Comment by Alex3917 | Hacker News Reader

Comment by Alex3917 | Hacker News Reader

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> E-cigarettes are not harmless and I wish people would stop perpetuating that lie.

They might be fairly harmless, we don't know. The three biggest risks of smoking are cancer, emphysema, and heart disease. For a casual smoker, heart disease is by far the biggest risk. This is caused by the carbon monoxide, and eCigs have zero of this. There's also no reason to think that they cause emphysema. In terms of cancer, the majority of the carcinogenic effect of cigarrettes is thought to be caused by radiation rather than by the tobacco itself. So with eCigs you can easily wash off the radiation from the tobacco, or else just use synthetic nicotine or other drugs.

Since the industry is completely unregulated I'm sure these things are filled with all sorts of poison, but even still there are no currently known risks. And even if there are risks, which there likely are, it's not clear that they'll be any bigger than, say, drinking the occasional glass of wine. And it's also likely that once we figure out what these risks are, we'll be able to mitigate them.

I certainly wouldn't use these things today, but in twenty or thirty years they may well be a really good bet.

> They might be fairly harmless, we don't know.

They might be less harmless (though we don't know that yet), but we can be fairly certain that they are least somewhat harmful.

This is not like vaporizing cannabis - the desirable compounds in cannabis are not carcinogenic[0] and actually have cancer-fighting properties, and the main drawbacks to smoking cannabis come from the act of smoking, not from the substance.

Nicotine, on the other hand, is harmful in its own right. It is less damaging to consume pure nicotine without the other harmful effects of smoking, but it is certainly a toxic substance, in the medical sense.

[0] Or poisonous in any other way (even overdose, since the LD50 for delta-9-THC, if one even exists, is so high that nobody has ever measured it reliably).

Nicotine, on the other hand, is harmful in its own right. It is less damaging to consume pure nicotine without the other harmful effects of smoking, but it is certainly a toxic substance, in the medical sense.

Citation needed.

Before responding, you might want to read http://www.gwern.net/Nicotine.

> Before responding, you might want to read http://www.gwern.net/Nicotine.

I can assure that this is a topic on which I have done far more research in my lifetime than that blog post. I'm not trying to be snarky; I'm just emphasizing that I have a lot more knowledge on this topic than I can reasonably compress into a 124-word HN post (like my original comment).

> Citation needed.

The post that you yourself link is a citation for my statement. Notice that I worded my post carefully - I did not say that nicotine has only harmful effects, or even that it has no positive effects.

All I stated is that it is a toxic substance in the medical sense - a statement which could also apply to the drugs used in chemotherapy. Therefore, it is correct to say "we can be fairly certain that they are least somewhat harmful."

I make no claim about the situations under which any alleged benefits outweigh the the toxic effects, simply that said toxic effects exist.

> I can assure that this is a topic on which I have done far more research in my lifetime than that blog post. I'm not trying to be snarky; I'm just emphasizing that I have a lot more knowledge on this topic than I can reasonably compress into a 124-word HN post (like my original comment).

Then I would appreciate your links to the studies of the harmful effects of nicotine alone that I have somehow failed to find.

> I make no claim about the situations under which any alleged benefits outweigh the the toxic effects, simply that said toxic effects exist.

So your confident assertions are merely technically correct, since everything has toxic effects under some situations such as high enough doses. But that's OK, since technically correct is the best kind of correct, as any geek knows!

http://www.cdc.gov/niosh/ershdb/EmergencyResponseCard_297500...

At one time, nicotine was used in the United States as an insecticide ... Nicotine affects the nervous system and the heart. Exposure to relatively small amounts can rapidly be fatal.

Like anything the dose makes the poison. The amount of nicotine used in ecigs or tobacco products is well below the amount needed to cause the effects described here.

True, you can die from overdosing on carrot juice.

Good thing I'm not an insect and people generally avoid taking anywhere near the LD-50 of 50mg or so (depending on bodyweight & tolerance etc).

Even pure water can be harmful. A few years ago a couple guys ended up in coma at a nearby Buddhist temple after a "cleanup weekend" where they were fasting and drinking lots of water (this water OD condition is called hyponatremia). Of course nicotine is more dangerous than water, yet I can't recall a death by overdose of it.

> Of course nicotine is more dangerous than water, yet I can't recall a death by overdose of it.

There actually are some cases if you go looking. Nicotine oil was famously used as a poisoner's tool for a while, prompting some of the early toxicology screens, but these days, most of the cases are accidental. I recall reading about an Israeli case, IIRC, where a child drank some of the e-cig liquid its father hadn't put up high enough.

> but it is certainly a toxic substance, in the medical sense.

Excuse me for not accepting the pseudo-science weasel word "toxic". Vitamin C is toxic at certain levels. If you do not bring in more specifics, then what you are saying is meaningless. Just saying "I choose to reserve judgement, but have a gut feeling that it will be shown to be more harmful than cigarettes" is about as far as strong a claim you can make based on the evidence you have presented.

> "I choose to reserve judgement, but have a gut feeling that it will be shown to be more harmful than cigarettes"

Please don't put words in my mouth. I never said anything like that - certainly never that I felt that they would be shown to be more harmful than cigarettes.

> Excuse me for not accepting the pseudo-science weasel word "toxic".

I don't know why you think that a medical term is a "pseudo-science weasel word".

> If you do not bring in more specifics, then what you are saying is meaningless.

It's a lot less meaningless than the original statement "e-cigarettes are harmless", which is backed not by rigorous scientific research on e-cigarettes themselves, but rather (at best) on fairly questionable reasoning based on a misunderstanding of drug toxicology.

> Please don't put words in my mouth

Putting words in your mouth is typically claiming you said X. I am suggesting that you instead, SHOULD have said Y.

> I don't know why you think that a medical term is a "pseudo-science weasel word".

"Cloud" is a technical word in computing with a specific meaning. This does not stop tech marketers from using it to mean things it does not. "Toxic" and "toxins" are medical words that are abused to the point of being meaningless much like "cloud". You are calling something harmful (to your credit, you do not specify how harmful) without specifying a dosage. Water is toxic at certain levels. Words that give a strong impression one way or the other, but are broad and do not commit to specifics are weasel words.

> It's a lot less meaningless than the original statement "e-cigarettes are harmless", which is backed not by rigorous scientific research on e-cigarettes themselves, but rather (at best) on fairly questionable reasoning based on a misunderstanding of drug toxicology.

I agree that you are "more right" than the OP, however, "harmless" and "toxic" are both just as bad in the context where dosage is not specified. It would be misleading to say that asbestos is harmless, although pretty much accurate at small enough levels. It would also be technically accurate to say that most things are toxic at some sufficiently high level.

In a nutshell, this debate between you and the OP is useless without specifying the amount being consumed.

I'm sorry, I must object to that line of thinking

We can say with near certainty that they are less harmful, because we know what caused harm when smoking cigarettes, and those elements are not present. We also know what is being inhaled is either inert, or the point of smoking.

Also, whether a substance has a measurable LD50 or not is irrelevant. Most medicens have easily measurable LD50's, Some Vitamins have LD50's.

> Most medicens have easily measurable LD50's

Well, most medicines could be considered medically toxic. It's just a matter of dosing and whether their desired effect outweighs any risk (whether negligible or non-negligible) of adverse reactions[0].

LD50 is only one of many ways to express toxicity; water can be considered toxic under some circumstances as well. It all depends on the context in which we're discussing the usage.

We don't say that Advil is "harmless", or aspirin, or caffeine, or any other substance, even in normal dosage. We simply say that any risk of harm is sufficiently small as to fall within tolerable limits, given the expected benefit of using that substance. But we can't say that about e-cigarettes - at least not yet.

In short, the medical impacts of drugs are difficult to predict, and oftentimes counter-intuitive. I'm just rather tired of the refrain that "e-cigarettes are harmless", because frankly,

(A) we don't have sufficient evidence-based research either to support or to reject that claim, and

(B) extrapolating based on existing evidence-based research and fundamental medical principles suggests that e-cigarettes are not "harmless".

Whether they are less harmful than cigarettes is a separate question, as is whether they are harmful enough to recommend avoiding usage (or regulation, or what have you) is a separate question.

I don't object to any logical arguments surrounding either of those two questions; I just object to fallacious interpretations of medical research to support illogical arguments.

[0] Unlike the word "toxic", I do not use the word "adverse" in the medical sense, which also has a very precise definition - I use it in the colloquial sense.

Then I think we are on the same page.

I can understand railing against the statement "e-cigarettes are harmless" because the active ingredients are definitely not.

That said, if you could replace every cigarette in the world right now with an e-cig. Would you not do it? I would. They have their own host of problems, but not so much as inhaling burnt plant matter has. Even with what we know now, we know it is the lesser of two evils.

I understand, you don't like people being imprecise, neither do I frankly. It's rather hard to stop though, one of those human nature thingies.

In casual conversation many people would describe advil as harmless

Particularly when comparing it to tylenol.

The LD50 of nicotine is low enough that it would be conceivable to die from the toxic effects, and that's not possible with cannabis, but that's already a risk with nicotine patches, and it's not that large a risk.

Nicotine certainly has some distinctive psychoactive effects. I suppose it's a matter of opinion whether you find them beneficial if you are otherwise healthy.

> we can be fairly certain that they are least somewhat harmful

Can we? How?

> Nicotine, on the other hand, is harmful in its own right.

Vaping doesn't necessarily involve nicotine.

If the bar is "somewhat harmful" then almost everything we put in our bodies would comply.

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