
The Strange and Complicated Future of the E-Cigarette Industry - benbreen
https://pointsadhsblog.wordpress.com/2016/08/30/the-strange-and-complicated-future-of-the-e-cigarette-industry/
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ecommerceguy
Is it just me or are we seeing more unabashed evidence of big government and
big corporation collusion. The UK has numerous studies touting e-cgis as a
more healthy than traditional cigarettes, by a quite large margin. This as
well as the DEA announcement of Kratom getting Tier 1 drug status (I'm not
kidding) proves that big tobacco and pharma dont give 2 #s about your lives or
health. I'm starting to lose faith in the US system. Fast.

~~~
jerkstate
It's not their fault! As Heather Bresch and Martin Shkreli have been telling
us, it's their fiduciary duty to their shareholders to manipulate government
regulation in order to reap as much profit as possible.

~~~
witty_username
I would actually agree, to some degree.

Sidenote: If you research more, Shkreli does have reasons for the price hike
(research). He says that 60-70% of Daraprim is given for free and no one is
dying from lack of access. I don't know how true it is, but he doesn't seem
like a villain.

~~~
tristanj
> _[Shkreli says that for most people,] Daraprim is given for free_

That's his PR pitch. Shkreli says he's giving drugs away for free, but really
he's not. What's actually happening is his company makes a tax-deductible
donation to an org that covers patients' _co-pay_ s, and leaves health
insurers/Medicaid to cover the other 80% of the cost. Covering the co-pay
keeps patients on the drug longer so his company can milk more money from
insurers. It's a great moneymaking scheme.

Shkreli didn't think of this himself, many drug companies do the same. Like
you mentioned, I don't think he's a villain for doing this, he's just a smart
guy who saw how drug companies abuse the system and tried to copy them.

There's a lot more on this topic in this Bloomberg article
[http://www.bloomberg.com/news/articles/2016-05-19/the-
real-r...](http://www.bloomberg.com/news/articles/2016-05-19/the-real-reason-
big-pharma-wants-to-help-pay-for-your-prescription)

~~~
witty_username
Well, it's debatable whether that's "abuse". Companies need to make money to
fund research (Shkreli says he's trying to find a "2016 version of Daraprim")
and pay investors, and if patients aren't hurt, it's not necessarily bad.

~~~
tristanj
Well, if his actual intent was to help patients who couldn't afford his drug,
then he could just sell it to them cheaply. I don't think people would
consider that abuse. Instead he chooses make roundabout tax-deductible
contributions to a "charity" that covers patients copay's in a legally
questionable matter, dumping the cost on their insurer/US government. Is that
just some clever money making scheme, or is that abuse? Depends on your
perspective.

Also, the patients _are_ hurt. Who pays for these drug price hikes? That cost
is paid by patients in their higher insurance premiums and American taxpayers
in their dollars to Medicaid. Companies that do what Shkreli did make
healthcare more expensive for all Americans.

The underlying theme is that there are seriously perverse incentives issues in
American healthcare that need to be resolved. Until then, some people will
make a lot of money.

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draw_down
I don't know enough to say how these changes will affect the industry, but
I've seen ecigs lumped in with tobacco in lots of ways and it's super shitty.
Everything from "don't smoke or vape within 50 feet" to public-advocacy
billboards warning kids not to get sucked in to this ecig thing because
they're just as bad, we swear!!

I'm not going to say they're good for your health but smoking tobacco is SO
bad for you that lumping them together is just disingenuous.

~~~
nitrogen
If people don't want you smoking by them, they usually don't want you vaping
by them either.

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evgen
Given the fact that it has no second-hand consequences to speak of should
anyone really give a shit if someone doesn't want you vaping by them? Didn't
think so.

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mjevans
Are you aware of any studies that examine the effects of the base fluids and
/all possible/ additives on those with varying levels respiratory issues?

Also, when I go out to a park for exercise I'm going there for healthy fresh
air. Not smoke of any form, or anything that looks like smoke, or adds funky
scents. (I'd prefer if strong perfumes were also banned in public places;
particularly restaurants and any form of waiting area.)

~~~
Freak_NL
The e-cigarette manufacturers have succeeded alarmingly well in conveying the
message that e-cigarette smoke is just water vapour. None explicitly say this
now that government regulation is picking up, but it took root nonetheless.

A quick glance at the research published on this topic shows that the vapour
from e-cigarettes contains significantly lower but not negligible amounts of
carcinogenic compounds. If you are a smoker wanting to quit, this is probably
a good trade off, but if you don't smoke, you are likely not to appreciate
being treated to an unnecessary increase of harmful substances in the air you
live and work in.

You are right to point out that these studies usually focus on a particular
brand of e-cigarette filling or a limited range of them. Funky additives can
add any amount of complex by-products to the vapour exhaled, further
exacerbating the health threat. So yeah, treating e-cigarettes as normal
cigarettes seems very sensible.

> I'd prefer if strong perfumes were also banned in public places;
> particularly restaurants and any form of waiting area.

Or deodorant for that matter. I vastly prefer a subtle hint of Chanel No. 5
over the musky clouds of deodorant excessively applied by teenagers to mask
the underlying teenage angst.

~~~
evgen
Care to cite the research? I have seen no carcinogens noted, although there
are some heavy metal compounds that are worth concern.

~~~
Freak_NL
I can't cite any research with authority, as I lack the academic
qualifications to do so in this field — like most of us I depend on the
insights of those who do to form an opinion — but studies like these¹⁺² seem
to indicate that e-cigarette vapour are at least not devoid of carcinogens.

Searches on Google Scholar yield a number of papers that mostly seem to
indicate that more study is needed to fully comprehend the toxicity of
e-cigarette vapour, but that via second-hand smoke (or vapour) you are at
least exposed to nicotine, and probably to some quantities of other toxins,
possibly including carcinogens.

1:
[http://www.sciencedirect.com/science/article/pii/S1438463913...](http://www.sciencedirect.com/science/article/pii/S1438463913001533)

2:
[http://www.nejm.org/doi/full/10.1056/nejmc1413069#t=article](http://www.nejm.org/doi/full/10.1056/nejmc1413069#t=article)

~~~
evgen
First of all "toxins" is not a word you want to be using in such discussions.
It is a term that tends to be thrown around by people who do not understand
chemistry. It is all about the dosage, and so far most research shows that we
are talking about some very low doses at best. The heavy metals I noted are
probably the most concerning, since those actually do bioaccumulate, but
"probably" and "possibly" are not sufficient here.

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fernly
I took a quick look at the linked FDA rule PDF, but I cannot figure out what
the penalty is for not registering. For instance it is not clear what would
happen to a small vape pen maker, selling into the legal marijuana states, who
simply labels a product "This device NOT approved by the FDA for use with
tobacco or substances containing nicotine; use with such substances may damage
your health".

~~~
paulajohnson
Thats because a rule like this is "secondary" legislation that hangs off some
piece of "primary" legislation. Primary is created by Congress, secondary is
created by government agencies as specified by the primary legislation.
Somewhere there is a piece of primary legislation saying that the FDA can make
rules regarding the manufacture and sale of some defined class of items. The
preamble to the FDA rule probably mentions it.

That primary legislation will lay down the penalties for failing to comply.
The problem is that the primary legislation doesn't relate the severity of the
crime to the penalty, it just prescribes the maximum penalty. Since this has
to cover anything up to selling baby milk adulterated with melamine, you are
talking vast fines and years or decades in prison. In theory this could apply
for failing to maintain proper paperwork on just one occasion. In practice the
FDA gets to decide how serious your crime is, although it does have to be
rubber-stamped by a judge, and if they wanted to do more than close you down
then normal criminal evidence rules would apply.

~~~
wtbob
So much for 'All legislative powers herein granted shall be vested in a
Congress of the United States'!

Y'know, the Constitution ain't perfect, but it's better than what we have now.

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berntb
For people dependent on nicotine, check snus.

It is cheap to make yourself. Google "home made snus". There are Youtube
videos.

It is not healthy -- still tobacco. You will be as dependent on this nicotine
source as any other.

That said, the extra cancer risk is so small it is hard to measure. (You
_probably_ risk mouth cancer -- but the risk seems to be less than the mouth
cancer risk from smoking.)

It won't destroy your lungs, it is common with sports people like ice hockey
players in Sweden.

And so on.

Disclaimer: I only use snus when drinking, so once or twice a month. I am not
dependent on nicotine and am scared to be -- it is a wonderful drug. My only
dependencies are coffee and the Dark Souls series.

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SparkyMcUnicorn
One of my biggest concerns is batteries. Are 18650 and 26650 batteries going
to get more expensive because they are used in ecigs and will need to be
stamped with FDA approval?

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Salijerr
Smokers are evolving to vapers(is there a word like that?) So the industry is
evolving too.

