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Comment by giancarlostoro | Hacker News Reader

Ecigs worry me the most since you really cannot tell what someone truly has in there, it could be nicotine, it could be “legal” THC or other random nonsense, I wouldnt know, it all looks the same.

I have a friend who gave up cigarettes for ecigs but he is actually doing it for the nicotine, saves him a fortune, he was smoking a pack a week in NYC.

My thing is, how healthy are ecigs compared to real cigarettes really?

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> Ecigs worry me the most since you really cannot tell what someone truly has in there, it could be nicotine, it could be “legal” THC or other random nonsense, I wouldnt know, it all looks the same.

You're more likely to get heavy metals, volatile organic compounds, pesticides and toxic industrial chemicals than a surprise dose of THC.

https://www.smithsonianmag.com/smart-news/nearly-2000-chemic...

In a society where government is not participating in helping people with their health care, what moral right does it have to make "unhealthy" things illegal?

The government does help (to the tune of trillions of dollars per year) with their health care.

Medicare and Medicaid represent the largest segments of U.S. federal health spending, consuming over a trillion dollars each. Medicare accounts for 21% of national healthcare expenditures. Medicaid constitutes $1 of every $5 spent on healthcare. The US government is helping the poor and the old with their healthcare

Option A: nicotine.

Option B: nicotine plus a lot of really bad stuff.

You're seriously questioning which is better?

Dose makes the poison and ecigs enable giving it's users 10x the nicotine you'd get from a single cigarette.

I think you are right that cigs are less healthy, but I have to wonder if megadosing nicotine isn't also a pretty big problem.

That's true, ecigs introduce different types of risks:

Wikipedia: "The recent rise in the use of electronic cigarettes, many forms of which are designed to be refilled with nicotine-containing "e-liquid" supplied in small plastic bottles, has renewed interest in nicotine overdoses, especially the possibility of young children ingesting the liquids."

And not just ingesting, but absorbing it through the skin.

Also: "Serious nicotine poisoning seems normally prevented by the fact that relatively low doses of nicotine cause nausea and vomiting, which stops users from further intake."

> Serious nicotine poisoning seems normally prevented by the fact that relatively low doses of nicotine cause nausea and vomiting, which stops users from further intake.

This is true, but this is also about short term poisoning. I'm more thinking about the long term problems. Alcohol will also stop many cases of acute poisoning through similar nausea and vomiting. However, prolonged use is still bad for your health.

To me that seems to mostly have been an excuse to ban refillable vapes to juice vap manufacturers profits. Refilling your own costs 10-100x less than nonrefillables or cigarettes, disosables give massive profit margins.

Kids can die from getting into all sorts of chemicals, nicotine isn't something especially poisonous or dangerous. They just need proper containers and handling like many other common chemicals and drugs and solvents.

> nicotine isn't something especially poisonous or dangerous.

It's not immediately dangerous, that's for sure.

My concern is more about long-term effects which I don't think we have good data on. Most of our data on the health effects of nicotine are centered on smoking or chewing.

What we do know about nicotine is it's addictive and it can generate a pretty high tolerance. And I think there are studies linking it to an increased risk of stroke.

I'm not trying to take away nicotine. I think it's reasonable to ban the sale of nicotine products to kids but otherwise I don't really care about people accessing it. I also think it's reasonable to research and understand the risks of taking it, even if such research is ultimately just informative.

Consuming excess nicotine is a pretty horrible experience. You just feel super ill and nauseous. But you don't have to use an ecig to do it, just buy a stronger cigarette and smoke 2 or 3 quickly. Or you can eat part of a cigarette. Or just smoke a big cigar and inhale it like a cigarette.

Anyone who smokes has experienced feeling sick from nicotine and quickly learn to avoid it because it sucks.

You build a tolerance and ecigs make it easy to climb up that ramp where regular cigarettes are harder. People get to the "10 packs a day" of smoking and to the point where there's just limits to how fast you can smoke.

Vapes make it a lot easier to blow past that amount of consumption.

Why do you think that? A cigarette contains 10-20 mg of nicotine depending on the tobacco blend used. The strongest e-liquid is 50-60 g/l so to get 10x nicotine of a mild cigarette you'd need to atomize 2ml of the strongest e-liquid. Coincidently, 2ml is the legal limit of disposable vapes in EU. So, to get nicotine of one pack (20) light cigarettes you'd need to empty two European vapes (provided they are filled with the strongest liquid and at the capacity cap). To get 10x nicotine of a pack-a-day smoker you need to vape 20 disposables a day, which seems like quite a feat to me both physically and financially.

A cigarette contains 10-20mg, but it's not readily available. On average, of those 10-20mg, you absorb only 1mg. [1]

My assumption, which could be faulty, is a lot more of the nicotine in the vape gets absorbed vs a cigarette.

[1] https://www.medicalnewstoday.com/articles/how-much-nicotine-...

Yes, neither is nicotine from a vape is all absorbed. Seeing they both have the same delivery mechanism (aerosol into lungs) it's quite a leap to assume one of these delivers an order of magnitude more nicotine, IMHO.

Here's my reasoning.

The nicotine in smoke is bound to plant matter which you are likely to exhale. The dose you get is basically entirely from whatever gets stuck on the lungs, but even then it's still bound to the plant matter, so there will be some that just even if attached to the lung won't cross over.

Contrast that to the vape juice, which is water, glycol, nicotine (and flavors). In that case, the nicotine isn't bound to anything and as the water/glycol evaporates you are left with just the nicotine on the lung.

It's true that a large portion of the vape smoke doesn't attach to the lung at all. But my presumption is that a hit from a vape carries more nicotine and that nicotine also more readily gets absorbed by the lungs.

I don't know if it's exactly 10x. I presume it's higher.

Vape juice is nicotine, glycol (PG) and glycerin (VG), the "V" in "VG" stands for "vegetable", which is a type of plant so if having a plant matter is a decisive factor in absorption then both delivery methods have it. It, however, depends on what you mean by "bound", from my limited knowledge nicotine is not bound chemically to anything in tobacco leaf either but perhaps water from plant cells has some properties which makes it very different from water from atomizing glycol and glycerin. And the concentration of nicotine in vape smoke is lower as I already shown with the numbers.

Cigarette smoking causes cancer and emphysema. Inhaling a mixture of propylene glycol, vegetable glycerin, nicotine, and flavoring does not.

You finally learned their one weird trick. Instead of just putting nicotine in ecigs, they add some more expensive ingredients like THC and maybe some meth or heroin and not tell people or charge them more than they charge for nicotine. For reasons.

That’s like worrying about Halloween candy being spiked with LSD. It’s irrational and w waste of money for no reason so it doesn’t happen.

> Inhaling a mixture of propylene glycol, vegetable glycerin, nicotine, and flavoring does not...That’s like worrying about Halloween candy being spiked with LSD.

The heavy metals, pesticides, and toxic chemicals in ecigs do though. If researchers pulled 64 types of Halloween candy off store shelves and found a bunch of LSD in every single sample I'd say you should be worried. https://refractor.io/health-wellbeing/unknown-chemicals-vape...

I see replies that keep repeating the same "it's got no smoke and tar so it must cause far less harm", as if common sense always matches reality. Coating the lungs with cooked propylene glycol and glycerine could cause similar harm to smoke and tar, or even entirely new harms, but I don't really know that. Use empiricism and share reviews, please.

Direct health implications of e-cigarette use: a systematic scoping review with evidence assessment https://pmc.ncbi.nlm.nih.gov/articles/PMC11317248/

"Conclusion: Smokers or former smokers who switch to e-cigarettes may reduce their exposure to carcinogens and lower their risk of developing severe health issues associated with conventional smoking. However, in healthy individuals who have never smoked traditional cigarettes, the use of e-cigarettes introduces several cardiovascular and respiratory adverse effects. These findings suggest that while e-cigarettes can be a strategic harm reduction tool for smokers, they are not a safe option for non-smokers."

E-Cigarette Use, Small Airway Fibrosis, and Constrictive Bronchiolitis https://pmc.ncbi.nlm.nih.gov/articles/PMC10137322/

"CONCLUSIONS: After thorough evaluation for other potential etiologies, vaping was considered to be the most likely common causal etiology for all patients due to the temporal association of symptomatic chronic lung disease with e-cigarette use and partial improvement in symptoms after e-cigarette cessation. In this series, we associate the histopathologic pattern of small airway–centered fibrosis, including constrictive bronchiolitis, with vaping, potentially defining a clinical and pathologic entity associated with e-cigarette use. (Funded in part by the National Institutes of Health.)"

E-cigarettes and Vaping: A Smoking Cessation Method or Another Smoking Innovation? https://pmc.ncbi.nlm.nih.gov/articles/PMC9833272/

"Abstract: [cut] With well-known health risks from traditional smoking, e-cigarettes are viewed as a safe way of smoking, appealing more to youth. Additionally, extensive e-cigarette marketing boosted by the internet and fame has resulted in worries that e-cigarettes can lead to a renormalization of cigarette smoking and can be used as a new method to consume vaporized drugs. Although the concern that e-cigarettes are as harmful as traditional smoking has been raised, youth and most healthcare providers remain relatively unaware. [cut]"

>> My thing is, how healthy are ecigs compared to real cigarettes really?

> Use empiricism

> Smokers or former smokers who switch to e-cigarettes may reduce their exposure to carcinogens and lower their risk of developing severe health issues associated with conventional smoking.

Why yes, I want to read research confirming common sense. And more valuable, I can read the nuance of it too (quantifying how much safer compared to cigarettes).

We do have many decades of inhaled medications that used pg and vg carrier vapors so its not like we have zero idea on their relative safety. It may cause some harm, but it is assuredly less harmful than smoking or else people using asthma inhalers would have shown significant problems from it.

Well, I have no clue about their relative safety and would like to read more.

The reality is that cigarette smoking was on the way out with young people before vapes came along. Whether it's less harmful isn't the only relevant point, if it's still harmful and has dramatically expanded the market then it's a bad thing.

Way healthier, it’s not even a comparison. Cigarettes have particulates that are not bioavailable and create the black lung tissue. Here in California we have banned any flavors from nicotine vapes so it’s very straight forward. The best vapes anymore are THC, due to psychoactive effects and flavors, similar level of safety to nicotine.

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