Vaping Is big tobacco’s bait and switch
nytimes.com
nytimes.com
Even cigarette packets on a shelf behind a shopkeeper must not be identifiable in any way, and be behind a closed door. And all brands look exactly the same except for small lettering of the product's name (in the same font for everyone).
They all look like this;
https://cdn.newsapi.com.au/image/v1/29360d2ce7cffa390ad072b2...
Just grey packets with a confronting image of disease.
But it's the cost that has had the most dramatic effect on smoking rates. Particularly with younger people. A single packet of 25 cigarettes costs something like $35-$40 (@$25US) in Australia now. Teenagers just cant afford to start smoking anymore.
https://www.cancercouncil.com.au/wp-content/uploads/2013/09/...
https://www.smh.com.au/national/does-this-colour-turn-you-of...
It used to be possible to buy them duty-free if you were traveling internationally, but that loophole was closed too. An individual can only bring a max. of 200 individual cigarettes, into the country now without paying the Australian taxes.
I was a smoker, and I looked into roll-your-owns as an option to save on the rising costs, but it was a negligible difference. Gram for gram it was a tiny difference between purchasing loose pouch tobacco and pre-made cigarettes.
It is also illegal for anyone to cultivate it in any amount without a government license, and the penalties are very harsh.
There is apparently a black-market for unprocessed tobacco (known colloquially as chop-chop) but I haven't ever come across it. It is much easier to buy weed, which is still outright illegal here.
https://www.vice.com/en_au/article/pae75k/we-asked-a-tobacco...
For some idea of the crazy high prices; https://www.cigars.com.au/products/cigarettes
It’s cheaper. The end result generally contains less tobacco than the pre-rolled, so go guess it goes further. And people often say “it doesn’t have all the chemicals that the pre-rolled ones have”, which is justified off the basis that pre-rolled cigarettes will finish themselves if left on a table, but a roll your own will go out. (I don’t smoke, so I’ve never bothered to look into it).
Additionally, mixing tobacco and marijuana is more common in Australia. Roll your owns go hand in hand.
I was in Australia on a trip last year, and met a lot of people who rolled their own because that was still affordable for them.
Anyway, once the young stop smoking they will start doing something else which is dangerous.
1. Smoked in college in earnest.
2. Started quitting after college with great difficulty.
3. Failed to quit for more than ~6 months at a go for a decade and half.
4. Started smoking e-cigs / vape last year (the liquid kind).
5. Quit vaping AND smoking months ago WITHOUT EVEN TRYING.
There was a pleasure loop hard-wired in my brain from smoking that I could ignore but would always win if 1) I was exceptionally stressed out or 2) I was drunk.
Without any difficulty whatsoever and without a conscious effort to do so, vaping somehow de-programmed that loop. My desire to smoke anything just disappeared. Stress and alcohol cause zero cravings now.
Further:
1. I don't recommend smoking. Risks far outweigh the benefits.
2. I don't recommend vaping unless you already smoke cigarettes and want to quit.
3. YMMV.
Keep up the pace!
Also, if e-cigs turn out to be safe, or can be made safe, what is the problem? Just a bunch of puritan's with their underwear in a knot.
This is weasle-wording.
"Just a bunch of puritan's with their underwear in a knot."
Reframing the debate in moralistic terms is not useful here. It's a public health issue, plain and simple. If there is research that you are privy to that shows nicotine to be harmless, please share it with us; don't keep it to yourself.
https://en.wikipedia.org/wiki/Nicotine#Contraindications
"The accepted medical position in 2007 was that nicotine itself poses few health risks, except among certain vulnerable groups"
Now, there is a public health discussion to be had about e-cigarettes, however they have inherited much of the moral baggage that we attached to traditional cigarettes (as well as much of the public perception of safety we have attached to traditional cigarettes).
If you are reading something in the opinion section of a general purpose news paper, odds are you are reading a moralistic piece. That is not the place where technical discussions of public policy occur.
[0] This is not to say the motivations of those conducting it were moralistic, but many of the compagns themselves were, and cigarettes are now widely viewed as a moral failing.
I have the feeling that with vaping there's a "safe until proven unsafe" factor... The fact that it is used as a way to get people away from cigarettes tends to make think that it can just be better, which might be true, but at the same time there's absolutly no knowledge about long term effects.
Personally I think it would make sense to apply tobacco regulations to vaping. For safety purpose as well as respect for non smoker/vapers.
I know for a fact from people who worked for BAT that it is now a big part of their strategy.
When I see news like this, i can't help but make a parallel with tobacco lobbying: https://www.bbc.co.uk/news/health-45212444
Of course it is a moral debate. Sure its not healthy, but shouldnt people be allowed to use it regardless if they decide to do so? It only becomes a public health issue once people who dont smoke are effected, which is why we got bans to smoke in certain places and not a ban on smoking in general.
2) Smoking impacts on individual productivity which directly impacts on economy:
> Current smokers missed more days of work and experienced more unproductive time at work compared with former smokers and nonsmokers. The average annual cost for lost productivity for nonsmokers was 2623 dollars/year compared with 3246 dollars/year for former smokers and 4430 dollars/year for current smokers. More than half the costs were due to unproductive time at work. https://www.ncbi.nlm.nih.gov/pubmed/17033509
3) Tobacco smoking is the cause of many preventable diseases and premature deaths in the UK and around the world. It poses enormous health- and non-health-related costs to the affected individuals, employers, and the society at large. The World Health Organization (WHO) estimates that, globally, smoking causes over US$500 billion in economic damage each year: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4502793/
Dismissing discussions about impacts of smoking as moralistic is borderline disingenuous in face of the numerous studies freely available on the internet.
I'm all for freedom of choice as long as it doesn't impact the collective. And To add to your point, imagine if sugar-rich and fast-food packagings were photos of sickly-looking obese people and insulin injections. Also imagine if fast-food was prohibited from being advertised. That's what some govs do with tobacco. As you said, allowing one but no the other is indeed a moral debate.
Are you sure you don't see any methodological issues with this study & those claims? Cuz I see a lot.
>Dismissing discussions about impacts of smoking as moralistic is borderline disingenuous
Please consider avoiding backhandedly calling people liars.
Meanwhile your comment also adds nothing to the debate by going straight to personal attacks and a vague dismissal of one of the linked studies.
To stay on topic:
Could you provide a study that disproves collateral damages, be it with to health or simply economic, to non-smokers?
Only if you can point out what the weasel word is.
Asking what's the problem if they're/can be made safe is not a weasel phrasing.
Is a totally legitimate question.
It would be a weasel phrase if the healthiness was assumed somehow.
We don't know if they're actually safe, and we don't know how addictive they are, and so the precautionary principle tells us not to recommend vaping to people who are not already smokers. Small amounts of harm across an entire population adds up.
We have very good reason to be wary of any action taken by tobacco companies because of their many years of abusive practices. An abundance of caution around tobacco companies isn't a bad thing.
The primary issue is that Big Tobacco is marketing to children, again, with the goal to get children who currently wouldn't use cigarettes. That needs to get stomped on.
Do you mind providing a source for this claim? :)
paragraphs 12 onward
Otherwise the section referenced said nicotine does not seem to be a carcinogen but some people suspect it may be a tumor promoter. If we're drawing the line at "suspected to be involved in cancer somehow but doesn't cause it" then we're going to have to rework most of society and then some.
The only other thing that stood out was the particulates issue, though they didn't mention any health effects of being exposed to the particulates and I don't have that knowledge off-hand.
I don't believe any e-cigarette research institute would agree with either of the claims that: 1) vaping is well studied. It is about 10-20 years from being well studied as most of the major research institutes are just starting (or are in grant application stage). 2) vaping is less harmful than the health effects of a high sugar diet (not to discount that a high sugar is very bad)
https://www.gov.uk/government/news/phe-publishes-independent...
I'm just going to say that this looks like the least rigorous assessment that I've ever seen. As far as I can tell, they went to a conference and over a 2 day period collectively came up with a list of "evaluation criteria" which is not at all limited to health. It includes (among other things) crime, environmental damage, family adversities, economic cost, community,etc, etc).
Then they scored each product against each criteria on a 100 point scale. This is not an evidenced based approach. It was a bunch of people sitting in a room arguing with each other how they think it should be scored.
Then they weighted the results. Finally they gave each a final score of "harm" base on a 100 point scale. Cigarettes ranked at 100. Pipe smoking ranked at 21 (nearly 5x "safer" than cigarettes!) ENDS ranked about 4 (based on what I can guess from the graph). There's your "at least 95% 'safer'" tag line.
Oh and the committee included a consultant working with companies on tobacco dependence, another consultant working with smoking cessation products, and another consultant working for an e-sig distributor. Several of the committee received grants from the nicotine industry.
[1] - https://www.karger.com/article/FullText/360220 [2] - https://www.gov.uk/government/uploads/system/uploads/attachm...
Here's an example of a gaping gap in research on e-cigs: "To our knowledge, there are no relevant study in humans on carcinogenic effects from pure nicotine including products, such as NRT and e-cigarettes." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553893/
It's really hard to summarize a body of research if there's barely any research been done in an area.
> After adjusting for these variables, e-cigarette users were 34 percent more likely to have a heart attack, 25 percent more likely to have coronary artery disease and 55 percent more likely to suffer from depression or anxiety. Stroke, high blood pressure and circulatory problems were no longer statistically different between the two groups.
> Cigarette smoking carries a much higher probability of heart attack and stroke than e-cigarettes, but that doesn't mean that vaping is safe
From the CDC (to get a sense of the magnitude of the health effects of smoking [0]:
> People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke.
None of these statistics talk about the base rate at all, which (imo) makes them very difficult to interperet, but I am too lazy to look up and factor in the base rate myself, so I just pretend that these statistics are meaningful without them.
To look at this from another perspective; we may not have studied e-cigarettes very much, but we have extensive studies showing the traditional cigarettes are very, very bad for your health. And, even absent empircal studies, we have strong theoretical reasons to believe that e-cigarettes are less bad; and the empirical studies seems to back this conclusion up.
[0] https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm
You are correct that it's entirely possible that e-cigarettes are not in the same magnitude of impact as tobacco. However, it's also possible it may be just as bad. The research is too early stage. What I do know (anecdotally), is that most of the researchers in the field have a gut feeling that it is a large issue. Specifically, early findings are showing the product has convinced an entire new generation of teens that vaping is cool even while they believe smoking is gross. It is reseting the gains made in the 80s and 90s on reducing teen addiction to smoking. There is also research to indicate it has a strong impact on health. Probably not as strong as tobacco, but if you are more likely to use it as a teen because you perceive it as healthy and cool, the net effect on public health is just as bad. i.e. the individual effect might be less, but the overall net effect on society is more since its a more compelling product (for young people).
We are probably 5-10 years from knowing with solid peer reviewed research of knowing whether vaping is more like eating a few donuts a day or whether it's closer to smoking a pack a day.
Most studies I’ve seen on e-cigarettes have had faulty controls or are designed with unrealistic scenarios in mind, I hope that changes because proper study is certainly warranted.
https://www.scientificamerican.com/article/is-nicotine-all-b...
FWIW, my friend's psychiatrist recommends nicotine gum.
Was this same person? "Reuters’ reporter Kate Kelland, who has a history of cozy relations with a group partly funded by agrichemical company interests," ( https://www.huffingtonpost.com/entry/monsanto-spin-doctors-t...)
> ...
> The purpose of this pilot study was to evaluate the pathobiologic effects of long-term, high dose nicotine treatment of A/J mice susceptible to tobacco product-induced lung carcinogenesis.
These were mice genetically engineered for increased cancer susceptibility and also given insane dosages. This study is designed to answer whether nicotine is not carcinogenic. That is, if the result was negative then it would suggest any future study would be wasted effort. A positive result doesn't say anything about the safety of nicotine, per se; just that there remains the possibility it may be carcinogenic. That's very different as many absolutely benign substances could also produce this result.
"To our knowledge, there are no relevant study in humans on carcinogenic effects from pure nicotine including products, such as NRT and e-cigarettes." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553893/
That's the first time I heard that. Do you have any links to this evidence?
What I can say about vaping is, my endurance and performance in gym/sports is noticeable improved after 3 days of vaping instead of smoking. I can breath deep and feel better. That's the only proof I need until a study tells me otherwise. I would love to quit everything, but I do enjoy a drink.
Does this story sound similar to anyone who successfully quit? Send advice if so.
I also suggest reading "The Easy Way to Quit Smoking". If nothing else it's very encouraging. It might also help you realize that nicotine and alcohol have no special relationship. Not any more than cigarettes and food or cigarettes and sex. When you are a nicotine addict, everything becomes a trigger for your addiction. Trying to differentiate is just playing into the addiction and giving it special powers.
> That same study, like many others, found that other ingredients in tobacco smoke are necessary to amp up nicotine’s addictiveness. Those other chemical ingredients things like acetaldehyde, anabasine, nornicotine, anatabine, cotinine, and myosmine—help to keep people hooked on tobacco. On its own, nicotine isn’t enough.
https://www.scientificamerican.com/article/will-a-nicotine-p...
There are other sources and studies I'm too lazy to look up, but AFAIU nicotine is a powerful cognitive enhancer that makes activities easier to perform and more rewarding (including, perhaps, the metabolization of other substances), and it's this experience boost that may be what addicts people. In any event, it's now understood--relatively uncontroversially--that this is why many people with certain cognitive deficits (ADHD, schizophrenia, depression, etc) self-medicate with nicotine, though it works to elevate cognitive performance even for people without deficits.
It's also very important to understand that nicotine, like most addictive chemicals, impacts different people in different ways. Some people have no problem smoking a few cigarettes a month for years bon end without every developing an addiction.
I thought the relationship was that alcohol lowers your inhibitions, including your inhibition against smoking?
I did the same thing, and started again in the same way. I've just quit once again, and I'm determined to stay away from nicotine, and vaping for good now.
Personal bias - smoked heavily starting at age 13/14 until my 30s. Switched to vaping heavily and saw marked improvements in my health. Eventually weaned down nicotine levels while vaping over the course of many months. Quit vaping with some difficulty, but not the difficulty level of quitting cigarettes. Now don't use nicotine at all, but will never be able to use it in moderation.
The reason it has appeared is because it is profitable. It is profitable because it is addictive. So some company or companies begins applying a population level medical experiment, introducing an addictive substance with only extremely ephemeral benefits and potentially serious health consequences. Intensifying this problem, the companies proceed to target children, in order to attempt to create lifelong money drips based on a physiological addition. The question is why is this a legitimate activity?
While you personally may have some intelligence and ability to not waste your health and money on this product, simply placing it in accessible areas, advertising it and making it appealing, means that less informed or more risk taking members of the population will basically trip into a bear trap and feel like they're making an affirmative decision about their life because it feels good for a few moments at a time.
This is insanity. Why do we allow known bad actors to manipulate and poison the public?
EDIT: I should clarify that I don't have a problem with individuals growing and making this stuff themselves, just with the license we give to apply these medical experiments at a population level by entities that care nothing about the people they serve.
This seems like a description of any method of nicotine use, and you're about 3500 years too late for that. I don't see how it's accurate to describe e-cigs advent as the introduction of a new addictive substance: it seems to me to largely be the introduction of a new (far safer) method of delivery for an existing addictive substance.
The complaint about e-cigarettes seems to me to be a complaint about the ease for teens of hiding their usage, relative to stinky cigarettes.
I thought about this a bit overnight and I think if we wanted to use this technology in a way to reduce harm and improve human health, we would offer it mainly through doctors' offices. While it would reduce reach among current smokers, it would also be fairly specific to that population sans some small scale cheating. This would prevent uptake by children and non-users. Instead, we take the opposite approach of selling it for profit and expand the market as far as possible. This is a gross behavior that does not care for the value of human life and health and we allow it.
1) Stylistically, it looks cool and makes great shots. The light going through the smoke, the burning sound of the inhale.
2) It tells us something about the character and their value systems and their psychological state. Maybe they have a devil-may-care attitude, maybe they are under distress.
3) It gives an excuse for characters to stand and talk. It also is an excuse for a character to be alone is silent contemplation while also doing something the audience can see (smoking). Without cigarettes, both of this situations feel more contrived and less natural.
- Started smoking as a young teenager (13) - Quickly turned into a pack a day smoker (16) - Went up to two packs a day (twenties) - Spent a year off and on cigarettes using a vape pen - Decided to completely switch to vaping
It's been 2 months since I've smoked (besides little mishaps at parties).
I've spent the most of the time coughing up all the shit my lungs have been accumulating since a child. I can breath a lot better now, suffer no lung/chest pains (daily before I quit cigarettes).
I'm a happy vaper and will continue to vape for now. I am 100% aware that it may not be risk-free, but I feel an enormous difference between smoking and vaping. I had tried numerous things before vaping (patches are pointless, nicotine gum horrible, champix made me extremely depressed/suicidal), and am grateful e-cigarettes are a thing.
> The worst are the people – one of whom has so far appeared in every article I have read on the subject – who say that we should be careful because “Big Tobacco” is pushing them as a “solution” to the problem of declining cigarette sales. First of all this is just factually wrong; most e-cigarettes are made by alternative companies in direct competition with Big Tobacco. Second, if your reasoning strategy is identifying the Evil People and then minimizing their utility, you probably shouldn’t be making public policy.
> ...if a public e-cigarette ban reduces the number of smokers who switch to e-cigarettes by 2%, you’ve just killed an extra 9000 people per year – about three 9-11 attacks, or twice the number of US soldiers who died in the Iraq War.
As soon as you do the math, it's clear that allowing vaping is extremely good for public health. Those opposed to it demonstrate their innumeracy and puritanism.
1. https://slatestarcodex.com/2013/03/28/thank-you-for-doing-so...
My concern is not that e-cigs are dangerous (they might be, but they're very probably not more dangerous than actual tobacco), but that e-cigs' perceived safety might eventually get people, a lot of them, to start actually smoking.
Personal anecdote: I'm an ex-smoker. I love that e-cigs are helping smokers quit, but I don't like that e-cigs are getting non-smokers addicted to nicotine.
I'm not enthusiastic about banning things in general, and e-cigs are no different. But as someone who was dependent on nicotine for years, I hope The Public is wary: nicotine goes from being your lover to being your boss very very quickly. And once it's your boss, all it does is make you feel terrible if you aren't consuming nicotine.
If you have a nicotine habit: try to kick it. Life's great on the other side.
If you don't have a nicotine habit: life's great on the side you're already on.
If cigarettes are cheaper, some people who use vapes exclusively will smoke cigarettes in order to get their nicotine fix. Addiction doesn't care about price or which delivery method is healthier.
If cigarettes are more accessible, as in if you're out and your vape's battery is dies and/or it breaks and you need your fix, some people who use vapes exclusively will smoke cigarettes in order to get their nicotine fix. Addiction doesn't care about where you are or if getting your fix is inconvenient.
You can draw similarities to the opioid epidemic: if you give 'safer' prescription opioids out like candy, and then take them away, some people who used prescription opioids exclusively will move to cheaper and more accessible heroin.
"the company also received a $12.8 billion minority investment in December from the tobacco giant Altria"
A little off topic, but I find that cigarettes really work for me as a software developer. Program for a couple hours, and then smoke a cigarette, rinse and repeat. More often than not, I catch bugs in my programs while smoking, not while at the computer. It significantly improves my cognition while also inducing a calm and reflective state. Part of this is probably from being alone and stepping away, but the tobacco definitely does have a strong effect separate of this.
This is a non-sequitur in context: Gwern's whole thing is trying to take a from-scratch look at the literature instead of relying on the standard appeal-to-authority arguments that sometimes lead to flawed conclusions due to things like institutional incentive structures. That is to say, if you're the kind of person who reads thing blindly based on whether the author is an expert or not instead of taking advantage of the fact that he shows his work to assess the quality of his analysis, then gwern's writings probably aren't for you. (FWIW, you should probably be doing this to some degree even when reading the recommendations of those designated experts)
Don't get me wrong, there's obvious ways for "ignore the experts and read the literature from scratch" to lead to flawed conclusions, but it's just a different type of analysis.
While they've somehow gotten the stigma of being flashy and hip, they're very much designed for a specific purpose: getting people off cigarettes. In doing so: they're expensive, harsh, and have poor flavor options.
I legitimately can't understand why high schoolers would be attracted to them when normal vapes are (1) substantially cheaper, (2) so much more flavorful, and (3) available on a wide variety of websites that do zero age verification. I mean, kids aren't smart, but its almost so unbelievable that, dare I say, the media is making broad generalizations and Juul is just taking the brunt of their ire.
Even the officials knew anything about the flavourings today, they will spin another five flavours by tomorrow.
And even if knew everything about a flavour.... what's in the mass produced / delivered to consumer flavouring will not remain the same day on day.
This whole thing makes my spidey sense tingle.
F1 was one of the biggest industries to embrace tobacco advertising, and indeed was exempt from several tobacco advertising laws in the UK. The Ferrari F1 team still takes sponsorship from Philip Morris International (the company that owns Marlboro), and indeed at the start of this year, the Ferrari team was named "Mission Winnow Ferrari". Mission Winnow is Philip Morris' project looking for Tobacco alternatives. Read: Vaping.
As @satori99 mentioned however, Australia has very strong advertising laws when it comes to tobacco, so as the first race is in a few weeks, the Mission Winnow branding was removed from the Ferrari as it was revealed that the Australian authorities had launched an investigation: https://www.autosport.com/f1/news/141908/ferrari-removes-mis...
I imagine there's some deep social need that's being met by the e-cigs.
I started smoking when I was 15. I smoked for 15 years and manage to quit 17 years ago. I can honestly say that to quit smoking is the best (health) choice I ever made.
That's terrible advice. Champix and Zyban produce "feelings of agitation, depressed mood, hostility, changes in behaviour or impulsive or disturbing thoughts, such as ideas of self-harm or of harming others". I had several doctors literally tell me "to stay the fuck away from that garbage"
My family is deeply grateful for that "garbage".
Of course, none of that includes flavoring. Flavoring, and the process, clean rooms, scientific equipment, that's the actual expensive part and why you'd never actually see those six figures. The nicotine itself is pretty much a rounding error in the total cost of the product.
[1] https://liquidnicotinewholesalers.com/100mg-nicotine-liquid....
It's worked far better than any traditional methods to quit. I haven't touched a cigarette in three months.