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Electronic Cigarettes (1 Viewer)

BigJim® said:
Maybe splitting hairs, but saying "we know little about the safety" is quite different from "are not safe at all." There have been actual studies conducted, although I don't have links off hand. I don't know about the alcohol commentary, or even whether that is an ingredient in few/some/most products on the market.
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The tobacco industry rode the "we know little about the safety" wave for a long time before they were finally outed as marketing something that was not only not safe, but deadly. It turns out that this was known almost from the get go. Knowing that AND using nicotine to capture as big an audience as possible for   :moneybag: was as insidious a marketing strategy as a there ever was. But, sure- give the vaping industry the benefit of the doubt. I'm sure they consider your health a priority.

Bottom line? Clean (as possible) air is what belongs in your lungs. But- free country.

 
(HULK) said:
I don't understand why this is wholesale overlooked by the media.

Regardless, it is not for kids, and I support anything that keeps it out of their hands. Banning flavors doesn't seem remotely targeted to kids as adults also like things that taste better than things that don't. Heck, even monkeys make that distinction.
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Smoking prevalence has been dropping consistently since the 70's. While E-cigs can help some people who already smoke, it's not clear they're benefitting society as a whole because 1) they've created a new market for users (many young) who might not have ever smoked conventional cigarettes. 2) most E-cig users continue to smoke regular cigarettes as well 3) inconsistent quality control/regulation of devices/additives may be contributing to recent illnesses among those who vape

 
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Ben & Jerry's said:
1) true

2) most likely not true.

3) as far as THC carts are concerned. The e-juice market is different.
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Everything I've read suggests #2 is true. Can you provide objective data that proves otherwise? One article stating my point

Of the U.S. adult current daily and intermittent cigarette smokers, 30 and 34 %, respectively, are likely to report current daily or occasional e-cigarette use [5]. It is not clear what proportion of cigarette smokers who try e-cigarettes actually switch over completely to e-cigarettes, reject e-cigarettes or continue to use both cigarettes and e-cigarettes (i.e., dual use). It appears that relatively fewer adult cigarette smokers who try e-cigarettes persistently use e-cigarettes daily for a substantive length of time (e.g., a month); the majority are likely to either reject e-cigarettes or become intermittent users [6]. Further, only a few daily e-cigarette users among adult cigarette smokers (e.g., 20 %) [6] may be able to abstain from smoking cigarettes completely. The majority of current cigarette smokers who use e-cigarettes are likely to be dual users, although there is no clarity as to for how long.
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Regarding e-juice, although the FDA was recently given authority to regulate the products more effectively, long term safety data is lacking for most of the ingredients, including many of the flavorings that may be banned.

 
Based on the people who have posted in the 67 pages of this thread, the vast majority of people who switch to vapes do NOT continue to smoke cigarettes.

Maybe FBGs are significantly different than the rest of the population, but probably not. Which means that statistic is likely BS, because it does not square at all with our experiences.

The government of the UK had stated that, while the long term effects remain somewhat unknown, they believe vaping is AT LEAST 95% less harmful than cigarettes. This is what reasonable science says, as there are significantly less chemicals involved, there is no combustion involved, and because nicotine is not a carcinogen.

But hey, this country wants to ignore science, let special interests drive the bus, and let the media fear monger. That's a great plan, always works in the people's interest.

 
(HULK) said:
Based on the people who have posted in the 67 pages of this thread, the vast majority of people who switch to vapes do NOT continue to smoke cigarettes.

Maybe FBGs are significantly different than the rest of the population, but probably not. Which means that statistic is likely BS, because it does not square at all with our experiences.

The government of the UK had stated that, while the long term effects remain somewhat unknown, they believe vaping is AT LEAST 95% less harmful than cigarettes. This is what reasonable science says, as there are significantly less chemicals involved, there is no combustion involved, and because nicotine is not a carcinogen.

But hey, this country wants to ignore science, let special interests drive the bus, and let the media fear monger. That's a great plan, always works in the people's interest.
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1. I don’t think you asked everyone who posted in this thread about smoking, and it’s probably less than 100 people anyway. I’ll stick with studies/surveys looking at broader cross sections of users. And it ain’t just a single set of data.

2. Vaping probably is less harmful than cigarettes, but that doesn’t mean we shouldn’t try to mitigate the risks. 

3. Science prefers data collection and hypothesis testing over anecdotes and untested assumptions. It’s not unreasonable to put the brakes on a little while studies are performed to have a better idea about long term vaping safety.

 
Terminalxylem said:
1. I don’t think you asked everyone who posted in this thread about smoking, and it’s probably less than 100 people anyway. I’ll stick with studies/surveys looking at broader cross sections of users. And it ain’t just a single set of data.

2. Vaping probably is less harmful than cigarettes, but that doesn’t mean we shouldn’t try to mitigate the risks. 

3. Science prefers data collection and hypothesis testing over anecdotes and untested assumptions. It’s not unreasonable to put the brakes on a little while studies are performed to have a better idea about long term vaping safety.
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https://www.gov.uk/government/publications/e-cigarettes-an-evidence-update

Feel free to read an actual study

 
I mean, by all means, keep quoting the Truth Initiative's propaganda and don't bother to check how that is funded (hint, entirely paid for by the Big 4 tobacco companies as part of a settlement agreement). An organization like that has zero reason to come out guns blazing against vaping, it's not like vaping is in direct competition with tobacco or anything.

 
Continuing the theme of me being absolutely correct:

https://thehill.com/opinion/healthcare/458717-the-ideological-divide-on-vaping-has-a-clear-winner-smokers

Some highlights:

Shapiro's report for PPI, The Impact of Electronic Cigarettes on Cigarette Smoking by Americans and Its Health and Economic Implications, is objectively and meticulously researched and comes to firm conclusions - vaping is the most effective method for smoking cessation and is not a gateway to cigarette use. Vaping improves health, saves health-care costs and adds to economic productivity.

It is important to put the human and economic value of smoking cessation into context. Smoking is the leading cause of preventable death in the United States. According the Centers for Disease Control, more than 16 million Americans suffer smoking related disease, nearly 500 million die every year because they smoke, and another 41,000 die because other people smoke. 

The report notes the annual impact of smoking to the economy is $170 billion in health-care and $156 million in lost productively. Smoking causes cancer, heart disease and lung disease, contributes to diabetes and vision loss, and shortens life. Smokers smell icky and they cough. Many people don't want to be around them, so add in a painful social stigma.

The critical take away of the Shapiro study is that approximately 70 percent of the rapid decline in smoking between 2013 and 2017 was directly related to the increased utilization of e-cigarettes. Among adult smokers in this time period, the use of e-cigarettes increased by up to 2.8 percent while smoking cessation increased by four percent.

The report noted other studies by international public health organizations that found smokers were 28 percent more likely to stop smoking with vaping and that smoking cessation with e-cigarettes was twice as effective than nicotine patches or gum.  

Reviewing patterns in adults who only vape, the study found no subsequent rise in cigarette use. PPIs data demonstrated that the successful switch from tobacco and its carcinogens to e-cigarettes (containing no carcinogens) decreases the health-care costs of former smokers and wards off billions in lifetime health-care costs for consumers who never start smoking because they vape instead. 

 
Terminalxylem said:
Everything I've read suggests #2 is true. Can you provide objective data that proves otherwise? One article stating my point

Regarding e-juice, although the FDA was recently given authority to regulate the products more effectively, long term safety data is lacking for most of the ingredients, including many of the flavorings that may be banned.
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As a former smoker, once I picked up a vape over six years ago I was done with cigarettes.  I know a lot of people who say the same.  

The article you linked is confusing.  It says 30-34% of cigarette smokers reported at least occasionally vaping. There are 210 million adults in this country.  Roughly 18% - or 38 million - American adults smoke cigarettes.  Ten+ million use e-cigarettes. 

If this data as it appears to be presented were accurate and able to be extracted to the general population, approximately every adult who uses a vape also smokes.  That’s demonstrably untrue.  

Of course, that article is about a series of round table discussions using a total of 62 participants on Oahu.  You seemed uncomfortable with using 100 upthread, in discussing the people in this thread. 

One of the potential problems with the article can be found in its source material.  It claims very few people have used them to quit smoking.  It cites a 2014 study (here) which was based on people who were vaping in 2011/2012. 

The FDA was seizing imports of all vaping devices until an injunction in 2010. The fact is, there wasn’t much vaping going on. And not much innovation or work done to make it an attractive product to smokers.  The state of the industry is significantly better now.  Personally, I didn’t start using one until 2013 and what I found then probably wouldn’t have held me off of cigarettes forever.  But as the industry changed, the products became more helpful with that.  Now, even if nothing else changed I don’t think I’d ever go back.  Current tech and juices are good enough. 

Using a Blu in 2012 wasn’t at all the same thing. 

I think it’s possible that old research on this subject doesn’t really hold up simply because of the newness of the industry. 

 
(HULK) said:
We can also ignore this study from this year that showed that vaping was literally twice as effective on helping people quit smoking than other forms of nicotine replacement:

https://www.health.harvard.edu/blog/can-vaping-help-you-quit-smoking-2019022716086

Direct link to study: https://www.nejm.org/doi/full/10.1056/NEJMoa1808779?query=TOC
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No need to get angry, Mr. Hulk. I said nothing about the efficacy of e-cigarettes relative to other smoking cessation methods. I just pointed out the following statement is incorrect:

Based on the people who have posted in the 67 pages of this thread, the vast majority of people who switch to vapes do NOT continue to smoke cigarettes
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From your link:

The 1-year abstinence rate was 18.0% in the e-cigarette group, as compared with 9.9% in the nicotine-replacement group (relative risk, 1.83; 95% confidence interval [CI], 1.30 to 2.58; P<0.001). Among participants with 1-year abstinence, those in the e-cigarette group were more likely than those in the nicotine-replacement group to use their assigned product at 52 weeks (80% [63 of 79 participants] vs. 9% [4 of 44 participants]).
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Eighteen percent is OK (FWIW, my link said 20%), but it ain't anywhere near a majority. And even if it is nearly twice as good as the comparators, the vast majority of people who quit smoking continue to vape a year later, unlike those who quit with other nicotine replacement methods. So they're continually exposing themselves to the risks, known and unknown, of inhaling a bunch of poorly tested aerosolized chemicals. My main point is we should be more rigorous in our assessment of said chemicals. Moreover, there are other cessation aids which work about as well, without the potential downsides of vaping.

At best, e-cigs are a harm reduction strategy for current smokers. But its foolhardy to assume the ingredients are harmless without good long term safety data. They're also problematic through creating an independent market for new e-smokers, who'd otherwise stay away from cigarettes, possibly because they think e-cigs are safe.

 
Henry Ford said:
As a former smoker, once I picked up a vape over six years ago I was done with cigarettes.  I know a lot of people who say the same.  

The article you linked is confusing.  It says 30-34% of cigarette smokers reported at least occasionally vaping. There are 210 million adults in this country.  Roughly 18% - or 38 million - American adults smoke cigarettes.  Ten+ million use e-cigarettes. 

If this data as it appears to be presented were accurate and able to be extracted to the general population, approximately every adult who uses a vape also smokes.  That’s demonstrably untrue.  

Of course, that article is about a series of round table discussions using a total of 62 participants on Oahu.  You seemed uncomfortable with using 100 upthread, in discussing the people in this thread. 

One of the potential problems with the article can be found in its source material.  It claims very few people have used them to quit smoking.  It cites a 2014 study (here) which was based on people who were vaping in 2011/2012. 

The FDA was seizing imports of all vaping devices until an injunction in 2010. The fact is, there wasn’t much vaping going on. And not much innovation or work done to make it an attractive product to smokers.  The state of the industry is significantly better now.  Personally, I didn’t start using one until 2013 and what I found then probably wouldn’t have held me off of cigarettes forever.  But as the industry changed, the products became more helpful with that.  Now, even if nothing else changed I don’t think I’d ever go back.  Current tech and juices are good enough. 

Using a Blu in 2012 wasn’t at all the same thing. 

I think it’s possible that old research on this subject doesn’t really hold up simply because of the newness of the industry. 
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While this is great for you and your buddies, it does nothing to prove e-cigs help most people to quit smoking cigarettes. They don't.

Also I have no idea how you concluded every adult who vapes also smokes, but the vast majority do.

Lastly, if the research is outdated, perhaps we should collect data reflecting contemporary vaping technology? Either way, long term safety data is critical IMO, especially in light of the recent vaping-related illnesses.

 
Terminalxylem said:
While this is great for you and your buddies, it does nothing to prove e-cigs help most people to quit smoking cigarettes. They don't.

Also I have no idea how you concluded every adult who vapes also smokes, but the vast majority do.

Lastly, if the research is outdated, perhaps we should collect data reflecting contemporary vaping technology? Either way, long term safety data is critical IMO, especially in light of the recent vaping-related illnesses.
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If you read the post you’re responding to, I did the math. 30% of approximately 38 million adult smokers is 11.4 million people. 

10.8 million people vape. 

So the math doesn’t work.  Even if you fudge it reasonable for changes in habits since the last surveys, those numbers being extrapolated to a general population still say every adult who vapes smokes. That’s just not a reasonable position to take. Even the Truth initiative acknowledges something like 30% of current vapers are former smokers. Those sets of numbers are incompatible. And of course their numbers are almost five years old.  Dealing with a less than ten year old industry. 

 
Henry Ford said:
If you read the post you’re responding to, I did the math. 30% of approximately 38 million adult smokers is 11.4 million people. 

10.8 million people vape. 

So the math doesn’t work.  Even if you fudge it reasonable for changes in habits since the last surveys, those numbers being extrapolated to a general population still say every adult who vapes smokes. That’s just not a reasonable position to take. Even the Truth initiative acknowledges something like 30% of current vapers are former smokers. Those sets of numbers are incompatible. And of course their numbers are almost five years old.  Dealing with a less than ten year old industry. 
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So you're gonna ignore the rest of my post and fixate on that study? You're better than that, Henry. But I'll give you some more recent data, if it helps:

We conducted a population-based, prospective cohort study of a random probability sample of 1284 U.S. adult smokers recruited in August/September 2015 and re-contacted one-year later (September 2016) from GfK’s KnowledgePanel, a national, probability-based web-panel designed to be representative of non-institutionalized U.S. adults. Among the 1081 baseline smokers who remained members of KnowledgePanel, 858 completed the follow-up survey. The primary outcome was smoking abstinence for at least 30 days prior to follow-up. Secondary outcomes were making a quit attempt during the 12-month study period and number of cigarettes smoked per day at follow-up.

The adjusted odds of quitting smoking were lower for those that used ENDS at baseline (9.4%, 95% CI = 5.22%-16.38%; AOR = 0.30, 95% CI = 0.13–0.72) compared to smokers who did not use at ENDS (18.9%, 95% CI = 14.24%-24.68%). Smokers who used ENDS daily at some point during the study period were also less likely to quit smoking than nonusers (AOR = 0.17; 95% CI = 0.04–0.82).
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Here's the most recent article on dual users from pubmed:

We examined quitting behaviors among a cohort of dual users (cigarettes and electronic cigarettes [e-cigarettes]) and exclusive cigarette smokers for: (1) cigarette smoking reduction, (2) quit attempts, (3) abstinence from cigarettes, and (4) abstinence from all tobacco products.

METHODS: 

Participants enrolled in the Tobacco User Adult Cohort and categorized as "daily" user of cigarettes and "daily" or "some days per week" use of e-cigarettes (ie, dual users; n = 88) or "daily" user of cigarettes only (ie, cigarette smokers; n = 617) served as the analytic sample. Participants were interviewed face to face every 6 months, through 18 months. Data on self-reported current product(s) used, cessation interest, quit attempts and abstinence from cigarettes, and all tobacco products were collected.

RESULTS: 

No difference in reduction of cigarette consumption over time was noted between groups. Rates of reporting an attempt to quit all tobacco products (≥ 24 hours of not using any tobacco in an attempt to quit) also did not differ by group. Compared to cigarette smokers, dual users were more likely to report abstinence from cigarettes at 6 months (OR = 2.54, p = .045) but not at 12 or 18 months. There was no significant difference in abstinence from all tobacco products by group at 6, 12, or 18 months.

CONCLUSIONS: 

Although dual use of e-cigarettes has been cited as a potential cessation tool for cigarette smokers, our findings indicated that this association was only observed in the short term. We also found no evidence of any association between dual use and eventual abstinence from all tobacco products.

IMPLICATIONS: 

Our study observed that, in the natural environment, dual users of cigarettes and e-cigarettes were more likely than cigarette smokers to quit cigarettes in the short term but no more likely to quit using cigarettes and all tobacco products over time.
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Or look at the NEJM article linked by the Hulk - 18% cigarette abstinence at 1 year. What about the other 82%?

Better yet, can you provide a link to any data which shows e-cig users quitting smoking at rates exceeding 18-20%?

I'll restate the salient point: the majority of people who vape continue to smoke cigarettes. They may cut down on analogue cigs, but most don't quit altogether.

 
Terminalxylem said:
So you're gonna ignore the rest of my post and fixate on that study? You're better than that, Henry. But I'll give you some more recent data, if it helps:

Here's the most recent article on dual users from pubmed:

Or look at the NEJM article linked by the Hulk - 18% cigarette abstinence at 1 year. What about the other 82%?

Better yet, can you provide a link to any data which shows e-cig users quitting smoking at rates exceeding 18-20%?

I'll restate the salient point: the majority of people who vape continue to smoke cigarettes. They may cut down on analogue cigs, but most don't quit altogether.
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I feel like we’re discussing different things. That pubmed you linked to indicates that dual use isn’t helpful for quitting smoking. I don’t know anyone who’s arguing against that.  

The other 82%? Didn’t manage to quit.  Which is, of course, better than 91% with pure nicotine replacement choices. 

The abstract you linked looks interesting   I’d like to read the study and will look at it if I can.  Particularly how they chose people and how those people used e-cigarettes. 

I don’t think anyone’s saying that e-cigarettes have fixed it for everyone. But for some people they are a useful tool to quit.  And many e-cigarette users are former smokers who used them for that. 

The fact that it doesn’t solve everyone’s problem is not indicative of whether or not people who use it do so primarily to solve that same problem. Or whether it is the best tool for some.  

It’s hard to measure the thing you’re claiming, that most e-cigarette users also smoke cigarettes.  But we can say that the majority of research that’s out there indicates that daily use of e-cigarettes suggests a roughly double percentage correlation with managing to quit versus not doing so.

https://news.harvard.edu/gazette/story/2019/07/daily-e-cigarette-use-may-help-smokers-quit-regular-cigarettes/

That seems like a good thing.

e-cigarettes aren’t some miracle sent to the world to end smoking.  But they do kinda feel that way for people who manage to use them to do so. And a lot of people do. 

 
Henry Ford said:
I feel like we’re discussing different things. That pubmed you linked to indicates that dual use isn’t helpful for quitting smoking. I don’t know anyone who’s arguing against that.  

The other 82%? Didn’t manage to quit.  Which is, of course, better than 91% with pure nicotine replacement choices. 

The abstract you linked looks interesting   I’d like to read the study and will look at it if I can.  Particularly how they chose people and how those people used e-cigarettes. 

I don’t think anyone’s saying that e-cigarettes have fixed it for everyone. But for some people they are a useful tool to quit.  And many e-cigarette users are former smokers who used them for that. 

The fact that it doesn’t solve everyone’s problem is not indicative of whether or not people who use it do so primarily to solve that same problem. Or whether it is the best tool for some.  

It’s hard to measure the thing you’re claiming, that most e-cigarette users also smoke cigarettes.  But we can say that the majority of research that’s out there indicates that daily use of e-cigarettes suggests a roughly double percentage correlation with managing to quit versus not doing so.

https://news.harvard.edu/gazette/story/2019/07/daily-e-cigarette-use-may-help-smokers-quit-regular-cigarettes/

That seems like a good thing.

e-cigarettes aren’t some miracle sent to the world to end smoking.  But they do kinda feel that way for people who manage to use them to do so. And a lot of people do. 
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People have stated repeatedly that e-cigs help the majority to quit smoking, and suggested this topic is evidence of such. Clearly, that isn't accurate. One in five is the best case scenario, though even that number has been disputed.

Nobody is saying e-cigs don't help anyone either. But some of us are skeptical of their safety, and have a hard time looking past their marketing success in young people, who may never have become smokers otherwise. On balance, I'm not even sure they do more good than harm, but I understand a case can be made for their utility.

This topic feels a little bit like gun control discussions. E-smokers tend to get defensive at the prospects of someone taking their devices away, even when that is far from what most people desire. All I want is more long term data, because as a scientist and atheist I tend not to believe in miracles.

 
Terminalxylem said:
People have stated repeatedly that e-cigs help the majority to quit smoking, and suggested this topic is evidence of such. Clearly, that isn't accurate. One in five is the best case scenario, though even that number has been disputed.

Nobody is saying e-cigs don't help anyone either. But some of us are skeptical of their safety, and have a hard time looking past their marketing success in young people, who may never have become smokers otherwise. On balance, I'm not even sure they do more good than harm, but I understand a case can be made for their utility.

This topic feels a little bit like gun control discussions. E-smokers tend to get defensive at the prospects of someone taking their devices away, even when that is far from what most people desire. All I want is more long term data, because as a scientist and atheist I tend not to believe in miracles.
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I see.  I think I catch the disconnect.  I think what those people mean (and I could be wrong, but I think I’m right) is that the majority of people who vape do so to aid in quitting smoking, and it helps. 

I don’t think many people believe that the majority of people who pick up a vape kit quit smoking completely (never smoke another cigarette) nor that the majority of people who try to quit using vaping succeed.  Just that most people (adults anyway) don’t start vaping because it’s cool, rather because of previous nicotine use and it often (maybe most of the time) at least heavily cuts down cigarette use. Most studies claim if you’ve had a cigarette this week you’re still a cigarette user.  You go from 2 packs of camels to 1 cigarette a week if you drink, I’m more inclined to say you quit smoking  

It could be a loose language issue, or just that I’m misunderstanding. But I think that’s it. 

 
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Henry Ford said:
I see.  I think I catch the disconnect.  I think what those people mean (and I could be wrong, but I think I’m right) is that the majority of people who vape do so to aid in quitting smoking, and it helps. 

I don’t think many people believe that the majority of people who pick up a vape kit quit smoking completely (never smoke another cigarette) nor that the majority of people who try to quit using vaping succeed.  Just that most people (adults anyway) don’t start vaping because it’s cool, rather because of previous nicotine use and it often (maybe most of the time) at least heavily cuts down cigarette use. Most studies claim if you’ve had a cigarette this week you’re still a cigarette user.  You go from 2 packs of camels to 1 cigarette a week if you drink, I’m more inclined to say you quit smoking  

It could be a loose language issue, or just that I’m misunderstanding. But I think that’s it. 
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Hmmm...I agree most people (adults) start vaping in an attempt to quit smoking altogether. But it usually doesn’t work, contrary to what’s been explicitly communicated in this thread. While it may be better than nicotine replacement strategies alone, multimodal approaches using pharmacologic aids in concert with cognitive behavioral therapy and financial (dis)incentives are probably just as effective, minus the potential downsides of aerosolizing a bunch of stuff with unclear health consequences and incentivizing teens to pick up the habit. Moreover, the presumed safety of e-cigs may prevent some people from ever committing to full abstinence from nicotine/tobacco.

I would be interested in the average decrease in analog smoking that occurs in dual users, but I bet it isn’t as drastic as 2 ppd to one cigarette weekly. 

 
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I think we're missing each other. If you've never quit smoking, maybe you don't know just how hard it is to do. 18% success is huge, way better than anything else I'm aware of.

 
(HULK) said:
I think we're missing each other. If you've never quit smoking, maybe you don't know just how hard it is to do. 18% success is huge, way better than anything else I'm aware of.
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18% is pretty good, better than what's usually cited for nicotine supplements alone. But that isn't what is recommended for smoking cessation - multimodal approaches are, combining things like cognitive behavioral therapy and pharmacologic aids. Good comparative data doesn't exist for all the permutations available to quit smoking, unfortunately, but some of us are concerned that vaping has adverse effects of its own (including the potential for long term health consequences). These must be considered if it will ever be officially advocated to help people quit, or simply promoted as a harm reduction technique. Coupled with the risk of teens picking up the habit, hopefully you can understand why the public health/medical community is reluctant to give their stamp of approval. I assure you it isn't due to a Big Tobacco conspiracy.

Here's one abstract discussing multimodal smoking cessation, but the numbers are all over the map:

Nicotine addiction is a complex, chronic condition with physiological and psychological/behavioural aspects that make smoking cessation extremely difficult. This paper reviews current recommendations for smoking cessation and the efficacy of pharmacotherapy and behavioural modification techniques, used either alone or in combination, for smoking cessation. Abstinence rates for pharmacotherapies range from approximately 16% to approximately 30% at 1-year follow-up, with efficacy odds ratios (ORs) compared with placebo of approximately 1.7 for nicotine replacement therapy (NRT), approximately 1.9 for bupropion sustained release and approximately 3.0 for varenicline. Behaviour modification therapies have achieved quit rates of between 8% and 43% for up to 1 year, with ORs in comparison to no treatment of between approximately 1.2 and approximately 2.2. No direct comparisons have been made between pharmacotherapy alone and psychological behaviour strategies alone. However, combining physiological approaches with counselling significantly increases the odds of quitting compared with either technique alone. Applying multimodal techniques for the treatment of nicotine addiction is the recommended approach and has demonstrated the potential to improve rates of permanent abstinence in smokers attempting cessation. While the numbers of patients receiving help and advice regarding smoking cessation is increasing, the multimodal approach appears to be currently underutilised by clinicians and therefore smoking cessation strategies are not being optimised.
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Nicotine replacement was 9% in that study where e-cigs were 18%.

Regardless of whether it is the best possible way, it is a possible way, and works for some people. My personal experience is that I tried 27 different things and none of it stuck until e-cigs. Seems like a terrible policy move to restrict it further. Some states are cracking down on it harder than cigarettes. The president is banning flavors via executive order. All of this seems patently stupid.

 
(HULK) said:
Nicotine replacement was 9% in that study where e-cigs were 18%.

Regardless of whether it is the best possible way, it is a possible way, and works for some people. My personal experience is that I tried 27 different things and none of it stuck until e-cigs. Seems like a terrible policy move to restrict it further. Some states are cracking down on it harder than cigarettes. The president is banning flavors via executive order. All of this seems patently stupid.
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That's one study. There are plenty others with a range of success rates; I've even linked a few. Try not to let confirmation bias get in the way of your objectivity.

I'm curious to see the 27 things you've tried to quit smoking - how many were multimodal, employing both behavioral modification and pharmacologic assistance?

And I don't think it's stupid to collect adequate safety data before promoting continued e-cig use, particularly in light of the recent collection of vaping-associated illness.  

 
Terminalxylem said:
That's one study. There are plenty others with a range of success rates; I've even linked a few. Try not to let confirmation bias get in the way of your objectivity.

I'm curious to see the 27 things you've tried to quit smoking - how many were multimodal, employing both behavioral modification and pharmacologic assistance?

And I don't think it's stupid to collect adequate safety data before promoting continued e-cig use, particularly in light of the recent collection of vaping-associated illness.  
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I literally tried therapy, nic gum, nic lozenges, nic patches, wellbutrin, and chantix. Of those, chantix was the only thing that somewhat worked, but you don't take it forever, and I backslid from it twice. I've not backslid from vaping.

I have no problem collecting safety data. However, THERE IS NO RECENT VAPING ASSOCIATED ILLNESS. This is what is driving me up a wall. Drug dealers cut THC vape cartridges with Vitamin E acetate to increase their profits and people are falling ill from that. That's all. It has ZERO to do with legal nicotine vaping products purchased in stores. 

As I read in an article recently, the current situation is like an e coli outbreak in lettuce from Wisconsin. The media and government are both like, "EVERYONE STOP EATING, E COLI! YOU AND YOUR LOVED ONES WILL DIE!" A scary few places are at least, "Wait, maybe just don't eat lettuce cause you might get food poisoning!" And then there are barely any voices saying, "Hey, don't eat lettuce from Wisconsin right now."

 
Working on making the switch.  Certainly a cleaner habit, less smelly, less trash and litter.  Probably less bad for one by many magnitudes, if not safe.  No reason to take it up if one does not have a nicotine habit, but if one does, well it seems a less harmful alternative.

 
Ditkaless Wonders said:
Working on making the switch.  Certainly a cleaner habit, less smelly, less trash and litter.  Probably less bad for one by many magnitudes, if not safe.  No reason to take it up if one does not have a nicotine habit, but if one does, well it seems a less harmful alternative.
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Two things in my opinion are the most important:

1. Find a flavor you like.  This is unquestionably the most important.  If you try one and think "meh, this isn't for me" after a few days, try something new.  It is virtually worthless as a fix if you don't like the flavor.  You will probably be back to smoking very quickly. (And this is why flavor restrictions are a big problem.)

2. Make sure the device is something you don't hate.

Currently what works for me is the Smok Infinix, using the Nicotine Salt flavor by 13th Floor "Django".  It's a little sweeter than I'd like, but it's sort of a dark sweet tobacco flavor with a little more caramel than I'd hoped for - the caramel flavor cuts the salt flavor.  The Infinix is like the Juul - it allows a much smaller battery which means you can have something light and easy to fit in a shirt pocket that you can use much more like a cigar/cigarette than the huge things I was using for years.   

 
Henry Ford said:
Two things in my opinion are the most important:

1. Find a flavor you like.  This is unquestionably the most important.  If you try one and think "meh, this isn't for me" after a few days, try something new.  It is virtually worthless as a fix if you don't like the flavor.  You will probably be back to smoking very quickly. (And this is why flavor restrictions are a big problem.)

2. Make sure the device is something you don't hate.

Currently what works for me is the Smok Infinix, using the Nicotine Salt flavor by 13th Floor "Django".  It's a little sweeter than I'd like, but it's sort of a dark sweet tobacco flavor with a little more caramel than I'd hoped for - the caramel flavor cuts the salt flavor.  The Infinix is like the Juul - it allows a much smaller battery which means you can have something light and easy to fit in a shirt pocket that you can use much more like a cigar/cigarette than the huge things I was using for years.   
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As long as it does not taste like a sweaty Jamie Fox hanging upside down by his feet waiting to have his pride clipped.  Fear sweat is particularly foul smelling.

 
(HULK) said:
I literally tried therapy, nic gum, nic lozenges, nic patches, wellbutrin, and chantix. Of those, chantix was the only thing that somewhat worked, but you don't take it forever, and I backslid from it twice. I've not backslid from vaping.

I have no problem collecting safety data. However, THERE IS NO RECENT VAPING ASSOCIATED ILLNESS. This is what is driving me up a wall. Drug dealers cut THC vape cartridges with Vitamin E acetate to increase their profits and people are falling ill from that. That's all. It has ZERO to do with legal nicotine vaping products purchased in stores. 

As I read in an article recently, the current situation is like an e coli outbreak in lettuce from Wisconsin. The media and government are both like, "EVERYONE STOP EATING, E COLI! YOU AND YOUR LOVED ONES WILL DIE!" A scary few places are at least, "Wait, maybe just don't eat lettuce cause you might get food poisoning!" And then there are barely any voices saying, "Hey, don't eat lettuce from Wisconsin right now."
Click to expand...
Well, you seem to know more than the CDC, who just created an emergency operations center to investigate the illness. Their last press release and web page:

Initial findings from the investigation into serious lung illnesses associated with e-cigarette products point to clinical similarities among those affected. Patients report similar exposures, symptoms and clinical findings and these align with the CDC health advisory released last week. While many of the patients, but not all, reported recent use of THC-containing products, some reported using both THC- and nicotine-containing products. A smaller group reported using nicotine only.

No evidence of infectious diseases has been identified in these patients, therefore lung illnesses are likely associated with a chemical exposure. However, it is too early to pinpoint a single product or substance common to all cases, according to authors of articles published today in the CDC’s Morbidity and Mortality Weekly Report (MMWR) and the New England Journal of Medicine.
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As of September 11, 2019 at 5pm, 380* cases of lung illness associated with the use of e-cigarette products have been reported to CDC from the following states and 1 U.S. territory: AR, CA, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MD, MI, MN, NC, ND, NE, NJ, NM, NV, NY, OH, OR, SC, SD, TN, TX, UT, VA, WA, WI, WV, and USVI. These numbers may change frequently.
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It ain't just the Wisconsin lettuce, Hulk. From the NEJM article:

CONCLUSIONS

Case patients presented with similar clinical characteristics. Although the features of e-cigarette use that were responsible for injury have not been identified, this cluster of illnesses represents an emerging clinical syndrome or syndromes. Additional work is needed to characterize the pathophysiology and to identify the definitive causes.
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Last week's MMWR report:

No consistent e-cigarette product, substance, or additive has been identified in all cases, nor has any one product or substance been conclusively linked to pulmonary disease in patients.
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And to be clear, this is the CDC's interim recommendation for vaping:

Until we know more, if you are concerned about these specific health risks, CDC recommends that you consider refraining from using e-cigarette or vaping products.

If you are an adult who used e-cigarettes containing nicotine to quit cigarette smoking, do not return to smoking cigarettes.

If you have recently used an e-cigarette or vaping product and you have symptoms like those reported in this outbreak see a healthcare provider.

Regardless of the ongoing investigation:

Anyone who uses an e-cigarette or vaping product should not buy these products (e.g., e-cigarette or vaping products with THC, other cannabinoids) off the street, and should not modify or add any substances to these products that are not intended by the manufacturer.

Youth and young adults should not use e-cigarette products.

Women who are pregnant should not use e-cigarette products.

Adults who do not currently use tobacco products should not start using e-cigarette products.
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Doesn't seem overly sensational, or hysterical to me.  :shrug:

 
The biggest problem for me is the overwhelming majority of these reported illnesses have been a result of altered or manufactured THC cartridges.

Because both delivery systems are considered "vaping", nicotine based users are going to lose access to something that has helped them stay off analogs.

Why not the push to ban cigarettes ? They are infinately more harmful than nicotine based vape. The answer is 💰

 
Stole it ‘cause it’s true... 🤷🏻‍♀️👀

55 years ago the Surgeon General warned us of the dangers of smoking. It's a product  that has killed TEN TIMES the number of Americans who died in ALL of our nation’s wars COMBINED. (according to the CDC)

Government: add taxes to reduce consumption

FDA: try these pills, patches, and gums

Smoker: these really don't work for us

Smoker/Inventor: here's a way to get nicotine without the 50% chance of death

Government/FDA: we don't know what that is and you shouldn't have it

Royal College of Physicians: our research shows that vaping is 95%+ less harmful than smoking

Government/FDA: we just don't know about this

Public: look at the dramatic drop in smoking rates among adults and teens

Government/FDA: that because of our taxes, pills, patches, and gums

Ex-smokers/Vapers: Uhhh.....there's 12 million of us who quit because there was a less harmful alternative created in spite of your ineffective solutions.....it's called vaping

Government/FDA: that's anecdotal. We don't know about that and besides, we need our taxes

Ex-smokers/Vapers: but it's proven twice as effective as any solution that you've produced in 55 years

Government/FDA: we don't care about that because we still need our taxes and we have to protect big tobacco and big pharma (they give us lots of cash and you don't)

Ex-smokers/Vapers: we're still going to vape

Government/FDA: no you won't because we're going to rally all of the "health organizations" that we fund. They'll spread a mountain of lies and misinformation against you and it will spread like wildfire.....we're very good at this

Ex-smokers/Vapers: but you're supposed to protect the public and the health of the citizens......what about the 480,000 Americans who will die this year from smoking related illnesses

Government/FDA: yeah but we still need our taxes

Ex-smokers/Vapers: wouldn't you see a net benefit from lower healthcare costs to offset those tax revenue losses

Government/FDA: who knows? Try this lower nicotine cigarette that we just approved......it'll still kill you like the old cigarettes that we approved of, but you'll have less nicotine in your body when you die

Ex-smokers/Vapers: but we're ex-smokers and we don't want to go back to tobacco or die any sooner than regularly scheduled

Royal College of Physicians: we just put vape shops in hospitals...….y'all know vaping is still 95%+ less harmful than smoking right?

Public: what in the cornbread hell is going on here???

 
Terminalxylem said:
Well, you seem to know more than the CDC, who just created an emergency operations center to investigate the illness. Their last press release and web page:

It ain't just the Wisconsin lettuce, Hulk. From the NEJM article:

Last week's MMWR report:

And to be clear, this is the CDC's interim recommendation for vaping:

Doesn't seem overly sensational, or hysterical to me.  :shrug:
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This is because my opinion can't be bought with dirty money or influenced by politicians.

The CDC deserves to be shamed for the stance they've taken.

 
The vast majority of people who fell ill reported using THC vapes purchased from drug dealers.

Those that didn't, I think a reasonable assumption is that they're lying. Kids who break the law typically don't just fess up.

I know it's not Juul. A product that has been out for years without anything like this happening doesn't just start having wildly different results. If it was, they'd 100% have it linked to it within a day or two.

Vitamin E acetate... Writing is already on the wall for those who like to read.

 
You guys with the Big Pharma/Tobacco conspiracies are too much. But you’ll get no argument from me that tobacco, alcohol, marijuana and vaping are all worthy of regulation.

Did you even read the CDC links? Nobody there is suggesting banning vaping, just putting on the brakes while they investigate the recent illnesses/deaths. While you may think you have it all figured out, the scientists on the front lines seem to think otherwise.

 
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Terminalxylem said:
You guys with the Big Pharma/Tobacco conspiracies are too much. But you’ll get no argument from me that tobacco, alcohol, marijuana and vaping are all worthy of regulation.

Did you even read the CDC links? Nobody there is suggesting banning vaping, just putting on the brakes while they investigate the recent illnesses/deaths. While you may think you have it all figured out, the scientists on the front lines seem to think otherwise.
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I did. I just know it tied into other policy and I'm reacting to the government as a whole.

Should it be regulated? Absolutely.

Kids vaping a problem? Absolutely.

An effective harm reduction strategy for smokers? Absolutely.

What has happened in the past month has been so problematic IMO. Maybe it's the media sensationalizing? Maybe it's politicians doing it with elections looming? Maybe it's a convenient distraction from other issues and the government has been told to laser in on it? Maybe donations are being made and the influence is visible? I honestly don't know. What I do know is that facts and common sense appear to be out the window and we have states passing bans, federal executive orders being issued, etc. I assume there is something driving this wedge between perception and reality, but no real clue beyond wild speculation as to what that may be.

 
Ben & Jerry's said:
“Without question, abolition of e-cigarettes would be a health disaster for the roughly 8 million adults who vape daily. Vaping is more popular as a method of quitting smoking than nicotine patches and gum combined.  U.S. smoking is at an historic low of 14 percent.”

https://www.usatoday.com/story/opinion/2019/09/13/dont-nontobacco-e-cigarettes-adults-more-danger-kids-column/2299006001/
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1. No one has suggested banning vaping altogether.

2. There are other ways to stop smoking, including some that pose no additional health concerns.

3. Smoking was already downtrending before e-cigs became popular.

 
(HULK) said:
I did. I just know it tied into other policy and I'm reacting to the government as a whole.

Should it be regulated? Absolutely.

Kids vaping a problem? Absolutely.

An effective harm reduction strategy for smokers? Absolutely.

What has happened in the past month has been so problematic IMO. Maybe it's the media sensationalizing? Maybe it's politicians doing it with elections looming? Maybe it's a convenient distraction from other issues and the government has been told to laser in on it? Maybe donations are being made and the influence is visible? I honestly don't know. What I do know is that facts and common sense appear to be out the window and we have states passing bans, federal executive orders being issued, etc. I assume there is something driving this wedge between perception and reality, but no real clue beyond wild speculation as to what that may be.
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OK, we basically agree. I just don’t get caught up in the media/political rhetoric, and am not yet convinced there is a net societal benefit from vaping in the first place.

 
Terminalxylem said:
You guys with the Big Pharma/Tobacco conspiracies are too much. But you’ll get no argument from me that tobacco, alcohol, marijuana and vaping are all worthy of regulation.

Did you even read the CDC links? Nobody there is suggesting banning vaping, just putting on the brakes while they investigate the recent illnesses/deaths. While you may think you have it all figured out, the scientists on the front lines seem to think otherwise.
Click to expand...
I didn't see the CDC even saying to put on any brakes.  I don't think the CDC has recommended any action be taken at all except "if you're worried about this happening, don't use vape products until we finish our investigation."  And, obviously, the "don't use nicotine products like this if you are a minor, pregnant, or haven't used it before."  

 
The issue for people who vape who I know is that the CDC saying "hey, something happened - no need to be alarmed, but if you're worried wait for our report" has turned into "ZOMG MUST BAN FLAVORS."  And that's weird.

 
Henry Ford said:
The issue for people who vape who I know is that the CDC saying "hey, something happened - no need to be alarmed, but if you're worried wait for our report" has turned into "ZOMG MUST BAN FLAVORS."  And that's weird.
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The president announced an executive order to ban flavored nicotine vapes last week. California and New York have moved to ban them even more aggressively. That's why I'm reacting as I am. I'm unsure if you're referring to politicians and media making that jump, or referring to the vapers here reacting to said jump.

 
(HULK) said:
The president announced an executive order to ban flavored nicotine vapes last week. California and New York have moved to ban them even more aggressively. That's why I'm reacting as I am. I'm unsure if you're referring to politicians and media making that jump, or referring to the vapers here reacting to said jump.
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I’m referring to politicians and media screaming for bans because of a CDC report that doesn’t recommend bans. 

 
(HULK) said:
The president announced an executive order to ban flavored nicotine vapes last week. California and New York have moved to ban them even more aggressively. That's why I'm reacting as I am. I'm unsure if you're referring to politicians and media making that jump, or referring to the vapers here reacting to said jump.
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Whats crazy to me is that vaping is an awesome harm reduction that's being attacked by two of the most liberal states.

Needle exchanges are dubious harm reduction that are embraced by the same states.

We've come to the point where heroin addiction is less reviled than smoking.

 
Gawain said:
Whats crazy to me is that vaping is an awesome harm reduction that's being attacked by two of the most liberal states.

Needle exchanges are dubious harm reduction that are embraced by the same states.

We've come to the point where heroin addiction is less reviled than smoking.
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How have you concluded vaping is awesome harm reduction? Sure it helps some people quit, and others cut down tobacco consumption. But that must be balanced by the harm it causes by encouraging teens and others to pick up the habit, plus the potential for long term toxicity. My major concern is we don’t know much about the latter, despite many smokers embracing it as the best thing since sliced bread. Moreover, less harmful alternatives for smoking cessation exist - even if you assume vaping is twice as good at promoting quitting (a controversial stance, despite the NEJM study), are the extra 9% who quit worth the collateral damage?

 
Henry Ford said:
The issue for people who vape who I know is that the CDC saying "hey, something happened - no need to be alarmed, but if you're worried wait for our report" has turned into "ZOMG MUST BAN FLAVORS."  And that's weird.
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I hardly think the CDCs actions convey no need to be alarmed.

 
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