
We ignored evidence linking cigarettes to cancer – Let's not do that with vaping - DanBC
https://www.theguardian.com/commentisfree/2019/feb/16/we-ignored-the-evidence-linking-cigarettes-to-cancer-lets-not-do-that-with-vaping
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crazygringo
I don't think anyone's ignoring evidence with vaping.

Rather, vaping is (from what we know so far) legitimately a far, far healthier
alternative to smoking cigarettes. The biggest health risk by far isn't the
nicotine, it's the smoke, which vaping doesn't have.

It's been framed as a public health question since the very beginning: do the
population-wide large health benefits of smokers who can't quit then switching
to vaping, outweigh the (as currently understood) much smaller potential
health problems with vaping, but which may be taken up by many people who
otherwise wouldn't smoke at all? It's a balance of harms.

What I've heard about Juul addiction among college-age kids sounds a little
scary. (But then in my generation it was scary binge drinking, and that's
fallen significantly over the past 10 years.)

But at the same time, I've seen friends finally be able to give up smoking for
vaping, which can only be a good thing given what we know right now.

~~~
tantalor
Vaping causes nicotine addiction which has the secondary risk using of tobacco
products later in life. In other words ecigs is a gateway to smoking.

 _Youth Who Use Vaping Products Are More Likely to Smoke Cigarettes, Increase
Use of Both Over Time_

[https://www.rand.org/news/press/2018/10/02.html](https://www.rand.org/news/press/2018/10/02.html)

~~~
treebeard901
The real long term danger here might be to get an entire generation hooked on
vaping as a safer alternative, then remove vape devices from the market.
That's a whole lot of potential new customers (nicotine addicts) for
traditional cigarette companies.

~~~
solarkraft
In what world would vaping devices not be sold, but cigarettes?

~~~
treebeard901
Recent comments about regulation lead me to believe it is possible. The
government has already pushed to remove Juul from gas stations while leaving
cigarettes. Maybe it is far fetched to say this approach could be expanded but
I’m not so sure anymore.

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lbj
It doesn't seem like the effects, good/bad are being ignored. A little over a
year ago, the british ministry of health conducted a very large study which
concluded that vaping is not health, but its approximately 95% less harmful
than cigarettes.

~~~
NeedMoreTea
It's most telling that the two writing this piece are from the US. British
medical opinion, and previous Guardian pieces, seem to boil down to it's good
as it's not tobacco and that vaping is far more successful at getting people
to quit whilst dramatically less harmful.

The "common knowledge" around vaping is dramatically different on each side of
the Atlantic

~~~
seanmcdirmid
The British have skin in the game via the NHS. In the USA, adverse health
affects due to smoking are masked via higher insurance premiums while states
reap sin taxes; in the UK reduced smoking is a public cost savings measure. It
makes sense that the views would differ due to different self interests.

~~~
NeedMoreTea
Good point, hadn't looked at it quite like that. Does the surgeon general
still put out scary warnings?

It's fair to say vaping has had huge and surprising impact on smoking in the
UK, it's now become _really_ rare to see a smoker. It's now an occasional
surprise when you catch a whiff of tobacco in the street.

It helped that cigarettes have been progressively taxed to nearly unaffordable
(not sure, but I think a pack of 20 is now comfortably over £10). At the same
time tobacco has been hidden in ugly packaging and no visibility is allowed in
stores.

~~~
madaxe_again
Yeah, a 20 pack is now well over a tenner. It’s great. I do not smoke at all
in the uk now, where I currently predominantly live, as the cost is just nuts.
£4000 a year or so if you’re on a pack a day, which is where most active
smokers sit. I now vape, spend about £200 a year on it.

I will confess that I do still smoke if I find myself in a country where
vaping is illegal and the cigarettes are 50p a pack, as I am still a nicotine
addict, but I would much rather vape. Cigarettes make my lungs hurt. Vaping
doesn’t.

So, unless it turns out that vaping is somehow worse than smoking, this is a
resounding public health policy success. My behaviour and the scarcity of
smoking you note underscores this.

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jarym
I spoke to a number of researchers several years ago before vaping really
became so mainstream.

To be honest a number had a rather surprising view: if it has nicotine in it
then it must be bad.

I formed my own opinion back then: the researchers did not seem that
inretested in the effects of vaping and preferred to instead just associate it
with cigarettes.

This article talks about us not knowing the long term effects (which is true)
but then goes on to regulating vaping. Why not advocate for more research
instead?

I don’t think vaping is without side effects but it’s my personal view and I
have no scientific basis for it. But we should be doing more research before
we clamp down on it.

~~~
JauntTrooper
Nicotine itself _is_ bad.

Yes, it's probably much better for you to not inhale hot smoke particles in
your lungs and all the other ancillary chemicals from cigarettes, but if
vaping is undermining decades of hard-fought progress against the single
largest preventable cause of death globally (responsible for ~30% of cancer
deaths) by bringing in new smokers and reducing the urgency to quit among
current smokers I can see how public health officials would be cautious about
embracing it.

~~~
bufferout
Addiction aside (looking at you too caffeine)... how is nicotine bad exactly?

~~~
JauntTrooper
Nicotine itself promotes tumor growth and metastasis. It increases your risk
of getting cancer.

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epmaybe
I think we are going to have much better evidence on e-cigarettes, and by
association, vaping, soon. NIH recently established and started producing a
standardized nicotine and placebo e-cigarette for researchers to use. A big
barrier to studying health effects was not being able to compare studies.

[https://www.drugabuse.gov/funding/supplemental-
information-n...](https://www.drugabuse.gov/funding/supplemental-information-
nida-e-cig)

------
qwerty456127
People should just learn these 2 simple facts and stop focusing on just one of
the pair: 1. vaping is not healthy. 2. vaping is much healthier than smoking
(as long as you use a liquid that doesn't contain nasty chemicals that cause
popcorn lung syndrome, e.g. diacetyl).

Whoever smokes and doesn't consider quitting as an option should try switching
to vaping, whoever vapes should consider quitting as whoever smokes should,
whoever doesn't smoke and doesn't vape should better avoid starting either.

~~~
haxus_the_great
> use a liquid that doesn't contain nasty chemicals that cause popcorn lung
> syndrome, e.g. diacetyl

The levels of diacetyl found in (certain) vape liquids are probably not a
concern. Cigarette smoke contains much higher concentrations of diacetyl and
popcorn lung doesn't appear to be endemic in smokers.

Indeed most of the cases in medical literature seem to involve factory workers
who were exposed to high amounts of diacetyl, plus a handful of people who
consumed massive amounts of microwave popcorn. Are there _any_ observed cases
of popcorn lung in smokers?

~~~
qwerty456127
Interesting. Thanks. Perhaps the idea of particular vaping liquids causing
popcorn lung is a myth too. Here's an article I've found that includes some
references to research: [https://www.snopes.com/fact-check/vaping-causes-
popcorn-lung...](https://www.snopes.com/fact-check/vaping-causes-popcorn-
lung/)

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seibelj
I’m not a scientist but I simply can’t imagine that vaping a full JUUL
cartridge and smoking a pack of cigarettes is even remotely the same.

~~~
pmlnr
Does the factor matter, if both are unhealthy enough to be a problem?

~~~
JamesBarney
Yes, it matters because the government has an interest in improving the public
health. When you reduce access to vaping that decreases the number of vapers
and increases the number of smokers. So the relative risks of each are
important in deciding how much you want to promote/restrict access to vaping.

If vaping is just as bad as cigarettes than you probably want to make vaping
really expensive and hard to get. If it's completely risk free you'd want to
subsidize vaping and make sure it's available at every store. The best
evidence looks like it's 5%-10% as deadly as smoking which means we probably
don't want to restrict it too much.

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code_duck
Inhaling nicotine is very harmful to your heart. Repeated doses of a stimulant
can cause heart disease, and about as many smokers die from that as lung
disease. With vaping, even more nicotine is delivered immediately to the
system. It seems that this would have the same negative consequences on
cardiac and vascular health. Why is that not more often discussed? It seems
like this risk alone is enough to declare vaping to be unsafe.

~~~
JamesBarney
Because most of the cardiovascular risks of smoking aren't related to
nicotine.

~~~
Alex3917
How do the CO risks compare with the nicotine risks? Because nicotine on its
own does raise your blood pressure substantially.

~~~
JamesBarney
This article argues that nicotine barely increases blood pressure, and
nicotine replacement therapy is therefore safe in hypertensive individuals.

[https://onlinelibrary.wiley.com/doi/full/10.1111/j.1524-6175...](https://onlinelibrary.wiley.com/doi/full/10.1111/j.1524-6175.2001.00483.x)

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matchagaucho
I vaped for 6+ months as a "nootropics" stimulant to augment caffeine intake.

Could I code/work one more hour per day? Yes, usually.

But the trade-offs were insomnia, irritability, and anxiety.

It wasn't until I quit cold turkey that the effects of nicotine withdrawal
really kicked in. I felt like crap for days.

Sure, e-Cigarettes are a _far_ better alternative than their counterpart. But
the addictive quality, and recurring financial investment are very real.

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siedes
I feel that the culture that builds up around things like vaping, marijauna,
etc. are far more overreaching than the health effects itself on the
individual. Because a culture has built up around it, easily influenced
people, especially those who are younger, willingly take part in something
that can/will worsen their health just because it is trending and 'everyone
else' is doing it and it's 'safe'. Yes, marijuana and vaping are not as bad as
cigarettes and other things. But I find using that as a justification is
concerning since they can still bad right? Weed may have not ever killed
anyone, but have you seen stoner culture? Let's say marijuana itself doesn't
make you dumber or lazy, but stoner culture certainly will.

You can justify anything if you have something worse to compare it to. Now
it's weed or vaping, in the future it may be something else.

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nazgulnarsil
Reminder that mainstream media pieces and non profits against vaping are being
funded by tobacco companies.

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exogeny
In my opinion, way too many people bend over backwards to defend the rise of
vaping through the lens of "better than cigarettes" equating to "healthy".

My view - just like my view with marijuana - we need to do a better job of
quantifying the negative impacts of addiction. It is fundamentally a bad thing
for your body to be addicted to something, and we normalize that view by
engaging in whataboutism; oh, it's just coffee, it's just sugar, it's better
than cigarettes and on and on.

There hasn't been enough research on it, it's certainly more opaque for
consumers to really know where the ingredients are being sourced and how much
nicotine they're actually receiving. These are all bad things, even if it's
"better" than combustibles.

That's of course in addition to the extreme shittiness of these companies
blatantly advertising to kids, but that's another argument altogether.

~~~
tekromancr
What blatant advertising to kids, tho? The only time I ever see vape ads, it's
in store promos for Juul and the only copy is along the lines of "Satisfying
alternative for adult smokers"

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guilhas
Also GMO, 5G, advert effects of vaccination, misprescribing and
overprescribing of drugs, bad diets, lack of exercise... lets not ignore.

