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US Surgeon General Declares E-cigarette Epidemic Among Youth [pdf]
- ProAm 8y agoEpidemic seems a little strong...
- happytoexplain 8y agoBecause you feel it's not widespread enough or not damaging enough (or both)?
- RosanaAnaDana 8y agoI think it would be about rates of increase or decrease rather than overall numbers. If it were about overall numbers, well, its pretty clear we've ended a tobacco epidemic over the past 60 years. Not sure if any one else here remembers cigarettes in restaurants, but imagine spelling camels while getting your salad bar refill at Sizzler. We've come a long way.
- snek 8y agoThat doesn't mean we're finished. Pretending this problem is solved will just result in it getting out of hand again.
- RosanaAnaDana 8y agoWhat do you mean by 'finished' and 'solved'? You speak as if there is some sort of societal goal in mind here. You've clearly got an agenda here and I think you should make it clear that you've got a goal in mind here regarding whats 'right' and 'wrong' for other people to do with their time, lives, and money. If people want to smoke, let them smoke. Is it bad for them? Yeah. Does it have a negative cost against society? Yeah. But its a slight cost that I'm willing to bear to uphold personal liberty and freedom of choice. Overall, smoking rates are pretty low, and we're probably on the other side of the overall costs smoking writ-large will have on society. So its fine. If people still want to smoke, warn them of the negatives, then let them smoke.
- snek 8y agoI assume the societal goal is to help young people, whose brains aren't yet able to make sound decisions (https://www.aacap.org/aacap/families_and_youth/facts_for_families/fff-guide/the-teen-brain-behavior-problem-solving-and-decision-making-095.aspx https://www.aacap.org/aacap/families_and_youth/facts_for_fam...) and keep them from doing things which might really hurt them in life like developing nicotine or alcohol dependency. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519837/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4519837/)
- ApolloFortyNine 8y agoThey already require people be over 18, maybe the punishment should be higher on those who are supplying children with them? The reason I'm so against more regulation is that the current trend in the war against ecigs is to ban pretty much any good tasting flavors (all but menthol), and I don't like that what entails for our future. I don't even vape, but the idea that the majority will go around banning what they don't like "for the good of the children" is something I refuse to support. It's not going to stop if it gets started.
- Dirlewanger 8y agoHow about we focus on the fact that today's kids have a shorter life expectancy than their parents due to shitty eating habits? I think that is an epidemic. Never heard anything about that from the Surgeon General though. Can't upset the Big Food apple cart too much.
- RosanaAnaDana 8y agoEspecially when you compare overall tobacco and tobacco derivative consumption across time. Simply put, the overall rate of tobacco and nicotine consumption now is significantly lower than 20 years ago, which was significantly lower than 20 years prior, which was significantly lower than 20 years prior, which was... well you get the idea. https://www.cdc.gov/tobacco/data_statistics/tables/trends/cig_smoking/ https://www.cdc.gov/tobacco/data_statistics/tables/trends/ci...
- Kurtz79 8y agoWell, this was due to the fact that the dangers were recognized when adoption was already widespread and, as you mention, dozens and dozens of years of PSAs, bans and medical consulting were necessary to lower consumption rates. Maybe this time it would make sense to start this process sooner?
- RosanaAnaDana 8y agoI think we largely already have. If something is legal in society, there is always going to be some rate of individuals interested in participating. At some point, if you want the government to nanny over you and make your choices for your, just possessing the substance illegal. Otherwise, warn people of its ills, then let them choose.
- stcredzero 8y agoThe references go way back! (Also applies to your user name. Actually, if I press on that link, I get a blank page.)
- mruts 8y agoE-cigs haven't shown to be harmful in the least bit, in fact, there's a lot of evidence that nicotine is a nootropic with neuro-protective properties. Increases cognitive performance and decreases the likelihood of developing Parkinson's or Alzheimer's. Also while nicotine is addictive, there is some research showing that it is addictive only in the presence of MAOI's (present in normal cigarettes not but E-cigs). EDIT: I'm getting downvoted, and maybe you guys are right, E-cigs haven't been shown to "not be harmful in the least bit." But their risk profile is more akin to eating junk food than tobacco, which is on a whole different level (disclosure: I don't smoke E-cigs, but I do smoke tobacco)
- wc- 8y agoThese are wild claims and we are going to need to see some references.
- mruts 8y agohttps://www.ncbi.nlm.nih.gov/pubmed/11772120 https://www.ncbi.nlm.nih.gov/pubmed/11772120 https://www.ncbi.nlm.nih.gov/pubmed/11230877 https://www.ncbi.nlm.nih.gov/pubmed/11230877 https://www.tampabay.com/news/health/study-finds-nicotine-safe-helps-in-alzheimers-parkinsons/2175396 https://www.tampabay.com/news/health/study-finds-nicotine-sa...
- diminoten 8y agoAlright, so dealer's choice on who you want to believe: * cancer.net? https://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/stopping-tobacco-use-after-cancer-diagnosis/health-risks-e-cigarettes-smokeless-tobacco-and-waterpipes https://www.cancer.net/navigating-cancer-care/prevention-and... * CDC? https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Q... * Harvard? https://www.health.harvard.edu/blog/electronic-cigarettes-good-news-bad-news-2016072510010 https://www.health.harvard.edu/blog/electronic-cigarettes-go... * Stanford? https://med.stanford.edu/content/dam/sm/tobaccopreventiontoolkit/documents/ecigarettes/Risks%20of%20E-Cigarette%20Factsheet.pdf https://med.stanford.edu/content/dam/sm/tobaccopreventiontoo... I think it's pretty far from "harmless".
- snek 8y agoI read an article the other day about how juul modifies the nicotine to make it less painful so they can put more in each pod. An interesting side effect of this is that people who don't smoke can start smoking easier because it's less painful. That information combined with this report just makes me so upset on so many levels...
- wbronitsky 8y agoCan you cite the article? I cannot find any reference to Juul modifying nicotine to make it more palatable.
- bgutierrez 8y agoTo start, this advisory mentions nicotine salts in JUUL pods toward the top of page two.
- g45y45 8y agoJuul uses nicotine salts, where as standard vape juice is just freebase nicotine. The salts are said to be 'milder' or easier to consume. In the US, vape juice comes in 0, 3 and 6mg/mL doses. Juul does not publish nic levels, but its probably closer to 48+mg/mL.
- mcguire 8y agoMost vape liquids I've seen come in 0-24 mg/ml (in 6mg increments, except for 3).
- snek 8y agoApologies, i'm unable to find the article i read before, but googling "nicotine salts" should get you on the right path.
- crushcrashcrush 8y agoCorrect. They have proprietary technology around nicotine salts.
- 8y ago
- tsmarsh 8y agoIs this more serious than the sugar epidemic? Or exposure to traffic pollution? Or reduced freedom to roam? It would seem that there are many social threats to my children, and vaping is maybe in the top 10? Should it be higher?
- deleted 8y ago[deleted]
- neaden 8y agoIt is rising faster than any of those which is concerning. In terms of danger, it's hard to say since we don't know what the long term effects of vaping are going to be, and how many of these teens are going to consume other tobacco products in the future.
- bicubic 8y agoAirborne pollution and sugar are both orders of magnitude worse than vaping could ever be. The authorities certainly seem to pick and choose which battles they fight.
- lotsofpulp 8y agoOne is easy to pin on a small private company, the other would involve targeting other politicians, larger deep pocketed companies, and raising taxes.
- vkou 8y agoOne is easy to pin on a particular category of non-essential products (The world won't stop if non-smokers don't pick up vaping), the other (air pollution) is a communal externality of nearly every single productive activity that our society engages in (Because those activities involve either electricity or transportation, or both.)
- deleted 8y ago[deleted]
- Shivetya 8y agofwiw, vaping is treated the same as tobacco use by most insurance companies with regards to what is provided to employees. I have been amazed at how some who vape think it is acceptable indoors in public places that other tobacco use is not. At work it had to be reminded more than once it was not acceptable outside of designated areas. It simply is an addiction that is easier to partake of and hide than most.
- elhudy 8y agoPeople who vape are under the impression that exhalation only releases water vapor into their immediate surroundings; I've heard this on multiple occasions from smokers. The question then of course becomes, how does it have a scent if it is just water vapor?
- cgag 8y agoI've heard people say this but it's never even been water vapor. It's vegetable glycerin and/or propylene glycol even if there were no other flavorings or nicotine.
- mullingitover 8y agoThe fun part about the e-cigarette epidemic: states have a perverse incentive to keep cigarette smoking rates from dropping too quickly. The Tobacco Master Settlement Agreement gave states an annuity from tobacco profits, and many states took a lump-sum payment instead. That money has already been spent. If cigarette smoking rates (and thus, profits) drop too much, they have to pay back the money. Everything with e-cigarettes was fairly hunky-dory and not an 'epidemic' until 2014, the year teen smoking rates plummeted and e-cigarettes took off. Most of those teen smokers who took up vaping instead of cigarettes will likely never become cigarette smokers. This alters the math on the annuity payments that were already cashed in for up-front money, and thus the states could end up in the red on their bond payments. Thus they have a financial incentive to keep e-cigarettes from fully replacing combustible cigarettes, even if they are a definite harm reduction tool.
- dragonwriter 8y ago> Everything with e-cigarettes was fairly hunky-dory and not an 'epidemic' until 2014, the year teen smoking rates plummeted and e-cigarettes took off. Yes. E-cigarette usage wasn't an epidemic until usage “took off”. That's just the definition of “epidemic”; everything else you try to associate is irrelevant.
- nulagrithom 8y agoThat's not the definition of epidemic. The dictionary definition is: a widespread occurrence of an infectious disease in a community at a particular time. "Infectious disease" being the key. If we limit the definition to "took off" then any new and popular software becomes an epidemic. It's naive to assume that something like this couldn't possibly be politicized simply because it relates to health. His points absolutely could be relevant to how the Surgeon General chooses to describe the uptick in vaping. Overall tobacco usage is still going down: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm https://www.cdc.gov/tobacco/data_statistics/fact_sheets/yout...
- deleted 8y ago[deleted]
- juulia 8y agoEcigs are this generations 70's cigarette moment, thanks to social media. It has been glamorized and thus cool: https://vsco.co/search/images/juul https://vsco.co/search/images/juul
- dpflan 8y agoJuul is cited many times in that document. I am generally intrigued by Juul. Their intention to "end combustible smoking" and help "adult smokers" smoke with less pain/more easily seems good for the target user (create a system with fewer toxins-to-nicotine ratio). The side-effect of engineering a better system is that it's easier for all users to smoke, i.e. intended for adults, but tech-savy kids will devour this concept).
- russley 8y agoJuul is reported to have higher nicotine levels though.
- dpflan 8y agoI see. I'm not very familiar with their product. I would think that their product is good for weening "adult smokers" off of nicotine through tapered usage (e.g. reducing nicotine intake over a timeline by using specific dosage cartridges). Which of course go against a sustainable business?
- owlninja 8y agoThey actually did just introduce lower level nicotine packs of their pods. The device worked for me because if you look into the world of vaping, it is almost like another hobby. So many parts, batteries, coils, juices, etc... the juul was dead simple and really just replaced my 13 year pack-a-day habit. It is a little unfortunate how it took off in schools and I do truly believe that was never their intention. It really works as a "cigarette replacement" if you aren't ready to quit cold turkey.
- dpflan 8y agoThanks for sharing! That's an interesting point regarding simplicity of design and how the complexity of vaping can actually create a hobbyism that keeps you in the realm. If you don't mind me asking (and you sharing): How long did it take to stop smoking? Can you describe the weening process?
- nulagrithom 8y agoWhy are there conflicting reports on the stats from the CDC? The CDC's website[1] says there's been a 0.6% increase in vaping in middle school and 1.5% increase in high school since 2011. This advisory however says "E-cigarette use among U.S. middle and high school students increased 900% during 2011-2015, before declining for the first time during 2015-2017." Was there a nearly 899% drop in 2015-2017? https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm https://www.cdc.gov/tobacco/data_statistics/fact_sheets/yout...
- yayana 8y agoA rise from 0.6% to 4.9%.. 0.5->5 would be 1000%. I think you misread the CDC numbers.
- nulagrithom 8y agoYup! You're right.
- dragonwriter 8y ago> Why are there conflicting reports on the stats from the CDC? There aren't. > The CDC's website[1] says there's been a 0.6% increase in vaping in middle school and 1.5% increase in high school No, it doesn't. The 0.6% and 1.5% numbers appear, but as the base incidence in 2011 from which an increase occurred, not the percent increase. Quoting the relevant passage of your own source (emphasis added): “Nearly 5 of every 100 middle school students (4.9%) reported in 2018 that they used electronic cigarettes in the past 30 days—an increase from 0.6% in 2011.” “Nearly 21 of every 100 high school students (20.8%) reported in 2018 that they used electronic cigarettes in the past 30 days—an increase from 1.5% in 2011.” There is a difference between an “an increase FROM x% IN 2011” and “an increase OF x SINCE 2011”; you seem to have confused the former for the latter. The middle school increase reported is 717%; the high school increase reported is 1287%. There is nothing obviously inconsistent with aggregate 900% increase 2011-2015 with a slight aggregate decline thereafter.
- nulagrithom 8y ago
- md224 8y agoWe should be clear what the actual object of this "epidemic" is. It isn't really about vaping. It's about Nicotine. And this fight is just one battle in a larger war: the societal struggle to define the proper moral dimensions of chemical dependency. Many people have a knee-jerk reaction to "chemical dependency"... they assume it must be a bad thing. That somehow sobriety is the "natural" state of human beings, and that any dependence on a mind-altering chemical is a weakness, a deviation. You can see this in the way we mix up terms like "dependency" and "addiction". People treat the former as if it were equivalent to the latter, but it isn't: "addiction" is when the harms of a dependency outweigh the benefits, when it becomes "maladaptive" (a vague, value-laden term). But a dependency by itself isn't necessarily maladaptive. Sometimes it's a positive adaptation. Consider this, one of my favorite essays, about a woman whose relationship with Nicotine appears to have enriched her life: https://www.nytimes.com/2016/03/06/opinion/sunday/can-nicotine-be-good-for-you.html https://www.nytimes.com/2016/03/06/opinion/sunday/can-nicoti... There are certainly chemicals that cause far more harm than good... there's no denying that. I'm not saying we should embrace Fentanyl. But it would be a mistake to treat every chemical dependency as an obvious evil. The moral valence of Nicotine dependency is far from black-and-white. Sometimes we depend on something because it's good for us. (Notice how nobody's complaining about a coffee epidemic.)
- winchling 8y agoYes to the moral dimension -- obscured by the health issue. It's also about children. Most parents won't allow young kids to drink coffee, for instance. Childhood ought to be a preparation for freedom and addictions have the potential to limit that freedom before it even gets started. Adults may weigh the benefits for themselves. Sometimes the result is indeed positive.
- LyndsySimon 8y ago> approximately two-thirds of JUUL users aged 15-24 do not know that JUUL always contains nicotine. I find this very, very difficult to believe.
- brianwawok 8y agoHow many people do you know aged 15-24? It would not surprise me one bit.
- dorchadas 8y agoI'm a high school teacher (and kids have no concept of privacy and talk openly about everything), and I completely agree. Not sure if it's 2/3, but I'd say definitely over 50% don't realize that most probably contain nicotine.
- snek 8y agoThis does not surprise me at all.
- cwkoss 8y agoThird-party pods which do not contain nicotine do exist. I wonder if that confounded their survey. I think there are even some companies making some with only THC and/or CBD.
- dorchadas 8y agoI don't know if it's 2/3, but there's a decent amount that don't. I teach high school, and they talk all the damn time about their JUULing habits (they have literally no concept of privacy anymore), and several of them say they only do it since it's nicotine free. They're shocked when I tel them that most they're smoking probably do contain nicotine.
- gehwartzen 8y agoJust my personal take but as an adult who just quite smoking a few weeks ago the availability of vaps has been tremendously helpful. I feel night and day better in terms of health despite consuming probably similar levels of nicotine. And while I don't view nicotine (or vaporized VG, PG) as particularly harmful it probably should be reserved for those 18+. What doesn't seem to be helpful is that vaping comes in all sorts of flavors (beyond synthetic tobacco flavor)that would probably appeal to people minors (mango, cotton-candy, etc). In contrast any flavorings of those types in cigarettes was banned a decade ago (with the notable exception of menthol). > Currently, no flavors are banned from other tobacco products, although research suggests flavors may also make these products more enticing to youth and young adults. Data from FDA’s Population Assessment of Tobacco and Health found that nearly 80 percent of youth ages 12-17 and nearly 75 percent of young adults ages 18-25 who were current tobacco users in 2014 reported that the first tobacco product they ever used was flavored.25 Alternatively, FDA is aware of self-reported information suggesting that the availability of flavors in some noncombusted tobacco products such as e-cigarettes and other ENDS may help some adult users reduce cigarette use or switch to potentially less harmful products. https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm2019416.htm https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredi...
- stefan_ 8y agoNicotine is little different from caffeine. Either you ban both, none, or you decide your policy is arbitrary moral posturing supported by no evidence. Ultimately, there is little in the way of physical dependency; nicotine is as addicting as sugar and fat loaded burgers and fries, and the health risk to the population of those blow any risk from nicotine out of the water. In fact, the evidence probably shows we could promote the use of vaping instead of overeating on junk-food, and should ban minors from entering fast food places.
- solomatov 8y ago>Nicotine is little different from caffeine. Either you ban both, none, or you decide your policy is arbitrary moral posturing supported by no evidence. They are quite different in their mechanism of action. Caffeine works via Adenosine, Nicotine works via Nicotinic Acetylcholine receptors.
- sctb 8y agoRecent related discussion: https://news.ycombinator.com/item?id=18712622 https://news.ycombinator.com/item?id=18712622.
- badrabbit 8y agoELI5: what makes vaping more dangerous or concerning than say coffee or energy drinks?
- hannasanarion 8y agoThe withdrawal symptoms are far worse, for one. If you go off caffeine, you're drowsy for a few days, no big deal. If you go off nicotine, you're condemning yourself to months or years of craving that never fully goes away: the physiological components of nicotine addiction are more or less permanent. That's just off the top of my head. I wouldn't be surprised if there are detrimental dosage effects of nicotine that caffeine doesn't have.
- badrabbit 8y agoI quit smoking daily (at least half a pack per day) for 3 years straight,and it was "cold turkey" as they say. Once I quit,I felt a bit uncomfortable like a very mild headache(almost background annoyance) for about two weeks and that was all there was to it. Now,I've never been addicted to caffeine even though I drink espresso shots daily for weeks and for a few more weeks might not drink any caffeine,so I have no frame of reference for comparison. Stress does still cause me to be tempted but it's no worse than being tempted to eat fast food.
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