5/31/2016 1 To vape or not to vape E cigarettes for smoking cessation Andie Lesowske, MD
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Transcript
5312016
1
To vape or not to vape E cigarettes for smoking cessation
Andie Lesowske MD
5312016
2
Disclosures
None
5312016
3
Case
33yo man presents for a ldquoPhysical Examrdquo
Requests STD testing ndash no other concerns
Smokes 1 pack per day
5312016
4
Whatrsquos the appeal
Appetite suppressant
Stimulant
Anxiolytic
Social connection
5312016
5
Tobacco Dangers
Life expectancy is reduced by around three months for
every year of smoking after the age of 35
Myocardial infarction
Stroke
Aneurysm
Lung cancer
ldquopeople smoke for nicotine but die from the tarrdquo
5312016
6
Comprehensive treatment
Address nicotine with replacement
Address anxiety with SSRI counseling
Address habit with behavioral therapy
5312016
7
What is vaping
Who is vaping
Evidence for smoking cessation
Safety and dangers
Laws and regulations
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
2
Disclosures
None
5312016
3
Case
33yo man presents for a ldquoPhysical Examrdquo
Requests STD testing ndash no other concerns
Smokes 1 pack per day
5312016
4
Whatrsquos the appeal
Appetite suppressant
Stimulant
Anxiolytic
Social connection
5312016
5
Tobacco Dangers
Life expectancy is reduced by around three months for
every year of smoking after the age of 35
Myocardial infarction
Stroke
Aneurysm
Lung cancer
ldquopeople smoke for nicotine but die from the tarrdquo
5312016
6
Comprehensive treatment
Address nicotine with replacement
Address anxiety with SSRI counseling
Address habit with behavioral therapy
5312016
7
What is vaping
Who is vaping
Evidence for smoking cessation
Safety and dangers
Laws and regulations
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
3
Case
33yo man presents for a ldquoPhysical Examrdquo
Requests STD testing ndash no other concerns
Smokes 1 pack per day
5312016
4
Whatrsquos the appeal
Appetite suppressant
Stimulant
Anxiolytic
Social connection
5312016
5
Tobacco Dangers
Life expectancy is reduced by around three months for
every year of smoking after the age of 35
Myocardial infarction
Stroke
Aneurysm
Lung cancer
ldquopeople smoke for nicotine but die from the tarrdquo
5312016
6
Comprehensive treatment
Address nicotine with replacement
Address anxiety with SSRI counseling
Address habit with behavioral therapy
5312016
7
What is vaping
Who is vaping
Evidence for smoking cessation
Safety and dangers
Laws and regulations
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
4
Whatrsquos the appeal
Appetite suppressant
Stimulant
Anxiolytic
Social connection
5312016
5
Tobacco Dangers
Life expectancy is reduced by around three months for
every year of smoking after the age of 35
Myocardial infarction
Stroke
Aneurysm
Lung cancer
ldquopeople smoke for nicotine but die from the tarrdquo
5312016
6
Comprehensive treatment
Address nicotine with replacement
Address anxiety with SSRI counseling
Address habit with behavioral therapy
5312016
7
What is vaping
Who is vaping
Evidence for smoking cessation
Safety and dangers
Laws and regulations
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
5
Tobacco Dangers
Life expectancy is reduced by around three months for
every year of smoking after the age of 35
Myocardial infarction
Stroke
Aneurysm
Lung cancer
ldquopeople smoke for nicotine but die from the tarrdquo
5312016
6
Comprehensive treatment
Address nicotine with replacement
Address anxiety with SSRI counseling
Address habit with behavioral therapy
5312016
7
What is vaping
Who is vaping
Evidence for smoking cessation
Safety and dangers
Laws and regulations
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
6
Comprehensive treatment
Address nicotine with replacement
Address anxiety with SSRI counseling
Address habit with behavioral therapy
5312016
7
What is vaping
Who is vaping
Evidence for smoking cessation
Safety and dangers
Laws and regulations
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
7
What is vaping
Who is vaping
Evidence for smoking cessation
Safety and dangers
Laws and regulations
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
8
E-cigarettes
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
9
What are e-cigarettes
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
10
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
11
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
12
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
13
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
14
E-cig vs vaping
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
15
Who is vaping
Current smokers
Adolescents
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
16
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
17
Data for smoking cessation
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
18
THE randomized control trial
Are e-cigarettes more effective than nicotine patches at
helping people quit smoking
Assessment abstinence at 6 months
657 people randomized
Nicotine patch (21mg)
Nicotine e-cig (16mg)
Placebo e-cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
19
Results
Nicotine e-cig gt nicotine patch gt placebo e cig
No significant increased adverse events
Intervention adherence
Nicotine E-cig Nictoine Patch placebo
1 month 78 46 82
3 months 51 18 53
6 months 29 8 35
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
20
Cochrane review
E-cigs with nicotine help smokers reduce amount
smoked by at least half
Short term e-cig use without increased risk adverse
events
Overall quality of evidence is low
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
21
Adverse effects
Current data moderate quality at best
Long term health effects unknown
Toxins
Second hand vapor
Not FDA Regulated
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
22
Laws and Regs
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
23
FDA Regulation
Purchase
Must be at least 18yo
Must show ID if 18 ndash 26yo
Production
Register with FDA
Provide list of all ingredients
Apply for permission of sale of product
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
24
My thoughts
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
25
Resources
Bullen C Howe C Laugesen M McRobbie H Parag V Williman J et al Electronic cigarettes for smoking cessation a randomised controlled trial Lancet 2013 Nov 16382(9905)1629ndash 37 doi httpdxdoiorg101016S0140-6736(13)61842-5
McRobbie H Bullen C Hartmann-Boyce J Hajek P Can electronic cigarettes help people stop smoking or reduce the amount they smoke and are they safe to use for this purpose Cochrane Review Dec 17 2014
Sarah Knapton E-cigarettes are no safer than smoking tobacco scientists warn The Telegraph December 29 2015
Brown J Beard E Kotz D Michie S West R Real-world effectiveness of e-cigarettes when used to aid smoking cessation a cross-sectional population study Addiction 2014 Sep109(9)1531-40
FDA Vaporizers E-Cigs and other Electronic Nicotine Delivery Systems (ENDS) httpwwwfdagovTobaccoProductsLabelingProductsIngredientsComponentsucm456610htm
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
26
Resources
John Britton Deborah Arnott Ann McNeill Nicholas Hopkinson Nicotine without smokemdashputting electronic cigarettes in context the BMJ Talk Medicine podcast April 27 2016 accessed onlinehttpwwwbmjcomcontent353bmji1745
J Christensen We know it kills us why people still smoke CNN Nov 19 2015 accessed online httpwwwcnncom20140111healthstill-smoking
J Christensen E-cigarettes healthy tool or gateway device CNN Feb 6 2104 accessed online httpwwwcnncom20130912healthe-cigarettes-debate
Sabrina Tavernise FDA Imposes Rules for E-cigarettes in a Landmark Move The New York Times May 5 2016
E Fernaacutendez et al Particulate Matter from Electronic Cigarettes and Conventional Cigarettes a Systematic Review and Observational Study Curr Envir Health Rpt (2015) 2423 ndash 429
Multiple images from Stanford School of Medicine Stanford Research into the Impact of Tobacco Advertising
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
27
Questions
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
5312016
28
Cost compare E-cig vs cig
Cost compare cig vs e cig
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