111 replies to this topic

[Toby]

Yeah, yeah Katherine.. f¨ck the BBC .. f¨ck the leukemia!
We really do all need you!

[Starlight]

Katherine, there's not much more that I can think of to say that others here haven't already said , so I can only say that I echo what they've all said.

Sending you many "Get well fast" wishes and hoping the chemo doesn't knock too much stuffing out of you

[SSWright]

Toby, on 29 March 2011 - 12:32 AM, said:

Yeah, yeah Katherine.. f¨ck the BBC .. f¨ck the leukemia!
We really do all need you!

I couldn't have said it better myself.
Heres to you fighting for our rights for years to come.

[stickyfingers]

Unfortunately with death, many want to blame somebody else and I wouldnt be surprised if the family of the deceased had put pressure on the doctor to pinpoint the use of ecigs as a possible reason. I can understand that but it all seems a bit alarmist. Nobody ever told me that vaping would reverse the damage i had inflicted on my body through smoking for 20 years.

Edited by stickyfingers, 29 March 2011 - 08:55 AM.

[Toby]

That e-cig footage is old BBC stock, 2+ years old, from when e-smoking was a "new thang"...

Here is it on YouTube for quicker linking, but with compressed image, and rather dodgy sound (why?) -



Notice the well informed doctor and extreme vapour production from the 901s...

Placebo Effect said:

Not surprisingly, Dr. Allcock appears to have a track record of being flimsy with his facts, complete with claiming 4 years ago that 5,000 lives would be saved each year because of an indoor smoking ban.

100 days - then we will kick the habit - Today's News - News - JournalLive

[doodlebug]

The problem with testing ecig users for the state of their lungs after using the products is that we are all former smokers who have lung damage already from however many years of smoking! I can't see anything useful coming out of such testing. Unfortunately, we are back to the ethical dilemma which Dr Joel Nitzkin talked about last year. His point was basically this:

"The missing level of evidence is data from clinical trials of sufficient duration and power to address these issues at a 95% level of confidence. The best estimate of our AAPHP Tobacco Control Task Force is that a controlled trial to conclusively demonstrate that E-cigarettes pose a miniscule risk of tobacco-related death compared to conventional cigarettes would be impossible to conduct for both ethical and logistical reasons.

The investigator would have to recruit 2,000 to 5,000 young adult non-smokers. They would then have to be randomized into a “control” group assigned to smoke two packs a day of a specified conventional cigarette, and a “case” group assigned to vape (use an E-cigarette product) to secure an equivalent dose of nicotine. Both groups would then have to be followed for about fifteen years to document differences in multiple causes of illness and death. In addition, family members and occupational contacts would have to be followed for evidence of illness related to environmental tobacco smoke vs. environmental E-cigarette vapor.

In an article published in December of 2009, Murrelle, et al, considered this issue from the perspective of continuing to smoke conventional cigarettes vs. switching to a lower risk product vs. quitting altogether. Without addressing whether such a study would be an observational or experimental study, they reached similar conclusions as to sample sizes and duration of study. Limiting their end point to incidence of lung cancer as the outcome variable, they estimated that a study to document the efficacy of a modified risk tobacco product expected to reduce lung cancer risk to a level equal to quitting smoking altogether (as would be the case with E-ciigarettes) would require observation of 8,000 subjects for five years, with 2,000 subjects in each of four groups: continuing smokers, quitters, switchers to the modified risk product, and non-smokers.

If testing a modified risk product expected to only reduce lung cancer risk by only a few percentage points (as would be the case with reduced exposure conventional cigarettes) the sample sizes would have to be about ten times larger, and the duration fifteen years or more.

Separate studies of similar magnitude would be required to document whether such marketing of E-cigarettes or any other presumably modified risk tobacco product would attract large numbers of teens to tobacco use, reduce long-term quitting of nicotine use, or serve as a gateway to use of conventional cigarettes.

All of the questions noted above could be easily and inexpensively addressed by implementation of the proposed harm reduction initiative, then implementing research and surveillance to track the issues noted above. Since participation would be huge, the time required to gather the needed data would be minimized. If results did not meet initial expectations, mid-course policy changes could be made."

What Dr Nitzkin is pointing out here is that the necessary clinical trials would never get past an ethics committee, because it would necessarily involve recruiting non-smokers and getting a significant number of them to start smoking! Clearly, this is not going to happen.

What we DO have, however, is a wealth of knowledge about the eliquids we are using, percentages of nicotine, and a great deal of knowledge about the base liquids. The flavourings are certainly more of an unknown, and this is something we shall need to address in the coming years.

But the fact remains abundantly obvious to any educated observer: when a like-for-like comparison is drawn between tobacco cigarettes and electronic cigarettes, the electronic cigarette HAS to be orders of magnitude safer than smoking tobacco.

I agree that it is understandable that the family would want to point the finger and apportion blame, but in this instance, the blame is misplaced.

Suffice to say my deepest sympathies are with Mr Miller's family at this dreadfully sad time.

[doodlebug]

Toby, on 29 March 2011 - 08:42 AM, said:

That e-cig footage is old BBC stock, 2+ years old, from when e-smoking was a "new thang"...

Here is it on YouTube for quicker linking, but with compressed image, and rather dodgy sound (why?) -



Notice the well informed doctor and extreme vapour production from the 901s...

Placebo Effect said:

Not surprisingly, Dr. Allcock appears to have a track record of being flimsy with his facts, complete with claiming 4 years ago that 5,000 lives would be saved each year because of an indoor smoking ban.

100 days - then we will kick the habit - Today's News - News - JournalLive

How extraordinarily disappointing, Toby! Stiff letters to the BBC will follow - we are NOT amused!

[Crundy]

I'm interested in two things from this:
1) What was the "oily residue"? Surely they can analyse a sample of it and find out if it came from the guy's eLiquid? and
2) Was it solely (if at all) this residue that caused the condition?
I'm not interested in the report until they answer these two questions. If the residue was from his eCig and it did cause his death then we need to know as soon as possible so we can ensure whatever it is isn't included in any flavourings.

I suspect the "oily residue" was actually PG and his condition was caused by something else. The article mentions that he already had emphysema, and according to WP there is an endogenous cause of LP:

Quote

from the body itself, for example, when an airway is obstructed, it is often the case that distal to the obstruction, lipid-laden macrophages (foamy macrophages) and giant cells fill the lumen of the disconnected airspace

Bear in mind that smoking-related emphysema is caused by macrophages consuming smoke particles and releasing elastase into the lungs, breaking down the elasticity of the alveoli resulting in reduced lung surface area. Over time the lungs become heavily populated with macrophages and if the intake of smoke is suddenly stopped it's possible that they may start consuming lipids from the capillary beds and turn into foam cells, in the same way as they do in the coronary arteries leading to ischemic heart disease (e.g. angina). That said, I'd be interested to know if any flavourings actually contain any lipids which could be consumed by macrophages.

[doodlebug]

Crundy, on 29 March 2011 - 08:49 AM, said:

I'm interested in two things from this:
1) What was the "oily residue"? Surely they can analyse a sample of it and find out if it came from the guy's eLiquid? and
2) Was it solely (if at all) this residue that caused the condition?
I'm not interested in the report until they answer these two questions. If the residue was from his eCig and it did cause his death then we need to know as soon as possible so we can ensure whatever it is isn't included in any flavourings.

I suspect the "oily residue" was actually PG and his condition was caused by something else.

Those are precisely the questions I asked of the reporter, and she was unable to give me anything like a satisfactory answer!

As for PG ending up as an 'oily residue' in our lungs, this is simply not possible. PG is a volatile substance, which is what makes it so ideal for use in eliquid. It is vaporised by our atomisers and if recondensation occurs at all, it would occur in the mouth and throat, long before it gets to the lungs - and certainly it could not reach the lungs in sufficient quantities to cause an 'oily residue'.

Bear in mind that PG is used in asthma inhalers and various other medical and non-medical applications. We are exposed to it on so many levels and its safety profile has been well-documented.

I suspect the 'oily residue' in Mr Miller's lungs would have been tar, or one of the other many toxic by-products of tobacco smoking. It is vicious and cruel, but it is a fact that smoking is an insidious killer. That said, it is still legal to use, and therefore we as individuals have the freedom to choose.

Fortunately, those of us in the vaping community know about some other free choices we have - including choosing far safer alternatives to tobacco smoking!

Edited by doodlebug, 29 March 2011 - 09:40 AM.

[drneil]

I was pretty incensed at the reporter saying this case is "medical evidence".

Two basic facts of research
1. Correlation does not imply causation
2. The plural of anecdote is not data.

No doubt the Daily Mail will be all over this story later.

[stickyfingers]

Just to pick up on a very simple point in the video clip, Mr Miller had been vaping for only 8 months, I would hazard a guess that he was in his fifties which gives the potential of 30+ years of smoking.

[Crundy]

doodlebug, on 29 March 2011 - 09:04 AM, said:

As for PG ending up as an 'oily residue' in our lungs, this is simply not possible. PG is a volatile substance, which is what makes it so idea for use in eliquid. It is vaporised by our atomisers and if recondensation occurs at all, it would occur in the mouth and throat, long before it gets to the lungs - and certainly it could not reach the lungs in sufficient quantities to cause an 'oily residue'.

PG is not volatile in the strict sense of the word, as it does not readily vapourise at room temperture. It does vapourise at higher temps, well above body temperature, thus is useful for vaping. It can and does settle in the lungs as it would settle back into a liquid at body temperature, but this isn't a problem as it is fully miscible in water (not an "oil") and does not cause respiratory problems. The tiny amount that does settle gets easily swept away by the cillia. It certainly won't cause lipoid pneumonia because of its solubility in water. I therefore suspect what happened was the coroner noted an "oily residue" in the patient's lungs (PG dissolved in mucus) and symptoms of lipoid pneumonia, and linked the two, as exogenous lipoid pneumonia is caused by inhaling oils. The two are not linked however, as despite the fact PG has an oily appearance, it is not itself an oil.

[Crundy]

We should try to ascertain if any flavourings do contain oils (although I'm guessing they don't, as they might not dissolve in PG/VG), because if any do, it is possible that the flavouring could cause lipoid pneumonia because small droplets could settle in the lungs and be consumed by macrophages, eventually turning them into foam cells (and subsequently giant cells when groups of them join). Is it worth asking F'Arts if they can provide a list of any oils in their flavours, what they are, and what percentage?

[doodlebug]

This is certainly an area we need to be looking at within the industry, since we really do need to know just how much potential impact the flavourings could have. I shall ask Pete to come in and give us the benefit of his wisdom - which is infinitely superior to my own in these matters!

[Crundy]

doodlebug, on 29 March 2011 - 09:49 AM, said:

This is certainly an area we need to be looking at within the industry, since we really do need to know just how much potential impact the flavourings could have. I shall ask Pete to come in and give us the benefit of his wisdom - which is infinitely superior to my own in these matters!

Cool, thanks.

One thing to note is that it's very important to know "what" they actually observed on his lung surfaces. If it was an "oily residue" then it probably was PG and was not linked to his death. If it was "oily droplets", then it certainly was an oil and could potentially have caused his death. The important part is knowing whether it was actually an oil in his lungs (which would appear as droplets as they would be insoluble in his mucous) or just PG/VG (which would appear as a film or coating as they are soluble in water).

[Crundy]

From flavourarts:

Quote

Ouf[sic] flavors are offered as water soluble and oil soluble.

Water soluble flavors are based on pharmaceutical grade propylene glycol and water. Average caloric count for water soluble flavors is 200 calories for 100 grams flavor. Oil soluble flavors are based on sunflower oil or triacetin. Average caloric count is 700 calories for 100 grams flavor.

So they do sell oil-soluble flavours, some of which presumably are liquid at room temp and insoluble in water.

Edited by Crundy, 29 March 2011 - 10:11 AM.

[acousticvillage]

drneil, on 29 March 2011 - 09:21 AM, said:

I was pretty incensed at the reporter saying this case is "medical evidence".

Two basic facts of research
1. Correlation does not imply causation
2. The plural of anecdote is not data.

No doubt the Daily Mail will be all over this story later.

I too am incensed and infuriated. It does seem that anyone these days can say anything and it is suddenly a "fact" or it is "data".
How dare this doctor play with the emotions and grief of this man's family by suggesting in a slightly sinister manner that there was something unusual about his death, that perhaps he should not have died, that perhaps someone is to blame......

How dare people sit on a two-bit programme and tout this crap as news...did anyone actually learn anything from this piece? -

I don't think we should add to the conjecture either by trying to guess what the cause of death ws, or what these mysterious "oils" are. The only information we have been provided with by the BBC and by the doctor is:
A Man has died
For the last 8 months he vaped considerably

The only correlation that exists is a psychological one....we see the two phrases and assume they are related...2 + 2 = 5.

It is scandalous. Unfortunately we do live in a society where people are generally less educated than 30 years ago, and where they have lost the ability to concentrate, reason and to question, and where we now assume that if something is on the telly, or on the internet then it must be true.

Edited by acousticvillage, 29 March 2011 - 10:12 AM.

[grizwald56]

Hope all goes well for you Kath, and if anyone can beat this thing, you can girl, and I hope the Chemo is'nt too hard on you either.

Just read this post and thought I'd mention a neighbour of mine who I introduced to vaping last July and who had shown an interest in mixing his own juices. After a few weeks of vaping he complained of a tight chest and that he was finding it hard to breath. Upon checking the juices he had mixed I found that he had been using Supermarket flavourings which he said were cheaper than the ones we associate with juices and also stated that the bottles contained a lot more flavouring i.e. 38ml.

I found that among the flavourings he was using were Vanilla, Oranga, Lemon, Almond and Peppermint, all extracts, and all oil based.

After pointing out the fact that he should not be using these as they may be the cause of his problems, and that they would damage his atomisers, which he did say were not lasting more than a few days, he switched to flavourings that I used and within a week found his breathing was much better and the tightness in his chest had gone. Also his atomiseres now last him far longer.

A lesson well learned by him I think.

Since then I have stressed to others that they should steer clear of Supermarket flavourings unless they are alcohol based.

Another instance of concearn occurred while at a family get together in the new year where a friend of my brother in law asked me if e-cigs could be used for drugs i.e. mrajuana, cocaine etc. I told him no as the e-cig does not get hot enough to vapourise these compounds and that they were specifically built to handle e-liquids only.

Later alarm bells started to ring as I wondered how long it would take some bright spark to freebase certain drugs and start using them in e-cigs. I sincearly hope this does'nt happen as we have enough of a fight on our hands already with the various organisations concearning e-cigs.

[Crundy]

grizwald56, on 29 March 2011 - 10:13 AM, said:

Just read this post and thought I'd mention a neighbour of mine who I introduced to vaping last July and who had shown an interest in mixing his own juices. After a few weeks of vaping he complained of a tight chest and that he was finding it hard to breath. Upon checking the juices he had mixed I found that he had been using Supermarket flavourings which he said were cheaper than the ones we associate with juices and also stated that the bottles contained a lot more flavouring i.e. 38ml.

I found that among the flavourings he was using were Vanilla, Oranga, Lemon, Almond and Peppermint, all extracts, and all oil based.

After pointing out the fact that he should not be using these as they may be the cause of his problems, and that they would damage his atomisers, which he did say were not lasting more than a few days, he switched to flavourings that I used and within a week found his breathing was much better and the tightness in his chest had gone. Also his atomiseres now last him far longer.

A lesson well learned by him I think.

Since then I have stressed to others that they should steer clear of Supermarket flavourings unless they are alcohol based.

This could actually be a potential cause of the above. If people just think "this flavoring from the supermarket is cheaper" and use it then they could end up with all sorts of health problems. I don't actually see any vendors warning people on their sites that they should only use "vape-safe" flavourings and explaining why. Perhaps this should be a recommendation?

grizwald56, on 29 March 2011 - 10:13 AM, said:

Another instance of concearn occurred while at a family get together in the new year where a friend of my brother in law asked me if e-cigs could be used for drugs i.e. mrajuana, cocaine etc. I told him no as the e-cig does not get hot enough to vapourise these compounds and that they were specifically built to handle e-liquids only.

Later alarm bells started to ring as I wondered how long it would take some bright spark to freebase certain drugs and start using them in e-cigs. I sincearly hope this does'nt happen as we have enough of a fight on our hands already with the various organisations concearning e-cigs.

Someone I introduced to eCigs (who is a bit of a toker) found a site detailing how to dissolve THC from cannabis resin into PG to vape, and the users of the site were bragging about how they've done it in front of cops because it doesn't smell. This isn't good news!

[Tdol]

acousticvillage, on 28 March 2011 - 08:29 PM, said:

The BBC, like all 24-hour channels with additional web content to boot, cannot continue to provide a 24 hour service unless it follows the pack - i.e. trying to find the sensationalist angle purely in order to get people to listen to or view them.

The BBC's impartiality disappeared long ago as can be seen in even the most serious of news stories, such as those concerning Israel, Islamic extremism and islamicism, religious persecution, UK and European politics...you name it. Today there is 10% information and 90% conjecture, opinion, analysis, viewpoint, soundbite, etc. Tragic.

The best we can hope for - and I mean this in the saddest and most shameful of ways - is that this is seen in the same way as the tragedy unfolding in Japan....sensation that is by and large being ignored by the news in favour of the idiocy in Libya!!!

I live in Tokyo and the reporting on events here has bordered on surreal at times- sometimes people brought their own agenda, but often it was simply through not knowing much about the place and misunderstanding things. It was a real eye-opener to see just how big the gap is at times. I agree that the demands of rolling news will inevitably be fleshed out with conjecture, etc, and in all likelihood, the next time they report on ecigs, the same vintage footage will be trotted out and the same platitudes. I doubt that we can do much to change the nature of the beast, but accepting it and trying to deal with what it is might be a good way forward. While the story will slide away from sight in a day or two, it will be remain in search; if enough appear it will help to manufacture the desired opinion. In many minds, it is already the first ecig death, even though an open verdict was recorded. It could easily harden into a "fact". They'll tag ECITA on at the end to achieve journalistic balance, but if you were a non-smoker watching that, what would you think? I think this may well be an early salvo across our bows- tobacco is an ugly business and there's DIY science on both sides and the fight will almost certainly be dirty.

Edited by Tdol, 29 March 2011 - 11:00 AM.