How Mentoring and Alkaloid Variation Affect Success with THR

The success rates for what we might call 'single-option vaping': artificial restriction to one make of mini ecig and one or two refill types, along with zero advice or support (as is the norm in clinical trials and studies) is known to be around 10% to 12%. This is when the subjects are offered the worst possible combination of factors. With some relaxation of these artificial restrictions, it can reach 30%. With a decent offer of product choice and basic support, the 'success rate' in switching at 1 year is 41% as measured in the latest trial [8].

The best success rate is, anecdotally, about 75%. The higher figure would be for people who want to switch away from cigarettes, who are well-mentored, and who have access to all options (all hardware and liquids that may be required). This combination is normally only available within a family environment or similar. These figures are all taken at the 1-year mark, from clinical trials and studies and from community feedback.

Clinical trials are forced to use a single option and therefore can never reproduce real-world results, and this is clear from the exceptionally low success rates they achieve in comparison with the real world. In the real world, an expert mentor can design the initial product combinations to suit the individual, and will then vary the products used as the individual's requirements change. None of this can be replicated in a clinical trial since (a) such trials are not run by experts but by people who are themselves beginners, and (b) it is normally the case that only one hardware/refill option is supplied.

Let's assume that good equipment choices are made and that reasonable support is available - in other words, the way things might be if the smoker who wants to switch locates a good forum. Even so, a percentage of people cannot avoid cigarette use without difficulty even with the best possible support: that is, the best equipment, a full range of liquids, and good mentoring. Nobody knows what this percentage is - opinions range widely, but we could guess at 25% as a rough starting figure, until some sort of research is carried out on this important issue. This group of people will still smoke the occasional cigarette even when using 36mg liquid on a capable VV device. They may also revert to smoking cigarettes under stress.

For these people, nicotine plus all the other replacement factors an e-cig can provide is not enough - something else is missing. 

Many of them, however, seem able to successfully avoid the use of cigarettes if they combine electronic cigarette use with Snus. This suggests that some other ingredient of tobacco is needed that is not supplied by an e-cigarette - in other words, nicotine alone is not sufficient. Providing a dual-product solution like this anecdotally raises the success rate to 80% or so, though expert mentoring is crucial with any type of smoking avoidance or smoking cessation attempt. Expert mentoring by definition is coaching by an expert user or users of the system in use.

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