Nicotine equivalence - why 20mg in ecigs are NOT the same as 20 cigarettes

It can be very frustrating when I read that people in the EU, making laws about e-cigs, seem to be saying that liquid containing 20mg/ml of nicotine is equivalent to 20 cigarettes.

It isn't - as I will explain.

The problem comes from a lack of understanding of the subject.

People look at the side of a bottle of e-liquid and read that it contains (say) 20mg/ml of nicotine.
Then they look at the side of a packet of cigarettes and read that each cigarette contains about 1mg of nicotine

They therefore state that 1ml of liquid is equal to 20 cigs - right ?

WRONG.

Now then, it is quite normal for new e-cig users to occasionally make this easy mistake - if they ask about it on a vaping internet forum they will receive the answer very quickly.

It is, however, completely unacceptable, negligent and ignorant for someone involved in the EU policy making to make this mistake. It demonstrates, at best, a complete lack of research - at worst, false propaganda.

WHY ?

The measure of nicotine that is declared on a bottle of e-liquid IS the amount of nicotine in the liquid.
The measure of  nicotine that is declared on the side of a packet of cigarettes is NOT the amount of nicotine in that cigarette.

It is easy to find out how much nicotine is actually in tobacco - HERE - and it is at least 10 times higher than the figure on the packet.

The amount of nicotine on the side of a cigarette pack is the dose of nicotine delivered to the body.

So, to compare the cigarette figure with the e-cig figure is quite simply not comparing the same thing.

Tobacco companies and Pharmaceutical companies WILL know this, but have not taken the opportunity to educate the legislators. Any competent Public Health professional should know this as well - but have left the legislators in ignorance - either that, or the legislators have been deliberately misled.

Tobacco smoking is the fastest way of delivering nicotine. If you use 1 ml of 20mg/ml e-liquid (over several hours), then not all of the nicotine will be absorbed into the body, and also the rate of absorption will be much slower than smoking tobacco, and nicotine is relatively rapidly metabolised - so the quantity of nicotine used will not be equivalent to the levels of nicotine obtained from smoking.

The rate of delivery is important - and in fact, it is believed that the concentration of nicotine in e-liquid that is required to deliver nicotine at the same rate as smoking tobacco is, in fact, 45mg/ml

The choice of strengths is important, and for those that need a higher dose then 20mg/ml there is a very good reason why.

There is another reason why the nicotine contained in e-cigs cannot be compared with the nicotine dose delivered by a cigarette - the habit and usage pattern is different. Smoking delivers a short, sharp, fast dose of nicotine, whilst vaping delivers a lower dose over a longer time - it is different

When looking at dosages, there are 2 important units of measure, T-max and C-max. T-max is the time to deliver the dose and C-max is the concentration that is delivered. ( Cmax is a term used in pharmacokinetics refers to the maximum (or peak) ... the drug has been administrated and prior to the administration of a second dose.)

Lets have a look at T-max and C-max for nicotine delivered by smoking and by e-cig vaping

- ( source - from ecigarette-research.com)

As you can see, there is not much difference between the time taken to deliver a dose of nicotine.

BUT - there is a huge, tenfold, difference between the C-max - in this case a 16mg/ml e-cig was used.

So - to come back to my original point :

You cannot compare the dose delivered from a cigarette with the concentration of nicotine in e-liquid - and most certainly not just by doing a quick sum, in your head, based on 2 labels.

The two figures are a measure of two completely things and in any case, the pattern of usage is different again.

Anyone that knowingly tries to do a simple mathematical comparison with cigarettes and e-liquid is a liar and attempting to deliberately mislead.


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Update

- Further recommended reading on this subject:
WHY 20mg/ml E-LIQUID IS USELESS FOR MANY
by Dave K.   -   aka 'The Happy Vaper'