the State Capitol in Sacramento (John L. Burton Hearing Room 4203) at 1:30pm. We strongly encourage our members and industry stakeholders (including non-SFATA members) to attend this hearing and oppose this bill.

SB140 Points of opposition (limited subset):

  • Defines vapor products as tobacco products (i.e. equate cigarettes with e-cigarettes).
  • Attempts to include products defined as “nicotine” regardless of source.
  • Public use prohibition (no vaping where smoking is prohibited, public parks, etc.)
  • Change in how vaping can be prohibited in rental, lease, multi-unit apt. dwellings, etc.
  • No vaping in workplaces (including vape shops)
  • No more “self service” (unassisted) handling products or sampling liquids/flavors.
  • No exemptions for vapor retailers to allow vaping in their stores.
  • No vaping in group homes, small family homes, transitional housing, or by foster families.
  • No vaping in a motor vehicle with a minor present, whether in motion or at rest.

About Mark Leno, SB140, and its sponsors:

Mark Leno’s financial contributors are who’s who of Big Pharma, including Genentech, GlaxoSmithKline, Johnson & Johnson, Gilead, Astrazeneca, Baxter Healthcare, Aventis Pharmaceuticals, Hoffman-Laroche, PHRMA, EMD Serono, and California Biotechnology.

The bill is being sponsored by the American Cancer Society, American Heart Association, and American Lung Association.

Read More

Some studies and research on vapor products


First Vs. New Generation Vaping Devices : Nicotine Absorption
According to a study led by Dr. Konstantinos E. Farsalinos, the vaping devices and liquid used in in this research delivered one-third to one-fourth the amount of nicotine after 5 minutes of use compared to tobacco cigarettes – and the new generation of devices significantly outperformed first generation ecigs. Published February 2015.

Ecigarettes Save Lives
Derek Yach previously headed tobacco control at the WHO. He says he understands why anti-smoking activists are so distrustful of vaping and is one of those activists. However, he also acknowledges that the evidence is clear – ecigarettes are saving lives. He states everyone involved with tobacco control needs make up for 50 years of ignoring the simple reality – that smoking kills and nicotine does not. Published February 2015.

Ecigarettes, Vaping And Public Health (PDF)
A summary for policy makers by Clive Bates, former Director of Action on Smoking and Health (London). Mr. Bates was also the founder of the NGO Framework Convention Alliance, set up to support the development of the WHO Framework Convention on Tobacco Control. Published February 2015.

Vaping And Formaldehyde Study Questioned
The validity of a recent study showing high voltage vaping creating formaldehyde, a carcinogen, has been questioned by Dr Konstantinos Farsalinos, who says there are many major issues in the way the research was carried out and the results presented. Published January 2015.

added note: a Reuters article on the same study reports one of the lead authors stated the study could have contained more context about overall relative risk, but the authors “just wanted to get it out.”


Ecigarette Vs. Cigarette Smoke Aerosols
This study, published in the journal Regulatory Toxicology and Pharmacology, examined harmful and potentially harmful constituents (HPHCs) in ecigarette and tobacco cigarette aerosols. Mainstream cigarette smoke HPHCs were 1500 times higher than e-cigarette HPHCs. Published December 2014.

New Study Indicates Vaping Not A Gateway To Smoking
More information is emerging that electronic cigarette usage doesn’t pose a major threat in terms of subsequent uptake of smoking tobacco. In a study of 1300 undergraduate students in the USA, only three had taken up smoking after using electronic cigarettes as their introduction to nicotine. Only one student was continuing to use ecigs. Published December 2014.

Electronic Cigarettes Effective for Smoking Cessation
A systematic review of six studies, including two randomised controlled trials, concluded 18% of 1,242 participants reported smoking cessation after using e-cigarettes containing nicotine for a minimum period of six months. Vaping was also effective in reducing smokers’ daily cigarette consumption. Published December 2014.

Health Survey For England : Ecigs And Vaping (PDF)
Recently published results from the Health Survey for England state 3 per cent of adults were currently using e-cigarettes (vapourisers) in 2013. The Survey also found little evidence of ecigarette uptake by non-smokers. Among men, 29% of current smokers, 6% of ex-smokers and just 1% of never smokers had ever used ecigs and the proportions were similar for women. Published December 2014.

Ecigarette Carcinogen Reports Misleading
Dr Konstantinos Farsalinos addresses the media frenzy in connection with a misquoted study performed by Japanese researcher Professor Naoki Kunugita concerning carcinogens in ecigarette vapour. Published November 2014.

Added note: the UK’s Daily Mail originally published an article stating this study found e-cigarettes contain 10 times more carcinogens than tobacco cigarettes. The Daily Mail has since published a retraction (found at the end of the article).

The Daily Mail now says “The study supports existing evidence that e-cigarettes are much less dangerous than tobacco products.”

Gateway Myth Busted?
Concerns of electronic cigarettes being a gateway to smoking may be unfounded suggests data from the UK’s Office for National Statistics. Fewer than one in 300 vapers who have never smoked are using ecigarettes. Published November 2014.

Vaping And Nicotine
Professor Peter Killeen is a behavioural neuroscientist . In this video, he discusses vaping, nicotine and its relationship to smoking and argues many assumptions made by scientists over the decades about the addictive nature of nicotine are wrong. Posted November 2014.

US High School Student Ecig Use
According to a survey by the CDC, in 2013, among all US high school students, cigarettes (12.7%) and cigars (11.9%) were the most commonly reported tobacco products currently used; current being at least 1 day in the past 30 days. Ecigarette use was at 4.5%. However, current use of only e-cigarettes was 0.6% among high school students; indicating perhaps that smoking students are looking for a less harmful option. Published November 2014.

Ecig Related Fires Rare (PDF)
More than 2.5 million Americans are using electronic cigarettes, but a paper from the U.S. Fire Administration says incidents involving fires and explosions are rare. Only 25 incidents were recorded between 2009 and 2014 and of those, 52% were classified as “minor fire spread”. Published October 2014.

Effectiveness Of The Electronic Cigarette
A small study has found second-generation e-cigs to be immediately and highly effective in reducing cigarette craving and withdrawal symptoms. Published October 2014.

Trends In Ecigarette Awareness (AU/UK)
73% of UK respondents in this study reported their ecigarettes contained nicotine as did 43% in Australia, even though the sale, possession and/or use of nicotine-containing ecigs is illegal in Australia. (Abstract – published October 2014)

A Longitudinal Study of Electronic Cigarette Use
According to this study by researchers at the Center for Survey Research, University of Massachusetts Boston; intensive users of e-cigarettes were 6 times as likely as non-users/triers to report they quit smoking. Daily use of electronic cigarettes for at least one month was strongly associated with quitting smoking at follow up. (Abstract) Published October 2014.

Ecigarettes And The Bullshit Assymmetry Principle
Commenting on a rather interesting study proclaiming ecigarettes as a source of ‘thirdhand’ exposure to nicotine (and a rather minor source at that), Clive Bates applies the ‘Bullshit Assymetry Principle’. Clive Bates has previously worked with ASH – Action on Smoking and Health. Published September 2014.

Various Factors Influencing Ecigarette Nicotine Yield
This study found depending on puff conditions and product features, 15 puffs from a personal vaporizer can provide far less or far more nicotine than a single tobacco cigarette. However, influences can be predicted well by a mathematical model of the relevant physics. Published September 2014.

Diacetyl, Acetyl Propionyl And Eliquids
Summary notes on a study evaluating the presence of diacetyl and acetyl propionyl in e-cigarette liquids. 74.2% of the samples contained either diacetyl or acetyl propionyl, but on average within safety limits – although some eliquids had higher levels. The authors also point out tobacco cigarette smoke contains levels 100 times higher for diacetyl and 10 times higher for acetyl propionyl compared to e-cigarette vapor average daily exposure. Published September 2014.

Particulate Metals And Organic Compounds
With the exception of nickel, zinc and silver, the use of e-cigarettes demonstrates a remarkable decrease in secondhand exposure to all metals and organic compounds according to this study. With regard to Ni, Zi and Ag; the report says implementing quality control protocols would further minimize the emission of metals. Published August 2014.

Electronic Nicotine Delivery Systems (PDF)
A report from WHO examining what it states is emerging evidence on the health impacts of electronic nicotine delivery systems (ENDS) use. It says ecigs “represent an evolving frontier, filled with promise and threat for tobacco control”. It also states, “The evidence and recommendations presented in this report are therefore subject to rapid change”. Published August 2014.

NOTE: This report has been criticised by Dr. Konstantinos Farsalinos, who says the organisation continues to “maintain an overcautious approach and present one-sided evidence”. Clive Bates says it is a modest improvement on WHO’s previous extremist views, but still involves a hugely disproportionate regulatory response. Professor Gerry Stimson, Emeritus Professor at Imperial College London, says WHO is once again exaggerating the risks of e-cigarettes.

Busting The Ecig ‘Gateway’ Myth
A recent study discussed in Australian Medicine says electronic cigarette use is associated with smoking reduction and use of electronic cigarettes by non-smokers is rare not only rare, no migration from vaping to smoking has been documented. Published August 2014.

Effectiveness Of Ecigs In Quitting Smoking
A cross-sectional population study (5863 people) of the effectiveness of e-cigarettes as a quit smoking aid has found ecig users were more likely to report abstinence than either those who used other nicotine replacement therapies or no aid. Published August 2014.

Briefing On Ecigarettes For Policy Makers
A briefing on e-cigarettes and related policy issues by Clive Bates, who was previously involved with ASH (Action on Smoking and Health). In the UK. Mr. Bates points out vaping could save up to a billion lives in the 21st Century. Published July 2014

Ecig Benefits Outweigh Potential Harm
A Queen Mary University (UK) study has found that despite gaps in knowledge, current evidence concerning e-cigarettes doesn’t justify the devices being more strictly regulated than, or even as strictly as, tobacco cigarettes. The study presents evidence from 115 references. Published July 2014.

Doctors Attitudes Towards Vaping
Two thirds  physicians surveyed last year felt electronic cigarettes are a helpful aid for smoking cessation and 35% recommended them to their patients. Published July 2014

ECF Big Survey 2014 Results
Data from a survey of more than 10,000 vapers carried out by Electronic Cigarette Forum (ECF) is gradually being released. The 75 question survey had a 97% completion rate. Published July 2014.

Reclassification Of Nicotine Eliquids Under CLP Recommended (PDF)
A report by toxicology consultants, which has been verified by Professor Riccardo Polosa, Professor Bernd Mayer and Dr Jacques Le Houeze states eliquids with typical nicotine concentrations should be reclassified as CLP category 4 (the lowest); the same classification as washing up liquids. Currently nicotine eliquids have been classified as CLP category 2 or 3; alongside strychnine and formaldehyde. CLP is the set of regulations covering classification, labelling and packaging of substances and mixtures in the EU. Published July 2014.

Eliquids And Inhalation Toxins (PDF)
A summary of a study headed by by Dr. Konstantinos Farsalinos evaluating sweet-flavored eliquids for the presence of Diacetyl and Acetyl Propionyl. Published June 2014.

Glantz Letter “Misleading, Without Scientic Foundation”
A letter to the World Health Organisation in May (see earlier entry below) signed by 53 nicotine specialists and health professionals was criticised by anti-ecig crusader Stanton Glantz and a number of others. The 53 original signatories have returned fire; deconstructing Glantz’s arguments. Published June 2014.

Myocardial Function – Tobacco vs. Ecigarettes (PDF)
A recent study found that while smoking causes a delay in myocardial relaxation, ecig use had no immediate effects. Published June 2014.

Effects Of E-cigarette Use On Exhaled Nitric Oxide
A study recently published in Toxicology and Applied Pharmacology that concluded based on nitric oxide (FeNO) levels, e-cigarettes are not safer than tobacco cigarettes and lung function is impaired has been labelled “arbitrary and completely wrong” by Dr. Konstantinos Farsalinos. Published June 2014.

E-Cigarette Vs. Nicotine Inhaler
A study comparing e-cigarettes with nicotine inhalers in terms of perceived benefits, harms, appeal, and role in quitting has found more subjects would use ecigs to make a quit attempt. Vaping devices gained a much higher total satisfaction score than inhalers. Published May 2014

Statement From Specialists In Nicotine Science And Public Policy (PDF)
Dozens of health professionals, including Australia’s Dr. Coral Gartner, have signed an open letter to Dr Margaret Chan, the Director General of the World Health Organisation (WHO) with their concerns regarding the body ignoring the importance of tobacco harm reduction strategies such the use as electronic cigarettes. The letter states among other points that it is counterproductive to ban the advertising of e-cigarettes and other low risk alternatives to smoking. The communication states these products could be among the most significant health innovations of the 21st century and could save hundreds of millions of lives. Published May 2014.

ASH Scotland E-cigarette Briefing (PDF)
ASH Scotland current views on vaping and ecigarettes. Published May 2014.

Ecigarettes Boost Quitting Success Rates
A survey carried out by University College London has found smokers are approximately 60% more likely to report succeeding quitting smoking if they use e-cigarettes than if they use willpower alone or nicotine replacement therapies such as patches or gum. Published May 2014 in the journal Addiction.

High Voltage Vaping And Carbonyl Compounds
A recent study measured twelve carbonyl compounds in ecig vapors where battery output voltage was gradually increased from 3.2 to 4.8 V. It found vapour did contain some toxic and carcinogenic carbonyl compounds; but these varied between eliquids and were at much lower levels than cigarette smoke when lower voltages are used. High voltages significantly increased toxic compounds. Published May 2014.

Ecigarette Vapor And MRSA
A study presented in May at the 2014 American Thoracic Society International Conference states while e-cigarette vapor appears to boost the virulence of dangerous and medication-resistant bacteria such as MRSA, it’s to a lesser degree than cigarette smoke.

Ecigs A “Much Safer Source Of Nicotine” (PDF).
A report commissioned by Public Health England states electronic cigarettes offer “vast potential health benefits”, but requires appropriate regulation, careful monitoring, and risk management. “However the opportunity to harness this potential into public health policy, complementing existing comprehensive tobacco control policies, should not be missed.” Published May 2014.

Ecigs Not A Gateway To Children Smoking (PDF)
In another report commissioned by Public Health England, the authors state they could not identify any evidence to suggest that non smoking children who tried e-cigarettes were more likely to then try tobacco. Published May 2014.

Ecigs Benefit Asthmatic Smokers
A study of asthmatic smokers has found those who used electronic cigarettes regularly showed objective and subjective improvements in asthma outcomes, and goes on to state: “This study shows that e-cigs can be a valid option for asthmatic patients who cannot quit smoking by other methods.” Published in International Journal of Environmental Research and Public Health, May 2014.

Formaldehyde Release In E-cigarette Vapor
A study to be published in Nicotine and Tobacco Research states e-cigarette vapor can be the source of carcinogens, but the devil is in the detail according to Dr. Konstantinos Farsalinos. Published May 2014

E-Cigarette Awareness and Perceived Harmfulness
A study on awareness and perceived harmfulness of ecigarettes among U.S. adults has found 77% of respondents were aware of e-cigarettes and off this, only 51% believed e-cigarettes were less harmful than cigarettes. The study was published in American Journal of Preventive Medicine, May 2014. (The study results have caused concern in the vaping community and among some pro-vaping health professionals that misinformation campaigns are having an impact on public perception).

Safety Evaluation And Risk Assessment Of Electronic Cigarettes
A systematic review by  Dr. Konstantinos E. Farsalinos and Riccardo Polosa states currently available evidence indicates electronic cigarettes are by far a less harmful alternative to smoking and significant health benefits are expected in smokers who make the switch from tobacco to ecigs. Published April 2014.

Use Of Electronic Cigarettes In Great Britain (PDF)
An ASH survey shows electronic cigarette use among adults in Britain has tripled over the past two years and according to the associated study’s lead author (and as with the study that follows this item); there is no evidence to suggest ecigarettes are renormalizing smoking. Published April 2014.

Trends In Ecig Use In England (PPT)
A study by researchers from University College London
has found the use of ecigarettes by those who have never smoked is negligible. Evidence also indicates ecigs are not ‘renormalizing’ smoking – and they may be contributing to a reduction in smoking prevalence. Published April 2014.

Ecigs Among The Least Harmful Nicotine Delivery Products
A study that sought to estimate the harm level of various forms of nicotine delivery products rated cigarettes as the most harmful (overall weighted score of 100) and ENDS (electronic nicotine delivery systems) were rated among the least harmful. Published in European Addiction Research, April 2014.

AASCP Position Statement (PDF)
In a position statement released by the Australian Association of Smoking Cessation Professionals (AASCP), the body provides some support for ecigarettes and states the final decision to use the devices “belongs to the individual smoker, who should weigh up the risk and benefits and make a decision for their circumstances.” It also mentions there is no evidence to support concerns ecigs are a gateway to smoking or normalise smoking. Published April 2014.

Nicotine Not The Great Satan?
It appears some of nicotine’s bad reputation may be unfounded. As has been suspected for some time, it seems it’s a combination of chemicals that make tobacco so addictive – in fact it’s been shown to be “almost impossible” to get laboratory animals hooked on nicotine on its own. Of course, humans may be another story; but perhaps the degree of addiction is amplified when nicotine is consumed through smoking. Furthermore, nicotine also appears to have some therapeutic properties. Published March 2014.

Royal College Of Physicians’ Stance
Switching completely from tobacco to e-cigarettes achieves much the same with regard to health as does quitting smoking and all nicotine use completely says the Royal College Of Physicians. The body goes on to say even in the absence of regulation, the risks to ecig users and others is low. Published March 2014.

“A Moral And Ethical Duty” To Provide Ecigarettes
In an open letter published on The Montreal Gazette; the medical director of the Smoking Cessation Clinic at the Montreal Chest Institute and other health professionals have voiced their support for the authorization of the sale of ecigs in Canada. In his letter, Dr. Gaston Ostiguy mentions states there is a “moral and ethical duty to provide these products to addicted smokers.”

Ecig Gateway Effect Claims Deconstructed
A study by Professor Stanton Glantz and Dr Lauren Dutra on teenage smoking and ecig use has been thoroughly debunked by Clive Bates, who called the document “false, misleading and damaging”. Mr. Bates was previously director of Action on Smoking and Health (ASH-UK). Published March 2014.

Glycerol Does Not Cause Lipoid Pneumonia
In March 2014, another story started doing the rounds of the media relating to a person who had contracted lipoid pneumonia and glycerol based eliquids were pointed to as the culprit. Dr. Konstantin Farasalinos details why glycerol cannot cause lipoid pneumonia.

Impact Of EU Ban On Higher Nicotine E-cigarettes On Smoking. (PDF)
The EU Tobacco Products Directive (TPD), which will limit nicotine eliquid levels to 20mg/ml, will curb the use of e-cigarettes says a report from London Economics. It estimates the TPD will result in the deaths of an additional 105,000 people a year in Europe. Published February 2014.

Real-World Effectiveness Of E-Cigarettes: A Population Study
This study found e-cigarette users were more likely still to be abstinent than either those who used NRT (Nicotine Replacement Therapies) bought over-the-counter or used no aid at all. Published February 2014 (abstract).

The Effects Of Nicotine On Human Health 
According to the American Council On Science And Health, the relative risk of mortality from lifetime use of various tobacco and nicotine products is comparatively low. “Electronic cigarette vapor appears chemically incapable of causing cancer
as cigarette smoke has done.” The report, Nicotine And Health, was published in January 2014.

Contaminants In Ecig Eliquids And Workplace Health Risks (PDF)
A study that reviewed available data on chemistry of ecig aerosols and eliquids found no evidence to suggest vaping produces inhalable exposures to contaminants that justify concerns relating to the health and safety of workplaces. Published January 2014.

A Longitudinal Study Of Ecig Users
A study carried out by has concluded electronic cigarettes may contribute to relapse prevention in former smokers and smoking cessation in current smokers. It also found in dual users who were still smoking at the point of follow-up had decreased their tobacco cigarette consumption by 5.3 cigarettes a day. Published January 2014.


Nicotine Myth Busting
Not a study or formal report as such, but I found this interview with nicotine expert Dr Jacques Le Houezec quite enlightening. Dr. Le Houezec busts a few myths surrounding nicotine and offers some advice on storage and related issues – valuable info for vapers.

Ecigs Do Not Stiffen Arteries (PDF)
Researchers from Onassis Cardiac Surgery Center in Greece have found that while smoking just 2 tobacco cigarettes caused significant stiffening of the aorta, no difference was observed after the use of e-cigarettes by both smokers and vapers. Published December 2013.

The Importance Of Flavours In Eliquids
A study headed by Dr. Konstantinos Farsalinos finds flavours play a major role in the overall experience of dedicated vapers and support the hypothesis that flavoured eliquids are important contributors in reducing or eliminating the smoking of tobacco cigarettes. Published December 2013.

Second Hand Vapor Study (PDF)
A new study (Published in Oxford Journal, December 2013) shows while e-cigarettes are a source of second-hand exposure to nicotine; it’s far, far less than that associated with second hand cigarette smoke. Additionally, e-cigarette second-hand vapor did not contain combustion related toxicants tested for. Lead author was Maciej Goniewic from the Roswell Park Cancer Institute in Buffalo, N.Y.

Smoking Kills, and So Might E-Cigarette Regulation
Gilbert Ross MD, is medical and executive director of the American Council on Science and Health. In this special report on The American, he states “simple common sense would dictate that inhaling the fewer, less harmful ingredients of e-cigarettes as compared to inhaling the thousands of chemicals in the smoke from burnt tobacco, many of which have been shown to be carcinogenic, is highly likely to be healthier.” Published November, 2013.

Regulation: When Less Is More (PDF)
Presentation slides from Clive Bates (of the Counterfactual) concerning the dangers of over-regulating ecigarettes. Mr Bates urges positivity about the vast potential about ecigs, to put the (minor) risks in perspective and regulate as though the 1 billion who are predicted to die from tobacco related illnesses in the 21st century matter most. Presented at The E-Cigarette Summit, Royal Society, London in November 2013.

Research on Safety of Electronic Cigarettes (PDF)
Dr. Konstantinos Farsalinos’ comprehensive presentation on existing data relating to the safety of ecigarettes. Presented at The E-Cigarette Summit, Royal Society, London in November 2013.

Nicotine Safety in the Context of E-Cigarette Use (PDF)
Contrary to popular belief, the fatal overdose level for nicotine may be far higher than the generally accepted 50 to 60 mg (adult) says Dr. Jacques Le Houezec. This research was presented at the The E-Cigarette Summit, Royal Society, London in November 2013.

A Longitudinal Study Of Electronic Cigarette Users
A study of 477 ecigarette users by researchers from the University of Auckland and University of Geneva has arrived at the conclusion that “E-cigarettes may contribute to relapse prevention in former smokers and smoking cessation in current smokers” Published October 2013.

Ecigs Not A Gateway To Smoking
The study is yet to be published, but according to research presented at the annual meeting of the American Association for Cancer Research (October 2013), the use of ecigarettes by teens does not lead on to smoking tobacco in the vast majority of cases.

E-Liquids Shown To Have Low Cytotoxicity (PDF).
The results of testing of 20 e-liquids has revealed the majority of the vapor samples were found to have no adverse effects on cardiac cells. Even on the several that did have some effect (two of which were tobacco derived), the worst was 3 times less toxic compared to cigarette smoke. Published October 2013 in the International Journal of Environmental Research And Public Health.

Nicotine Levels Selection and Patterns of Electronic Cigarette Use
Another study from Dr. Konstantinos E. Farsalinos that concludes nicotine levels seem to play a crucial role in achieving and maintaining smoking cessation in a group of motivated subjects. The study involved 111 participants who had completely substituted smoking with electronic cigarette use for at least 1 month. Published September 2013

Vaping: coronary circulation and oxygen supply (PDF)
Recent research indicates electronic cigarette use does not affect the oxygenation of the heart. Lead by principle investigator Dr Konstantinos Farsalinos; results of the research were presented at the European Society of Cardiology annual congress in Amsterdam in August, 2013.

Eliquids: No Health Concerns
A study by Professor Igor Burstyn of Drexel University School of Public Health based on a review available data has confirmed chemicals generally found in ecig eliquids pose no health concerns. Published August 2013 (PDF).

MHRA Ecigarette Research
The UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) carried out extensive research on ecigarettes, arriving at the conclusion there was little concern that e-cigarettes can harm users by delivering toxic nicotine levels and little evidence of non-smokers taking up electronic cigarettes. The link above takes you to the general page on nicotine containing products and the findings mentioned are contained in 3 documents (all PDF) here, here and here. Published in June 2013.

Dual Use – Siegel Vs. Chapman
Dr. Michael Siegel, a Professor in the Department of Community Health Sciences, Boston University School of Public Health has challenged Australia’s Dr. Simon Chapman on the topic of dual use. Dr. Chapman maintains there are no health benefits associated with smoking reduction. Dr. Siegel counters this claim – and has some particularly harsh words relating to Chapman’s attitude towards electronic cigarettes and dual use. Published June 2013.

Efficiency and Safety of an Electronic Cigarette as Tobacco Cigarettes Substitute
In a 12-month trial of ecigarettes to evaluate smoking reduction/abstinence in 300 smokers not intending to quit; complete abstinence from tobacco smoking was documented in 10.7% and 8.7% at week-12 and after a year respectively. For the group receiving the higher dose nicotine cartridges, the tobacco cigarette cessation rate was 13% after a year. The study was published on PLOS One on June 24, 2013.

Evaluation of Electronic Cigarette Use And Liquid Consumption
This 2013 study challenges an EU proposal that would result in eliquids containing more than 4 milligrams of nicotine per milliliter being banned unless approved as medicinal products. The link above will take you to the International Journal of Environmental Research and Public Health abstract. Commentary from one of the study researchers, Dr Konstantinos Farsalinos, can be viewed here.

Cytotoxicity evaluation of ecig vapor extract
A 2013 study designed to evaluate the cytotoxic potential of 21 eliquids compared to the effects of cigarette smoke found ecig vapor is significantly less cytotoxic compared to tobacco. At this stage, the study notes are paid-access only, but comments on the study by Dr. Michael Siegel, can be viewed here. Additional commentary from the study’s lead author, Dr Konstantinos Farsalinos, can be accessed here.

Vaping profiles and preferences
1,347 vapers were surveyed in an effort to characterize e-cigarette use, users and effects. Results generally showed respondents found ecigarettes to be satisfying to use; cause few side effects; considered healthier than smoking, resulted in improve cough/breathing and lowered levels of craving. The survey was hosted at the University of East London. Published March 2013.

Ecigarette toxicants study
Levels of selected carcinogens and toxicants in vapour from electronic cigarettes have been found to be 9 to 450 times less than tobacco cigarettes in 12 brands studied; leading the researchers to conclude “substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants”. The study was first published online on March 6, 2013.

Ecigs – therapeutic medical device.. or not?
An in-depth look at the politics behind the push for e-cigarette regulation and the case for electronic cigarettes  being neither a tobacco product or a medical device; therefore not requiring such controls.

Impact of ecigarettes on schizophrenic smokers
Researchers from the CTA-Villa Chiara Psychiatric Rehabilitation Clinic and Research center in Italy determined the use of ecigs decreased tobacco cigarette consumption in schizophrenia sufferers who were smokers – and without significant side effects. Published January 2013.

2012 and prior

Electronic cigarettes: achieving a balanced perspective
This 2012 paper argues that while more research is needed on the cost–benefit of ecigs and appropriate regulation, the harms so far have been overstated relative to the potential benefits. The paper mentions a study that found of more than 2000 former smokers in this survey, 96% reported that the e-cigarette helped them to stop smoking.

ASH UK Ecigarette Briefing
Given there is little real-world evidence of e-cigarettes causing harm to date; particularly when compared to smoking, UK anti-tobacco group ASH believes if properly regulated, ecigarettes should be made available as part of a harm reduction approach to tobacco. The briefing contains various statistics related to vaping and points out between 2009 – 2011, Google searches using the terms ‘electronic cigarette’ increased
by fifty fold in the UK. The briefing is in PDF format.

E-cigarette Vapor And Cigarette Smoke Comparison
High nicotine e-liquids were vaporized in a series of experiments and the emissions compared to tobacco smoke. The study results indicate “no apparent risk to human health from e-cigarette emissions based on the compounds analyzed”.

Is Passive Vaping A Reality?
This study sought to identify and quantify the chemicals released on a closed environment from the use of e-cigarettes – the findings? There’s little to be concerned about with regard safety. This research again confirms the type and quantity of
chemicals released are by far less harmful to human health compared to regular
tobacco cigarettes. In fact, it “could be more unhealthy to breath air in big cities compared to staying in the same room with someone who is vaping.”

Indoor Vapor Air Quality Study
Data at Clarkson University’s Center for Air Resources and reviewed by an independent toxicologist indicates electronic cigarettes produce very small exposures to byproducts relative to tobacco cigarettes. The study has been peer reviewed and will appear the Journal of Inhalation Toxicology.

E-cigarettes: harmless inhaled or exhaled
Report from Health New Zealand stating e-cigarette vapors do not contain substances known to cause death in the quantities found.

Society for Research on Nicotine and Tobacco (PDF)
This research acknowledges that no drug is safe, but the emissions associated with the e-cigarette brand tested appear to be “several magnitudes safer” than tobacco smoke emissions.

Electronic Cigarettes As a Smoking-Cessation Tool
The findings of this study indicate “e-cigarettes may hold promise as a smoking-cessation method” and that further research should be carried out.

Electronic Cigarettes Do Not Damage The Heart
Electronic cigarettes appear to have no acute adverse effects on cardiac function according to research by cardiologist Dr Konstantinos Farsalinos.  He says based on currently available data, ecigs are safer and substituting tobacco with electronic cigarettes could in fact be beneficial to health.

Principles to Guide AAPHP Tobacco Policy
The American Association of Public Health Physicians recommends electronic cigarettes as a safer smoke-free tobacco/nicotine product.

Athens University Ecig Study Challenged
Dr. Michael Siegel questions a University of Athens study claiming e-cigarettes can cause lung damage.

Propylene Glycol Safe
Monkeys and rats were exposed continuously to high concentrations of propylene glycol, a common component of eliquids for periods of 12 to 18 months. Results of the research state “air containing these vapors in amounts up to the saturation point is completely harmless”.

Effect of ecigs on smoking reduction and cessation
A study showing the use of ecigarettes substantially decreased cigarette consumption without causing significant side effects in smokers who had no intention to quit. Published in 2011 (PDF).

Tobacco harm reduction as a human right
Approximately one-quarter of all lifelong smokers will die in middle age (between 35 and 69) as a result of smoking and the authors of this 2006 paper (PDF) urge tobacco harm reduction being viewed as a human right.

Tobacco cigarette addiction – it’s not just the nicotine
Nicotine is the major neuroactive compound of tobacco, but according to this 2005 paper; on its own it has weak reinforcing (addictive) properties. It appears other compounds found in tobacco smoke when combined with nicotine  produce the intense reinforcing properties of cigarette smoking that lead to addiction.”

Long-term effects of inhaled nicotine
An experiment where rats breathed in a chamber with nicotine at a concentration twice found in heavy smokers for 20 hours a day, 5 days a week over a 2 year period found no harmful effect of nicotine when given in its pure form by inhalation. Published in 1996.