
FDA is considering drugs to help kids quit vaping - LinuxBender
https://lite.cnn.io/en/article/h_66afc59fee1feb0f28b5944c6a8b2384
======
drewmol
Companies like JUUL have patented formulations for nicotine salts that quickly
spike blood nicotine levels similar to levels of analog cigarettes, then the
sudden drop off promotes stronger cravings and more frequent usage. Cavings
resulting from this quick spike and drop off significantly increases habit
forming behavior by boosting both the intensity of withdrawl symtoms and
frequency of usage compared to freebase nicotine formulas that have been
common in traditional "ejuice" of the past decade. Combine this with their
cornering the teenage vaping market you can see why Altria (malboro parent co)
just gave them 13B for 35%. These nic salt formulas can ease the transition
from traditional cigarettes, but also increase the first time user to addict
conversion rate and lessen the likelyhood of users tapering off usage by
gradual reduction of comparibly stabilized nicotine levels of freebase
formulations.

I've been rolling around an idea for a device to help ween off nicotine for
years now. I need to consult with an EE, but don't have any in my network. If
anyone's willing to chat for 30 mins, or interested in colaberating I'd love
to hear from you, emails in my profile. If you're aware of any service out
there to buy small block of consultation time, that would help at well.

~~~
owlninja
JUUL was the only thing that got me off a pack-a-day 13 year habit. I think
very highly of the product and it is a shame teenagers made it so 'cool'.
(Much like cigarettes at one time...)

~~~
Aloha
Conversely, I switch to Dipping Tobacco as my quitting smoking mechanism, I
dont think I can quit nicotine and stick to it, but quitting dip does seem
legitimately easier than smoking, as there is much less ritual associated with
it.

~~~
ams6110
Mouth cancer though. Horrible stuff.

~~~
celrod
My dad's dad smoked a lot when my dad was young, but managed to quit by
chewing cigars. He died of mouth cancer.

My dad swore off of drugs and alcohol, and always said he wanted to work until
the day he dies. He's instead spent the last 10 years dying of Alzheimer's.

For what it's worth, I'm inclined to follow my dad's approach. Perhaps with a
different interpretation of retiring when I die. But there are some games you
just can't win.

------
standardUser
Anti-tobacco extremists believe the ends justify the means. They'll happily
give people dangerous psychoactive drugs or get them hooked on nicotine
replacement therapy if it means advancing their agenda.

I quit smoking a couple years back and I was baffled by the lack of quality
information I could find online. It's 90% propaganda, thanks to the anti-
smoking warriors. Most of it pushes these quit-smoking drugs or just different
forms of nicotine intake (which is the very drug you're supposed to be trying
to quit in the first place).

You'd think we would have collectively learned something from the abysmal
failure of things like the DARE program and abstinence-only education. Facts
work better than scare tactics and propaganda.

~~~
SilasX
>Most of it pushes these quit-smoking drugs or just different forms of
nicotine intake (which is the very drug you're supposed to be trying to quit
in the first place).

Wait, what? I thought nicotine itself was pretty harmless, and that most of
the harm from smoking comes from all the other junk you suck into your lungs?
Wikipedia seems to agree:

>The health effects of long-term nicotine use are unknown. The general medical
position is that nicotine itself poses few health risks, except among certain
vulnerable groups, such as youth. Nicotine use as a tool for quitting smoking
has a good safety history.

[https://en.wikipedia.org/wiki/Nicotine](https://en.wikipedia.org/wiki/Nicotine)

~~~
standardUser
Nicotine is viciously addictive. I don't see how anyone could consider one of
the most addictive substances, and its associated withdrawal symptoms, to be
"harmless".

And yes, nicotine replacement therapy has a decent track record compared to
other methods, which should not be surprising since you don't have to actual
break the addiction. You just maintain the same addiction with a different
delivery system.

Interestingly, vaping itself is just another nicotine delivery system, but one
that the anti-smoking zealots decided to demonize, unlike the various
inhalers, patches and gums they push.

~~~
SilasX
>Nicotine is viciously addictive. I don't see how anyone could consider one of
the most addictive substances, and its associated withdrawal symptoms, to be
"harmless".

Addictive stuff is bad _if taking it has other negative effects_. Food, water,
and air are likewise addictive, but that doesn’t mean you should do without.
You’d need to cite something other than being addictive to establish a reason
to avoid them entirely.

>And yes, nicotine replacement therapy has a decent track record compared to
other methods, which should not be surprising since you don't have to actual
break the addiction. You just maintain the same addiction with a different
delivery system.

I think the idea is to follow them up with a tapering off of the nicotine
levels, which is much easier at that point.

~~~
edflsafoiewq
> Food, water, and air are likewise addictive

This is a perverse usage. The physiological need for food, water, or air is
innate; it arises from your body itself, not the action of the external
substance on your body. Additionally they do not induce the classical
development of tolerance.

Many people would hold that addiction itself is bad. Even if there are no
other negative effects, there is the effect of dependence on the addictive
substance and commensurate loss of independence (the addiction always occupies
some mental space since you must always think about how you are going to
satisfy it).

~~~
SilasX
Okay, if I may rephrase the point in a less cheeky manner:

It's not very informative that a substance is addictive in the sense that "you
must use this every day or experience extreme negative side effects". You have
to also look the cost of taking it and what it does to you when you use it.

I have to constantly eat to stay alive? Manageable. I have to consume water
and breathe air? Manageable. I have to inject 50 cents of insulin? Manageable.
I have to absorb 50 cents of nicotine? Manageable.

If I have to consume expensive amounts of crack, which also makes me
homicidal? Okay, then that's a problem.

I was objecting to the OP's criticism of the lingering nicotine addiction and
usage as some kind of be-all end-all deal-breaker. No, it depends on the
relative harm. If you go from "expensively sucking down toxic junk to get your
nicotine fix every day" to "taking a cheap nicotine-only does everyday",
that's not defeating the purpose of anything, and it's very much missing the
point to dismiss it as "still being addicted to nicotine".

~~~
darpa_escapee
There's a difference between a physiological need, like consuming water and
air, and a chemical dependence.

> I have to constantly eat to stay alive? Manageable. I have to consume water
> and breathe air? Manageable.

No matter where you go, the entirety of society is structured around the fact
that all people need to eat, drink and breathe.

> I have to inject 50 cents of insulin? Manageable. I have to absorb 50 cents
> of nicotine? Manageable.

This is where the disconnect is. The cost of insulin dependence is not merely
the cost of insulin itself. An insulin dependent person must always be aware
of their blood sugar levels and diet. They must always be prepared for a
situation in which they're away from their insulin supply. They must be
prepared for an emergency or incapacitation due to complications with their
condition and its treatment. There's a significant cognitive load that isn't
accounted for by the fabric of society like the need for food is.

Likewise, there's a psychological, social and occupational cost to nicotine
addiction that isn't reflected in nicotine's price alone.

This is why people are saying that chemical dependence is inherently bad: it's
an inconvenience at best, a costly burden to most and a killer at worst.

------
pixelpoet
I cannot fathom how people still use phrasing like "drugs and alcohol" and
"drugs instead of vaping" etc.

How can there be such a disconnect, those are first class drugs! Is it
cognitive dissonance, i.e. actively refusing to acknowledge it? It's pretty
much universal too, not just one or two countries.

~~~
chiefalchemist
This just reminded me of the time, not too long ago, I was on a date and she
said to me, "I'm not into drugs." The problem was, she was on her second
cocktail.

~~~
grawprog
Personally...I like to be really pedantic and point that out to people who say
that while drinking a coffee...and consuming the most widely used stimulant in
the world.

~~~
pixelpoet
Being pedantic can easily be addictive / a drug; win a little logic game,
score some imaginary points! Especially on an internet forum.

~~~
dgzl
Bad analogy... The drug you're thinking of might be dopamine released by your
brain, but not a third-party drug like alcohol or caffeine, like everyone else
is talking about.

------
devereaux
Bright idea: instead of letting kids vape (harm profile: uncertain, could be
low), let's hook them to drugs like Varenicline (Champix) which are known to
cause thing like cardiovascular diseases and suicide ideation.

(Actually, it's a bright idea for all the parties involved, because "think of
the kids" brings positive karma points, and parents and insurance plan will
cough up the money)

~~~
fanzhang
What a surprise: Varenicline is still under patent and available from only one
provider in the USA [https://www.drugs.com/availability/generic-
chantix.html](https://www.drugs.com/availability/generic-chantix.html)

I wonder who's paying the dinner bills after today's hearing.

~~~
devereaux
I suppose we are both bad cynical people because I thought the same when
reading the article

------
ben509
> "I believe FDA posed the wrong questions for today's meeting," said Lauren
> Lempert, a law and policy specialist for the Center for Tobacco Control
> Research and Education at the University of California, San Francisco.

> Instead of debating the role of nicotine replacement and drug therapies, the
> agency "should be focusing on policies that will prevent youth initiation
> with e-cigarettes and addiction to nicotine,"

I've been noticing this form of argument... in case it's not clear why I find
it strange: yes, for a hypothetical child it's ideal that he not get addicted
in the first place. But you still have these children who are addicted, that's
a real problem, so while it's useful to also consider prevention, a regulatory
agency is mandated to address an actual problem.

~~~
soared
Why would you plan to continuously use band-aids when you could prevent
getting cuts in the first place?

It seems more important to address the source of the issue to prevent it from
continuing to occur rather than only treating the symptoms. (Fixing the
current is still important, but seems secondary to me)

------
quitsuffocating
It seems to me that it would be in the best (financial) interests of big
tobacco and pharma that vaping be outlawed entirely.

Failing that they would probably both find it in the their best interests to
force companies who want to produce vape related products through a regulatory
process so expensive that only massive companies such as Marlboro or Pfizer
can afford to comply - can’t have the little guy taking a slice of their
poison pie.

I think that if kids are going to try nicotine (and let’s face it - they are)
better it be through a vape than a cigarette.

Anecdotally as a person who has sometimes smoked as many as 100+ cigarettes a
day - I am finding vaping to be helpful in quitting the horrible cigarettes
and if it were not offered as an alternative, would probably go back to
smoking because none of the other cessation methods have been effective for
me.

I know both smoking and vaping are far from ideal but the lesser of two evils
is still better any way you slice it.

When you have something that is taking significant profits from big companies,
one of the first ports of call for them is to whip up some hysteria along the
lines of “think of the children” if applicable.

The rhetoric surrounding this appeals to something deep within human nature
and it becomes trivial to demonise people who have a contrary point of view -
in this case people who happen to be proponents of harm reduction and freedom
of choice.

------
goldcd
[https://www.hhs.gov/ash/oah/adolescent-
development/substance...](https://www.hhs.gov/ash/oah/adolescent-
development/substance-use/drugs/tobacco/trends/index.html)

I posted a very well researched response, to a similar article (unfortunately
somewhere else, I can't remember where).

As a big opening gambit - "Smoking rates of children have gone off a cliff
since ~ 2000". Not only have they dropped, they've accelerated. If any of this
acceleration is associated to the corresponding increase in vaping over this
time, then the vaping industry is possibly the leader in saving lives. (I'm
open to other suggestions).

~~~
ceejayoz
> If any of this acceleration is associated to the corresponding increase in
> vaping over this time, then the vaping industry is possibly the leader in
> saving lives.

That doesn't appear to be the case.

See the chart in [https://www.motherjones.com/kevin-drum/2018/12/the-juul-
fad-...](https://www.motherjones.com/kevin-drum/2018/12/the-juul-fad-is-far-
bigger-than-i-ever-would-have-guessed/)

~~~
goldcd
That's trends in percentages - not absolute numbers Makes perfect sense that.
If there are more smokers than vapers (which there will be historically as
vaping is new and smoking is old) - then a few switching to vaping will cause
the smoking like do drop a little, and the vaping line to go up like a rocket.
i.e. If there were 100 smokers and 10 vapers. Then one of them switches.
Smoking has gone down 1% and vaping up 10%.

Plus doesn't seem to include relative harm. I'd have thought it would take a
large number of non-smokers taking up vaping, to match the harm-reduction of
one smoker switching to vaping.

~~~
ceejayoz
What? No.

It's the percentage of high schoolers who've tried each. 1% of high schoolers
switching from smoking to vaping will cause the percentage of high schoolers
smoking to go down by one and the percentage of high schoolers vaping to go up
by one.

~~~
goldcd
My apologies. I was just recycling a previous argument against a different
report (without reading this one properly).

------
Simulacra
Where there’s a way, pharmaceutical companies will make money.

------
Udik
I can't read this article without shuddering. It sounds completely hysterical
about kids using what is considered a _smoking cessation tool_ , that is not
proven to cause any harm, and that delivers varying, but usually pretty low,
if not zero, amounts of nicotine.

The solution? Prescribing other drugs to these kids (as if there are any that
actually work against smoking, except the very one they're trying to gegt them
off).

~~~
mistermann
> I can't read this article without shuddering.

It's a wonderful example of fake news, using clever (but technically true, if
someone ever called them on it) language to persuade people to be scared.

------
RcouF1uZ4gsC
>Experts worry that the devices could put kids' developing brains at risk, get
them hooked on nicotine early in life and be a gateway to smoking and other
drugs. But, the long-term effects aren't clear.

The vast majority of smoking’s harmful effects are due to the combustion
products not the nicotine. It is really unclear if vaping will really have a
long term effect on kids. In addition, given that vaping doesn’t really hurt
other people via second hand smoke or altered behavior(see alcohol) this whole
panic about vaping seems overblown. How much do you want to bet that the
“medical experts” who are harping about the dangers of vaping without a lot of
data are “consultants” for pharmaceutical companies looking to get their
“anti-addiction” drug approved.

~~~
skwb
Vaping certainly does damage air quality by releasing ultafine aerosol
particulate matter (also known as pm10 or pm2.5) [0]. It's worth noting that
these are associated with respiratory distress and can contribute to stroke
and heart attacks as well as asthma. In fact, we now have compelling
epidemiological evidence that vaping almost doubles risk of cardiac events
[1].

Think about it like this: would I want to run a marathon on a bad air day in
China? Probably not.

[0].
[https://www.nature.com/articles/s41370-017-0005-x?fbclid=IwA...](https://www.nature.com/articles/s41370-017-0005-x?fbclid=IwAR1X7IPVGTwF30C5nEeO3bMsjMI11-Ak01fv0JuA-
FmTc4EAH8YM3fEIb2M) [1]. [https://www.ucsf.edu/news/2018/08/411476/risk-heart-
attacks-...](https://www.ucsf.edu/news/2018/08/411476/risk-heart-attacks-
double-daily-e-cigarette-users)

Edit: Study 1 focused on PM10 (particulate matter smaller than 10 microns) air
quality levels, and not PM2.5. PM 10 tends to be associated with more acute
respiratory distress, while PM2.5 is a more chronic threat [2]. Nevertheless,
there is sufficient evidence that monitoring environmental PM10 levels remains
an important public health metric.

~~~
mistermann
> In fact, we now have compelling epidemiological evidence that vaping almost
> doubles risk of cardiac events

 _If you continue to smoke tobacco_.

"Scientific" studies like this that assert causation when all they have is
correlation, based on surveys that we know little about (and likely wouldn't
be able to learn the full details of even if one was energetic enough to hunt
down the original paper), certainly don't do anything to convince me. If
anything, it just increases my suspicion around the "science" we're fed.

~~~
skwb
Well they have correlation that remains correlated after you adjust the model
for other risk factors. So is that direct evidence? No.

But when you add in the other lines of evidence, you start building a case.
It's sorta like a murder trial (not withstanding a separate discussion of our
criminal justice system...) where the case is built over lines of evidence.

And as one of my graduate professors once said, "there is no double blind
randomized trial for the efficacy of parachutes" ;) [0].

[0].
[https://www.bmj.com/content/327/7429/1459](https://www.bmj.com/content/327/7429/1459)

~~~
mistermann
> But when you add in the other lines of evidence, you start building a case.
> It's sorta like a murder trial (not withstanding a separate discussion of
> our criminal justice system...) where the case is built over lines of
> evidence.

When you're dealing with a murder trial, whether harm has occurred is clear.
In this case, not only is there a lack of evidence for causation, there's not
even any evidence for harm.

~~~
skwb
People have died of cardiac events and lung cancer. Some people have used
e-cigarettes. Some have not. Is there evidence that connects the use of
e-cigarettes to these deaths? That's for science to decide.

~~~
mistermann
Similarly: People have died of cardiac events and lung cancer. Some people
have chewed gum while walking. Some have not. Is there evidence that connects
chewing gum while walking? That's for science to decide. As it is, we have
none. But until then, I'd rather not have it outlawed or be forced to pay for
research without some reasonable reasoning that there may be some significant
risk involved.

------
chiefalchemist
Does nicotine have an medicinal value? It seems to me, it's used as an
additive with one ends in mind: addiction.

While I'm not in favor of the Nanny State, the fact that tobacco products
(read: known carcinogens) are sold freely boggles my mind. Imagine if a
terrorist (e.g., UBL) had said, "I'm going to developer a product that addicts
it's users. This product will cause health issue, and perhaps even cause
cancer. I'm going to bring this product to the masses wolrdwide."

If such an proclamation where made, the public and the governments would FLIP
OUT. The war on terror would ratchet up ten-fold. It's a mad world

~~~
thebigspacefuck
Yes. It's an appetite suppressant, helps you focus similar to ADHD drugs, and
relaxes you. Snus (steamed tobacco) doesn't have carcinogens, cause cancer, or
reduce lifespan. Pipe Tobacco users live on average 3 years longer than non
Pipe Tobacco users. Nicotine is not an issue with respect to cancer. It's
everything else in cigarette smoke. Nicotine's not even that addictive by
itself. What's more addictive are the social behaviors surrounding it.
Overcooked steaks are carcinogens and psychologically addictive, should we ban
those too?

~~~
sithadmin
Quite a few studies implicate nicotine as a carcinogenic agent. Further,
nicotine is absolutely terrible for cardiovascular health.

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

~~~
_Schizotypy
Thank you! This is an important point that I almost never see mentioned.

------
soundpuppy
Can’t we make some sort of waxy nanostructure material in the form of a
cigarette that burns with zero particulates? Won’t help the issue directly but
will help smokers.

Here’s an idea - since all vapes except home made devices are electronic, put
a Bluetooth chip that requires a phone app that securely identifies the age of
the vaper. Make it mandatory for all vaping devices and boom - massive cut in
underage vaping.

------
jimhefferon
How about if we make it so they do not start?

------
cat199
like, say, 0% nicotine vaping?

~~~
linkingday
This is exactly how I quit vaping a few years ago. Crazy, right? Offer 0% nic
Juul pods for parents to buy their kids and they'll stop giving a shit after a
while.

------
rspeele
This was originally going to be a reply to ben509's comment but turned into a
rambling mess only even tangentially related to the original article. Rather
than throwing it away, I am posting it as a top-level one.

I don't think it's just the substance that is perceived as unclean. Even for a
libertarian, there is a slimy texture to any industry based around an
inherently addictive product. Especially when it comes to marketing to kids --
potential lifelong loyal customers if you can hook them while they're more
easily influenced.

Suppose there was a substance that was completely neutral in terms of its
effects on your body. It has no caloric content, is not caught on drug tests,
it tastes like water, and doesn't even make you feel different when you take
it. The _only_ effect that it has is that, several hours after your last dose,
you find yourself craving another.

How would you feel about this substance being marketed? It's not hurting
anyone, other than that they spend a portion of their money on the habit. But
the companies selling it aren't doing their own customers any good, either,
and in fact, each new customer they get to try the substance is just being
roped into a life of either willing themselves through the cravings or
spending a little money to make them go away.

Now, obviously nicotine is not this substance. For one, I do think nicotine
users actually enjoy the products and also get some alertness benefits from
them. But there is that skeevy layer to it too.

I'm not coming at this from a place of puritanism. I'm not a nicotine user but
I do consume alcohol. I think we all know alcohol is worse than nicotine in
terms of health effects, and the alcohol industry has done an extremely
effective job of positioning their product as something cool grown-up adult
people use, joke about, and have "sophisticated" tastes in. Just run through
your favorite TV shows from the past 20 years or so and try to find any that
don't show main characters either a. enjoying alcohol as part of all their
social events, or b. abusing alcohol and it's played off as funny, or c.
abusing alcohol as part of a "tortured genius" trope.

In a lot of industries the top 10-20% of customers account for the majority of
sales. It just gets weird when you have an industry that has to pretend it
cares about "responsibility" when its bottom line is as dependent on its most
addicted users as they are on the product.

I guess my point is, at some point we call people adults and let them weigh
the benefits vs. the risks. Even if they suck at doing that, it's on them. But
I'm totally OK with the FDA's aggressive stance on e.g. Juul marketing to
teenagers, because that seems to me to be all about getting somebody to start
the habit when they're least likely to make wise decisions.

~~~
leetcrew
> But I'm totally OK with the FDA's aggressive stance on e.g. Juul marketing
> to teenagers, because that seems to me to be all about getting somebody to
> start the habit when they're least likely to make wise decisions.

is there any evidence that juul is marketing to teenagers? genuinely asking,
as I receive their promotional emails and they never strike me as targeting
underage users.

~~~
ceejayoz
Trying to get their "anti-vaping" curriculum in schools (aping what the
tobacco industry did):

[https://www.nytimes.com/2018/08/27/science/juul-vaping-
teen-...](https://www.nytimes.com/2018/08/27/science/juul-vaping-teen-
marketing.html)

> Five days later, Carrie Yantzer, the principal at Nederland Middle-Senior
> High School, received an email that immediately struck her as suspicious.
> The writer introduced himself as Bruce Harter, a former educator working
> with Juul to develop an anti-vaping curriculum for schools.

> “I read about the challenges you’re having with Juul,” Mr. Harter wrote. He
> offered a free, three-hour curriculum provided by Juul to discourage teens
> from using e-cigarettes by teaching them about their brains and giving them
> mindfulness exercises.

The "cool flavors" thing was a (now banned) tobacco industry trick, too:

[https://www.smithsonianmag.com/history/electronic-
cigarettes...](https://www.smithsonianmag.com/history/electronic-cigarettes-
millennial-appeal-ushers-next-generation-nicotine-addicts-180968747/)

> Other efforts from Big Tobacco to target children were eventually stymied by
> the government as well. In the late '90s, the Federal Trade Commission
> banned the indelible Joe Camel, and the Food and Drug Administration banned
> kid-friendly flavors like strawberry, grape, and chocolate from traditional,
> or combustible, cigarettes in 2009.

~~~
leetcrew
> Trying to get their "anti-vaping" curriculum in schools

I can agree, that seems suspicious.

> The "cool flavors" thing was a (now banned) tobacco industry trick, too

this is more along the lines of what I expected, and I strongly object to this
argument for two reasons. the first is just that, as an adult, I don't accept
that I should be prohibited from buying something that tastes good to me just
because a child might also enjoy the flavor. the second is that having vape
flavors that actually taste good makes it a much more effective harm reduction
tool; after a giving it a chance, many smokers actually end up _preferring_
the experience of vaping. if you ban all the good flavors, a good chunk of
these people are just going to switch back to smoking.

also, I notice there are a lot of people that support the flavored cigarette
ban of the 90s and are now railing against vape flavors. I never hear these
people complain about sweet, fruity liquors. if strawberry vape juice is
targeting children, who is strawberry vodka for? do we also need to think
about banning sweet wines?

------
porpoisely
Ah yes, lets drug our kids even more to fix the fact that we drug our kids so
much. We have to think about those poor pharma execs who need more mansions
and private jets. When your paycheck depends on it, I guess drugs are the
answer for everything.

Do people still believed that government and its agencies exist for the
benefit of the public rather than to benefit capital and corporate interests?

The US government has never been a country of the people, by the people, for
the people. It's been a government of the rich, by the rich, for the rich.

