The Strange and Complicated Future of the E-Cigarette Industry
pointsadhsblog.wordpress.com
pointsadhsblog.wordpress.com
i.e. sunlight is the best disinfectant, PR feedback loop, etc, etc...
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.
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-pays, 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...
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.
Some shady Chinese pharma lab will create an analogue that is x times more potent, and the drop shipping "legal high" e-commerce sites will start carrying it.
If anything, this will cause more deaths than prevent them.
I figured it was all part of the "designer drug" problems that started with bath salts.
But honestly, what do I know? All these retarded products remind me of the days when kids would cut class in middle school and smoke Lipton's tea in rolled up pages from a looseleaf notebook. (get off my lawn!)
[0] https://en.wikipedia.org/wiki/Synthetic_cannabinoidsit is habit-forming. to an addict it can stop withdrawals in it's tracks, to an opiate naive person it can provide a buzz, nothing extreme and the subsequent withdrawals are also nothing too terrible.
to an opiate addict it is, frankly, a life saver. this is something with the potential to free a person of an opiate addiction, provided they want to be free badly enough.
it's quite easy to use kratom to replace your drug of choice, not for getting high, it'd be pointless. you simply use the kratom to keep the withdrawals at bay. then, simply get off the kratom after a few weeks of use. you do this because kratom withdrawal is more forgiving than something like heroin.
this is impossible with methadone and suboxone. once you go on methadone, you better plan on never getting off. the withdrawals can quite literally last months.
people have successfully transitioned from methadone/suboxone to kratom and then quit use of opiates altogether, being free from the prison of withdrawal in a week instead of months.
this ban will only serve to worsen the structure fire that is the opiate epidemic.
https://en.wikipedia.org/wiki/Single_Convention_on_Narcotic_...
Also makes me wonder if the politicians that are heavily in favor of methadone programs are useful idiots for big pharma, or in their pocket.
The reason for their opposition is twofold; e-cigarettes appear to act as a gateway drug for people who don't smoke; teenagers in particular. colourful packaging, synthetic fruity flavours; the e-cigarette industry is well aware of this particular demographic.
Secondly, there are concerns about the perceived harmlessness of the vapour exhaled. While certainly not as bad as second-hand smoke, the exhaled vapours are not free of unhealthy (even carcinogenic) substances, the effects of which are not fully known. In many parts of the world smoking is no longer accepted inside public buildings and the work place; a huge victory for public health! Quite rightly there is some fear that e-cigarettes are encroaching upon that domain.
Reminds me of an event in Norway. There anything above 4.5% beer is only sold via vinmonopolet. Note that it says beer, and thus things like cider was vinmonopolet only.
Except that after entering the EEA, various foreign breweries pressed for having anything 4.5% strength sold alongside beer.
The response from the teetotalers was that those "tastier" options would attract kids to drinking.
None of that happened. For the first year or so after ciders and such were allowed alongside beer, there was a small uptick in sales. But then it went back to the very same numbers as the years before.
the most likely explanation is that adults picked up a couple of bottles to check it out, and that was it.
No sudden epidemic of drunk kids in gutters ever materialized.
(I have the same question about fracking too.)
The "mainstream" of ecig liquid makers (and certainly all the DIY folks) have been at the forefront of testing these things for what they produce when heated, atomized, and inhaled. For the most part, all currently accepted flavoring agents produce negligible levels of anything carcinogenic or otherwise toxic as far as I've been able to find.
The traces of potentially harmful compounds that do exist are at levels that are a small fraction of what's found in any combustible cigarette so for ex-smokers, it's the equivalent of getting the active drug (nicotine) while removing 99%+ of the harmful byproducts of smoking as a delivery method. The way I understand things, it's largely the combustion of tobacco and the tars and particulates deposited in your lungs that cause the health detriments associated with smoking. Without that stuff, your health issues are largely limited to your addiction to a mild stimulant drug.
The really nice thing about vaping for cessation is that it allows you to drastically lower your nicotine intake without changing your physical addiction-sating behavior (i.e. you can still chain-vape for hours on end). My method was, a week before my quit date, I started stepping down my mix bottle by half (it was a 30ml bottle, so when it would get about halfway down, I would refill it with PG and no nicotine). I did this 3 or 4 times over the course of the week (I had a powerful mod and nice TC coil/tank so I went through a lot of juice) and when I hit my quit date, I threw everything away. I was surprised that I did not suffer significant physical withdrawal effects (I have quit smoking cigs a couple times before and there's always a lot of anxiety, restlessness, and discomfort for the first couple of days). So if you're a vaper and interested in quitting, I strongly recommend this step-down method.
A few years ago I had a nasty cold - the kind I got way too often and could never seem to shake - and decided I was gonna give it another shot. By that time, the pen-style devices had come out and over the course of a couple weeks, I'd completely switched over. Since then the change has been very noticeable. Haven't had a single real cold or other respiratory issue since then and I mix my own liquid with about 3mg/ml nicotine as opposed to the old 12-18mg/ml stuff I'd started out with.
At this point I could probably wean myself off completely but for the time being I've settled into a habit of occasional use of low level vaporized nicotine in my own liquid so I can control what flavor agents are used. No doubt less healthy than only breathing fresh country air but much better experience than smoking 8-12 cigs a day.
At this point quitting nicotine entirely feels more like quitting coffee due to the habituation and very minor health toll of daily caffeine intake. Either way, thanks for your input. It can be difficult to find discussions online that aren't either vape "boosters" or breathless demonizers whose information is limited to gut feelings or dodgy PSAs.
But why would they care if people take it up, if it's not particularly harmful?
> While certainly not as bad as second-hand smoke …
Since so-called 'second-hand smoke' is essentially harmless (it's less bad than wood smoke!), that means that they are safe enough.
'Second-hand smoke' is junk science propagated purely to advance bigotry.
> In many parts of the world smoking is no longer accepted inside public buildings and the work place; a huge victory for public health!
And, of course, a huge loss for freedom. It's no-one's business but mine if I choose to permit smoking in my spaces: the public are free to avoid them.
They don't care if adults do so; they do care about teenagers getting hooked, because it acts like a habit forming step up to tobacco smoking. This doesn't mean they seek to ban e-cigarettes; merely to limit its sale to adults, just like tobacco in most countries.
> 'Second-hand smoke' is junk science propagated purely to advance bigotry.
I'm surprised to find that sentiment on HN, even most smokers seem to agree that their smoke may harm others and are considerate about it. Ask any asthmatic over the age of 30 if they agree — we've seen the world shift from smoking everywhere to smoking only outside and in your own home. You have no idea how much of a difference that makes to us in our daily lives.
> And, of course, a huge loss for freedom.
Don't be silly. No one is forbidding you to smoke in your own home. Do you really want to go back to the fifties where smoking in the office, public transport, or in public buildings was commonplace? The reason smoking is banned in the workplace is simply because many workers do not have the luxury of simply quitting their job to work for an employer that doesn't allow smoking on the premises. Freedom is about the balance between one person's freedom to do something and another's not to be unduly burdened by it — unless you are an anarchist.
The question is not whether people agree that something may be true; the question is whether it is. As it happens, it's not.
> Do you really want to go back to the fifties where smoking in the office, public transport, or in public buildings was commonplace?
Yes. When I was a boy I remember going to a hospital that had ashtrays next to the elevators. I remember loving it whenever we went (my parents & their friends didn't smoke, and smoking wasn't allowed in my school, so I could only smell tobacco rarely).
> The reason smoking is banned in the workplace is simply because many workers do not have the luxury of simply quitting their job to work for an employer that doesn't allow smoking on the premises.
That line of specious pseudo-reasoning could be used to justify just about anything, to include mandating smoking in places of employment.
> Freedom is about the balance between one person's freedom to do something and another's not to be unduly burdened by it — unless you are an anarchist.
No, freedom is about doing what one will, where one's will holds sway. My will should hold sway where I am the proprietor, to include my place of business.
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.
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.)
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.
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...
2: http://www.nejm.org/doi/full/10.1056/nejmc1413069#t=article
The spice of life is like spice in food.
Can you back that up?
Did they only look at the room as a whole, or also second-hand vapor from inches away?
Because if I'm sitting right near someone at a table who just exhaled a cloud of vapor, I have zero interest in breathing that in. (If I have no [polite] choice I hold my breath till the cloud dissipates, and I'm not pleased at having to do so.)
I'd much rather it either be illegal or there is proof that second-hand vapor inches away from the primary user has no consequences whatsoever.
And I do mean inches - cheek by jowl as they say.
So let's not add to it.
> But I would never dream of trying to regulate either one.
You will most likely feel different if you or your loved ones ever suffer from the effects of second hand smoking.
It doesn't have to be toxic to be rude.
Sure, and the decent thing to do is not to do it.
Can I get the law to enforce my preference regarding body odour? Can some racist get the law to enforce his preferences about the people he'd like to see?
The law shouldn't care about that, and it should care about smoking or vaping.
Chewing tobacco cause mouth and gum cancer.
The 2006 UCLA study on marijuana, the largest of its kind, by an anti-marijuana professor who wanted to prove it's just as bad as tobacco, showed no increase risk of lung cancer.
Remember the effects from tobacco are slow. They take time. We won't know the effects of vaping for another decade at least.
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.
Y'know, the Constitution ain't perfect, but it's better than what we have now.
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.