Hacker News Reader

Comment by S_A_P | Hacker News Reader

I don't think kids should vape. I don't think vaping is 100% harmless. I don't vape or smoke. I also think that there is some contingent of people who are excessively worried about vaping and looking for problems that don't seem to exist. It doesn't help that there is conflation between cannabis and e cigs, and that (based on best evidence right now) the fake cannabis liquid is causing the handful severe lung infections.

I don't mind more regulation here, absolutely make sure it's safe and find a set of ingredients that cause the least amount of harm to humans. Why is vaping perceived as so dangerous? Compared with cigarettes its damn near harmless. I don't get it.

View on HN

I'm not sure we can say it's damn near harmless at this point. It hasn't been around long enough to measure the really long-term health impacts, especially considering there are chemicals present in vaping that aren't in traditional cigarettes. They've only seen wide use for a little more than 10 years. Do we really know what propylene glycol will do to lungs or bodies over decades? There are also some harmful chemicals that are actually higher in e-cigs [0]

In short, while available research points towards these things being safer, we really don't know what that margin is. Even if it's, say, 10 times safer, if vaping explodes to more than 10x the current smoking population then net harm could still be increased. Or not! But that's my point: we really don't know.

Personally, I don't think they should be outlawed. I think fruit flavors should be banned just like they are in cigarettes, and I think anti-smoking education campaigns need to ramp up their message to include vaping as a "no, just don't ever even start" part of the effort, and e-cigs should be required to only be marketed as aids for quitting smoking.

[0]https://pediatrics.aappublications.org/content/141/4/e201735...

> I'm not sure we can say it's damn near harmless at this point.

Compared to what? Harm isn't measured in a vacuum. In the comparisons that make sense (e.g. vaping vs smoking american cigarettes) vaping is in fact damn near harmless in comparison, even if harmless is not the term I'd use for a vasodilator as potent as nicotine.

All of these "well we don't know vaping is harmless" monologues are coming from bad faith where you compare it to breathing "air" or something. Even that comparison doesn't really work because city air can itself be on the order of harm of a smoking habit—wouldn't it be funny if simply existing in SF turned out worse for your lung health than vaping?

https://www.washington.edu/news/2019/08/13/air-pollution-can...

So... of course we don't know what the harm of these things are, but we do know the harm of cigarette smoking, a factor that seems repeatedly absent from calls for regulations of vaping. Why aren't people banning cigarettes?

Of course it's relative. I'm comparing. Being relative is both implicit and synonymous with comparing rates of harm between two things. But you simply can't definitively say something is damn near harmless relative to cigarettes when you don't actually know what harm it causes, and nothing you've said changes that we don't know what harm it causes. Available evidence strongly points towards not being nearly as harmful, but that's at a relatively short term time scale.

I also don't see how comparing vaping to not vaping is a bad faith argument. If smoking causes lung cancer at 13 to 23 times the rate as not smoking, it would seem important to compare vaping's rate to both of these, along with any other health effects. It's one (albeit imperfect) baseline. Sometimes, as in the case of living in a polluted city, the baseline varies and should be controlled for in studies. You yourself emphasized relative harm. So comparing harm of doing something to that of not doing it is exactly what you would want in order to get that relative relationship.

More on pollution-- maybe living with air pollution is worse than vaping, but then living that way and vaping would be worse still. Again, there's that relative harm again. These studies have been done with traditional cigarettes, showing living in pollution increased lung disease but smoking then increases it even more, again all relative (in most studies) to "never smokers". An important piece of research to find out for vaping as well.

Finally you put a straw man up against my arguments when you talk about banning hypocrisy: I don't advocate banning it, and you're right that it seems a silly conversation to talk about banning vaping if you're not thinking about the same for cigarettes. For my part, I generally want vaping to be treated on par with cigarettes, excepting I think it should be marketed as a quitting method, not an alternate life-long choice.

>But you simply can't definitively say something is damn near harmless relative to cigarettes when you don't actually know what harm it causes

I totally get where you're coming from and am sympathetic to this argument, but I don't agree with it. We have learned a great deal from decades of research in to the harms of cigarette smoking, and have drawn some uncontroversial conclusions about why smoking causes so many health problems. We also can be reasonably sure that vaporizing nicotine does not create those same harmful conditions. I'm not saying anyone knows the long term implications of vaping, but "no one knows what will happen" is not a strong argument to me. As it stands, I think we have every reason to believe that smoking cigarettes is drastically more harmful than vaping.

> I think fruit flavors should be banned just like they are in cigarettes

Should this apply to vodka and other liquors as well?

Does Vodka enter your lungs?

It enters your body and is absorbed by your bloodstream. Is the delivery mechanism the issue?

The delivery mechanism is certainly an issue here. Food additives are tested for how safe they are to ingest, and they are not tested for how safe they are to inhale. In general we know that there are a lot of compounds safe to ingest which are not safe to inhale.

Just to pick an obviously stupid example, I could chug a can of soda (or seltzer, if you prefer) in one go. It would contain around 2.2g of CO2. If you put that 2.2g of CO2 in my lungs, I would be dead. (Well, you would have to keep it there. It would at least be very painful.)

Or to pick another obviously stupid example, I could drink enough alcohol to kill myself. In most situations, I would vomit or pass out before I got to the fatal dose. But instead, I could give myself an alcohol enema and just die (which does happen, from time to time). So, delivery matters absolutely.

For the non-obvious examples we (at least) need data. If you are putting “high” concentrations of a chemical (for some appropriate definition of “high”) in your lungs you will want some good safety data. For ingestion we already have an FDA approval process. You may disagree with the methodology, but at least it’s there.

Digested material generally gets partially broken down by either the gastric mechanisms or the liver and other organs involved.

Hence dosage for injections/sublingual delivery is much lower than dosage for normal pills to swallow.

The idea behind banning the flavoring is to make is less appealing to children. I don't see why the way it's consumed matters.

It's pretty rare, but yes, some people vape alcohol.

LOL yeah let's ban menthols too. You have a great point.

No. With alcohol we want to encourage responsible use, so a kid having a wine cooler seems okay. With cigarettes we basically want elimination so a kid taking a puff off a 'unicorn cake' vape seems bad.

I don't know. I don't know if there's any research about flavored alcohol appealing primarily to under-age drinkers the way flavored cigarettes were linked to underage cigarette use. Also there are levels of regular drinking that have neither definitive long term health consequences or the capacity for rapid addiction. Direct comparisons aren't really applicable, at least not without taking those vast differences into account.

I think it's pretty solidly established that an alcohol addiction is drastically more harmful than a nicotine addiction -- keeping in mind that we're talking about vaporized nicotine, not cigarettes.

Your point about certain populations of drinkers being able to indulge without obvious adverse health outcomes is also applicable to users of vaporized nicotine. And again it is worth pointing out that alcohol is significantly more harmful than nicotine.

I would be curious to see any research that supports the idea that flavored vape products are primarily appealing to underage users. I suspect there aren't many teenagers opting for scotch as their drink of choice, but I am certain there are plenty of adults who prefer a rum punch, peach white claw, jameson and ginger ale, or a glass of wine (it's made from grape juice for god's sake, brazenly targeting the children!), etc.

I think it's more that Juul pods have a very high level of nicotine and are creating a new generation of addicts. Even if they don't end up dying of cancer, this is still potentially millions of lifetimes of addiction for society to bear over the next 20-50 years.

My opinion: keep the nicotine for tobacco-flavored pods as a smoking cessation tool; otherwise drop the nicotine and go for a La Croix-style strategy.

Yes, if Juul had really wanted to position itself as a responsible actor they would offer further step-down nicotine levels, 2% and 1%, to better assist in quitting. I'd love it if a few lawsuits could get internal discussion surrounding those conversations.

Being addicted to nicotine isn't really a problem, it doesn't give you cancer or other diseases. The problem is all the other unpleasant things in cigarette smoke.

cigarettes are a very close substitute for vaping and much cheaper

I'm not sure that's true [0].

"Nicotine causes catecholamine release both locally and systemically leading to an increase in heart rate, blood pressure and cardiac contractility. It reduces blood flow in cutaneous and coronary vessels; and increases blood flow in the skeletal muscles. Due to restricted myocardial oxygen delivery there is reduced cardiac work. In a study, chewing a low dose (4 mg) of nicotine gum by healthy nonsmokers blunted the increase in coronary blood flow that occurs with increased heart rate produced by cardiac pacing. Thus, persistent stimulation by nicotine can contribute to Coronary Vascular Disease by producing acute myocardial ischemia. In the presence of coronary disease, myocardial dysfunction can be worsened."

"Nicotine alters the structural and functional characteristics of vascular smooth muscle and endothelial cells. It enhances release of the basic fibroblast growth factor and inhibits production of transforming growth factor-β1. These effects lead to increased DNA synthesis, mitogenic activity, endothelial proliferation and increases atherosclerotic plaque formation. Neovascularization stimulated by nicotine can help progression of atherosclerotic plaques. These effects lead to myointimal thickening and atherogenic and ischemic changes, increasing the incidence of hypertension and cardiovascular disorders."

"Nicotine plays a role in the development of emphysema in smokers, by decreasing elastin in the lung parenchyma and increasing the alveolar volume."

"The simultaneous effect of bronchoconstriction and apnea increases the tracheal tension and causes several respiratory disorders."

"Nicotine use has been associated with Gastro Esophageal Reflux Disorder (GERD) and peptic ulcer disease (PUD)."

"Nicotine has been known to be immunosuppressive through central and peripheral mechanisms. It impairs antigen and receptor mediated signal transduction in the lymphoid system leading to decreased immunological response."

"Nicotine promotes pathologic angiogenesis and retinal neovascularization in murine models. It causes age-related macular degeneration in mice."

"There is synergistic relationship between nicotine and glucose metabolism which increases the risk of diabetes mellitus. This might cause accelerated cataract formation."

"Nitrous oxide liberated from parasympathetico-nergic nerves plays a pivotal role in generating immediate penile vasodilatation and corpus cavernosum relaxation, and NO derived from endothelial cells contributes to maintaining penile erection. Nicotine causes impairment of NO synthesis. This may lead to loss of penile erections and erectile dysfunction."

"Nicotine affects the ovaries and alters the production of oocytes in various animal studies. Nicotine-treated oocytes appeared nonspherical with rough surface and torn and irregular zona-pellucida. Nicotine also caused disturbed oocyte maturation. There is a decreased blood flow to the oviducts and thus impaired fertilization."

"Various animal studies show retarded fetal growth and lower birth weight when treated perinatally with nicotine. The lower levels of ACTH and cortisol due to nicotine are probable reasons for the incidence of lower birth weight in the newborns."

"Nicotine adversely affects many organs as shown in human and animal studies. Its biological effects are widespread and extend to all systems of the body including cardiovascular, respiratory, renal and reproductive systems. Nicotine has also been found to be carcinogenic in several studies. It promotes tumorigenesis by affecting cell proliferation, angiogenesis and apoptotic pathways. It causes resistance to the chemotherapeutic agents."

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/

I'm not highly convinced here. While I only fast-read the paper you linked and checked out few references, I found cases of the usual (unintentional or not) confusion between nicotine and tobacco, or where the study population was that of smokers.

It's not controversial to say smoking is bad for you. But that's always been not because of nicotine, but all the other substances you inhale when smoking, some of which are known to interact with nicotine. What's controversial is whether nicotine itself is bad for you, in isolation, and it's of interest to people taking it in the form of chewing gums, or more recently, vaping.

Here's Gwern with a bunch of papers arguing that nicotine isn't more addictive than coffee and doesn't cause cancer, and the whole thing is just confusion: https://www.gwern.net/Nicotine#addictiveness.

It is also an upper so when you are under the influence you are actually more effective, in some sense, than otherwise.

"Compared with cigarettes its damn near harmless." Maybe. Maybe it is. Maybe it is not. We don't know what the long term effects will be, and conducting a real time trial on 20% of the nations high-schoolers isn't the optimal way to find out.

Well it is much more harmless than tobacco. Which is not a reason to encourage its usage for kids of course.

Says who? What long-term studies have there been on the effects of vaping?

Odd how no one says that about produce that has had bacteria genes spliced in to it and is now fed to hundreds of millions of people. We won't even label it.

We actually study it quite a bit. But nice job trying to distract the conversation onto a completely separate issue.

It was an apt comparison, and obviously we have not studied it over a 30 or 40 year period. Same as with vaping.

Reply on news.ycombinator.com