E-smokers will NOT be hired at 2 FL hospitals
- Thread starter Petrodus
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this hospital is basically digging its own grave. the bottom line is that many medical professionals smoke or use some kind of nicotine replacement. matter of fact, respiratory therapists tend to be the ones i have smoked with most outside any hospital i have worked at (yeah, the ones who are suctioning out lungs of a COPD'er on a ventilator). there is a large number of us "baby boomer" nurses who are getting ready to retire. there is a growing population of elderly people due to advances in health care/medicine, there is a growing population of people with diabetes, obesity, cancer and many other disease processes. well guess what? hospitals will find it even tougher to staff their hospitals. this hospital in FL is really going to hurt. but who will really hurt in the long run...the poor folks who live in that area and have no other choice but to go to those hospitals and wont get good care because of understaffing. the outlook is dismal.
I sent Mr. Mattison a lengthy response with a multitude of links to important resource articles.
Dear Mr. Mattison:
I was pleasantly surprised to have received such a prompt response from you. It was particularly refreshing to learn that you are interested in additional feedback and suggestions from Mr. ____ and me and you may have already heard from him by now. Thank you so much for your interest and hospitality. Since you seem to have a genuine interest in learning more about our perspective on harm reduction I have attached some resources and provided some links that may offer greater insight into the efforts we are making to distinguish cigarette smoking from nicotine addiction. If you are able to make time to review this information I think it will help you and your colleagues in your considerations about the new policy before it is instated. I also would really love to hear what you think about the information, as your perspective is truly of interest to me.
Mr._______ may have mentioned to you that there is a CO test that can actually measure whether or not anyone has inhaled smoke within 48 hours. If any employee tested positive for cotinine, the CO test would be a way to distinguish cigarette smokers from other forms of much safer nicotine use.
It was disheartening for me to hear that nearly all of the responses you had received had been communicated in such a negative way. While I understand that not everyone is a gifted writer, ideally most would understand that being abusive is generally not conducive to making your position understood. I suspect that a lot of the vitriol is in response to the cumulative frustration that most cigarette smokers and other nicotine users have experienced as the anti-tobacco movement has gained momentum. Specifically, there is a perceived hypocrisy on the part of our government which continues to profit tremendously from the revenue generated by cigarette sales while simultaneously insisting that they are one of the most dangerous products consumed. It would appear that given what we know is in cigarettes and the preventable illnesses and deaths that are caused by their use that these products would have been made illegal a long time ago. Paradoxically, cigarettes are sold everywhere and no matter where you live or work there is usually a place that sells them within a 5 to 10 minute drive from you. It appears that the government wants to make things as difficult, inconvenient, and socially uncomfortable as possible for smokers while not making any real changes that address the fact that for whatever reason, the decline in the number of smokers has stagnated. That is, there are approximately 20% of people who continue to smoke for whatever reason and the government actually depends on that number to be a consistent supply of billions collected in tax revenues. Also, smokers are blamed for incurring more health care costs than non-smokers, but sadly the reality is that people who live longer actually cost our health system more and that smokers save the system money by dying earlier on average than non-smokers. Therefore, smokers seem to feel that the government benefits from their addiction while they are living and again when they expire, leaving them essentially feeling like second class citizens.
It’s also worth noting that the social and legal changes related to smoking have occurred very rapidly, and there are many smokers who are now seniors and began smoking as young as 12 years of age. I am only 39 and even I can recall when I entered high school there was a smoking section for students in the courtyard and there was no legal age to purchase cigarettes. Understandably, non-smokers made efforts to protect their right to clean air which resulted in smoking sections in restaurants, then smoke free interiors to public places. We banned sales of tobacco products to minors and I believe most people have been cooperative with these efforts, as they should be. Next we began seeing companies refusing to hire smokers and this was upheld by the courts, as smokers are not a ‘protected class’. Now we witness efforts by some to report parents who smoke to Child Protective Services and more companies have now refined their employment criteria to not only exclude smokers, but anyone who uses nicotine in any form, even if it provides them with a means of abstaining from the dangers that come from inhaling carcinogenic smoke from combustible tobacco. Basically, it seems that the anti-smoking lobby continues to move the goal posts so that nothing short of complete abstinence from nicotine in any form is acceptable. People find it deeply offensive to be deemed unemployable for engaging in a legal behavior that our government continues to profit from.
The shameful irony is that people who quit smoking are being penalized for making changes that dramatically improve their health as well as the health of others. What began as a movement to improve health outcomes appears to have morphed into a morality based endeavor that relies on governmental support for social engineering in an effort to maintain norms for behavior of private individuals regardless of whether they are causing any actual harm or not. The battle now seems to be over the concept of addiction as being equally destructive in all forms without regards to the actual impact on public health. For instance, caffeine is known to be very addictive and is comprehensively the most widely used drug in the United States. Even our children can purchase limitless quantities of caffeine which affects the body in ways that are nearly identical to nicotine use (excluding cigarette smoking). However, a person who is addicted to caffeine does not suffer the same impairment in every day functioning as a ...... or crack ....... addict and the cravings for caffeine are easily (and legally) satisfied, allowing the individual to function at full capacity (and at times at an ever greater capacity because of the positive effects that some stimulants have on brain functioning). The same is true for nicotine dependence. One of the attachments I have included specifically addresses documented improvements on memory functioning with dementia patients and notes that the withdrawal from the transdermally applied nicotine is very minimal. This also suggests that nicotine absorbed through smoking cigarettes affects the body differently than nicotine obtained from other sources.
The natural progression of concern when socially based preferences are used in the hiring process is that smokers are far from being the only non-protected class of citizens. As I said previously, obese people, unattractive people, short people, and even parents are not a protected class. It is very easy to begin making judgments about the potential character flaws in those who have traits that we don’t approve of or identify with: fat people are lazy and slovenly, ugly people aren’t pleasing for customers to interact with, pretty women can’t be taken seriously as managers, mothers are likely to miss too much time from work, short men don’t make good bosses, etc. There is no shortage of stereotypes about smokers or nicotine users that imply impoverished character of some sort but nicotine use and/or dependence is simply not an issue of character. All kinds of people from all walks of life have once made the decision to smoke and many became addicted before we had all of the information we have today. Many of our greatest historical leaders used tobacco and even though they may not have known the dangers it didn’t negate their intelligence or their efforts to contribute to society. It concerns me that so many anti-tobacco supporters seem oblivious to the fact that once it is considered acceptable to alienate nicotine consumers from society that it will easily become acceptable to target other traits and behaviors that could well include themselves. I believe that we all as Americans have the responsibility to remain vigilant about protecting the rights of others even when they don’t share our own lifestyle choices. One could argue that if people don’t like the policy they can work elsewhere, but what happens when every employer starts to instigate hiring practices that exclude legal users of nicotine (even without smoking)? It essentially means that if you are unwilling to allow employers to mandate your legal behavior during the time that you are not being paid to work then you may be unemployed, homeless, and hungry. That just doesn’t seem morally right to me.
Please accept my apologies for the extensive length of this message. I could tell that you put a good deal of thought into the reply that you sent to me and that indicated that you are someone who is receptive to exposure to other perspectives. No matter how knowledgeable we are, none of us can possibly view every issue through every lens. I interpreted your response as very sincere and I appreciate that you are open to exploring other possibilities while not compromising your core belief in maintaining good standards of health for your company. Thank you again for your attention, and I look forward to hearing from you again.
Have a peaceful and joyous holiday with your family and friends and a prosperous New Year!
Sincerely,
Dear Mr. Mattison:
I was pleasantly surprised to have received such a prompt response from you. It was particularly refreshing to learn that you are interested in additional feedback and suggestions from Mr. ____ and me and you may have already heard from him by now. Thank you so much for your interest and hospitality. Since you seem to have a genuine interest in learning more about our perspective on harm reduction I have attached some resources and provided some links that may offer greater insight into the efforts we are making to distinguish cigarette smoking from nicotine addiction. If you are able to make time to review this information I think it will help you and your colleagues in your considerations about the new policy before it is instated. I also would really love to hear what you think about the information, as your perspective is truly of interest to me.
Mr._______ may have mentioned to you that there is a CO test that can actually measure whether or not anyone has inhaled smoke within 48 hours. If any employee tested positive for cotinine, the CO test would be a way to distinguish cigarette smokers from other forms of much safer nicotine use.
It was disheartening for me to hear that nearly all of the responses you had received had been communicated in such a negative way. While I understand that not everyone is a gifted writer, ideally most would understand that being abusive is generally not conducive to making your position understood. I suspect that a lot of the vitriol is in response to the cumulative frustration that most cigarette smokers and other nicotine users have experienced as the anti-tobacco movement has gained momentum. Specifically, there is a perceived hypocrisy on the part of our government which continues to profit tremendously from the revenue generated by cigarette sales while simultaneously insisting that they are one of the most dangerous products consumed. It would appear that given what we know is in cigarettes and the preventable illnesses and deaths that are caused by their use that these products would have been made illegal a long time ago. Paradoxically, cigarettes are sold everywhere and no matter where you live or work there is usually a place that sells them within a 5 to 10 minute drive from you. It appears that the government wants to make things as difficult, inconvenient, and socially uncomfortable as possible for smokers while not making any real changes that address the fact that for whatever reason, the decline in the number of smokers has stagnated. That is, there are approximately 20% of people who continue to smoke for whatever reason and the government actually depends on that number to be a consistent supply of billions collected in tax revenues. Also, smokers are blamed for incurring more health care costs than non-smokers, but sadly the reality is that people who live longer actually cost our health system more and that smokers save the system money by dying earlier on average than non-smokers. Therefore, smokers seem to feel that the government benefits from their addiction while they are living and again when they expire, leaving them essentially feeling like second class citizens.
It’s also worth noting that the social and legal changes related to smoking have occurred very rapidly, and there are many smokers who are now seniors and began smoking as young as 12 years of age. I am only 39 and even I can recall when I entered high school there was a smoking section for students in the courtyard and there was no legal age to purchase cigarettes. Understandably, non-smokers made efforts to protect their right to clean air which resulted in smoking sections in restaurants, then smoke free interiors to public places. We banned sales of tobacco products to minors and I believe most people have been cooperative with these efforts, as they should be. Next we began seeing companies refusing to hire smokers and this was upheld by the courts, as smokers are not a ‘protected class’. Now we witness efforts by some to report parents who smoke to Child Protective Services and more companies have now refined their employment criteria to not only exclude smokers, but anyone who uses nicotine in any form, even if it provides them with a means of abstaining from the dangers that come from inhaling carcinogenic smoke from combustible tobacco. Basically, it seems that the anti-smoking lobby continues to move the goal posts so that nothing short of complete abstinence from nicotine in any form is acceptable. People find it deeply offensive to be deemed unemployable for engaging in a legal behavior that our government continues to profit from.
The shameful irony is that people who quit smoking are being penalized for making changes that dramatically improve their health as well as the health of others. What began as a movement to improve health outcomes appears to have morphed into a morality based endeavor that relies on governmental support for social engineering in an effort to maintain norms for behavior of private individuals regardless of whether they are causing any actual harm or not. The battle now seems to be over the concept of addiction as being equally destructive in all forms without regards to the actual impact on public health. For instance, caffeine is known to be very addictive and is comprehensively the most widely used drug in the United States. Even our children can purchase limitless quantities of caffeine which affects the body in ways that are nearly identical to nicotine use (excluding cigarette smoking). However, a person who is addicted to caffeine does not suffer the same impairment in every day functioning as a ...... or crack ....... addict and the cravings for caffeine are easily (and legally) satisfied, allowing the individual to function at full capacity (and at times at an ever greater capacity because of the positive effects that some stimulants have on brain functioning). The same is true for nicotine dependence. One of the attachments I have included specifically addresses documented improvements on memory functioning with dementia patients and notes that the withdrawal from the transdermally applied nicotine is very minimal. This also suggests that nicotine absorbed through smoking cigarettes affects the body differently than nicotine obtained from other sources.
The natural progression of concern when socially based preferences are used in the hiring process is that smokers are far from being the only non-protected class of citizens. As I said previously, obese people, unattractive people, short people, and even parents are not a protected class. It is very easy to begin making judgments about the potential character flaws in those who have traits that we don’t approve of or identify with: fat people are lazy and slovenly, ugly people aren’t pleasing for customers to interact with, pretty women can’t be taken seriously as managers, mothers are likely to miss too much time from work, short men don’t make good bosses, etc. There is no shortage of stereotypes about smokers or nicotine users that imply impoverished character of some sort but nicotine use and/or dependence is simply not an issue of character. All kinds of people from all walks of life have once made the decision to smoke and many became addicted before we had all of the information we have today. Many of our greatest historical leaders used tobacco and even though they may not have known the dangers it didn’t negate their intelligence or their efforts to contribute to society. It concerns me that so many anti-tobacco supporters seem oblivious to the fact that once it is considered acceptable to alienate nicotine consumers from society that it will easily become acceptable to target other traits and behaviors that could well include themselves. I believe that we all as Americans have the responsibility to remain vigilant about protecting the rights of others even when they don’t share our own lifestyle choices. One could argue that if people don’t like the policy they can work elsewhere, but what happens when every employer starts to instigate hiring practices that exclude legal users of nicotine (even without smoking)? It essentially means that if you are unwilling to allow employers to mandate your legal behavior during the time that you are not being paid to work then you may be unemployed, homeless, and hungry. That just doesn’t seem morally right to me.
Please accept my apologies for the extensive length of this message. I could tell that you put a good deal of thought into the reply that you sent to me and that indicated that you are someone who is receptive to exposure to other perspectives. No matter how knowledgeable we are, none of us can possibly view every issue through every lens. I interpreted your response as very sincere and I appreciate that you are open to exploring other possibilities while not compromising your core belief in maintaining good standards of health for your company. Thank you again for your attention, and I look forward to hearing from you again.
Have a peaceful and joyous holiday with your family and friends and a prosperous New Year!
Sincerely,
Enjoyed your letter. I hope that we actually get a response from these people about their position on the CO test. I fear that these people have already made up their mind and nothing will change their minds.
Thank you.
This and the King County BOH's recent actions are the kind of thing that make me want to set an American flag on fire. I don't mean to enrage anyone here, but I get tired of hearing how so many people fought and died for 'that flag' when really, people fought and died for freedom and individual rights, and without those things the flag is just a piece of fabric. Is this the America we sing about, the one I'm supposed to be so proud of? I can vent about the 'government' but really I'm most angry at our lazy, uninformed, head in the sand American public. Most can't be bothered to vote, much less know what's going on in our local, state, and federal governments. I'm sick of people just assuming things will never go too far and that someone else will take care of it. I get angry at people who are taken aback by my intensity or passion, all the while enjoying the benefits of the work and advocacy done by 'intense' people. Yes, we are supposed to vote and trust officials to do the right thing but the real onus is on us to make sure that they represent us. It is the responsibility of the citizens to make sure democracy and freedom are upheld. People who are 'too busy' with their mundane bs to pay attention and get involved will be the first ones wondering what happened when it's too late. We deserve the country we get. I guess it was just a matter of time.
I hope the nurses at this hospital like mopping floors and cleaning toilets, because if this policy moves forward they aren't going to have any housekeeping staff to do it. Most blue collar workers I know smoke and even if they don't but use the patch or whatever to get through the day they'll still be SOL.
Being a Nurse I think if they do institute it as is, someone who uses nicotine should just go there and apply for a job, then if they refuse because of nicotine, tthey could file lawsuit on several grounds.
1) By Law there can be no ban on smoking by a government institution even the FDA. So a hospital has the right to effectively Ban smoking by any employee in their free time? The answer is no No institution can tell people what they are or are not aloud to do with their own time in their own homes as long as its a legal activity, OR there would be nothing to stop say a church from banning members of said church from having freeky BDSM sex. They can say its against their religion but they can't ban it, it sounds like a crazy example but it is the same thing in principle.
2)Yes they have a right to decide who they can hire and who they do not with in limits. Again it is illegal to not hire someone who meets the quals for a job, based on them partaking in a legal activity on their own time. Now before some says its to expensive to sue, They will be forced to pay the lawyers bills of the case as part of the lawsuit should you win, which in this case you would have a good chance to do just that.
1) By Law there can be no ban on smoking by a government institution even the FDA. So a hospital has the right to effectively Ban smoking by any employee in their free time? The answer is no No institution can tell people what they are or are not aloud to do with their own time in their own homes as long as its a legal activity, OR there would be nothing to stop say a church from banning members of said church from having freeky BDSM sex. They can say its against their religion but they can't ban it, it sounds like a crazy example but it is the same thing in principle.
2)Yes they have a right to decide who they can hire and who they do not with in limits. Again it is illegal to not hire someone who meets the quals for a job, based on them partaking in a legal activity on their own time. Now before some says its to expensive to sue, They will be forced to pay the lawyers bills of the case as part of the lawsuit should you win, which in this case you would have a good chance to do just that.
Ex, the only problem with your thought process is that Fla court has already established that it wasn't illegal. A while back a town in Fla was planning to ban all municipal workers to be smoke (nicotine) free. In one of the articles they had identified another borough that had done the same thing and it was taken to court and the ban stood. The court ruled they were within their right to refuse employment.
The ban didn't get through on this second borough. It got voted down for the time being. Perhaps part of the reason was that the argument made was that it would save on medical premiums. What I found amusing was the borough that had gotten sued also used the medical premium argument for putting the ban in. After having to fight it in court and winning, they eventually came back and changed their regulations to allow smokers because they found that they saved no insurance money with the ban. Why is that not a surprise.
The ban didn't get through on this second borough. It got voted down for the time being. Perhaps part of the reason was that the argument made was that it would save on medical premiums. What I found amusing was the borough that had gotten sued also used the medical premium argument for putting the ban in. After having to fight it in court and winning, they eventually came back and changed their regulations to allow smokers because they found that they saved no insurance money with the ban. Why is that not a surprise.
Sooner or later...There's going to be attorney ads on TV saying
"Were you recently denied employment because you stopped smoking
and now use an E-cigarette, Nicotine patch, or Nicotine gum?
If so call our hot-line.
That would be the first attorney ad that wouldn't tick me off. Especially it it was bought by Bansash III.
That would be the first attorney number I not only call, I would set myself up fast as all hell..
crying..
Your honor the fact they turned me down has broken my spirit and caused me to revert to smoking actual cigarettes which put my health in serious harm.
Tears roll down my face like someone just stabbed me in the wewe.
It has caused me serious mental and physical harm, your honor, and it has put my family through serious stress as well your honor, My daughter was so happy when I had switched to a safer way of getting my nicotine, and now she can't sleep at night because my addiction, has made her sure I am going to die your honor, but it was a direct result of them refusing to hire me while I was using a safe nicotine product, that caused me to switch back.
crying..
Your honor the fact they turned me down has broken my spirit and caused me to revert to smoking actual cigarettes which put my health in serious harm.
Tears roll down my face like someone just stabbed me in the wewe.
It has caused me serious mental and physical harm, your honor, and it has put my family through serious stress as well your honor, My daughter was so happy when I had switched to a safer way of getting my nicotine, and now she can't sleep at night because my addiction, has made her sure I am going to die your honor, but it was a direct result of them refusing to hire me while I was using a safe nicotine product, that caused me to switch back.
Those living in the Florida "infected" area...might want to
drop a dime on a few of the law firms that advertise on TV.
Those ambulance chasers should jump on this
like the "Last Chopper out of 'Nam"
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Here is the response I just got. Not to be too optimistic, but this guy is one of the more reasonable sounding people I've encountered in regards to this topic and at least he is very respectful:
Dear _________:
This is most helpful!! Thank you very much for going through the process of putting all this together for us. I am trying to become familiar with the material you sent. It may take me to the end of the week, but I want to gain the benefit of the education you intended and invested in. It is a most valuable resource that I will share with others who may be facing the same decision in the future, if you don’t object.
Did have a question related to the use of replacement products containing nicotine. How likely is it that there would be a physician’s order for the nicotine replacement products involved in the population we are trying to give consideration to? Am trying to assess the likelihood of someone reverting back to cigarettes or chewing tobacco after successfully negotiating the screening/employment process utilizing over the counter substitute products. Is it more likely that those who are under a physician’s care through this process will follow through with it, or not? I know this adds cost and structure, but was curious your thoughts on whether or not those considerations would incentivize compliance.
Again, thank you very much for all your help as we have given thought to your compelling appeal.
By the way, do you object to my sharing this information with _________? Have found his communication helpful, but your complete set of resources may be of benefit to him now and into the future.
Warm regards,
Ken
-------------------------------------------------------------------
This is my response:
Dear Mr. Mattison:
It was my pleasure to share with you a portion of the information that I have on hand. I can assure you that if nothing else it will be a very interesting read. Being in my field, I am constantly researching information on a variety of topics that are of concern to me personally as well as professionally. You can probably tell I'm a passionate person, but I also try to be informed so that I can make decisions based on facts as opposed to emotion. In my experience, I have far fewer regrets about choices that I made after careful and deliberate consideration as opposed to those that I just jumped into head first. Sifting through all of the information available now certainly requires a lot of patience as well as diligence because as you know, the news has become quite sensationalized! I certainly understand that it will take you some time to review most of it and am quite grateful that you are willing to do so. Feel free to share any information you find particularly helpful or informative.
Regarding your question about nicotine replacement products and reverting back to tobacco use: almost all of the commonly used nicotine replacement therapies are available over the counter. This includes patches, lozenges, and gum as well as the newer electronic cigarettes. The NRTs aren't labeled for long term use, but there is also no identified harm in doing so. In fact, I personally know a woman who has been smoke free for three years because she has continued to use the lozenges. Her doctor supports this and has noted that her breathing has markedly improved. The continued nicotine use, even at much lower levels, seems to negate the weight gain that many smokers experience when they quit. Unfortunately, many people (especially women) panic at the sudden weight gain and for some it is so disconcerting that they feel they'd rather take the health risks and social stigma that come with smoking than to experience the poor self esteem and stigma that comes with being overweight. Not only that, but it isn't uncommon for people to experience weight related health problems when they gain any substantial amount of weight after quitting. Regardless, I do not doubt that most doctors approve of patients using whatever method works best for them to abstain from smoking and sometimes it takes a bit of trial and error to learn what works best for you. People are not always equally addicted to any given substance and with smoking in particular there are many different components to the addiction that impact people differently. For me, the hand to mouth habit that had been reinforced daily for nearly 20 years was the biggest obstacle as opposed to the nicotine dependence that may be more of an issue for others. I did receive some benefit from Wellbutrin which curbed my cravings and over the counter nicotine replacement products pacified the nicotine cravings short term. Countless others have tried many different things that offered no relief. However, there is also a social aspect to cigarette smoking and people's cravings can be triggered by very different things. That’s why I’ve always been so careful to not judge or compares myself with others and why I cringe whenever someone says that if they quit cold turkey anyone else can, too. No one is addicted in exactly the same way or for the same reasons, or even to the same degree. I have encountered research suggesting that there are many different genetic components or preexisting conditions (such as ADHD) which may determine why some people become addicted and others don't, even when exposed to the same things. It makes sense because certainly not everyone who ever puffed on a cigarette decided to do so twice, even long before the dangers of smoking were known.
On a very personal note, while I am in favor for making as many smoke free options as possible available to the public, the one I have been the most impressed with is the electronic cigarette. The term itself is somewhat of a misnomer since there is no tobacco or lighted material and certainly no 'smoke'. These devices are vaporizers that are battery charged and allow the user to mimic the experience of smoking without ingesting the 400+ carcinogens in cigarette smoke and there is no odor. When one inhales, the liquid in the cartridge heats up mildly and produces a fine vapor, so the users gets the feeling of inhaling and exhaling. What is exhaled is a vapor mist that dissipates very quickly. For people like me who were more into the mannerisms of smoking than the nicotine itself this invention is particularly ingenious. The liquid that is in the cartridges is generally composed of propylene glycol and/or vegetable glycerin and may contain liquid nicotine or not. Some people start with higher levels of nicotine and gradually wean themselves down to a much lower level until they discontinue the nicotine use altogether. They may continue to use the vaporizer because they enjoy the mechanics of 'smoking' even though they no longer use nicotine. Others find that maintaining some level of nicotine, however low, is their best option to continue to abstain from lit tobacco cigarettes.
Let me say outright that I have no financial motivations for my fondness of this product. I do not sell these devices or profit from them in any way, nor do I know anyone who does. My investment is personal, as I have witnessed how life changing these vaporizers have been for so many people, including close friends and family members. I have witnessed firsthand how many people began using one as a means to get their nicotine fix when in situations where smoking was not permitted but ended up converting entirely and with minimal effort. My introduction to this product came when a close family member found himself struggling while in the company of his smoking co-workers and friends even though he had quit for three years. He didn't want to give up all of his friends who were very nice people and he didn't want to relapse either. I started doing research and learned about electronic cigarettes on the internet. I'm known as the Sherlock Holmes of my family because of my obsession with researching things in tedious detail before making any purchases, especially technical items. After two solid weeks of me researching and comparing consumer reviews, he purchased the vaporizer of his choice along with very low nicotine cartridges. He instantly fell in love and was amazed to have found it but sad not to have known about it sooner. Making a long story short, the device caught on with his curious friends, most of whom are heavy smokers who have made multiple attempts to quit. They experienced the same satisfaction. One friend was a 2 pack per day smoker who was able to smoke all day since he worked outside. From the first day, we watched him put down his Marlboro Lights and he hasn't touched another one in 2 months. This man is 43 and has smoked since age 14. Figuring that if he could do it anyone could, 2 more friends made a similar purchase and were surprised to find that they, too found the vaporizer so enjoyable because it provided them with their nicotine as well as the hand to mouth motion unlike other forms of nicotine such as the gum or patches which only address the chemical piece. I purchased one for my 68 year old mother for her birthday, as she heard about all of this and expressed interest. She has smoked since she was 14 as well and since she retired 3 years ago and is home most days she had gradually been smoking more. To be honest, I held my breath on this one. However, she took to it like a duck to water and although she has not completely quit tobacco in the month she has had the product, she has gone from a pack and a half per day to a pack per week in this short amount of time. The beauty of quitting tobacco smoking is that it doesn't take long at all to start to notice some benefits. I could tell she wasn't smoking by the way her voice sounded over the phone and noticed within a week that she was no longer clearing her throat and we both noticed that she was hardly having any more coughing spells. Selfishly, I really enjoy going to her home and not smelling smoke and not smelling like smoke when I leave. I actually get pretty emotional about this subject because I am seeing something I never thought I would see happen and I may get to have my Mom around longer than I would have otherwise.
When I started my research on electronic cigarettes what I found was pretty overwhelming at first. For one thing, there was a lot published about the 'controversy' and concerns about the 'unknown dangers' and since I was investigating on behalf of my own family I paid close attention. A topic that was discussed frequently was the recent FDA report on their findings about the devices and another was the lawsuit against the FDA filed by some e-cigarette manufacturers. At first I was alarmed by the FDA report because the abstracts reported they had found ingredients identified in antifreeze in one cartridge they sampled. When I read the full report in more depth, the scholar in me was quite angry to learn that in fact the FDA only found trace levels (and certainly not enough to do any actual harm) of a substance in only 1 of the 18 cartridges they sampled. Also, the 'antifreeze' ingredient they referred to was propylene glycol. True, it is an ingredient in antifreeze..... but so is water. I learned that PG was added to antifreeze to in fact make it less toxic if ingested and that the liquid is generally regarded as safe (GRAS) by the FDA and that it is very commonly used in a variety of widely used products like toothpaste, cosmetics, fog machines, human food, animal feed, and even in pharmaceuticals (such as asthma inhalers). Right then I became skeptical, especially since the report overlooked the fact about PG being used in pharmaceuticals they approve of which includes over the counter nicotine patches. So why was it such a big deal in the electronic cigarettes? Also, the DC court found that the FDA had no right to ban the electronic cigarettes as they had tried to do (as well as confiscating shipments of the products which is why they were sued in the first place) because they had presented no evidence that the product was unsafe. Well, further research into the testimonies of e-cigarette users was dumbfounding. Over and over I kept reading remarks from ex-smokers saying that after trying everything known to man, this product was the first and only thing that had worked for them long term. The stories from all these different people all over the world were very similar. I was gob smacked. It seems that other over the counter NRTs have a fairly low success rate long term, but not this. I learned that in 7 years that they have been widely available there have been no reported illnesses and certainly no deaths related to their use. They have been used longer in Europe than they have in the US. This segued into learning about Harm Reduction theory and the input from physicians explaining how smokeless alternatives could reduce smoking related illnesses by as much as 98% since most of the damage from smoking is caused by the smoke itself. They were looking at all options from a public health perspective as opposed to the 'quit or die' approach employed by many non-profits like the American Lung Association and the American Cancer Society. What resonated with me most was their assertion that it is unethical and immoral to tell people that their health cannot improve dramatically unless they quit tobacco and all nicotine related products altogether. It is assumed that their reasoning is that if you let people think that they can get healthier without discontinuing nicotine altogether, then why would anyone bother? Well, maybe people would 'bother' quitting cigarettes if they thought there were products that would reduce their chances of relapse while eliminating the health risks caused by smoke. Otherwise, people just assume based on what they're told that there really isn't any use in making any changes in their smoking habits because if they can't stay away from nicotine altogether then their health won't improve anyway. Quite frankly this is a LIE. If one product comes with the risk of lung cancer, emphysema, COPD, and mouth cancer and the other one doesn't, how can you logically and ethically tell someone there is no difference? It is clear to me that some people are fighting the wrong battle here. It doesn't help my confidence to know that three representatives from Big Tobacco are on the FDA board and that the FDA has extremely close ties to Big Pharma. Many people also don't realize that pharmaceutical companies are some of the biggest contributors to organizations like the ALA and ACS, nor do they know that most of the money these organizations get goes towards salaries. As someone who works for the local division of a federal agency I am well aware that non-profits must pay close attention to the interests of their funding sources. Therefore, it makes sense that these organizations would not approve of products that threaten to decrease the cash flow of their funding sources while they outright promote the FDA approved products manufactured by pharmaceutical companies such as the nicotine patch, lozenge, and gum. Meanwhile, Chantix and a host of other drugs with potentially lethal side effects are fast tracked onto the market and cigarettes (approved by the FDA) continue to be legal and readily available everywhere when we all know exactly how damaging they are to smokers and those around them. This has all left me feeling sad, angry, and betrayed.
It wasn't my intention to make this a personal issue, but hopefully it offers clarification as to why I am so passionate about all of this. Thanks again for being willing to listen and let me know if there is anything else I can elaborate on. Also, would you be open to receiving feedback from any other folks such as consumer advocacy groups? I don't want to overwhelm you but there are people who have been involved in this far longer than I have and may be able to provide even more information.
Take care,
_______
Dear _________:
This is most helpful!! Thank you very much for going through the process of putting all this together for us. I am trying to become familiar with the material you sent. It may take me to the end of the week, but I want to gain the benefit of the education you intended and invested in. It is a most valuable resource that I will share with others who may be facing the same decision in the future, if you don’t object.
Did have a question related to the use of replacement products containing nicotine. How likely is it that there would be a physician’s order for the nicotine replacement products involved in the population we are trying to give consideration to? Am trying to assess the likelihood of someone reverting back to cigarettes or chewing tobacco after successfully negotiating the screening/employment process utilizing over the counter substitute products. Is it more likely that those who are under a physician’s care through this process will follow through with it, or not? I know this adds cost and structure, but was curious your thoughts on whether or not those considerations would incentivize compliance.
Again, thank you very much for all your help as we have given thought to your compelling appeal.
By the way, do you object to my sharing this information with _________? Have found his communication helpful, but your complete set of resources may be of benefit to him now and into the future.
Warm regards,
Ken
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This is my response:
Dear Mr. Mattison:
It was my pleasure to share with you a portion of the information that I have on hand. I can assure you that if nothing else it will be a very interesting read. Being in my field, I am constantly researching information on a variety of topics that are of concern to me personally as well as professionally. You can probably tell I'm a passionate person, but I also try to be informed so that I can make decisions based on facts as opposed to emotion. In my experience, I have far fewer regrets about choices that I made after careful and deliberate consideration as opposed to those that I just jumped into head first. Sifting through all of the information available now certainly requires a lot of patience as well as diligence because as you know, the news has become quite sensationalized! I certainly understand that it will take you some time to review most of it and am quite grateful that you are willing to do so. Feel free to share any information you find particularly helpful or informative.
Regarding your question about nicotine replacement products and reverting back to tobacco use: almost all of the commonly used nicotine replacement therapies are available over the counter. This includes patches, lozenges, and gum as well as the newer electronic cigarettes. The NRTs aren't labeled for long term use, but there is also no identified harm in doing so. In fact, I personally know a woman who has been smoke free for three years because she has continued to use the lozenges. Her doctor supports this and has noted that her breathing has markedly improved. The continued nicotine use, even at much lower levels, seems to negate the weight gain that many smokers experience when they quit. Unfortunately, many people (especially women) panic at the sudden weight gain and for some it is so disconcerting that they feel they'd rather take the health risks and social stigma that come with smoking than to experience the poor self esteem and stigma that comes with being overweight. Not only that, but it isn't uncommon for people to experience weight related health problems when they gain any substantial amount of weight after quitting. Regardless, I do not doubt that most doctors approve of patients using whatever method works best for them to abstain from smoking and sometimes it takes a bit of trial and error to learn what works best for you. People are not always equally addicted to any given substance and with smoking in particular there are many different components to the addiction that impact people differently. For me, the hand to mouth habit that had been reinforced daily for nearly 20 years was the biggest obstacle as opposed to the nicotine dependence that may be more of an issue for others. I did receive some benefit from Wellbutrin which curbed my cravings and over the counter nicotine replacement products pacified the nicotine cravings short term. Countless others have tried many different things that offered no relief. However, there is also a social aspect to cigarette smoking and people's cravings can be triggered by very different things. That’s why I’ve always been so careful to not judge or compares myself with others and why I cringe whenever someone says that if they quit cold turkey anyone else can, too. No one is addicted in exactly the same way or for the same reasons, or even to the same degree. I have encountered research suggesting that there are many different genetic components or preexisting conditions (such as ADHD) which may determine why some people become addicted and others don't, even when exposed to the same things. It makes sense because certainly not everyone who ever puffed on a cigarette decided to do so twice, even long before the dangers of smoking were known.
On a very personal note, while I am in favor for making as many smoke free options as possible available to the public, the one I have been the most impressed with is the electronic cigarette. The term itself is somewhat of a misnomer since there is no tobacco or lighted material and certainly no 'smoke'. These devices are vaporizers that are battery charged and allow the user to mimic the experience of smoking without ingesting the 400+ carcinogens in cigarette smoke and there is no odor. When one inhales, the liquid in the cartridge heats up mildly and produces a fine vapor, so the users gets the feeling of inhaling and exhaling. What is exhaled is a vapor mist that dissipates very quickly. For people like me who were more into the mannerisms of smoking than the nicotine itself this invention is particularly ingenious. The liquid that is in the cartridges is generally composed of propylene glycol and/or vegetable glycerin and may contain liquid nicotine or not. Some people start with higher levels of nicotine and gradually wean themselves down to a much lower level until they discontinue the nicotine use altogether. They may continue to use the vaporizer because they enjoy the mechanics of 'smoking' even though they no longer use nicotine. Others find that maintaining some level of nicotine, however low, is their best option to continue to abstain from lit tobacco cigarettes.
Let me say outright that I have no financial motivations for my fondness of this product. I do not sell these devices or profit from them in any way, nor do I know anyone who does. My investment is personal, as I have witnessed how life changing these vaporizers have been for so many people, including close friends and family members. I have witnessed firsthand how many people began using one as a means to get their nicotine fix when in situations where smoking was not permitted but ended up converting entirely and with minimal effort. My introduction to this product came when a close family member found himself struggling while in the company of his smoking co-workers and friends even though he had quit for three years. He didn't want to give up all of his friends who were very nice people and he didn't want to relapse either. I started doing research and learned about electronic cigarettes on the internet. I'm known as the Sherlock Holmes of my family because of my obsession with researching things in tedious detail before making any purchases, especially technical items. After two solid weeks of me researching and comparing consumer reviews, he purchased the vaporizer of his choice along with very low nicotine cartridges. He instantly fell in love and was amazed to have found it but sad not to have known about it sooner. Making a long story short, the device caught on with his curious friends, most of whom are heavy smokers who have made multiple attempts to quit. They experienced the same satisfaction. One friend was a 2 pack per day smoker who was able to smoke all day since he worked outside. From the first day, we watched him put down his Marlboro Lights and he hasn't touched another one in 2 months. This man is 43 and has smoked since age 14. Figuring that if he could do it anyone could, 2 more friends made a similar purchase and were surprised to find that they, too found the vaporizer so enjoyable because it provided them with their nicotine as well as the hand to mouth motion unlike other forms of nicotine such as the gum or patches which only address the chemical piece. I purchased one for my 68 year old mother for her birthday, as she heard about all of this and expressed interest. She has smoked since she was 14 as well and since she retired 3 years ago and is home most days she had gradually been smoking more. To be honest, I held my breath on this one. However, she took to it like a duck to water and although she has not completely quit tobacco in the month she has had the product, she has gone from a pack and a half per day to a pack per week in this short amount of time. The beauty of quitting tobacco smoking is that it doesn't take long at all to start to notice some benefits. I could tell she wasn't smoking by the way her voice sounded over the phone and noticed within a week that she was no longer clearing her throat and we both noticed that she was hardly having any more coughing spells. Selfishly, I really enjoy going to her home and not smelling smoke and not smelling like smoke when I leave. I actually get pretty emotional about this subject because I am seeing something I never thought I would see happen and I may get to have my Mom around longer than I would have otherwise.
When I started my research on electronic cigarettes what I found was pretty overwhelming at first. For one thing, there was a lot published about the 'controversy' and concerns about the 'unknown dangers' and since I was investigating on behalf of my own family I paid close attention. A topic that was discussed frequently was the recent FDA report on their findings about the devices and another was the lawsuit against the FDA filed by some e-cigarette manufacturers. At first I was alarmed by the FDA report because the abstracts reported they had found ingredients identified in antifreeze in one cartridge they sampled. When I read the full report in more depth, the scholar in me was quite angry to learn that in fact the FDA only found trace levels (and certainly not enough to do any actual harm) of a substance in only 1 of the 18 cartridges they sampled. Also, the 'antifreeze' ingredient they referred to was propylene glycol. True, it is an ingredient in antifreeze..... but so is water. I learned that PG was added to antifreeze to in fact make it less toxic if ingested and that the liquid is generally regarded as safe (GRAS) by the FDA and that it is very commonly used in a variety of widely used products like toothpaste, cosmetics, fog machines, human food, animal feed, and even in pharmaceuticals (such as asthma inhalers). Right then I became skeptical, especially since the report overlooked the fact about PG being used in pharmaceuticals they approve of which includes over the counter nicotine patches. So why was it such a big deal in the electronic cigarettes? Also, the DC court found that the FDA had no right to ban the electronic cigarettes as they had tried to do (as well as confiscating shipments of the products which is why they were sued in the first place) because they had presented no evidence that the product was unsafe. Well, further research into the testimonies of e-cigarette users was dumbfounding. Over and over I kept reading remarks from ex-smokers saying that after trying everything known to man, this product was the first and only thing that had worked for them long term. The stories from all these different people all over the world were very similar. I was gob smacked. It seems that other over the counter NRTs have a fairly low success rate long term, but not this. I learned that in 7 years that they have been widely available there have been no reported illnesses and certainly no deaths related to their use. They have been used longer in Europe than they have in the US. This segued into learning about Harm Reduction theory and the input from physicians explaining how smokeless alternatives could reduce smoking related illnesses by as much as 98% since most of the damage from smoking is caused by the smoke itself. They were looking at all options from a public health perspective as opposed to the 'quit or die' approach employed by many non-profits like the American Lung Association and the American Cancer Society. What resonated with me most was their assertion that it is unethical and immoral to tell people that their health cannot improve dramatically unless they quit tobacco and all nicotine related products altogether. It is assumed that their reasoning is that if you let people think that they can get healthier without discontinuing nicotine altogether, then why would anyone bother? Well, maybe people would 'bother' quitting cigarettes if they thought there were products that would reduce their chances of relapse while eliminating the health risks caused by smoke. Otherwise, people just assume based on what they're told that there really isn't any use in making any changes in their smoking habits because if they can't stay away from nicotine altogether then their health won't improve anyway. Quite frankly this is a LIE. If one product comes with the risk of lung cancer, emphysema, COPD, and mouth cancer and the other one doesn't, how can you logically and ethically tell someone there is no difference? It is clear to me that some people are fighting the wrong battle here. It doesn't help my confidence to know that three representatives from Big Tobacco are on the FDA board and that the FDA has extremely close ties to Big Pharma. Many people also don't realize that pharmaceutical companies are some of the biggest contributors to organizations like the ALA and ACS, nor do they know that most of the money these organizations get goes towards salaries. As someone who works for the local division of a federal agency I am well aware that non-profits must pay close attention to the interests of their funding sources. Therefore, it makes sense that these organizations would not approve of products that threaten to decrease the cash flow of their funding sources while they outright promote the FDA approved products manufactured by pharmaceutical companies such as the nicotine patch, lozenge, and gum. Meanwhile, Chantix and a host of other drugs with potentially lethal side effects are fast tracked onto the market and cigarettes (approved by the FDA) continue to be legal and readily available everywhere when we all know exactly how damaging they are to smokers and those around them. This has all left me feeling sad, angry, and betrayed.
It wasn't my intention to make this a personal issue, but hopefully it offers clarification as to why I am so passionate about all of this. Thanks again for being willing to listen and let me know if there is anything else I can elaborate on. Also, would you be open to receiving feedback from any other folks such as consumer advocacy groups? I don't want to overwhelm you but there are people who have been involved in this far longer than I have and may be able to provide even more information.
Take care,
_______
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I also added:
I'm sorry I overlooked this, but as far as incentivizing compliance, I think that people knowing that if they test positive for nicotine that they will be subjected to a CO test which can differentiate smoke from nicotine it will definitely encourage smoking abstinence.
I also told him about how nic is less w/ecigs than tobacco cigs and that it doesn't appear to raise blood pressure the same way, either
I'm sorry I overlooked this, but as far as incentivizing compliance, I think that people knowing that if they test positive for nicotine that they will be subjected to a CO test which can differentiate smoke from nicotine it will definitely encourage smoking abstinence.
I also told him about how nic is less w/ecigs than tobacco cigs and that it doesn't appear to raise blood pressure the same way, either
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You are right. I worked for a multinational company for 36 years before retiring. Once they sent 5 corporate lawyers to a small town in the South to scare a small town lawyer who sued them for replacement of a table that was broken by the weight of a piece of heavy electronic equipment. The lawyer had been warned that the table was insufficient to support the machine. They crowded into his office and intimidated him to the point of dropping the suit and then flew 1500 miles back North. A $200 table would have been much cheaper than 5 lawyers on a Lear Jet from home office, but the company refused to accede to his demands.
The world is crazy with legal battles.
Crumpet, that was very well developed and hopefully he understands and develops an alternative approach. You seem to have got his attention.
Yes, great letter Crumpet.
Thanks to this campaign, it seems that the hospital might be considering a common sense (at least when compared to the original plan) middle ground, wherein NRTs will be permitted as long as the person has a doctor's permission.
Thanks to this campaign, it seems that the hospital might be considering a common sense (at least when compared to the original plan) middle ground, wherein NRTs will be permitted as long as the person has a doctor's permission.
That was a great letter, Crumpet - I really hope he takes the time to read it.
Just one correction for your future correspondence - the reference of "anti-freeze" the FDA found in one sample wasn't regarding propylene glycol, it was diethylene glycol they found, which is actually quite toxic. What makes the announcement of finding that "toxic chemical" disingenuous is that it was found only in one cartridge out of 18 tested and it was at a NON-toxic level - approximately 1%. It was also NOT detected in the vapor and has not been found in any tests performed since. For some reason people seem to easily confuse the anti-freeze claim with propylene glycol (also used in anti-fereze) and don't understand that the FDA was actually talking about diethylene glycol, so it's a common mistake.
It's great to have people like you fighting for the cause and it shows how just one or two calm, rational voices CAN make a difference. I hope you're a member of CASAA - we can use people with your skills!
Just one correction for your future correspondence - the reference of "anti-freeze" the FDA found in one sample wasn't regarding propylene glycol, it was diethylene glycol they found, which is actually quite toxic. What makes the announcement of finding that "toxic chemical" disingenuous is that it was found only in one cartridge out of 18 tested and it was at a NON-toxic level - approximately 1%. It was also NOT detected in the vapor and has not been found in any tests performed since. For some reason people seem to easily confuse the anti-freeze claim with propylene glycol (also used in anti-fereze) and don't understand that the FDA was actually talking about diethylene glycol, so it's a common mistake.
It's great to have people like you fighting for the cause and it shows how just one or two calm, rational voices CAN make a difference. I hope you're a member of CASAA - we can use people with your skills!
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