5 ms·

You've used some jargon here that I don't understand, so I'm probably just missing it, but I don't see where any of this addresses the claim that, "Smoked a cig

You've used some jargon here that I don't understand, so I'm probably just missing it, but I don't see where any of this addresses the claim that, "Smoked a cigarette in the last 12 months" is a strikingly low bar.

doctorpangloss 8y ago
On the one hand, I don't want to condescend. Relative risk and odds ratio are best explained on Wikipedia. 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.
- agency 8y ago
  > 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. What an absolutely insane claim.
- thomasfedb 8y ago
  > There have been no clinical trials for Juul or any e-cigarette product. 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 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.
- NeedMoreTea 8y ago
  > If e-cigarette companies had a study, much like Theranos, they'd publish it 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-less-harmful-than-tobacco-estimates-landmark-review 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.
- pandaman 8y ago
  E-cigarettes companies are in business of selling product, not doing research for once. Another thing you might be missing is that the only reason you can buy vape products with pocket change unlike the "researched" things like patches, gum etc. is that they do not sell them as any kind of medical treatment. If they tried to claim anything to that effect they would have been dealing with FDA and doing whatever expensive procedures FDA demands and their product would be as expensive as patches etc and they would have been out of business since their $100 per 10 ml "researched" juice would not stand a chance against the same compound but not researched and sold at $20/100ml. So, even if they had a study they would not publish it if they had any sense. 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.
- girvo 8y ago
  You do know that both nicotine replacement users and people prescribed Champix, both well studied and proven to work sometimes smoke? Your bar means literally any and all things other than pure abstinence will fail. That’s ridiculous.
  - dionidium 8y ago
    The other side of the abstinence issue is that it's difficult to find good information about the relative risks of different smoking behavior. Nearly all smoking advice and all smoking regulations are based on the notion that literally no amount of exposure is acceptable -- full stop, end of story, do not inquire further. 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." [0] That's a religious claim, not a scientific one. [0] https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm https://www.cdc.gov/tobacco/data_statistics/fact_sheets/seco...

doctorpangloss 8y ago

On the one hand, I don't want to condescend. Relative risk and odds ratio are best explained on Wikipedia. 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.

agency 8y ago
> 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. What an absolutely insane claim.
thomasfedb 8y ago
> There have been no clinical trials for Juul or any e-cigarette product. 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 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.
NeedMoreTea 8y ago
> If e-cigarette companies had a study, much like Theranos, they'd publish it 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-less-harmful-than-tobacco-estimates-landmark-review 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.
pandaman 8y ago
E-cigarettes companies are in business of selling product, not doing research for once. Another thing you might be missing is that the only reason you can buy vape products with pocket change unlike the "researched" things like patches, gum etc. is that they do not sell them as any kind of medical treatment. If they tried to claim anything to that effect they would have been dealing with FDA and doing whatever expensive procedures FDA demands and their product would be as expensive as patches etc and they would have been out of business since their $100 per 10 ml "researched" juice would not stand a chance against the same compound but not researched and sold at $20/100ml. So, even if they had a study they would not publish it if they had any sense. 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.
girvo 8y ago
You do know that both nicotine replacement users and people prescribed Champix, both well studied and proven to work sometimes smoke? Your bar means literally any and all things other than pure abstinence will fail. That’s ridiculous.
- dionidium 8y ago
  The other side of the abstinence issue is that it's difficult to find good information about the relative risks of different smoking behavior. Nearly all smoking advice and all smoking regulations are based on the notion that literally no amount of exposure is acceptable -- full stop, end of story, do not inquire further. 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." [0] That's a religious claim, not a scientific one. [0] https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/general_facts/index.htm https://www.cdc.gov/tobacco/data_statistics/fact_sheets/seco...