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Comment by atlasunshrugged | Hacker News Reader

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

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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.

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.

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