The important question isn't "were vapers more likely to smoke 1+ times"--it's "how many cigarettes (from 0 to n) would the average vaper have smoked in the absence of vape options?"
The latter is a counterfactual, and thus much harder to study. It's almost as if valuable research is hard, and you can't just slap together a few variables and toss the "Science!" label on it.
Edit for context: I'm an ex 1-2 packs-a-day smoker, and vaping definitely helped me substitute a less harmful behavior. I smoke 5-30 cigarettes per year still, and vape about the same number of times per year. Having substitute options definitely helps avoid slipping back into cycles of addiction, to the point where I don't worry about that at all now.
I've known vapers that would pick up a pack for the blizzard when they expect to get snowed in for days on end. Some of them quit vaping (and smoking) by the end of digging themselves out.
Ive known vape shop owners who were regular daily cigarette smokers in between vaping 0 nic. That's the most damaging thing possible - give that sticky tar glycerin to attach to in new ways. Give that glycerin new ways to get stuck in tar. And layer it up!
I may not like it, but I respect Britain's cutoff for tobacco leaf products. If you were born 2000 or later, you will only ever get to buy vapes. Not cigars, not cigarettes, not hookah nor dojah. They're banned from you.
Where the US is close to banning the cleaner nicotine option (salt nic vapes aside), Britain chose to ban the stuff that seriously clogs lungs.
Wait, what? I Googled pretty extensively and it appears that was just a vote between doctors with no legal binding. Did it actually become law?
4.78 RR for smoking one year after vaping for non-smokers is pretty huge. That’s definitely a clinically significant result. Smoking itself is the highest OR for lung cancer and therefore mortality of any behavior (in the 60s for Americans), and using cigarettes really dooms you to that outcome.
Nicotine patches, as transdermal delivery, don’t get people as high as Juul does, and that’s the likely reason you don’t observe either recreational use of them nor people becoming smokers from using them.
> These results contribute to the growing body of evidence supporting vaping as a one-way bridge to cigarette smoking among youth.
If you want to get advice on smoking cessation, ask a doctor. There have been no clinical trials for Juul or any e-cigarette product. No doctor following the letter of what they're supposed to be doing is going to recommend an e-cigarette product to a person seeking smoking cessation.
The strikingly low bar thing... People here defend Juul like people defended Theranos. Nobody wants to accept that the Juul guys are liars. Not yet anyway.
If e-cigarette companies had a study, much like Theranos, they'd publish it. They'd compare it to nicotine patches. They just don't. There's no secret, it's really just an agglomeration of personal experiences and unfortunate but real stories quitting addiction masquerading as a positive public health development.
This study shows pretty unequivocally that vaping can't possibly just substitute for cigarette smoking. If it did, we'd observe zero cigarette smokers in the vaping-only population. Correlation versus causation, whatever logic puzzles commenters invoke, it just distracts from both the evidence presented here and the total lack of a rigorous trial from e-cigarette sellers.
Rubbish. Just 10 seconds on PubMed found me this:
Rahman et al. E-cigarettes and smoking cessation: evidence from a systematic review and meta-analysis. PLoS One. 2015. https://www.ncbi.nlm.nih.gov/pubmed/25822251
"Six studies were included involving 7,551 participants. … Use of e-cigarettes is associated with smoking cessation and reduction."
> No doctor following the letter of what they're supposed to be doing is going to recommend an e-cigarette product to a person seeking smoking cessation.
Also rubbish. Even if there were no studies, absence of data of effect is different from data of absence of effect. There are good reasons to believe (even pre-hoc) that vaping is safer than cigarettes.
As a student doctor and I would happily council a patient to consider vaping instead of smoking as a harm minimisation intervention.
Will this do? "In a nutshell, best estimates show e-cigarettes are 95% less harmful to your health than normal cigarettes, and when supported by a smoking cessation service, help most smokers to quit tobacco altogether."
From the extensive Public Health England study: https://www.gov.uk/government/news/e-cigarettes-around-95-le...
E-cigarettes are now available on prescription in the UK as one of the smoking cessation aids available to doctors.
No idea about Juul, they're not in the UK yet.
What an absolutely insane claim.
As for people you suspect being uninformed and defending a fraudulent business, all I can see people who actually quit smoking saying they did it through vaping. We don't know if they are just unique rare cases but, on the other hand, you rarely see people claiming this with patches and gum. Most mentions of these in relation to quitting smoking I've seen were "I tried patches/gum, they did not work". I am lazy to look up research but from what I remember, patches and gum are amazingly inefficient in any prolonged smoking cessation. So pushing patches might appear more similar to shilling for Theranos than you might have suspected.
Even the CDC uses that kind of hysterical, unscientific language to describe the risks of secondhand smoke: "There is no risk-free level of secondhand smoke exposure."  That's a religious claim, not a scientific one.
Why not just ban real cigarettes? Wouldn't that solve all the problems?
Oh yes... black markets, prohibition, arrests, expanding prison population, and on and on...
If we aren't going to throw cigarette smokers in jail, and e-cigarettes are already illegal for those under-18, then I'm not sure what else we can do. The state could aggressively fine retail stores who sell to those underage (although I doubt they sell them illegally). More likely, arrest 18 year old high school kids who buy them for their friends and underclassmen.
Alcohol and cigarettes were bought for me by the burnout and local junior college kids when I was in high school.
The conclusion in the article suggests "restricting youth access to e-cigarettes." It's not talking about a general ban.
> e-cigarettes are already illegal for those under-18,
In the US, individual states have varying laws, and the FDA position has been evolving. Research like this presumably provides input to that ongoing process.
> Why not just ban real cigarettes?
They are already restricted at the federal level for under 18.
> Alcohol and cigarettes were bought for me by the burnout and local junior college kids when I was in high school.
The problem with personal anecdotes like this is that they give no idea of how many kids actually didn't do alcohol or cigarettes, or consumed less than they would have otherwise, because of restrictions.
Your unstated premise seems to be that restrictions like this don't work. If you look into that, you'll find that's incorrect.
Of the ones who only vape, most of them will still smoke the occasional dart. They'll smoke them if they can't use their e-cigarette (e.g. out of fluid, left it at home), because they're still addicted to nicotine they'll take what they can get.
There's also the social aspect of smoking cigarettes. I don't know why, but standing in a circle puffing on e-cigarettes just isn't as social as smoking a real cigarette, so if everyone else is smoking cigarettes the vapers will usually have a smoke too.
Why shouldn't those quitting smoking be allowed fruit flavours? I can only think you want them to fail and end up keeping on smoking tobacco.
Now one might say 'who in their right mind would want to start a nicotine habit?' Well centuries of tobacco use to more recent times with people eating detergent pods, huffing glue etc should readily provide the answer. Also, the tobacco industry knows what they're doing and I suspect it's not about getting people off nicotine but rather changing the delivery mechanism. (You do know big tobacco is big into vaping, right?)
I would be comfortable with discouraging kids as far as possible, requiring ID and so on. For some of the adult ex smokers I know, including myself, I doubt they'd have quit without vaping with some of the sillier sounding flavours. Some of the quitters will be kids who regret starting smoking 5 years previously. I don't have good answers to balance the conflicting needs or to prevent it becoming a growth sector far beyond smokers wanting out.
When I first tried vaping one of the few flavours I got was tobacco - which was awful, and never tried again. It took some months to step down the strengths to zero, and kept on vaping a while at 0 nicotine. That was 7 or 8 years ago, and no vaping or tobacco since.
Regulation in the US and UK is very different for vaping, but here big tobacco seems to be badly failing at vaping. Every shop that sells cigarettes now has a selection of the tobacco company's cartridge style "pretend cigarettes" vaping at five or ten times the cost of the simple juice bottles. I've only ever seen one person using one. Most towns have gained a juice stall selling cheap flavours.
I mean, it we remove all the bad part of being addicted to nicotine, why is it still bad to be addicted to nicotine?
It's like the experiment of a room with monkeys, ladder, banana and water hose.
By the way, there's nothing preventing one to use nicotine-free fruity vaping liquid.
I personally chose the fruit flavors when I was quitting cigarettes so I could distance myself from the flavor of tobacco, and it worked well for me. I cannot even finish a real cigarette now without feeling nauseated (even though I always seem to try after a few beers). I'm thankful for those fruity flavors every day.
If the quitting tool is less appealing, then it makes people more reluctant to quit. That's just simple logic.
I don't get why this isn't obvious.
> and start being addicted to nicotine as well?
Then they'll be addicted to nicotine. And?
You're dropping that like it's some sort of trump card, but the reality this is about harm reduction, and trying to find a policy that will lead to optimal outcomes. If you can get X smokers to switch to vaping while Y non-smokers also start vaping, is that good? Depends on the harm of smoking, the harm of vaping, and the size of X relative to Y. Just yelling that Y is non-zero number without all the other information we need is just pointless noise.
If "...and then they'll be addicted!" was a compelling argument, we'd be banning Starbucks.
If group X is larger and/or the harm avoided from their switching to less harmful behaviours is more serious, then a simple utilitarian calculation says yes, it is more valuable.
What data I've seen is still tentative, but suggestive that this is the case.
Do you have data to show the opposite?
However, in most cases e-cigarettes deliver only nicotine, while tobacco also also contains harmala alkaloid monoamine oxidase inhibitors. In animal studies these have a synergistic effect in producing addiction when combined with nicotine, and anecdotally many humans report whole tobacco alkaloids having a subjectively different effect than pure nicotine.
No one’s following these kids around to verify their responses are accurate. A sizable percentage of high school kids lie about anything for any number of reasons. Yeah man, I vape, can I go now? Yeah man, I smoke, are we done?
That alone is plenty to throw out this data. The agenda here is clear: more research funding to justify harebrained regulations supported by halfassed written surveys.
“It’s dark in that alley. I’d never find my keys there.”
Doesn’t matter if it’s extremely difficult to get good data here. What matters is we can’t substitute bad data if that’s all we can come up with.
And although I stated it as smokers lying, the implication is that the nonsmokers are lying (by claiming to smoke).
On the other hand, I know several people who are successful professionals that vape. They order their stuff online, and don't advertise the fact that they vape.
If I am mistaken or unaware of any contradictory information, I would really appreciate being pointed in the right direction.