Safety, or effectiveness? What do we want to prove?

[Ande]

This question has come up in my mind a lot as we've discussed clinical trials and ecig related research on a lot of threads. In future study of electronic cigarettes, what are the goals we want to see met?

Investigation of the effectiveness of electronic cigarettes as a stop-smoking aid?

Or investigation of the health effects of use of electronic cigarettes?


Personally, I think this is a crucial distinction:

Some of us see the future of ecigs as being best protected by finding evidence that they are uniquely effective in helping folks leave cigarettes behind.

Some of us really see them as a smoking alternative- as long as they're shown to be (much) less dangerous than cigarettes, we should be able to use them.

I'm personally leaning towards safety on this- over a few years, the market will show (and really already is) whether they are effective or not. People won't keep buying and using them if not.

Health effects studies, though, will be useful in terms of informing consumers. And if positive, health studies of this product will probably increase its use.



BUT....honestly, I'm confused, sometimes, by all the fuss. Both these questions have already been answered to my satisfaction. Ecigarettes are much safer than smoking cigarettes.

And ecigarettes are extremely effective in helping ME to not smoke cigarettes.

Best,
Ande

 

[burns_erin]

There problem here is that anecdata is not acceptable in use for scientific research. What I think is needed is a large scale nih grant. Those size studies often endeavor to answer multiple questions. So in theory, we could get one set up that starts with a large group and looks st the quit rates for analogues. Then follows those consistent quitters longitudinally to find the health benefits or risks. I think it would be difficult to set up a double blind placebo controlled study (admittedly the gold standard), but they could do subject matching of people who don't want to quit or want to quit with other methods.

 

[Ande]

The thing is, anectdotal evidence and clinical trials are NOT the only two options, nor are they the best ones for a product like this.

I'm gonna say that larger population studies are the way to go.

But I'm still curious to hear opinions: Which should be studied first? Safety, or effectiveness?

Best,
Ande

 

[milo hobo]

These do not seem mutually exclusive to me. Safety will quell concerns, but requires longitudinal studies. Once it is proven safe for short term applications (like NRTs), then we can study effectiveness. After that is proven, then we can study long term applications' safety.

 

[J**2]

Study both. They are not mutually exclusive. Must be compared to regular analogues.

J


GG stealth, Provari, DIY chef

 

[ProveIt]

You need safety researched 1st.
I would split this into 2 parts:
1. Safety to the user to counter attempts to pass legislation to outlaw electronic cigarettes.
2. Safety of 2nd hand smoke to prevent legislation against the use of electronic cigarettes.
It is a disgrace on the medical research community this hasn't already occurred.

I would split these into 2 parts as well:
1. Clinical analysis of vapor (1st hand and 2nd hand) taken under realistic test conditions.
2. Large number studies of people who have used for an extended period of time, compared to people who smoked and quit for similar lengths of time to get an apples to apples comparison.


Effectiveness in smoking cessation is needed to promote use, expand the market, and decrease the cost.
If they are classified as a smoking cessation alternative, they become eligible for deduction as medical expenses just like other smoking cessation aids (the equivalent to a 15-30% cost reduction).
If their popularity expands as a smoking alternative, the price can be expected to drop, the variety can be expected to increase, and the quality and technology can be expected to increase.
However, it means nothing to prove it as a viable smoking cessation device if it isn't proved as safe as other methods to start with.

 

[ProveIt]

...also, am I the only one who now looks at the cost of nicotine gum, lozenges, patches, etc. and believe they are raping the public?

Obviously, the ingredients aren't that expensive.

 

[recidivus]

12 week schedule at 30-40/week, with little to no substitute for the habitual side of smoking. I am more amazed that people manage to quit using them than the costs.

 

[vapmex]

Efectiveness is not a matter of subject IMO, most of us know that these are effective from reducing considerably the analog cigarettes consumption to going cold turkey all the way..... we should focus on safetiness since there might be something that we don't know and that can be fixed.... most of us "Want to Belive" but we don't have a strong base to confirm that (for example) transforming PG into vapor doesn't degenerate in a harmful substance or it's safer to use VG instead of PG.

 

[skydvejam]

I must agree with this, effectiveness can be highly subjective, but safety is not. How safe are these compared to both analogs, other replacements, and of course cold turkey? If we can prove these safe, or make adjustments to them to make them safe, then people can make there own minds up on if they are effective or not.

Efectiveness is not a matter of subject IMO, most of us know that these are effective from reducing considerably the analog cigarettes consumption to going cold turkey all the way..... we should focus on safetiness since there might be something that we don't know and that can be fixed.... most of us "Want to Belive" but we don't have a strong base to confirm that (for example) transforming PG into vapor doesn't degenerate in a harmful substance or it's safer to use VG instead of PG.

 

[ohnoitsthomas]

Safety has to be at the forefront. Without proof of safety, or rather proof of being a "safer" alternative, why anyone care if it helps people quit?

For example copious amounts of alcohol can help someone quit too but it is also addictive and hazardous and thats why its illegal....oh crap nevermind. ha