Comment by Reelin | Hacker News Reader

Comment by Reelin | Hacker News Reader

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> vaping being a safer alternative

A safer alternative to what? Smoking cigarettes? There's absolutely no question that it is.

One is a plant product (smoke is bad to inhale) that naturally contains a number chemicals that you probably don't want to be consuming. On top of this, there are additional additives (which vary by manufacturer) that also have significant health effects. Overview (https://en.wikipedia.org/wiki/List_of_additives_in_cigarette...) and more details (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040350/).

The other is almost entirely a mixture of Propylene Glycol and Vegetable Glycerin.

...except when it isn't, as seems to be happening here. The safety of vaping is entirely dependent on what's in the liquid you're vaporizing; always keep that in mind when purchasing it.

Also, do bear in mind that it's probably not fantastic for your health to be chronically inhaling anything other than highly purified air, no matter how benign it may seem. Relative to smoking cigarettes (or any other plant product), it's much safer. Relative to not vaping at all, there are likely to be at least some health risks, even if they haven't been clearly established yet.

> Is there any known experience similar to vaping/smoking of today that has really minimal health consequences but maybe isn't as addictive?

If you're asking about drugs with similar effects to nicotine that are less addictive, I'm not aware of any. You could always purchase vaping liquid that doesn't contain any nicotine though.

> The other is almost entirely a mixture of Propylene Glycol and Vegetable Glycerin.

What an extraordinary meaningless statement. The question is the health effects of vaporizing those and inhaling them (along with other ingredients). You are happy to provide links about health effects of cigarettes, including ingredients present in n minute amounts, but will only provide a list of major ingredients in vaping products and provide no evidence on whether inhaling them is safe or not.

I believe the current scientific consensus is that more research is needed. These are fairly new products and studies have only started. There are definite impacts on the lung physiology and the heating process does cause chemical reactions between flavorants and the carrying solution creating new compounds such that even if the flavorants and major ingredients are safe independently (which they aren't, see next link), there are byproducts that are produce that may not be[2]. The glycerol in commercial vaping solution seems to be a source of impurities that are known to be harmful[3].

[1] https://www.ncbi.nlm.nih.gov/pubmed/31483291

[2] https://www.ncbi.nlm.nih.gov/pubmed/30335174

[3] https://www.ncbi.nlm.nih.gov/pubmed/31460462

Is the question "is vaping harmful?" (because it probably is) or "is vaping about as harmful as smoking?" (because it almost certainly isn't).

Unless vaping makes you smoke more compared to cigarettes. In my experience it does. Nicoteen us crazily addictive whatever form you provide it in people will do that too much. The more convenient the more they will do it.

I don't think even this is true. The nicotine isn't really what's bad for you, it's the smoke and 600+ carcinogens in cigarette smoke.

I'd imagine it'd be safer to vape 10x than smoke 1x.

That has not been my experience. With a cigarette, once you start it going, you basically need to finish the whole thing in a short period of time. If you really only wanted one or two drags, sorry, you're down for 10 minutes or so of smoke. (Or you could put it out and waste it, but given how expensive cigarettes are I doubt many smokers are inclined to do that.) With vaping, you can take one drag and put it down. Figuring out the volume or amount of nicotine consumed would be very complicated. And, of course, most of the negative effects of smoking have nothing to do with nicotine and it seems if there are negative effects from vaping, those will likely also not come from the nicotine itself.

I don't have time to thoroughly examine your references right now, but I can tell you off the bat that the third study is very poor - they measured vapor samples at 500°F and 600°F, which is substantially in excess of normal vaping temperatures and would almost certainly produce an acrid, foul-tasting vapor. The presence of CO in the vapor samples clearly indicates oxidation rather than vaporisation. Of course you get lots of nasty byproducts if you burn the liquid.

I think what's going on there is that one of the e-cigs they used had a configurable temperature (200-600 °F). I'll give them the benefit of the doubt and assume that they selected a reasonable one (they don't appear to specify in the methods).

Separately, there's the GC-MS machine - oven (30 - 220 °C ramp) and inlet (320 °C). This shouldn't be (much of) an issue though, as an inert carrier gas is used. Plus you always have controls, so if the GC-MS itself is tearing things apart it should hopefully be obvious.

That being said, I didn't see anything particularly concerning listed in their results (relative to recreational cigarette or alcohol consumption).

Recreational cigarette smoking? I've never met such a creature. Your either hooked or your not.

In the medical literature there is a classification referred to as a "chipper" who generally smokes only 1 or 2 cigarettes a week on average. Humans are many and varied.

> > The other is almost entirely a mixture of Propylene Glycol and Vegetable Glycerin.

> What an extraordinary meaningless statement.

Not at all. The point being made is that we're dealing with a product composed primarily (99%) of two chemicals that are very clearly established as safe for human consumption (propylene glycol is commonly _injected_). As such, it seems unreasonable to assume absent evidence that the chemicals themselves would pose any significant threat to health.

That leaves other additives (which I noted) and the inhalation itself (which I also noted). As I stated in my previous comment, chronic inhalation of anything is likely to be bad for your health.

You really seem to have missed the context of the question I was responding to - it asked not about absolute safety, but rather safety relative to cigarette consumption.

Yes, as you note, there is always the potential for chemical reactions when mixtures are heated. Given the particular chemical composition and temperatures involved, I'm not personally concerned absent solid evidence. None of the byproducts listed in the study you linked appear particularly worrisome to me. Compared to cigarette, weed, or wood smoke, the contents of vaping such aerosols appears downright healthy. (Only in comparison, of course!)

Rereading my previous comment, something I failed to mention is the risk of inhaling things that are too hot. Depending on what temperature the aerosol is heated to, it could burn you internally (but then we're comparing this to inhaling burning plant matter, so... meh).

> I believe the current scientific consensus is that more research is needed.

To establish what, their precise negative health effects? Of course. But not to establish that they are safer than smoking cigarettes - there's absolutely no question about that.

Fog machines also use a glycol solution, and have been shown to be harmful. Thus vaping glycol may not be safe. https://www.cdc.gov/niosh/hhe/reports/pdfs/1990-0355-2449.pd...

The report you linked shows quite the opposite, actually. They concluded:

> Based on the results of this study, there is no evidence that theatrical "smoke," at the levels found in the theaters studied, is a cause of occupational asthma among performers.

That being said, chronic exposure is probably not good for you. From a health perspective, don't inhale anything other than air!

Asthma is only one of many possible heath impacts. It was associated with others, just not Asthma.

When compared to actors from the non-"smoke" productions, actors from two or more of the four productions utilizing theatrical "smoke" reported experiencing a significantly greater prevalence of nasal symptoms (sneezing, runny or stuffy nose), respiratory symptoms (cough, wheeze, breathlessness, chest tightness), and mucous membrane symptoms (sore throat, hoarseness, dry throat, itchy/burning eyes, dry eyes) during their performances for the week prior to the survey.

The final line is: The quantity and frequency of use of the various fogs during a performance should be minimized.

PS: A method of action was suggested to be the breakdown of glycol due to high temperature.

The report he cited proved his point.

Fog machines cause noticeable effects on breathing at significantly lower exposure levels and concentrations than vaping. IOW, it provides a lower bound for the purported safety of vaping.

Here is the conclusion of that study to save a click:

"Based on the results of this study, there is no evidence that theatrical "smoke," at the levels found in the theaters studied, is a cause of occupational asthma among performers. Some of the constituents of theatrical "smoke," such as the aerolized glycols and mineral oil, could have irritative or mucous membrane drying properties in some individuals. Therefore, it is reasonable to minimize exposures by such means as relocating "smoke" machines to avoid exposing actors to the direct, concentrated release of the aerosols, minimizing the amount of "smoke" necessary for the production, and using only fog fluids approved by the manufacturers of the machines. The glycols used should be at the level of "food grade" or "high grade." Glycol-based systems should also be designed to heat the fog fluids only to the lowest temperature needed that achieve proper aerolsolization. This would help to avoid overheating the fluid and minimize the generation of decomposition products."

What grade of glycol is used in a vape and are they required by law to state what grade it is?

Mainstream vendors use USP grade PG/VG and food grade flavouring (which can also include a small amount of PG or VG as a carrier)

The ingredients you list are safe for human ingestion. It doesn't follow that they are safe for inhalation.

Your point that they are likely safer than cigarettes is well taken, but your insistence on the ingredients being known to be safe to inhale is faulty.

> your insistence on the ingredients being known to be safe to inhale is faulty

Please reread my comment - I never claimed that. I very explicitly stated that inhalation of anything is likely to be bad for your health.

Is that what the marketers of the product are claiming as well? I see quite the opposite in the world around me. I feel the vaping industry is just as corrupt if not more so than the awful cigarette companies. https://www.cbsnews.com/news/juul-came-to-a-9th-grade-classr...

> very clearly established as safe for human consumption (propylene glycol is commonly _injected_).

Consumption, injection, and inhalation are very different routes of introduction to the body, and safe for any one does not imply safe for the others.

Many things that will cause no problem if injected or eaten will cause problems in the lungs.

>> The other is almost entirely a mixture of Propylene Glycol and Vegetable Glycerin.

> What an extraordinary meaningless statement.

>> ...except when it isn't

Emphasis on "except when it isn't" which highlights the other impurities that might be there. I found the comment to be useful at highlighting what it was designed to highlight - that the safety depends entirely on what's inside the carts. You have no guarantees with some suppliers what the heck's actually inside, and I think saying "it's fairly simple at the base, but rather complicated in reality" is quite helpful for framing.

>The safety of vaping is entirely dependent on what's in the liquid you're vaporizing

This is statement is incorrect. It discludes the very real and proven health threats that heavy metal consumption can enlist.

A simple understanding of the chemistry involved is enough to infer the presence of dangers not dependant on the liquid being used. If you cook an acidic tomatoe sauce in a completely copper pot... the safty of consuming that sauce is not entirely dependant on the tomatoes and the same applies to vaping[0].

[0] https://www.webmd.com/smoking-cessation/news/20180226/toxic-...

Sorry, yes, safer alternative to smoking cigarettes

Fair enough, I'm sure it's not healthy to chronically inhale anything other than air

> If you're asking about drugs with similar effects to nicotine that are less addictive, I'm not aware of any. You could always purchase vaping liquid that doesn't contain any nicotine though.

I was asking that but a broader question for me is, are there any safe replacements for cigarettes out there that match the qualities that cigarettes have without the harmful side effects (the idea being if you could create something that was just as fulfilling, addictive, etc. but without the negative side effects you could dramatically decrease the health toll of cigarette smoking). You could argue vapes are that product but it seems like the jury is still out on how much better they actually are than cigarettes and the trouble with attracting new users into the market

> it seems like the jury is still out on how much better they actually are than cigarettes

No. IT IS NOT. You have been mislead.

Unfortunately, for whatever reason, there is currently a lot of FUD and propaganda surrounding vaping. Perhaps due to the term "e-cigarette"?

Other than artificial flavors, the major constituents in the liquid are what I listed above - propylene glycol, vegetable glycerin, and nicotine. Only nicotine has significant documented health effects (at least that I am aware of), and even that's almost entirely down to it being addictive.

Bear in mind that I'm comparing this to smoking weed or drinking alcohol - both extremely common pastimes throughout the world, and both clearly more harmful than vaping. Anyone trying to scare you off of vaping while not worrying about those other two activities is out of touch with reality.

Of course, abstaining from all of those would be the best advice as far as your long term health is concerned.

Do you have any solid RCTs or meta analysis you could point me to about how much better they are than cigarettes?

Agreed, there's a lot of FUD, but a lot of it is coming from sources that give me a lot of hesitation to doubt (lots of public health leaders, tobacco control groups, WHO people)

I understand alcohol or weed is more harmful than vaping, I'm personally just interested in cigarettes as that seems to be the replacement part, I'm not sure someone would quit drinking or smoking weed and replace with vaping

Edit: I know you pointed me to a solid report in an earlier comment, any additional ones? There are huge numbers of reports on tobacco in general and it's easy to find 1 or 2 reports reflecting one opinion or another

See https://www.nhs.uk/smokefree/help-and-advice/e-cigarettes which cites

> Public Health England's 2015 independent evidence review found that, based on the available evidence, vaping is around 95% less harmful than smoking. The Royal College of Physicians came to a similar conclusion in its 2016 report 'Nicotine without smoke: tobacco harm reduction'.

> Agreed, there's a lot of FUD, but a lot of it is coming from sources that give me a lot of hesitation to doubt (lots of public health leaders, tobacco control groups, WHO people)

None of these sources are saying that vaping is comparable to smoking in terms of harms caused.

They're saying that some harm is caused, and that we don't know what harms are caused, and so the precautionary principle means we should make sure that non-smokers do not take up vaping, and that smokers should use other nicotine replacement methods.

> we should make sure that non-smokers do not take up vaping

How about we let adults do as they please instead.

The most anybody should ever do about vaping is warn people that maybe it's not the safest thing in the world.

Instead in the EU we have a ridiculous law that makes it illegal to sell nicotine liquid in container bigger than 10ml, which means that if I don't want to spend twice what I used on cigarettes, I have to buy non-nicotine 100ml bottles of liquid and then buy separate 10ml bottles of nicotine concentrate and mix them myself, doing the math myself to get the proportion I used to be able to just order and generating a small pile of empty small plastic bottles every month because people who can't sleep at night unless somebody does something about everything!!!OHGODSTHECHILBREN!!! keep coming up with stupid ideas like that.

Please we should not be making sure of anything! We don't need to be sure that every body is absolutely safe all the time, put a warning label and let us do as we wish with our health.

Letting adults do as they please is a common refrain, but when you're living in a country with subsidized healthcare, the government has an incentive (at the macro level) to not let you do stupid things that raise healthcare costs, which are then passed on to the population at large.

In America, you break it, you buy it. Everywhere else, I have no problem with a bit of governmental oversight to make sure people don't hurry themselves to a quicker and more expensive death.

That is a savagely, tragically dangerous position to take in a country with subsidized healthcare. We have many examples of unintended consequences resulting from attempted behavior modification with the goal of improving health, and government policies, due to the way they are executed, are inherently much more difficult to reverse or change than education. Just for one example, look at the American Heart Association. In the 70s, they believed they saw evidence that the amount of the diet which came from saturated fats produced increased risks to heart health. So they pursued governmental avenues to reduce the saturated fat intake of Americans by 15%. They succeeded. Saturated fat was removed from many products available on store shelves. Which made them taste like cardboard. Which made sales fall. To restore flavor, they filled the products with sugar and salt. Sales improved. Average American caloric intake skyrocketed. It birthed an obesity epidemic, a diabetes epidemic, and yes, a heart disease epidemic. Meanwhile, research showed saturated fat wasn't quite so dangerous as once thought.

Trusting people to their own devices and doing no more than education is not perfect. But it reduces the odds of unintended consequences like this drastically. It also makes it much easier to change course when necessary.

But even in this supposed nanny-state of the UK with it's single payer commie healthcare there are no laws preventing people buying and using vapes.

Sounds like a good argument against subsidized healthcare to me

Since smokers use health services much less than non-smokers, your view is that non-US governments should encourage smoking then?

Not the case at all. We have subsidized healthcare in the USA and have had it for a long time. The poor (typically the demographics of vapers and smokers) rely on free healthcare quite a bit via Medicaid and or just having the tax payers foot their hospital bill for them. Older people have Medicare. We also subsidize addiction facilities and mental facilities as well. We pay way more for our healthcare than most other nations but we also have most of the medical innovations occurring in the states. All that said, yeah the government does not allow citizens to jump off buildings and run out into traffic because they think it's a good idea. We try to warn against those types of things and it's no different than what the CDC is doing by warning Americans to stop vaping until we know what is killing people.

> How about we let adults do as they please instead.

I don't understand why your post is so angry. In England there are no laws that stop people vaping. We have a government organisation that has to make recommendations for public health, and they've given their recommendation.

The link below is a systematic evidence review published by Public Health England, covering 415 studies relating to e-cigarettes and heated tobacco products. Key quotes:

One assessment of the published data on emissions from cigarettes and EC calculated the lifetime cancer risks. It concluded that the cancer potencies of EC were largely under 0.5% of the risk of smoking.

Comparative risks of cardiovascular disease and lung disease have not been quantified but are likely to be also substantially below the risks of smoking. Among EC users, two studies of biomarker data for acrolein, a potent respiratory irritant, found levels consistent with non-smoking levels.

Biomarkers of exposure assessed to date are consistent with significant reductions in harmful constituents and for a few biomarkers assessed in this chapter, similar levels to smokers abstaining from smoking or non-smokers were observed.

https://assets.publishing.service.gov.uk/government/uploads/...

Don't forget that most of the evidence they used comes from research funded by the tobacco industry, and when you exclude that data the research shows more harm.

It's all relative. I don't see the CDC telling people to stop stuffing donuts in their mouths, which is far more harmful for public health.

I mean, they definitely are doing that:

https://www.cdc.gov/healthyweight/losing_weight/eating_habit...

But that kind of content very definitely grabs fewer headlines.

You sound extremely biased.

> Bear in mind that I'm comparing this to smoking weed or drinking alcohol - both extremely common pastimes throughout the world, and both clearly more harmful than vaping.

What about the dosage though? The people I know who drink alcohol and have a beer or 2 on the weekend. The people I see who vape, do it constantly. Are there people who vape once or twice a week?

Here’s some detailed analyses from neutral third parties about just how much less hazardous vaping is than smoking: https://news.ycombinator.com/item?id=18717697#18718028

(For THC, strongly consider eliminating lung damage entirely by consuming edibles instead of either vaping or smoking.)

Thanks for this!

Agreed on THC, but I'm purely looking at cigarettes/tobacco right now

A few Swedes have also highly recommended looking into Snus as an alternative and I need to do some more research there

Snuff or chewing tobacco, as it is more commonly known in the states, still causes cancer.

The number of people who have died within days or weeks of using a new cigarette from smoking-related causes they didn't have before the switch: 0.

The number of people who have died within days or weeks of trying a new vaping product: 5 and counting. Out of a much smaller user base.

Right now the evidence is that vaping is more dangerous in the short term, with no evidence that it is any healthier in the long term.

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