Self-titration by experienced e-cigarette users: blood nicotine delivery and subjective effects

Rationale Self-titration is well documented in the tobacco literature. The extent to which ecigarette users (vapers) self-titrate is unknown. Objective This study explored the effects of high and low nicotine strength liquid on puffing topography, nicotine delivery and subjective effects in experienced vapers. Methods Eleven experienced male vapers completed 60 minutes of ad libitum vaping under low (6 mg/mL) and high (24 mg/mL) nicotine liquid conditions in two separate sessions. Measurements included: puffing topography (puff number, puff duration, volume of liquid consumed); and changes in: plasma nicotine levels, craving, withdrawal symptoms, selfreported hit, satisfaction and adverse effects. Results Liquid consumption and puff number were higher, and puff duration longer, in the low nicotine strength condition (all ps < 0.01). The mean difference in nicotine boost from baseline in the low condition was 8.59 (7.52) ng/mL, 16.99 (11.72) ng/mL and 22.03 (16.19) ng/mL at 10, 30 and 60 minutes respectively. Corresponding values for the high condition were 33.77 (34.88) ng/mL, 35.48 (28.31) ng/mL and 43.57 (34.78) ng/mL (ps < 0.05). There were no statistically significant differences between conditions in self-reported craving, withdrawal symptoms, satisfaction, hit or adverse effects. Conclusions Vapers engaged in compensatory puffing with lower nicotine strength liquid, doubling their consumption. Whilst compensatory puffing was sufficient to reduce craving and withdrawal discomfort, self-titration was incomplete with significantly higher plasma nicotine levels in the high condition.

Professionalizing school governance: the disciplinary effects of school autonomy and inspection on the changing role of school governors

Since the 1980s, state schools in England have been required to ensure transparency and accountability through the use of indicators and templates derived from the private sector and, more recently, globally circulating discourses of ‘good governance’ (an appeal to professional standards, technical expertise, and performance evaluation as mechanisms for improving public service delivery). The rise of academies and free schools (‘state-funded independent schools’) has increased demand for good governance, notably as a means by which to discipline schools, in particular school governors – those tasked with the legal responsibility of holding senior leadership to account for the financial and educational performance of schools. A condition and effect of school autonomy, therefore, is increased monitoring and surveillance of all school governing bodies. In this paper, I demonstrate how these twin processes combine to produce a new modality of state power and intervention; a dominant or organizing principle by which government steer the performance of governors through disciplinary tools of professionalization and inspection, with the aim of achieving the ‘control of control’. To explain these trends, I explore how various established and emerging school governing bodies are (re)constituting themselves to meet demands for good governance.