Comment by guylhem | Hacker News Reader

Comment by guylhem | Hacker News Reader

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"Local governments are already taking steps to limit e-smoking in places where traditional smoking is banned"

For no health reason, but for governments to demonstrate their power and how they are doing something - a bit like the pre-flight security theater.

The fact that we have a technological replacement better than the original (ie no tars or carcinogens) while giving the sample pleasure (nicotine, inhaling) should be ground enough to change the laws in the other direction - ie allowing e-cigarattes wherever they are possible..

But this is not about logic. The new habitus sees tobacco as low class and bad http://www.powercube.net/other-forms-of-power/bourdieu-and-h...

Why I am not surprised the government will fight against it, regardless of the scientific facts or the right to pursue happiness?

EDIT: From the original article "The FDA has said that it plans to assert regulatory authority over electronic cigarettes" - just like every government agency looking for a piece of the cake, while consumers will suffer.

There is another good article on e-cigarettes on http://www.economist.com/news/leaders/21573986-world-should-...

"Smoking tobacco is the most dangerous voluntary activity in the world. More than 5m people die every year of the consequences. That is one death in ten."

Want to save human lives? Don't regulate e-cigarettes- in fact, it might be a better idea to GIVE THEM AWAY in poor countries instead of spending the same amount to procure them with expansive drugs that may help at best a hundred people per year (cancer drugs are expansive, and except in specific cases their efficiency is limited. we still have a lot to learn).

Since people will consume tobacco products anyway, we might as well give them the good stuff that won't give them cancer, our last technology - that's e-cigarettes, instead of exporting the old foul smelling plant.

We are talking about the potential to save 5'000'000 humans every year.

It should be about helping people, not just subsidizing the agricultural industry or making feel good but ultimately counter-productive actions.

But reason won't prevail. It will be a sad thing to watch.

EDIT2: I originally said "it is about", which is an incorrect formulation since it could be interpreted as a statement on how current systems work. It was ironic, and may not have been very clear.

The FDA should most definitely regulate e-cigs in some way. If not the vaporizers, then certainly the fluid. At the very least, I would want my country's regulatory body (Canadian here) to at least enforce labeling and quality standards (if you claim your fluid is 95% propylene glycol, and 5% nicotine concentrate, then you better be selling that). As a customer, I do not have the expertise, equipment, nor funding to do this testing myself, just as I do not have the expertise, equipment, nor funding to determine if ibuprofen actually has the stated amount of active ingredient, that my free range chicken actually is free range chicken, that my nicotine patches contain nicotine, etc.

I believe he means the FDA will impose restrictions that will reduce the use of e-cigarettes. Not precisely what "regulate" means, but a common connotation.

Is there any indication that the FDA will actually do this?

There are already FDA regulations which severely restrict their advertising, FTA:

"The companies are not allowed to market them as smoking cessation devices because that would put them in the category of other nicotine replacement products that are regulated by the FDA, such as nicotine gum or patches," Felberbaum says.

Certianly this slows down their adoption. This is his point: FDA restricting something harmful without regard for harm reduction. This kills people, in the net.

I think you are quite confused about the issue. This is not a restriction imposed by the FDA, this is a restriction manufacturers impose on themselves. There would be no problem marketing those cigarettes as smoking cessation devices, they would then just fall under the same rules as other such devices (nicotine patches, gum) and manufacturers don’t want that.

That’s the issue. Surely, if those cigarettes are marketed as smoking cessation devices they should have to follow the same rules as other such devices have to follow.

As to why those devices are more tightly regulated? Well, duh. They claim to have a medical effect. If you want to claim that you better, well …

This seemed perfectly clear from this passage in the article. You seem to be quite confused about it.

There would be no problem marketing those cigarettes as smoking cessation devices, they would then just fall under the same rules as other such devices (nicotine patches, gum) and manufacturers don’t want that.

If they are being deterred, then maybe the FDA regulation is too burdensome.

Well, that’s a nice get-out-of-jail-free card for those manufacturers, isn’t it?

I’m sorry, but if you want to claim that something is a smoking cessation device you better back it up with solid evidence. If you don’t want to, you can still sell it, but don’t claim it’s something you didn’t prove it is.

That isn't really a "maybe"; it's almost a certainty.

All reputable manufacturers provide GC/MS data for their e-liquids. The best own their own analytical laboratories and provide test data for every manufactured batch. I double-dog-dare you to find any industry with higher standards of transparency and integrity.

Any industry in which testing is done by independant laboratories is better by nature.

Minor nitpick: I'm pretty sure that ratio would kill you immediately. You would inhale, and then spontaneously die.

Which kind of supplements your point. Really nicotine is pretty scary stuff if it's isolated.

E-cigarettes are nicotine delivery devices and nicotine promotes cancer growth. And yes there is secondary inhalation with e-cigarettes. You probably would not call it secondary smoke, but whatever is being vaporized by the e-cigarette gets exhaled by the user and then inhaled by other non-users in the area. I worked closely with an e-cigarette smoker once and I could definitely feel it.

E-cigarette proponents say that because e-cigarettes do not burn anything, they are safer than cigarettes. That is probably true, but safer does not mean safe. They are definitely not safe as the main substance they are intended to deliver -- nicotine -- is itself unsafe.

So until there are studies that show that there is no danger to others in the environment all smoking bans should apply to e-cigarettes.

Nicotine is, itself, pretty damned safe. There is currently no epidemiological evidence to support a direct link between nicotine and cancer. There are reasons to believe it can plausibly cause cancer from animal models, but there's no good reason to think that it is more carcinogenic than a boatload of other things.

The main reason that nicotine "feels" significantly likely to cause cancer is its association with tobacco. But there's already a perfectly adequate explanation for the carcinogenicity of tobacco. So it's important to resist the affect heuristic[0] which makes us tend to find all things associated with tobacco "cancery".

In addition, it's extremely doubtful that you'd get any nicotine second-hand from someone using an e-cigarette.

[0] http://lesswrong.com/lw/lg/the_affect_heuristic/

Nicotine is not a carcinogen, i.e. nicotine does not promote cancer growth. The carcinogen in cigarettes is the "tar", which is absent from E-cigarettes.

From https://en.wikipedia.org/wiki/Nicotine#Toxicology

Indirectly, nicotine increases cholinergic signalling (and adrenergic signalling in the case of colon cancer[77]), thereby impeding apoptosis (programmed cell death), promoting tumor growth, and activating growth factors and cellular mitogenic factors such as 5-LOX, and EGF. Nicotine also promotes cancer growth by stimulating angiogenesis and neovascularization.[78][79] In one study, nicotine administered to mice with tumors caused increases in tumor size (twofold increase), metastasis (nine-fold increase), and tumor recurrence (threefold increase).[80]

It may not cause cancer directly, but it does sound pretty toxic and does help cancer growth. There might be a "safe" upper limit at which inhaling secondary smoke from e-cigarettes would have an insignificant impact, but we need more studios.

You would probably take in more nicotine from eating a meal of eggplant than you would get from secondhand vapor. You wouldn't get enough from secondhand vapor to have psychoactive effects, let alone come anywhere near toxicity. Here is some reference to an indoor air quality showing vaping to not harm other people: www.ivaqs.com

Here is reference to a study showing that nicotine did not promote lung cancer growth: http://www.aacr.org/home/public--media/aacr-in-the-news.aspx...

All sorts of things we take in can "promote cancer growth". Nicotine by itself is so far from a carcinogen that IARC doesn't even investigate it as one. There are roughly 50 components of tobacco and tobacco smoke called the "Hoffman analytes" which are the carcinogens. There are studies showing the relative cardiovascular and cancer risk, and the worst carcinogens are produced by burning plant material. These are not present in ecigs.

Some studies which are dubious because of the choice of equipment and researchers not simulating the way ecigs are actually used have shown a handful of components way down the list of dangerous ingredients. Other studies have been done where these didn't even show up, but we are talking about things like formaldehyde and acetaldehyde near the level put out by smoking. If you compare the cancer risk of these to smoking, you are still looking at less than 5% of the cancer risk of smoking (probably under 1% really).

You'll be hard pressed to find anything stimulatory/anabolic that does not stimulate already existing cancers. The simplest example, protein consumption can also promote cancer growth (I can find a ref if pressed, I'm just lazy right now).

On the other hand, this study found that a high protein, low carb diet can reduce cancer growth in mice[1]. This is not to say that what you said is inaccurate. I just see your comment and the first thing I think is "uh oh, can I still eat paleo?"

Given that anabolism can promote tumor growth, do weightlifters tend to have more intense bouts of cancer?

[1] http://cancerres.aacrjournals.org/content/71/13/4484.full

Remember that a high protein low carb diet is significantly different from a normal high carb high protein diet.

As to the second point the best answer I can give you is maybe. Unfortunately different cancers have completely different mechanisms, while high protein may be bad for mammary cancers it might be good for bone cancers. So it's really situational.

So what you're telling me is I can't have complete knowledge or control over my life? How am I going to live forever, then??

Edit: but seriously, thanks for the response. I think a lot of people are torn by trying to make basic decisions like this, and making sense of conflicting findings is pretty frustrating. Seems like a lot of carbs is bad, though, so I'm going to go with that.

More importantly avoid fats :)

Interested in a ref.

[1] Effect of Casein, Lactalbumin, and Ovalbumin on 3-Methylcholanthrene-Induced Mammary Carcinoma in Rats. doi: 10.1093/jnci/33.2.243

[2] Effects of Varying the Proportion of Protein in the Diet. http://cancerres.aacrjournals.org/content/9/3/162.short

[3]The combined effects of dietary protein and fat on 7,12-dimethylbenz(a)anthracene-induced breast cancer in rats. http://jn.nutrition.org/content/114/7/1213.long

Thanks!

If you consider e-cigs a harm reduction device, the carcinogenic potential of standalone nicotine dwarves that of traditional cigarettes.

More research is needed but all the evidence so far points to e-cigs being safer than cigarettes for those who can not kick the habit. But the passive smoking impact is a very valid point and needs to be studied.

Clearstream "Passive Vaping" study: http://clearstream.flavourart.it/site/wp-content/uploads/201...

It shows that the amount of passive vapor is extremely low. Though it should be mentioned that it was commissioned by flavourart, a major eliquid producer.

Surely nicotine is a drug and within the purview of the FDA to regulate.

Regulate purity and accuracy of labeling. Then their job is (or should be) done.

Not quite. E-smokers are drugging everyone near them. I'm not OK with that.

Smoke is definitely worse, don't get me wrong. But it should be illegal for a 3rd party to force someone to take a drug.

Your deodorant is "drugging" me significantly more. Same for your car. If you use neither then something else you use is forcing more chemicals into my body than second hand e-smoke would.

Car yes, deodorant no. Not all chemicals are created equally, and it doesn't help anyone to make unfair comparisons.

I do sympathise with the smokers here, who see e-cigarettes as a compromise, but ultimately it's a compromise that non-smokers shouldn't have to make, because like everyone should have the right to do to their own body what they want, they also don't have the right to passively drug someone else and impose your own choices on other people. That's not okay.

My comment was a response to "But it should be illegal for a 3rd party to force someone to take a drug." So my claim stands even if deodorant is less harmful in tiny amounts than vapor in tiny amounts.

However, if you were wondering, it has not been proven that tiny amounts of vapor are more dangerous than tiny amounts of deodorant. In fact it seems likely that both have negligible effects on health.

So you're equating somebody expelling water vapour laced with minute quantities nicotine with the phrases "drugging everyone near them" and "force someone to take a drug"? Way to ratchet up the rhetoric. Using such emotive and inflammatory language isn't going to get the discussion anywhere.

Source? I don't believe this one bit. You'd have to be french kissing a smoker for it to have any effect.

I'm not sure that's true. You can buy caffeine pill over the counter. Energy drinks surely have nothing to do with food and everything to do with delivering caffeine and other stimulants. You can put vodka in a vaporizer and get stupid drunk in seconds. In these cases you have to ask if it crosses the line into being a drug that can be regulated.

E-cig makers, at least, can argue that e-cigs are a form of harm reduction. Maybe energy drinks, too, if they keep you from falling asleep at the wheel, but that's more tenuous.

I very much enjoy the trend of "tobacco as low class and bad". I can finally go places without inhaling crap and washing my smoked hair and clothes afterwards.

>it's about helping people, not about feeling good about our own actions.

sure, ideally. In reality going by the metric of dollars spent -> outcomes it is far and away about feeling good.

You are correct. While proofreading I realized my irony might cause confusion, so I edited it away. My apologies, I upvoted you since you present a solution.

There are many things in the health system I find highly illogical, and sometimes I use irony instead of simply presenting the case and possible solutions.

There are in fact various metrics to which programs should be judged against; while they differ by country trying to save the as much years of life at the lowest possible cost is usually well accepted.

It is changing due to the wider dissemination of information, but it is a slow process uprooting entrenched organizations that serve as jobs programs more than accomplishing their stated goals.

Reliable statistics on the lung cancer danger of smoking have always been difficult to find ... particularly for second-hand smoke ... possibly because it's easier to blame cigs than to find real numbers for the hundreds of carcinogens we're all regularly exposed to, all day long, wherever. Society must have its scapegoats, and smokers are a (relatively powerless) minority.

The lung cancer statistics I've seen usually for cig-smoking fall around 3 per 100,000 for second-hand smoke and about 50 per 100,000 for a half-pack-a-day smoker. Considering what's in E-cigs, the risks are, at worst, a very tiny fraction of these numbers.

So yes, for E-cigs, "For no health reason, but for governments to demonstrate their power and how they are doing something" is a very likely explanation. But consider the insane response to global warming, and what more should we expect?

Surely it should be regulated. What if somebody's e-cig juice formulation consisted of asbestos and ebola? The idea that e-cigs must be safe because they are not tobacco is far more hysterical about the possible dangers of smoking than the idea that the FDA should be regulating them. I want the FDA to regulate mascara, too, which is also not tobacco.

If a manufacturer wants to put "asbestos and ebola" into an e-liquid, how exactly is a regulation going to stop them?

Is it a regulation that stops the restaurant down the street putting asbestos and ebola into my morning coffee and muffin?

Yes, through testing, followed by inspections, followed by endorsements or shutdowns as needed. Also, since the sequester, I wouldn't trust that they aren't putting asbestos into your muffin.

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