Comment by who_is_firing | Hacker News Reader

Comment by who_is_firing | Hacker News Reader

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This is incorrect. E cigarettes are still in a very early stage of research. My partner works at one of the leading institutes in tobacco research and they are literally just kicking off most of their research on e-cigs. Most of the researchers (including one of the world experts on tobacco research) has a gut feeling that the health effects will be in the same magnitude as cigarettes. Early research confirms this, but again it's still a gut opinion. Literally the first major study on e-cigs affect on heart disease was released last year (and it does not look good): https://www.sciencedaily.com/releases/2019/03/190307103111.h...

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)

Public Health England published a review of evidence of e-cigs. They concluded e-cigs are about 95% safer than tobacco. So being the same magnitude as cigarettes seems an absurd claim, on the strength of all studies so far, anecdotally too.

https://www.gov.uk/government/news/phe-publishes-independent...

Because a statement like "e-cigs are about 95% safer than tobacco" seems meaningless to me without any scale to reference it to, I dug out the paper that they based their estimate on [1] (which I got from [2]).

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...

Doing a review of the current research isn't valuable for the reasons I outlined: overall research is immutare so an overall review isn't going to be that insightful right now.

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.

From your article:

> 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

I think my overall argument was that we have barely studied studied e-cigarettes so OP's assertion "Vaping has been pretty well studied (except for the flavorings" is false.

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.

Nicotine remains a vasoconstrictor, that doesn’t change - some increased risk of certain cardiovascular disease isn’t going to shock anyone. Sugar is terrible for your cardiovascular health too though, yet we continue to ignore that fact.

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.

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