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Is Vaping Safe? A health strategy or smoke screen?

Author’s Note: As I update this column (which originally ran on March 15, 2018) I’m even more concerned about e-cigarettes than I was a year and a half ago. CBS News reported last week that about 20 percent of U.S. kids are vaping, some as young as 8th grade; A study published by the British Medical Journal (BMJ) shows a 74 percent increase in vaping in Canadian youth. As of September 6, 2019, U.S. health officials are investigating 450 possible cases of severe lung disease associated with vaping across 33 states and one territory, five deaths, and death under investigation — associated with critical lung disease associated with vaping. A lack of regulation or research makes it impossible to know which chemicals or substances are responsible for this sudden increase in lung injury and death.

According to the World Health Organization (WHO), “Tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers.”  In the most recent 2017 update, the WHO writes that:

  • Tobacco kills up to half of its users
  • Tobacco kills more than 7 million people yearly: 6 million from direct tobacco use and approximately 890,000 due to second-hand smoke
  • Nearly 80% of the world’s more than 1 billion smokers live in low-and-middle-income countries.

    There is no such thing as safe smoking whatsoever, this study concludes. … They found that men who have about one cigarette per day had a 48 percent higher risk of heart disease and 25 percent higher risk of stroke compared to people who have never smoked.

The NCD Alliance reports that tobacco is the leading cause of non-communicable diseases and is the risk factor common to the four main groups of NCDs – cancer, heart disease, chronic lung disease, and diabetes.

Smoking tobacco also increases the risk of death from communicable diseases such as influenza and tuberculosis because it increases susceptibility to bacterial infection — a particular problem in underdeveloped countries where smoking rates are rapidly increasing.

So, are e-cigarettes a safer option? Or as WebMD.com ponders, are they a high-tech way to hook a new generation on a bad nicotine habit?

Are e-cigarettes a better option?

What’s the difference between e-cigarettes and “vaping”? Both are nicotine delivery systems — without combustible tobacco.

The e-cigarette looks like a traditional cigarette and usually come with pre-filled cartridges. Vaporizers are larger, with a big battery on one end, with a tank to refill e-liquid. I’ll use e-cigarettes here to refer to both.

They work similarly: they have containers filled with liquid, typically made of nicotine, flavorings, and other chemicals. A heating device turns the liquid into a vapor that you inhale when you take a drag. Although most use nicotine derived from tobacco, some companies use synthetic nicotine — the same molecular structure as the plant-derived drug — and just as addictive.

As reported in ScienceNews.org, e-cigarettes generate toxic chemicals similar to tobacco. Even though the vapor that’s inhaled doesn’t contain combustion products or tar released by tobacco burning, “vaping” causes lung inflammation and protein damage, and lowered immunity.

According to Cancer.net, the e-cigarette ‘juice’ contains a toxic chemical found in antifreeze and several cancer-causing chemicals, such as nitrosamines. Because e-cigarettes have only been readily available since 2006, there is limited research on their health risks.

Nicotine is addictive — how addictive?                                       

The National Institute on Drug Abuse reports that nicotine is as addictive as heroin, cocaine or alcohol. Nicotine binds to an area of the brain known as the adrenal medulla, increasing the flow of adrenaline, leading to increased blood pressure, heart rate and respiration, and exacerbating existing heart and blood pressure problems. Nicotine is also linked to birth defects and reproductive harm (women, including pregnant and breastfeeding women, take note).

When you stop smoking or vaping, withdrawal sets in, sometimes as soon as two hours after you last use. Symptoms include intense cravings, anxiety, depression, drowsiness or trouble sleeping, bad dreams and nightmares, headaches, problems concentrating, and increased appetite leading to weight gain.

A gateway to smoking cigarettes?

Tobacco-Free Kids reports that although the U.S. 2009 Family Smoking Prevention and Tobacco Control Act prohibited the sale of cigarettes with characterizing flavors other than menthol or tobacco, including candy and fruit flavors, this prohibition did not apply to other tobacco products, including the ‘juice’ in e-cigarettes and vaping devices. “In recent years, tobacco companies have significantly stepped up the introduction and marketing of flavored non-cigarette tobacco products, especially electronic cigarettes (e-cigarettes) and cigars.”

And it’s not only little kids that are attracted to e-juice flavors like Kool-Aid, Cotton Candy, Gummy Bears, Banana Split, Rocket Pop, and Skittles. The New York Times describes a store in San Francisco near a high school where students can buy flavored liquids to refill e-cigarettes or hookah pens (another popular vaping device) in flavors like cinnamon apple, banana nut bread, vanilla cupcake, chocolate candy bar, and coconut bomb. Nicotine concentrations range from zero to 24 milligrams — similar to a pack of 20 cigarettes.

A February 2019 study published in JAMA Network found that teens who start vaping are nearly three times more likely to switch to smoking tobacco. Former Food & Drug Commissioner Scott Gottlieb called vaping e-cigarettes an “on-ramp” to smoking tobacco.

Researchers have known for years that cigarette smoking functions as a “gateway drug”—a drug that lowers the threshold for addiction to other substances, such as marijuana and cocaine. More recently, research shows, like conventional cigarettes, e-cigarettes may function the same way.

Matthew L. Meyers, President of the Campaign for Tobacco-Free Kids, testified in 2014 before the U.S. Senate about how manufacturers are directly targeting kids, similarly to how cigarettes were pitched to kids in the past. He spoke to the absence of marketing regulation, allowing manufacturers to “set the agenda” and drive the evolution and sales of these products in a way that only serves the manufacturers interests and not public health.

Updated research

Adolescents who smoke e-cigarettes are exposed to significant levels of potentially cancer-causing chemicals also found in tobacco cigarettes, even when the e-cigarettes do not contain nicotine. A March 2018 study, published in the journal Pediatrics, compared a group of teens, average age 16.4 years. Sixty-seven used e-cigarettes only and 17 used both e-cigarettes and traditional tobacco cigarettes. They were compared with a control group of 20 non-smoking teens. Levels of toxic organic compounds were up to three times higher on average in the e-cigarette users compared to the controls. In teens using both e-cigarettes and regular cigarettes, levels of toxic compounds were six times higher than in the control group of non-smoking teens.

The researchers concluded, “E-cigarettes are marketed to adults who are trying to reduce or quit smoking as a safer alternative to cigarettes… while they may be beneficial to adults as a form of harm reduction, kids should not be using them at all.”

 

What about the flavored e-cigarettes without nicotine? Surely they’re not dangerous? The authors of the study report, “Some of the toxic chemicals were found in the bodies of teens who used flavored e-cigarettes without nicotine … propylene glycol and glycerin, which are used to keep the products smoked in e-cigarettes in liquid form, are approved by the FDA as safe at room temperature… but when they’re heated to the high temperatures required for vaporization, they can produce toxic substances that are potentially carcinogenic.”

A February 2018 study published in the journal Environmental Health Perspectives, researchers tested e-liquids in the dispensers from 56-daily users of vaping devices and found significant (nearing or exceeding current health-based limits) of heavy metals chromium, manganese, nickel, and lead in about half the samples. The researchers urge more research and say, “It’s the heating coils that are leaking toxic metals, getting into the aerosols that vapers inhale.”

A more recent (April 2019) study found that e-cigarette products may be contaminated with microbial toxins which could lead to “adverse respiratory effects.”

Trading in one addiction for another? What’s in it for the tobacco companies?

No longer a “niche product,” I previously reported that the global e-cigarette market was set to reach USD 44.55 billion by 2024. Today, VynZ Research has upped that number to USD 53.4 billion by 2024. The New York Times reports that tobacco manufacturers are getting into e-cigarettes and nicotine delivery systems in a very big way. They write, “Vapes began as enigmatic underground products that might subvert Big Tobacco, but today the old corporate giants are major stakeholders in the market. Among them are Altria, which own Philip Morris, the maker of Marlboro cigarettes, yet also holds 35 percent of the vaping giant Juul; Reynolds American, which owns Vuse; and Imperial Tobacco, which owns Blu.”

Like all manufacturers, tobacco companies are looking for profits, and as cigarette use is falling out of favor, tobacco companies are investing in alternative nicotine delivery systems. Gregg Haifley, the American Cancer Society’s director of federal relations said, “You’ve got to be extremely skeptical about what they’re [tobacco companies] are up to — they are just too profitable for them to be interested in doing that” [creating a safer smoking experience].

It gets worse. As reported in the Daily Herald (Chicago), a growing number of e-cigarette and vaporizer sellers have started offering college scholarships as a way to get their brands listed on university websites and to get students to write essays about the potential benefits of vaping.

Consumers may be seduced into the rationale that e-cigarettes are safer than tobacco, but they’re buying into the manufacturer’s need to addict consumers to nicotine. Tobacco companies are not investing in these products to help people quit smoking, just to smoke something different but no less addicting.

Those with some financial skin in the game will, of course, insist that dragging on an electronic cigarette is the lesser of two evils, and they might be right. There is limited evidence that e-cigarettes work any better than regulated medications and behavioral modification and support groups to break the nicotine habit.

Designed to appeal to kids.

An addiction is an addiction

People who vape are likely to become addicted to nicotine. As reported by Time.com, kids are not taking up vaping to quit tobacco, and as kids get hooked, “parents are desperate for treatment that doesn’t exist.”

For many, smoking addiction is linked to the physical act of smoking, breathing out the smoke (or vapor), and may include the ritual of lighting up and sharing — there’s a social, physiological and psychological aspect to addiction.

From the moment e-cigarettes came to market, I thought, hey, these are just electronic nicotine delivery devices and they are clear pathways to tobacco, both to kids who start their addiction believing that it’s a somewhat “safer” experience to use electronic devices and for those long-term nicotine addicts using them to replace smoking tobacco.

Electronic devices can be expensive, especially at the start — fluids need to be refilled and batteries replaced.  When nicotine-addicted individuals need a fix, they can always head down to the local tienda and purchase cigarettes.

In June 2019, San Francisco’s City Supervisors voted 11 to 0 to ban e-cigarettes, the first U.S. city to do so. San Franciso’s ordinance bans any e-cigarette that hasn’t received FDA clearance  – which none have to date. Lawmakers in Colorado have followed suit. And Michigan has become the first state to ban sales of flavored e-cigarettes. Read more from CNBC here

I’m not the first to say that electronic cigarettes are like methadone — sure, methadone is better than heroin, but it’s still addictive. If part of your reason for quitting tobacco but taking up e-cigarettes is because you don’t want to be controlled by your nicotine addiction, then you’re having a pipe dream.

Disclaimer: I started smoking cigarettes at age 12 (sorry, Mom and Dad!). I was 22 when I quit and it was the hardest and best thing I ever did. I’ve known too many people who died from lung cancer and other cancers as a result of smoking tobacco, some near and dear to me. Nicotine is addicting, in all of its forms. Learn more about nicotine addiction and how to conquer it here.

Sources
Addictions and Recovery. How to Quit Smoking – 8 Steps to Quitting For Good.
CBC News. We have a big problem’: spike in youth vaping sparks calls for legislation. CBS News. Teens who use e-cigarettes exposed to toxic chemicals, study finds.
JAMA Network. Association of electronic cigarette use with subsequent initiation of tobacco cigarettes in US youths.
Journal of Addictive Diseases. The association between cigarette smoking and drug abuse in the United States.
Journal Environmental Health Perspectives. Endotoxin and (1 -> 3) – B-Glucan contamination in electronic cigarette products sold in the United States.
Journal Environmental Health Perspectives. Metal concentrations in e-cigarette liquid and aerosol samples: the contribution of metallic coils.
Journal Pediatrics
. Electronic cigarette use and progression from experimentation to established smoking.
GlobalNewsWire.com. Global E-cigarette market is set to reach USD 53.4 billion by 2024.
NBCNews.com. In taking on vape companies and menthol, FDA faces determined foes.
PR Newswire. The global e-cigarette market is set to reach USD 44.55 billion by 2024.
ScienceNews.org. Health risks of e-cigarettes emerge. 
The National Council on Drug Abuse. Tobacco, Nicotine, and E-Cigarettes. Is nicotine addictive?
The NCD Alliance. Tobacco: A major risk factor for non-communicable diseases.
The New York Times. A bolder effort by Big Tobacco on e-cigarettes. 
The New York Times. E-cigarettes, by other names, lure young and worry experts. 
The New York Times. How big tobacco got a new generation hooked. 
Time.com. As kids get hooked on vaping, parents are desperate for treatment that doesn’t exist. 
TobaccoFreeKids.org. The Flavor Trap: How Tobacco Companies Are Luring Kids with Candy-Flavored E-Cigarettes and Cigars. 
Washington Post. Lung illness tied to vaping has killed five people, may be a new ‘worrisome’ disease, officials say.
WebMD.com. The Vape Debate: What you need to know.
Wired.com. E-Cigs are going tobacco-free with synthetic nicotine. 
World Health Organization. WHO global report on trends in prevalence of tobacco smoking 2015.
_________________________________
Susan Burke March, a Cuenca expat, is a Registered Dietitian/Nutritionist and a Certified Diabetes Educator who specializes in smart solutions for weight loss and diabetes-related weight management. She’s the Country Representative from Ecuador of the Academy of Nutrition & Dietetics. Do you have a food, nutrition or health question? Write to her – SusanTheDietitian@gmail.com

48 thoughts on “Is Vaping Safe? A health strategy or smoke screen?

  1. Thank you, Susan. I recently discovered that a friend here in Cuenca has begun “vaping” nicotine. I sure hope he thoroughly reads this article.

    1. Thanks, Mike. When the tobacco chiefs lied to congress about tobacco’s addictiveness, it brought the regulations against publicizing them. Tobacco kills, And I think it’s deja vù all over again with e-cigarettes. there’s increasing evidence that inhaling toxic fumes from “vaping devices” will have pretty severe health consequences.

    2. Hi Mike. I think you should at least get another prospective. I am giving you the links from the Cancer Research Uk, Royal College of Physicians and the newest statement from the American Cancer Society on this subject.
      http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/e-cigarettes?_ga=2.38856362.822079810.1521404314-102985658.1521404314.
      https://www.rcplondon.ac.uk/guidelines-policy/e-cigarettes-inquiry
      https://www.cancer.org/healthy/stay-away-from-tobacco/e-cigarette-position-statement.html

      1. Gee, Ann. I don’t believe you read the newest statement or my column very carefully. In my column I note that e-cigarettes may be helpful in helping an addicted nicotine addict transition from combustible tobacco to not smoking cigarettes, but there is NO evidence that once you start vaping you’re able to stop vaping — you’re trading one addiction for another. I also say that manufacturers are targeting children, and that is exactly what the ACS statement says.

        1. “Gee, Ann. I don’t believe you read the newest statement from the ACS or my column very carefully.”

          I’ll bet she didn’t read either one, at all.

        2. I think you are biased on this subject. You start the article saying that you are more concerned now than a year ago. No where in this article are you stating that electronic cigarettes are 95% safer than smoking regular cigarettes, or that the United Kingdom has it in their system and in courage people to make the switch. You don’t even mention that these new illnesses are associated with illegal THC cartilages found on the black market. Even the FDA changed their statement. Are you suggesting people quit cold turkey. Have you even been around vapers, they will tell you that their tastes buds improves and their breathing abilities improve quickly from making the switch. I personally know people who have smoked two packs a day switch to vaping, vape for a while and then have quit that as well.

        1. Hi Charlie, who are you? Are you related to Susan? It also seems like you are very interested in this conversation. Shouldn’t you disclose your reasons for being in this conversation. I personally am a vaper and find that people should be given all the information to make the right decision for themselves. I’ve seen the benefits of vaping. I have never stated that vaping is one hundred percent safe. I have added included articles like the Royal College of Physicians. The ACS wrote: “The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes. Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation medications. These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.” All I am asking is for people to do some research and view things from all sides.

          1. No, I am not related to Susan, nor do I know her nor have I ever met her. My interest is as a person who informs his beliefs based on science, and you and your husband James have put out a bunch of information that has been widely refuted and that has an enormous body of evidence to the contrary.

            1. Based on science, what articles or evidence have you posted. I have not seen any response to the research and science that has been posted by James or I. Actually much of the evidence we have provided refutes the claims made in this article, including a major Gov entity and highly respected medical professionals. However, everyone is entitled to their opinion of research and information.

              1. Now you are just being disingenuous. The scientific evidence against vaping is voluminous and Susan presents tons of it right in her article. Did you not bother to read her references?

                1. Ha, you clearly did not read any of the contradictory research that was posted that directly refutes the claims in this article. But then again I am not surprised. I guess the RCOP in the UK do not know what they are talking about huh Charlie. I prefer the opinions of an elite group of doctors who have studied this issue in great detail. Have a good one Charlie

                  1. Ann, I understand that you have an axe to grind and it is clear what that axe is. You are James Evans’ wife and your livelihood comes from selling a highly addictive substance——– nicotine. Trying to use facts, logic and reason in a discussion with you or your husband is a waste of time.

                    Personally, I’d be fine if your products are banned and you have to find gainful employment that harms nobody. Your arguments of “less harm” fall on deaf ears.

                    1. Oh please Charlie, you did not read a single bit of research that we posted. You are the one who refuses to use logic and listen to the recommendations of researchers and medical associations.

                      Nicotine is additive, never disputed this fact. But nicotine is not what is killing people. Nicotine is not a carcinogen, tobacco kills people. Hence you haven’t read anything on this subject apparently.

                      Also in Susan’s article, under the source titled “Addictions and Recovery.” How to Quit Smoking – 8 Steps to Quitting For Good. Susan recommends Nicotine replacement therapies, such as nicotine inhalers, gum. patches..etc. Which suggests she really doesn’t have a problem with nicotine, just the delivery method.

                      I was waiting for you to pull out the “sells Nicotine” statement.
                      Fact is we have helped hundreds of people quit using deadly tobacco. How many people have you helped Charlie Schultz?

                      You have never addressed one single piece of research we have provided. Instead you have decided to make a pathetic smear at us. This only further proves you have no interest in this actual subject and only engaged us in this conversation with bad intentions.

  2. Good article. If people knew the truth about nicotine they would never start smoking. There is no point in taking a drug that’s as addictive as cocaine or heroin when it does not even get you high.

  3. Nicotine is not the problem, but rather, the vegetable oil which is used to contain the nicotine and other “feel good” elements. You need an oil-based substance to deliver the nicotine through the cigarette’s heating element, and vegetable oil is the product of choice because it’s cheap, has a long shelf life, and burns in the temperature range the small heating elements can hold.
    Vegetable oil causes lung cancer by eating and cooking with it, just like margarine does; to use it in electronic ciggies is just as dangerous to health.

    1. Hi Abel,
      Vegetable oil is not an ingredient in e-cigarettes, however, vegetable GLYCERIN is. As I noted in the column, “propylene glycol and glycerin, which are used to keep the products smoked in e-cigarettes in liquid form, are approved by the FDA as safe at room temperature… but when they’re heated to the high temperatures required for vaporization, they can produce toxic substances that are potentially carcinogenic.”” As I further noted, new research shows that besides the uncertainty of long-time effects of breathing in vaporized chemicals, “In another recent study (February 2018) published in Environmental Health Perspectives, researchers tested e-liquids in the dispensers from 56-daily users of vaping devices and found significant (nearing or exceeding current health-based limits) of heavy metals chromium, manganese, nickel, and lead in about half the samples. The researchers urge more research and say, “It’s the heating coils that are leaking toxic metals, getting into the aerosols that vapers inhale.””

      And I’m sure you will agree that nicotine IS a huge problem with addiction and that e-cigarettes are not a healthful solution, but an exacerbation of the problem.

  4. A lack of regulation..lol..The current narrative is that regulations of any sort (particularly financial regulations) are anti-business and get in the way of the mighty dollar. Big Pharma will come up with some new fix now that they have gotten over opiods. Just wait…

  5. I find it interesting that you failed to mention that the so called vaping injuries that have been reported, have been attributed to Illegal THC black market vape cartridges. High quality vape juice is not causing these injuries. This information has been available for many days now. Quality Vape juice is not the problem, Illegal black market THC vape cartridges are. These illegal THC cartridges contain Vitamin E compounds and petrol based additives, they are not water soluble and are deadly. These so called Vaping Injuries are only happening in the United States. Nothing has been reported in other countries. This is because quality vape juice is not causing this problem, illegal black market poison is.

    The mainstream media along with the FDA and Big Pharma have been trying to lump Vape juice and “Vaping” into this problem. If you want to know what is really happening please read Dr. Farsalinos new article regarding this matter. He is one of the most respected and experienced e-cig researchers.

    http://www.ecigarette-research.org/research/index.php/whats-new/2019/274-us-lung

    The Royal Collage of Physicians in the UK published a comprehensive study on e-cigarettes and vape juice. They concluded that e-cigs are at least 95% safer than tobacco and regular cigarettes.
    Additionally, the Brits have incorporated electronic cigarettes into their national health care system.
    The United States needs to adopt the same policies and standards.

    If you are really interested in knowing the facts please read their report:

    https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0

    The hysteria and outright false info being pushed by mainstream media, the FDA and Big Pharma is very dangerous and will lead people to switching back to regular cigarettes. Please read the article below for more detail.

    https://www.heartland.org/news-opinion/news/vaping-hysteria-will-mean-more-tobacco-deaths

    Tobacco kills approx. 480,000 people every year. Electronic cigarettes and vape juice are designed to greatly lower this number. Nicotine is not a carcinogen. The combustion of tobacco is carcinogenic.

    The ingredients in Quality vape juice are Vegetable Glycerin, Propylene Glycol, high quality food flavorings and the option for Nicotine, or not. Propylene Glycol is used in Asthma inhalers and is sterile. All of the items are USP grade, not industrial grade. USP grade Propylene Glycol is not used as anti freeze. This is just more propaganda.

    The point of electronic cigarettes is harm reduction. The goal is to get people off of tobacco and greatly reduce the risk of death from cancer and other tobacco related illnesses. Nicotine is not the killer. Nicotine in tobacco cigarettes, averages around 10-15mg. Most Vapers start with vape juice in that same strength and quickly drop down too much lower levels like 6mg and 3mg.

    Nicotine also has some benefits as outlined in this article:

    http://discovermagazine.com/2014/march/13-nicotine-fix

    The bottom line is that Kids should not start Smoking or Vaping. Adults who do not smoke, should not start vaping. However, Smokers who want to greatly reduce the risk of death from tobacco should consider switching to vaping. They should then start lowering the nicotine level and ideally move to zero nicotine and then quit. However if one chooses to continue vaping at lower nicotine levels, their risk for serious tobacco related health conditions is greatly reduced.

    Approx. 10 months ago Ecuador raised the import tax on e-cigs and vape juice to 175%.
    When Governments ban outright, or ban via tax, they create a black market. The risks to the public are greatly increased. Quality tested vape juice becomes scarce or non existent and the black market takes over, Very Dangerous. This is already beginning to occur in Ecuador. Prohibition of substances has never worked and it never will. Regulation, testing and safety do work.

    Finally, the following detailed article debunks many of the myths and false propaganda about e-cigs and vape juice. It also provides many harm reduction policy recommendations for policy makers. Please download the .pdf at the link below.

    https://www.heartland.org/publications-resources/publications/latest-heartland-policy-booklet-addresses-vaping-myths

    1. You’re full of it, James. Blame “Big Pharma” for vaping? puh-leese!
      The Big Tobacco companies are pushing vaping, and pushing kids to vape. The flavors are designed to appeal to kids. Addict kids to nicotine – it’s a gateway to tobacco. What the hell…’ benefits to nicotine’?

      1. Actually I think you are full of it Susan. Why did you not report the available information that illegal THC cartridges are responsible for the recent lung illnesses, Not Vape juice. You state that people switching from tobacco to vaping are just trading one addiction for another. No, what they are doing is trading one deadly addiction for something that is up to 95% safer. Most adult vapers use fruit and mint flavored liquids, a much smaller percentage like the tobacco flavored juice. Flavor bans will only cause vapers to switch back to regular cigarettes. I am not blaming big pharma for vaping. I am saying that they are trying to lump vape juice and vaping into the the recent outbreak of lung illness, and this is completely false. If the goal is to prevent deaths from tobacco, then vaping provides a way for people to accomplish this. Regarding Nicotine, did you read the article about nicotine that I posted? What is clear is that countries like the UK have studied, and then incorporated ecigs into their health system. They realize it will save lives. Virtue signaling does not save lives. Your claim that vaping is a gateway to tobacco is also highly doubtful as documented in the following study at University of Buffalo.

        https://www.sciencedaily.com/releases/2017/03/170313135003.htm

        Your claim that Big Tobacco is pushing vaping is also highly dubious.

        https://reason.com/2019/09/11/michael-bloombergs-anti-vaping-crusade-is-objectively-pro-tobacco/

        1. i am full of contempt for those who massage the message to justify selling junk like vaping devices. I didn’t report the suspected (not conclusive) THC connection because the column was posted more than a week ago.
          And the recent deaths could certainly be from “illegal “ thc cartridges but there’s a reason why cities and even states are banning vaping. It’s because there is no evidence that any vaping product is safe. I posted the information in my column.

          1. Well “Junk” Vaping devices are saving many lives by getting people off of tobacco. Your contempt is of no concern to me. I have not massaged anything. I have only pointed out the science, research and facts. The reason for your update of this article was to report that you were concerned with the reported deaths from vaping. You posted this on Sep 12th, today is the 14th. This concern should have inspired you to research what the known leading causes of these events were. There was already info online available regarding the illicit cartridges. However you did not even mention it in your update. You have also recommended other nicotine replacement therapies and other prescription drugs like Chantix. There are far more serious side effects from prescription medications like Chantix than e-cigs. The Royal College of Physicians and other medical professionals completely disagree with you about the safety of vaping. I think I will go with their analysis and research, as have millions of others. You are anti e-cig and I am not. Thats fine, and it is up to each person who uses tobacco to research for themselves and choose what options are best for them. My main desire is that people stop using tobacco. Also it is important for people to discuss this topic and highlight research on all sides.

        2. James, your fervor in this discussion is too intense for you not to have a dog in this fight. Could you identify for us what that issue is? Do you sell these products here in Cuenca? You sound like the fellow James Evans who had a vape shop here. If that is still the case, don’t you think you should disclose that? It would be disingenuous not to do so.

          1. Hello Charlie. I have disclosed that in a previous article on this same subject that Susan had written. And Susan is aware of that. What difference would that make anyways. There is a reason I opened the vape shop in the first place. Vaping got me off cigarettes and greatly improved my health. The same thing has occurred for other smokers who have switched. I know hundreds of them here locally.

            1. My recollection of the article that you refer to is that it was published years ago. I didn’t know if you were that person. The reason it matters is that it is obvious you have an axe to grind and can hardly be objective. While your posts have some valid points, they ignore the obvious fact that you are buying into a less bad vs bad rationalization about vaping vs smoking. To me that is analogous between the choice between Hillary or trump.

              When you choose between the lesser of evils, you still get evil. No way is vaping good for anyone, even if it is less bad for a smoker. It is anathema to children. If you are honest, you will admit that companies like Juul purposely marketed to kids and in my book, marketing a highly addictive substance to children is criminal.

              1. I don’t have an axe to grind Charlie. However, I do feel the need to present research and scientific fact to counter claims made in this article. Remember I am not the one who posted this article. Is it not legitimate to have a debate over a topic? Regarding my so called bad rationalization about vaping vs smoking. How is it bad to encourage people to quit something that is scientifically know to kill millions, and switch to something that the research has shown to be far far safer. The UK understand this and has enacted it on a national level. The success rates for quitting smoking cold turkey is very bad. People addicted need help quitting tobacco, and many top doctors and medical groups have studied e-cigs and recommend e-cigs. I know so many people who have switched to vaping and then quit everything outright.That is why I proposed we follow the model of the UK for handling this issue.

                Regarding minors, anyone caught selling any tobacco product or nicotine replacement product to a minor should be prosecuted to the full extent of the law. I say a felony charge with 6 months in jail and a $10,000 fine. No minor ever purchased a damn thing at my shop I can guarantee that. All of the vape shop owners I know and have talked to would never sell anything to a minor.

                I never sold the pod type juul systems in my shop. I do agree that the packaging of the vape juices should be plain and as non enticing to minors as possible. I hope that is something that will be enacted sooner rather than later.

                Anyways, I think we have all said our peace here today. Have a great rest of the weekend.

                1. James, you seem to insist on ignoring half the story when you offer only a defense for vaping based on the notion that it may help some people quit smoking. Let’s grant, arguendo, that such is the case. Let’s even agree that vaping is “less bad” and that SOME vapers will quit nicotine addiction completely.

                  Now please address the vapers that will be permanently addicted to nicotine and will continue to vape and the children that begin by vaping and who then go on to become smokers as a result of their addiction to nicotine.

                  Less bad is still bad.

                  1. Well let’s look at it logically. Is it your assertion that there is a solution available that will 100% eliminate minors from experimenting with cigarettes, alcohol, drugs or vaping? No such solution exists or will ever exist.

                    An adult has the freedom to choose what they want to do and what is right for them.

                    However, danger/risk mitigation options are available, wether e-cigs or other NRT’s. Less bad is much better than really bad. At least there will be people that are saved and will not die from tobacco. Should we only accept a 100% outcome that will eliminate all smoking and nicotine alternatives? Let me know when that option is available, I will be on board. Until then we have to use the tools that are available.

                    1. You wrote this: “However, danger/risk mitigation options are available, whether e-cigs or other NRT’s. Less bad is much better than really bad. At least there will be people that are saved and will not die from tobacco.”

                      That is just more sophistry with false equivalence. The real issue is will more people be saved from smoking because they were smokers who started vaping, compared to the harm caused by the minors addicted to nicotine by vaping, plus those that will go on to smoke anyway because of their addiction to nicotine.

                      If you can make a case for that, I’ll listen.

                    2. Hold on a second. Are you saying that you disagree that switching from something that is known to kill millions of people to e-cigs, that are widely considered far less dangerous…..is a bad thing?

                      Some of the finest medical groups, doctors and researchers, and the head of the FDA have said ecigs have far less risk. They have stated that if all smokers switched to ecigs the health benefits would be huge. Link below:

                      https://www.aier.org/article/vaping-saving-lives

                      Now before e-cigs, there was only tobacco available. So minors who experiment had only tobacco to choose from. So if they experimented, and became hooked, the option for a much safer alternative like ecigs was not available. (of course I do not want minors experimenting either, but they do)

                      If you are asking the question “Are teens who vape switching to smoking?” There is a new study that shows that is not the case. You can read the article/study at the link below

                      https://www.independent.co.uk/life-style/health-and-families/vaping-ecigarettes-tobacco-smoking-cigarettes-teenagers-young-people-a8850326.html

                      The FDA has claimed that there is an epidemic of ecig use among adolescents. The following article by Dr. Farsalinos, (a e-cig researcher) raises some serious concerns about this claim. His analysis is below:

                      https://www.ecigarette-research.org/research/index.php/whats-new/2018-2/267-fda2

                      Also, a new study in the New England Journal of Medicine shows that e-cigs are twice as effective as nicotine patches, gum and sprays.

                      https://www.nhs.uk/news/heart-and-lungs/e-cigs-twice-effective-nicotine-patches-gum-or-sprays-quitting/

                      So then. E-cigs are far safer than tobacco. They also are more effective than other NRT’s. So the people that switch to e-cigs have greatly reduced their health risks. If minors are vaping ecigs, they are at less risk than using tobacco. The claim that teen vaping leads them to cigarettes is not substantiated.

                    3. James, you are a waste of my time. All you do is write your own propaganda and never address the issues and points I raise. Until you do, I won’t waste further time with you. I’m confident that objective people that will read our words will see right through you and I’ll let them judge for themselves.

                    4. You did not respond to a single bit of documented research that i provided. I just addressed the points you raised above, you offered not a single counter to those studies and medical opinions. But then again it is very clear that was never your intention in the first place. I think people reading these comments will see through you and your lack of intellectual integrity during this conversation. Cheers, Charlie.

                    5. I don’t want you to disappear on us now, James, until you have read Susan’s update on what the Brits are saying about the nonsense you are using to support your position. I’ll make it easy for you and re-post it here:

                      Update: the UK reconsiders their endorsement of electronic cigarettes and vaping devices (nicotine delivery systems). “-E-cigarettes may damage the heart, scientists have concluded, and have called for Public Health England (PHE) to stop recommending vaping.

                      Researchers looked at 38 studies into the cardiovascular impact of vaping and found worrying signs of damage in nearly three quarters of tests.

                      When they discounted trials which had been funded by the tobacco industry – or where the scientists involved had conflicts of interest – the number of studies showing harm rose to 90 per cent.

                      Asked whether PHE should now change its advice, Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine, who co-authored the new analysis said: “The simple answer is yes.”

                      https://www.telegraph.co.uk

                      By the way, I had to ask around what you were trying to say with your parting shot of calling me Charlie Schultz. Nice try. I no more resemble that short fat guy than you resemble a thinking person.

                    6. Apologies for getting your last name wrong, I will correct that in my previous post. Please disclose your last name Charlie, then we can be on equal footing in this conversation.

                      Furthermore, your insistence on insulting me or my wife personally is out of line. If you would like to continue this conversation, great, but personal insults do not help your positions.

                      Also, you have never given any direct analysis or counter to all of the research information that I have provided. Why not?

                      Regarding the telegraph.co.uk article/study posted by Susan.

                      This study was just released. Therefore, Public Health England, other doctors and researchers need to review the research, and we need to examine their analysis as well. Are you suggesting that this research is definitive before it has been reviewed by other experts? Or that this research changes the fact that e-cigs are far safer than tobacco?

                      I did not see any comparison to tobacco smoke in this Study. Why was that not also tested, so we can see the statistical difference between e-cigs and smoking in their tests?

                      You see, no one said e-cigs are 100% safe. We just know that they are much safer than tobacco. We also know they are more effective than NRT’s in helping people quit tobacco.

                      There has been other research and analysis on the cardiovascular effects of e-cigs as well. You can read those here.

                      https://tobaccoanalysis.blogspot.com/2016/08/anti-tobacco-researcher-cardiovascular.html

                      https://www.ecigarette-research.org/research/index.php/whats-new/2019/268-ecig-heart

                      Another Study by the National Academy of Sciences confirms that despite the opposition to vaping by many anti-tobacco groups and state health departments, use of these products is much safer than smoking, and there are no known long-term health effects associated with vaping. Link below:

                      https://www.usnews.com/opinion/policy-dose/articles/2018-01-25/new-vaping-report-shows-there-are-no-known-long-term-health-effects?src=usn_fb&fbclid=IwAR2rjfWZj53CJxx5WfO6riuu2iaNh-R_c-6yZK2m9Mvx6IBV6_ipPFlTc8U

                      And finally, if you do not agree with the policy the Brits have on e-cigs, why don’t you watch a video interview with Martin Dockrell, the head of tobacco issues at Public Health England. He lays out the case in detail. Then tell me what information that he covers you disagree with, item for item.

                      https://regulatorwatch.com/brent_stafford/vaping-saves-lives-if-you-smoke-make-the-switch-says-public-health-england/

                      If you do not address the research I have provided then there is really no reason to continue this conversation.

                    7. James, when you go back to all of my replies to you from the very beginning and then address the points I make without deflection or obfuscation, especially including offering points of your own instead of addressing the issues I raise, I will do the same for you.

                      As far as insulting you or your wife, please identify specifically what you feel is insulting and I’ll review it and respond accordingly.

                      As for Charlie Schultz, this is a small gringo community and I do know of the man. Rumor has it that you got into a fist fight with him and he cleaned your clock. Because I have never received a direct account of that affair from either of you, I’ll give you the courtesy of telling me what may have happened.

                      As for my last name, that is none of your business because it will in no way enhance the discussion. I am not a public person here in Ecuador and my surname isn’t germane as yours was in identifying you as the owner of a vape shop with an axe to grind.

                    8. You wanted my wife and I to identify ourselves, we did, why don’t you? Are you afraid to put your full name behind your comments? How about this, I will just give you the name “Charlie the Great Debater”

                      Once again you have failed to address any of my points/research. I have responded to each of your points and you have responded to none.

                      I love your statement about him cleaning my clock, that’s really good stuff man! That really made me laugh. Great tool for hiding behind the fact you are clueless about this subject matter.

                      It is just another example of your ridiculous behavior in this exchange. You have no knowledge about this subject and you have even less ability to debate facts or science. This is the end of the conversation, I do not engage in conversations with disingenuous people. Toodle Loo Charlie!

  6. Update: NBC News ran this story yesterday: “Chris Gatus of Whittier, Calif., switched from traditional cigarettes to Juul because he thought the device would help him quit smoking, he said.

    But because his Juul is always glued to his palm, he found himself using it everywhere and all the time.

    “I’ve sort of forgotten what it’s like not to be on nicotine,” said Gatus, 21.

    He switched back to cigarettes this year after noticing his growing addiction, but that only resulted in his using both. Now he’s trying different vaping pens, looking for something less harsh than the Juul or cigarettes, he said.”

    https://www.nbcnews.com/health/vaping/vapers-seek-relief-nicotine-addiction-wait-it-cigarettes-n1054131

      1. Sure Susan, some people do not quit tobacco after trying ecigs, however a whole lot do. And when they do, they are at far less risk using e cigs. This is an example of 1 person, I am sure there are more but this is in no way proof of anything.

        Additionally a new study has shown that ecigs are twice as effective as other NRT’s such as gum, spray, patches.

        https://www.nhs.uk/news/heart-and-lungs/e-cigs-twice-effective-nicotine-patches-gum-or-sprays-quitting/

        You had stated previously that there is a reason why govt’s and states are banning ecigs and or flavors. Well a major reason for this is money. States are loosing money on the bonds they created from the settlements with big tobacco. As tobacco sales decrease they are loosing money. By banning ecigs, people will go back to smoking and the big money will start rolling back in. Please see the video below that clearly lays this out.

        “You will need to login to facebook first”

        https://www.facebook.com/ejuicedirect/videos/1582699135330282/

        Also a new study shows that “the rising number of young people using e-cigarettes over the past few years has not led to increased interest in tobacco smoking, as some may assume.

        https://www.independent.co.uk/life-style/health-and-families/vaping-ecigarettes-tobacco-smoking-cigarettes-teenagers-young-people-a8850326.html

        The UK Govt-Public Health England has launched a campaign to convince smokers vaping is a significantly less damaging alternative to smoking.

        https://www.independent.co.uk/news/health/vaping-quit-smoking-cigarettes-health-nhs-lung-damage-cancer-tobacco-a8701506.html

        So you see, I am not the only one recommending ecigs as a much safer alternative to tobacco. The Brits have studied this issue and have been much more effective than the USA at regulating and addressing this. That is what I am calling for.

        At the end of the day we should use all available tools to get people to quit smoking tobacco. If that is nicotine gum….great, patches…..great, ecigs……great.

        We also need to increase penalties for sales to minors, and let adults choose what method works best for them in quitting tobacco. Not everyone will be successful unfortunately, but many will.

  7. Update: the UK reconsiders their endorsement of electronic cigarettes and vaping devices (nicotine delivery systems). “-E-cigarettes may damage the heart, scientists have concluded, and have called for Public Health England (PHE) to stop recommending vaping.

    Researchers looked at 38 studies into the cardiovascular impact of vaping and found worrying signs of damage in nearly three quarters of tests.

    When they discounted trials which had been funded by the tobacco industry – or where the scientists involved had conflicts of interest – the number of studies showing harm rose to 90 per cent.

    Asked whether PHE should now change its advice, Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine, who co-authored the new analysis said: “The simple answer is yes.”

    https://www.telegraph.co.uk/science/2019/09/08/e-cigarettes-may-damage-heart-scientists-say-ask-public-health/

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