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New Study Claims E-Cigs Don’t Help With Long Term Quitting

New Study Claims E-cigs Don’t Help With Long-Term Quitting

New Study Claims E-Cigs Don’t Help Smoker Quit in the Long-Term

 One of the most important and hotly-contested points about e-cigarettes is whether they help smokers kick their combusted tobacco habit, and a new study claims that there is very little evidence for their long-term effectiveness. The finding is based on previously conducted studies, however, and conflicts with a recent Cochrane review of the evidence, suggesting that there is more to this story than meets the eye. So, is the evidence for e-cigs’ long-term effectiveness really lacking, or has this study overlooking something crucial?

The Study – Looking at the Long-Term Evidence on E-Cigs for Quitting

The study was presented at a conference, and is therefore only available as an abstract – with no full, peer-reviewed version. This isn’t a huge problem, but it means that information about what the authors actually did is very limited. The abstract explains that the authors read 297 full texts about e-cigarettes (available as of May 2014), in the end settling on just four studies that met the inclusion criteria.

Two of these studies were randomized controlled trials and two were uncontrolled, before-and-after studies, but unfortunately the abstract offers no information as to which studies were actually included. From the information provided, it’s clear that one of these was the randomized controlled trial comparing e-cigs to patches for quitting smoking. Needless to say, there have been many studies published since May 2014, so this is only a review of a small portion of the evidence to date.

The Findings: Do E-Cigarettes Help Smokers Quit?

The researchers pooled the results of the four quitting studies to produce an estimate of the effectiveness of e-cigs for quitting smoking, finding that smokers using e-cigarettes were 71 percent more likely to have quit smoking after one month than those using a placebo, but at three months and six months, these differences disappeared. However, a closer look at the statistics underlines the uncertainty in this conclusion.

Since you can’t possibly test every smoker in the world to see what the true average chance of quitting using e-cigarettes is, every study conducted ultimately does its best to estimate how likely it is. To account for the uncertainty in an estimate based on a small number of data points, researchers use “confidence intervals,” which ordinarily say, “based on this estimate, we can estimate with 95 percent confidence that the actual answer will be between this number and this number.”

In the one-month results in this study, the best estimate for the odds of quitting with e-cigarettes was 1.71 (71 percent more than the comparative value of 1 for the placebo), with 1.08 and 2.72 as the probable lower and upper limits for the true value. Since the lower limit was above 1.00, the researchers were able to say there was a significant difference between vapers and placebo users. At three months, the best estimate for the odds was 1.95 (95 percent more than the placebo), but the confidence interval was between 0.74 and 5.13. Since the lower bound (0.74) was less than one, this is non-significant, but the true result could be anywhere from this to over five times the odds of quitting with a placebo. For six months, the best estimate was a 32 percent increase in odds, but the confidence interval ranged from 0.59 to 2.93, again non-significant because the interval includes the no-difference mark of 1.

One thing that’s immediately obvious from this is that there’s a lot of uncertainty in these estimates, and the finding is still consistent with the idea that e-cigs do help with long-term quitting. Clearly (as the authors point out), as of May 2014, more evidence was needed to make any sort of definitive determination about e-cigs’ effectiveness as long-term quitting aids.

The Cochrane review mentioned above included studies up to July 2014, and despite only having an extra couple of months, found the same two randomized controlled trials and 11 uncontrolled, before-and-after studies. The analysis based on the trials showed that nicotine e-cig users were 2.29 times more likely (confidence interval: 1.05 to 4.96) to quit over 6 to 12 months than those using placebo e-cigs, and were 31 percent more likely (confidence interval: 1.02 to 1.68) to reduce their smoking by 50 percent or more. Although – like this study – their analysis of the one randomized controlled trial comparing e-cigs to patches found no difference in quit rates, they also looked at reductions in smoking, finding that vapers were 41 percent more likely to reduce smoking than patch users.

Many other studies were also conducted after both of these reviews. For example, one real-world study published in August 2014 found that quitters who chose to use e-cigarettes were 61 percent more likely to quit than those choosing nicotine replacement therapy. Other real-world studies have also shown positive effects and small clinical trials have also suggested that e-cigarettes do help with long-term quitting.

As well as the limitations imposed by the small number of included studies in this recent review, studies done prior to May 2014 were also only of “cigalike,” first-generation devices, which don’t provide nicotine as efficiently as later-gen options, and appear less effective for helping smokers quit.

Conclusion: Outdated Data on Outdated E-Cigs, and Not Much of It

 Clearly, in the rapidly-evolving world of the e-cigarette, this handful of studies provides outdated evidence (released over a year ago and using inferior products) which is of limited validity considering things learned since then. The wide confidence intervals will be narrowed by more research, and studies conducted since then (and a more reliable systematic review conducted only months later) do offer evidence of e-cigs’ long-term effectiveness for quitting smoking.

However, there is a grain of truth to the claims being made. We – and many, many other people around the world – have quit smoking through vaping, but there genuinely is only limited scientific evidence for their effectiveness, and more studies really are needed to see how big an effect – assuming one does genuinely exist – e-cigs have on smoking habits. Currently, many positive studies have small numbers of participants – a fact which led the Cochrane reviewers to grade the evidence as “low” or “very low” quality – and we will only be able to definitively answer the question when we have larger studies on more modern e-cigarettes.

The only truly important thing, though, is whether it works for you. A randomized controlled trial can’t really tell you what will happen to you personally; you can only really give it a try and see if it works.

 Resources:

Michael Grey
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Michael Grey

With a passion to educate through my writings and a passion to help others, I found my place here at Black Note. Being that I am a former smoker who quit smoking because of vaping, I knew I could help others do the same. Working for Black Note is a true blessing. Not only do I help educate vapers on a daily basis through my writings, but I am also enjoying the benefits of working with an amazing team and sharing an authentic tobacco solution with the vaping community.
Michael Grey
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What is E-Juice?

E-juice, also known as e-liquid or vaping liquid, is the liquid that’s placed in the vaping device and subsequently atomized into vapor. When you go to buy e-juice, you’ll notice it contains a mix of several ingredients. These typically include vegetable glycerin (VG), propylene glycol (PG), some type of flavoring, and nicotine.

VG and PG form the base of the e-liquid. VG is a component used in food and personal care products; its role in e-liquid is to create a thick, dense vapor. PG is another popular solvent used in a variety of everyday items. It carries the e-liquid flavor, provides the “throat hit,” and enhances the vaping liquid’s ability to soak into wicks or cartomizer materials.

Nicotine is an optional ingredient, often available in different levels. E-juice also contains some type of flavoring.

Black Note leads the pack of tobacco vaping liquid by using only natural flavoring – extract from real tobacco leaves to produce real tobacco taste. When you go to buy e-juice from other companies, you may find any number of chemicals used to create synthetic flavors that include fake strawberry, manufactured vanilla, and even man-made tobacco flavors.

If your aim when you buy e-liquid is to experience the subtle nuances, genuine flair and authentic taste of real tobacco, then you’ll be on the mark if you buy e-juice from the Black Note lineup.

Best E-Juice

When you’re going to buy e-liquid, it’s only natural you’ll want the best e-liquid. But what, exactly, does it “best e-juice” mean? We’ll tell you.

For starters, you’ll want an e-juice that doesn’t contain all kinds of strange chemicals and concoctions that you can’t even pronounce. True, even the best e-liquid will contain vegetable glycerin (VG) and proplene glycol (PG), which serve as the base of e-juice, but you don’t necessarily need a host of other chemical compounds.

The best e-juice will stick to natural ingredients, like real tobacco extract, rather than rely on synthetic flavorings, colorings and other additives. Diacetyl is one of those synthetic ingredients that has gotten a pretty bad rap, although its use is not all that uncommon for producing sweet e juice flavors.

Definitely read the ingredient list before you buy e-juice to ensure you recognize what’s on it. Better yet, see if the e-juice company offers a lab report to confirm what’s actually inside the e-liquid.

In addition to having as few chemical ingredients as possible, the best e-juice will have an amazing taste. For those who enjoy authenticity over imitation, the most amazing taste is the most natural taste, especially when it comes to tobacco. Since Black Note uses real extract from tobacco leaves, we not only avoid all those weird chemical flavorings, but we also produce the most authentic experience: tobacco vaping liquid that actually tastes like tobacco.

Best E-Liquid on the Market

Anyone looking for the best e-liquid on the market need look no further than Black Note. Black Note tobacco vaping liquid ranks as the best e-juice across the board in every category, starting with the taste.

Black Note’s main claim to fame is producing a tobacco vaping liquid that actually tastes like real tobacco. That because we use real tobacco extract, not chemicals, to create the best e-juice tobacco flavor. Using extract from real tobacco leaves retains tobacco’s nuances and flavor notes, giving you the most authentic and multi-faceted tobacco experience.

In addition to being the best e-juice for tobacco taste, Black Note also has the best e-liquid manufacturing process. We spent years researching and testing various production methods, and finally landed on one that we believe is absolutely perfect.

It starts with growing carefully selected tobacco seeds, followed by an equally precise of steps that include an extensive natural extraction process. Even our bottling and packaging is done with the utmost care, using recycled and recyclable packaging materials to ensure our products are as earth-friendly as they are vapor-friendly.

One more category where Black Note ranks as the best e-liquid is with the value. Every order comes with free domestic shipping, one-to-three day domestic shipping guarantee, and a 90-day, money-back satisfaction guarantee. If you’re not happy for any reason, or don’t agree we’re the best e-juice on the market, send it back on us and we’ll refund your money.

Vape Juice Ingredients

Vape juice ingredients can be pretty straightforward – or not. At the very least, most vape juice contains propylene glycol (PG), vegetable glycerin (VG), and some type of flavoring. Nicotine has largely become an optional ingredient that can be included at varying levels or left out altogether.

Vegetable glycerin (VG) and propylene glycol (PG) are usually the two main ingredients that make up the base of most vape juice.

VG is a plant-based substance with the ability to produce a dense, thick vapor. PG is an additive found in many food items and certain medicines. It carries the flavoring, provides the “throat hit” and enhances the vape juice’s ability to soak into the wicking materials.

Nicotine levels can vary, as can ingredients that make up the flavorings. The components that make up vape juice flavoring are where ingredients can get rather complicated.

Vape juice that relies on artificial flavorings can contain any number of extraneous chemicals and other additives, whatever it takes to recreate the flavor the ecig juice is going for.

Black Note uses only natural flavorings: extract from real tobacco leaves. That keeps our ingredient list incredibly simple, backed by a lab report to prove it. You won’t find any strange chemical concoctions used to produce our tobacco flavor, just real tobacco extract that delivers a real tobacco experience.

What is the Best Flavor for Ecig Juice?

From strawberry shortcake to banana rum, ecig juice comes in tons of flavors. While folks can debate and discuss all the fruity, sweet or food-like flavors all day long, the best flavor for e-cig liquid is straight-up tobacco.

Why? Vaping was originally created as an alternative for traditional cigarettes, mainly for those who enjoy the taste of tobacco. And when you can find an e-cig liquid that is able to recreate tobacco’s full-bodied yet delicate flavor notes and nuances, but without the harmful chemicals found in cigarettes, then you’ve found the best ecig juice.

Recreating tobacco’s complex flavor isn’t easy, especially when it’s attempted with artificial ingredients. That’s why Black Note sticks to the real thing, extracting the essence of real tobacco leaves to flavor our vaping liquid. Not only does this avoid the harmful chemicals in cigarettes, but it also eliminates the flavoring chemicals found in many ecig juices. The end result is real tobacco taste, an authentic tobacco experience and the best flavor for ecig juice you can find.

Notice also we said the best e-cig flavor was straight-up tobacco, not plain old tobacco. Black Note’s real tobacco vaping liquid happens to come in a variety of different blends, from the light and airy to the peppery and robust. Not all tobacco is created equal, and different blends capture the specialized subtleties that make each tobacco unique.

Best Sweet Tobacco E-Juice

When it comes to sweet tobacco e-juice, your options can be broken down into two categories.

The first category contains tobacco e-juice that overlays the tobacco flavor with artificial chocolate, caramel, vanilla, fruity or other dessert-like flavorings. We wouldn’t classify any such flavors as the best tobacco e liquid, simply because they typically use chemicals and other artificial ingredients to create the tobacco taste, the sweet taste, or both.

The second category of sweet tobacco e-juice is where you’ll find the best tobacco e-liquid, sweet or otherwise. This category contains vaping liquid created using only natural flavorings, which is exactly where Black Note fits in. Instead of concocting flavors using synthetic ingredients, Black Note uses an extensive extraction process that slowly and deliberately extracts the tobacco essence from real tobacco leaves.

The result is the best tobacco e-juice: tobacco vaping liquid that actually tastes like real tobacco. And if you’re going for the best sweet tobacco e liquid, we have a few tobacco blends that offer varying levels of sweetness.

Prelude is our sweetest tobacco e-liquid, containing golden Virginia tobacco. Made from fire-cured dark Virginia tobacco, Sonata is our Cavendish blend with a mildly sweet and nutty flavor. Solo is our menthol blend, giving you a semi-sweet minty taste created from natural menthol crystals extract from dried mint leaves.

For the best tobacco e-liquid that’s naturally sweet and remarkably delicious, Black Note is at your service.

WARNING: Black Note products are not smoking cessation products and have not been tested as such. Black Note products are intended for use by adults of legal smoking age (21 or older in California), and not by children or women who are pregnant or breastfeeding. Black Note products contain nicotine, a chemical known to the State of California to cause birth defects or other reproductive harm. Ingestion of the non-vaporized concentrated ingredients can be poisonous. Keep out of reach of children and pets. For immediate advice, contact poison control center: (800) 222-1222