Vaping news....old considering vaping thread.

[noxiousdog]

There's no such thing as secondhand drowning or meat-eating.

This is what you're concerned about? People vaping next to you?

[Isgrimnur]

It's on the list.

[TheMix]

ND, can you clarify your stance? It seems like you have a big chip on your shoulder, but I'm not really sure what you are against. Are you trying to argue that vaping is fine and everyone should just shut the hell up about it? It seems like everyone else is trying to be cautious and is concerned that it may not be safe, and you are arguing... well, I'm not sure. You seem to be trying to convince everyone to take up vaping. Is this personal for you or something?

[Smoove_B]

It's so funny to me how much the vaping issue directly parallels cigarette risk communication. They're harmless! It's relaxing! Everyone should smoke - just ask your doctor! Then all of a sudden we learn maybe that's not true, particularly after decades of use, but no worries, second hand smoke is totally harmless! It's my choice if I want to smoke and it doesn't affect you at all. Well, as it turns out, no, that's not true either.

The core issue here (that for whatever ND seems to be stuck on) is that e Cigarettes/vaping is presented/marketed as a healthy alternative to smoking. While that might be technically correct (the best kind of correct) it is not risk free. Are there low-risk acute issues? Yes. Are there low, medium and high risk chronic issues? Unknown. Given what we know vs what we don't know, it is not unreasonable to clamp down on this product - particularly in light of how it's being represented.

[Smoove_B]

ND, can you clarify your stance? It seems like you have a big chip on your shoulder, but I'm not really sure what you are against.

Ask him about laws requiring window guards. I suspect that he's also against the bright yellow stickers in cars advising seat belt use. Or mandatory helmet laws for kids that are on bicycles or skiing. Or laws requiring anti-vortex drains in pools and hot tubs. Or childproof caps on OTC medications.... the list goes on and on. For some (I think) there's a magic number where investing in prevention or modification isn't worth the token lives it would save. Here, the idea is that not enough people are dying from vaping, so just let it be and focus on something important.

[noxiousdog]

While I fully admit my risk tolerance is higher than most folks, this thread is one of the most risk adverse I've ever seen.

[noxiousdog]

ND, can you clarify your stance? It seems like you have a big chip on your shoulder, but I'm not really sure what you are against. Are you trying to argue that vaping is fine and everyone should just shut the hell up about it? It seems like everyone else is trying to be cautious and is concerned that it may not be safe, and you are arguing... well, I'm not sure. You seem to be trying to convince everyone to take up vaping. Is this personal for you or something?

Mostly it's a big trigger for me for two reasons.
1) Wildly inaccurate risk analysis and reporting drives me crazy.
2) The stance of "my vices are fine, yours are intolerable" drives me crazy, which is often supported by point #1.

My stance is there is currently nothing to indicate that vaping is significantly more dangerous than a whole multitude of things that we do every day.

Yet, we are already seeing legislation to outlaw it. Why? Not based on any scientific data. But because it's unpopular.

I don't know if it's the same folks, but I'm guessing there's a lot of folks in this thread that would ban vaping, but endorse marijuana legalization. Why? A multitude of reasons of course, but most likely is they might want smoke a joint. Yet, there's way more evidence of marijuana harm than there is of vaping harm, but one's popular and one's not.

[Smoove_B]

While I fully admit my risk tolerance is higher than most folks, this thread is one of the most risk adverse I've ever seen.

Shrugging the risk of something that likely has a 20+ year latency period is a bit much to ask anyone.

[noxiousdog]

It's so funny to me how much the vaping issue directly parallels cigarette risk communication. They're harmless! It's relaxing! Everyone should smoke - just ask your doctor! Then all of a sudden we learn maybe that's not true, particularly after decades of use, but no worries, second hand smoke is totally harmless! It's my choice if I want to smoke and it doesn't affect you at all. Well, as it turns out, no, that's not true either.

The core issue here (that for whatever ND seems to be stuck on) is that e Cigarettes/vaping is presented/marketed as a healthy alternative to smoking. While that might be technically correct (the best kind of correct) it is not risk free. Are there low-risk acute issues? Yes. Are there low, medium and high risk chronic issues? Unknown. Given what we know vs what we don't know, it is not unreasonable to clamp down on this product - particularly in light of how it's being represented.

No, the core issue here is that we have a 102 page thread about drinking even though we know alcohol causes 88,000 deaths per year. Is anyone in that thread trying to get prohibition back?

What percentage chance do you honestly feel that vaping could be even half that bad?

[Smoove_B]

We definitely need to do more regarding alcohol use and abuse in America, without question. Just because one bad thing is (mostly) legal, that doesn't mean we should throw up our hands and say Angel Dust should be available via vending machines on every corner.

The vaping issue is complicated. It's complicated because we don't know the true risk. Its complicated because it's being marketed as a healthy alternative. It's complicated because it's being marketed specifically towards teenagers. It's a moving target, but good science and decades of experience is telling us that we should not let this product into the marketplace unchecked.

What percentage chance do you honestly feel that vaping could be even half that bad?

I honestly don't know. Alcohol has both acute and chronic impacts - much easier to quantify immediate negative consequences when someone drinks to much and kills someone behind the wheel. Vaping seemingly has none. I've known people that have switched from smoking to vaping and they report feeling better. Terrific - maybe it really is a better option for smokers and a valuable tool for smoking cessation. But it's not a medical device that's being prescribed to someone that's trying to stop smoking. Instead, it's being marketed to everyone and anyone.

Unfortunately there's really no way for us to resolve this because the true impacts of vaping aren't going to be seen until we're both collecting social security checks. Instead we will likely disagree over whether or not the government has an obligation under a Parens patriae doctrine to make decisions about what we find acceptable or do not.

Marijuana (like alcohol) has a complicated history here in the United States - legally, morally and socially. It should be legal and the risks of smoking it should be communicated. The risks of eating it whatever else kids are doing these days, also communicated. I am honestly not sure how much risk work has been done in those areas and when I asked my peers about regulating how marijuana would be inspected as part of a food service operation, no one knows. I'm getting off topic here but that's likely because I took a hit of LSD before writing this.

[Daehawk]

I think the problem in part is smoking and lung cancer along with drinking and liver disease/vehicle deaths are a slow process where vaping seems very fast but only in some people and or type of vape smoked. Its in your face and people are over reacting because it is fast and so shocking . Its also whats making the sensationalism news.

I thought about vaping but didn't. Wouldn't start now. If Id been vaping for years when this started it wouldn't affect me any more than smoking or drinking. I used to smoke when I was young and I have always had a drink on occasion and will continue.

Ive always been surprised how they continue to allow cig sales. My only thought is it is too lucrative a business to just ban.

[McNutt]

But we have a good idea of what alcohol does to us. We don't really have an idea of what ecigs will do to us. There's a big difference when you jump into a vice blindly.

[dbt1949]

Personally I find it hard to believe vaping will help you quit. From the pictures I've seen it looks like you get more smoke than a cigarette.
Of course kids and many adults are adjusting their doses to THC other things and don't want to quit.

[Daehawk]

Its not smoke though.

[dbt1949]

If not smoke they're exhaling then what is it?

[Blackhawk]

If not smoke they're exhaling then what is it?

Vaporized liquid. Sort of like steam.

[Daehawk]

Its why I could never figure how they didn't have bad pneumonia.

[Alefroth]

If not smoke they're exhaling then what is it?

It's like a hand-held fog machine.

[noxiousdog]

But we have a good idea of what alcohol does to us. We don't really have an idea of what ecigs will do to us. There's a big difference when you jump into a vice blindly.

It's not blind. We've already established there has been a lot of research, there should be more, and it should be regulated (note: the CDC has confirmed that black market fluid is involved in all the cases of death.

However at this time, there is nothing to indicate that it's at the super risky part of the scale. If that changes, I'll change my stance. If it doesn't, I'll lump it into the artificial sweetner pile. Who knows what that will do to us after 30 years?

[McNutt]

In an attempt to get me off the ledge, was the kid with the lung transplants using black market vape stuff too?

[Smoove_B]

Health officials declined to release the teen’s name and said he is expected to recover. They also did not specify what the teen vaped or how long he vaped.

Based on what we've seen, I'd be surprised if he wasn't in the Vitamin E acetate cohort.

[Stereotaxis]

I have tried it and that's an interesting sensation.

[dbt1949]

Did you eventually quit smoking?

[Smoove_B]

From NPR, How vaping snuck up on regulators:

"Today, nearly a decade after these products were first introduced, not a single e-cigarette has been reviewed for safety purposes, for addiction purposes, for youth abuse purposes or for efficacy in helping smokers quit," says Matthew Myers, president of the Campaign for Tobacco-Free Kids.

Some 10.8 million Americans had started vaping as of last year, including more than 25% of high school students, according to a government study. The surge has been driven to a great degree by the immense success of Juul, by far the most popular vaping product.

[Blackhawk]

Probably harmful, we don't know how harmful, and it'll be years before we know for sure. If it ends up on the 'super harmful' end of the scale, we'll be figuring it out too late to save the early adopters.

So my view? What benefits does it offer?

None?

Ok, I think I can find better things to spend my money on than "probably bad, might be lethal, but sure does taste good!"

[gbasden]

I agree with ND on every point he makes. I don't think we should be looking at banning it, especially when all evidence shows that it is a much safer alternative for people who smoke currently. OTOH, I would freak out if my son started. I'd be upset if he started to smoke or do pot, or drink to excess as well. It's complicated.

[noxiousdog]

From NPR, How vaping snuck up on regulators:

"Today, nearly a decade after these products were first introduced, not a single e-cigarette has been reviewed for safety purposes, for addiction purposes, for youth abuse purposes or for efficacy in helping smokers quit," says Matthew Myers, president of the Campaign for Tobacco-Free Kids.

Some 10.8 million Americans had started vaping as of last year, including more than 25% of high school students, according to a government study. The surge has been driven to a great degree by the immense success of Juul, by far the most popular vaping product.

The claims about lack of research is absolutely false.

Safety
Addiction
NPR refutes his youth abuse purpose claim.
Smoking replacement

[LawBeefaroni]

Folks, vaping is OK now. There are polls.

Just two months ago, President Donald Trump responded to the growing health crisis fueled by e-cigarette use, particularly among teens, by calling for a ban on flavored vaping products. Six weeks later, however, Trump indicated—without giving his reasoning—a softening in his stance on e-cigarettes. Now, just over two months after his initial statement, the initiative to ban flavored products favored by teens appears to have been completely snuffed out. Why? “As he had done so many times before,” the Washington Post reports, “Trump reversed course—this time on a plan to address a major public health problem because of worries that apoplectic vape shop owners and their customers might hurt his reelection prospects.”


..
“One such poll was commissioned by John McLaughlin, one of the Trump campaign pollsters, for the Vapor Technology Association. The poll, which surveyed battleground state voters who vape, showed negative results for Mr. Trump if he went ahead with a ban, and was passed around to a number of people in Mr. Trump’s circle, including Brad Parscale, his campaign manager, and senior White House officials.”

Shortly after, Trump decided against signing the one-page “decision memo,” canceling the administration’s rollout of an announcement, before coming out and saying that he didn’t want to go through with the ban that he said was really his wife and daughter’s idea anyway. The ban, which would have cleared candy-, fruit-, and mint-flavored e-cigarettes used by some 5 million American teenagers off the shelves in 30 days, had already been vetted and cleared by federal regulators at that point. After the reversal, three administration officials told the Times, “Trump was now upset with Health and Human Services Secretary Alex Azar, who had taken the lead in rolling out the plan.”

[Daehawk]

[naednek]

While I don't agree with NoxiousDog's position on the ban, I do respect it. I understand the reasoning.

This reversal about Trump not wanting to ban is only about benefiting himself. He realized this would hurt his base, his votes. Him him him

[Smoove_B]

The claims about lack of research is absolutely false.

He didn't say lack of research. He said lack of review. Slight (but important) difference. Namely (highlight is mine):

A review article or review paper is based on other published articles. It does not report original research. Review articles generally summarize the existing literature on a topic in an attempt to explain the current state of understanding on the topic. Review articles can be of three kinds:

A narrative review explains the existing knowledge on a topic based on all the published research available on the topic.
A systematic review searches for the answer to a particular question in the existing scientific literature on a topic.
A meta-analysis compares and combines the findings of previously published studies, usually to assess the effectiveness of an intervention or mode of treatment.

[FishPants]

For what it's worth I ended up quitting vaping long before this got vilified in the media (and that got me off cigarettes). I just dwindled my nicotine down until I bought a bunch of juice with 0mg of nicotine, and never really bothered vaping it after the first day or two.

It works for getting people off cigarettes, and I guess I'd rather see teens vaping than smoking -- neither is good, but guess what they are going to do with vaping being banned? Right back to smokes.

[dbt1949]

Are most of the teens regular vaping or are they using "third party" substances?

[noxiousdog]

The claims about lack of research is absolutely false.

He didn't say lack of research. He said lack of review. Slight (but important) difference. Namely (highlight is mine):

A review article or review paper is based on other published articles. It does not report original research. Review articles generally summarize the existing literature on a topic in an attempt to explain the current state of understanding on the topic. Review articles can be of three kinds:

A narrative review explains the existing knowledge on a topic based on all the published research available on the topic.
A systematic review searches for the answer to a particular question in the existing scientific literature on a topic.
A meta-analysis compares and combines the findings of previously published studies, usually to assess the effectiveness of an intervention or mode of treatment.

That is getting really nuanced so I will defer to your expertise, but I also believe that statement is untrue.

[noxiousdog]

Are most of the teens regular vaping or are they using "third party" substances?

Who knows? It's illegal for them to buy the equipment and the vape juice.

[Smoove_B]

That is getting really nuanced so I will defer to your expertise, but I also believe that statement is untrue.

It is all nuanced and I think (broadly) the press does a terrible job of reporting the terrible job scientists are doing communicating their findings. This is a huge problem in public health, and not just with smoking. It comes down to an initial study being done (on anything) and then having that study repeated and then reviewed by other agencies or individuals. The problem here is time and how long this all takes. I believe this is the most current review by the NIH:

Results:

Evidence shows that e-cigarettes can have detrimental effects on several cell lines and animal models with their flavourings and nicotine content implicated; this has, however, not translated into major health outcomes after 3.5 years follow-up but has been linked to chronic lung disease and cardiovascular disease. While advertised as an effective smoking cessation tool, no consensus can be made regarding their effectiveness although the first robust randomised controlled trial reports some success. This, however, is offset by the fact that the most common e-cigarette use is as a dual user and that there is evidence of threefold increased risk of future tobacco smoking.

Conclusion:

Future research is needed to evaluate the long-term health outcomes and efficacy of e-cigarettes as a smoking cessation tool with greater discussion between patients and clinicians regarding this smoking cessation tool.

Full conclusion:

Conclusion

E-cigarettes are vigorously promoted by the tobacco industry, product manufacturers and trail outlets as new means to quit smoking and have consequently gained considerable public awareness. Currently, the greatest users of e-cigarettes are youths and current tobacco smokers. While many claims exist with regard to their efficacy, studies have yielded conflicting results but do highlight the role e-cigarettes may have in reducing smoking levels and helping promote smoking cessation with the first robust RCT providing encouraging results; however, further trials, systematic analysis and long-term follow-up are needed before this is certain. However, while their role continues to be defined, ongoing concerns exist with regard to their safety profile. Early in vitro and in vivo studies show they can upregulate pro-inflammatory cytokines in a plethora of cell types, increase susceptibility to infection and the development of emphysematous lesions in animals. This is not translated in the early human trials that have been conducted although larger more robust trials are needed before any definitive conclusion can be made. In addition, concerns have been raised to the effects they have in the unborn child with evidence that they may be linked with congenital deformities and structural changes within the foetal brain and lungs. Key safety issues remain their highly variable content of nicotine, carrier substances and flavouring chemicals as well as their unforeseen vaporisation products and the future risks of tobacco use. This narrative review while helpful in summarising what is known on this topic is limited by being narrative in nature and highlights the need for systematic review and meta-analysis. This would help to solidify what is known on this topic and minimise any reporting biases and incomplete retrieval of the literature. For clinicians, this review hopefully will alert them to engage in this discussion with patients while making them aware of potential links to ill health that remain unexplored and will require RCT and systematic analysis in the future.

I tried looking for a news article covering this study, but couldn't find one, which is unfortunate as it would be rather helpful.

[morlac]

While I don't agree with NoxiousDog's position on the ban, I do respect it. I understand the reasoning.

This reversal about Trump not wanting to ban is only about benefiting himself. He realized this would hurt his base, his votes. Him him him

It was a baseless knee jerk reaction anyhow. Much like everything he touches .

Anyhow, I am with ND here. All deaths have reportedly involved illegal black market, homebrewed weed infused juice. Banning all E cigs is not the correct response to this very isolated, yet tragic issue. A correct response would be to pay for a serious study, legalize marijuana to get rid of the black market and educate people on the actual, factually proven risk. The response we have gotten thus far has been ill thought out and based on bad data. It does nothing but undermine the whole process and shed doubt on the Govt's ability to properly regulate anything. It's a bit absurd. Plus I love the fact that big tobacco is now abandoning Juul and the billions they invested at the first sign that people will be pushed back to their cancer sticks. LOL, perfect.

[Daehawk]

And probably not mod your vape to burn hotter and or produce more vapor. Get those metals in your lungs then.

[noxiousdog]

Smoove, those findings seem perfectly reasonable to me. It's a shame we don't get that popularized instead of "not a single e-cigarette has been reviewed for safety purposes, for addiction purposes, for youth abuse purposes or for efficacy in helping smokers quit."

[Smoove_B]

More to that,I'm waiting to see how a study out of Canada is reported by the media, namely that it seems one vaping teen has popcorn workers lung:

This case of severe acute bronchiolitis, causing near-fatal hypercapnic respiratory failure and chronic airflow obstruction in a previously healthy Canadian youth, may represent vaping-associated bronchiolitis obliterans. This novel pattern of pulmonary disease associated with vaping appears distinct from the type of alveolar injury predominantly reported in the recent outbreak of cases of vaping associated pulmonary illness in the United States, underscoring the need for further research into all potentially toxic components of e-liquids and tighter regulation of e-cigarettes.

It's yet another lung injury that is distinct from what's been observed here and instead similar to an occupational exposure to diacetyl.

If nothing else, it complicates the message and underscores that multiple chemicals could be (can be) responsible for a short-term medical crisis.