Why does the medical field know so little about vaping?

[fourthrok]

Both my husband and I have numerous health issues...his are quite critical. Perhaps it's the region we live in, I don't know. But we have not gotten any negative reaction to our vaping from EMTs, nurses, physicians or doctors. My husband and I have both vaped while in the hospital (discretely, behind our little "privacy curtain" of course) and both of us have vaped on hospital grounds. The only time there was a "confrontation" was when husband was there for a procedure and while waiting, he vaped a little in a quiet corridor. A security guard approached him..then seeing the shirt hubby was wearing ("It's just vapor!") stopped and chuckled and said "I wish more people who use those things would wear something like that! When someone reports smoking I have to check it out. It'd sure save me some running around!".

When I was in the hospital being checked out due to having heart attack type symptoms and an abnormal EKG ...I vaped in my hospital room. The heart surgeon came in to chat and asked if I smoked. I told him no, that I'd quit using electronic cigarettes (I was a newbie to vaping back then). He nodded and made a guarded reply that he'd "heard" that people had had success with that method, and that he was glad I'd quit smoking. He didn't really endorse...nor did he discourage. He seemed receptive, but kept the official aloof stance where he wouldn't appear to be telling me directly it was okay.

My general practitioner took the exact same stance. However, when hubby was talking about joining me with the vaping thing (I quit smoking first) the doctor nodded and wished him success.

Part of my husband's illness requires us being at the Mayo Clinic a great deal of the time. We openly vape on campus, but are discrete. One time I dropped one of my PVs during one of our long treks across the many buildings on the campus...so I retraced my steps trying to find it; inquiring, with various nurses, receptionists etc. along the way. I even pulled out my spare PV and showed it to them telling them what it was and what color the lost one was. None of them batted an eyelash...and one even went to one of the examination rooms to unlock it so I could look in there. When we were being interviewed by my husband's specialist, and the subject came up, we told him about the e-cigs. He just nodded. Didn't say anything "yay" or "nay". We took that as a tacit approval. Same reaction from the social worker.

More than one nurse has asked my husband for a vendor business card because she wanted to look into e-cigs for herself. (not that there aren't male nurses, but so far it's just been the ladies who've asked).

Overall, the climate in the medical community in this area is accepting...but not openly involved. Which is fine with us.

 

[Racehorse]

I'm not the Troll here . You can Question what you want . I have studied human nature . WE do things like "helping others " because it feels good or nice . That releases certain "drugs" into our brain . WE continue to do tose things because of that feeling . Others say " WOW what a saint , helping others like that !" and that makes us feel good to . Every action has a reason , the overt and the covert . Overt " I do this to HELP OTHERS " but I still get paid . Covert is " when I do these things it FELLS GOOD " I want MORE . Deny what you want , it's how the human body works !

Sounds like you read the latest self help book or something........old Skinner and behaviourism.......no real doctor would express such a simplistic concept in the manner you just did,,,,

.... but even moreso, they wouldn't reduce human behavior to such old simplistic models of lab rats and pidgeons.

That reward reinforces behavior is hardly Big News to any lay persons here.

 

[mikejm]

Do you know what all those doctors and nurses do when they leave the hospital?


THEY GET SMASHED ON ALCOHOL.

Just so you know...

 

[Edd Harbin]

First off , never claimed to be a Doctor , only have my masters . Second if someone claims to ba a Doctor he should already kmow this . Breaking it down to the most simple level is the best way for ALL , including said Doctor to see the truth in the matter . The whole thing is more complicated but in the end not so much . Why do you think we as a species are so apt to get addicted ? It's the way we are wired ! Why do you think e-cig's work in helping to quit analog's ? The same reason methodone clinics work . It is as simple and basic as that . Putting things in plain basic talk is just pulling back the veil . It's like when the bible was only in latin . You had to believe and do what the church told you because you couln't read the Bible . When printed in common all of the sudden the veil was pulled back

And the problem here isn't that people don't know about reward for behavior , it's the denial that it works for "YOU" (whomever "YOU" may be ) too that is the issue . If you deny that you get something out of "doing this to help others " then you are just plain wrong , not bad or evil , just wrong .

Big Pharm , doctors , hospitals and insurance companies ARE BUISNESSES . If they don't make money they don't keep doing what they do . If they shoot themselves in the foot and tout somehting they don't recieve reward for they go out of buisness . NO Person in the medical world can tell you that 2000 or more chemicals is not worse than less than 10 . And yet they can say we don't KNOW so I can't say . Why is that ? They want to protect themselves from repercusions both in the wallet and at work . That is very basic reward and punishment behavior . Ring, ring Pavlov's dogs !

 

[Butters78]

Oh snap!

 

[Tail11]

For the record - I'm sure there is a majority of health care professionals in this world that do care about peoples health and want to help them. What I don't like the perceived stranglehold that BP has over the FDA <which is riddled with many folks that were executives and lobbyists of BP> calling the shots on behalf of the citizens/health care providers. IMHO, it is one big racket where company profits are paramount to actual healthcare received in this country.

 

[Edd Harbin]

I agree , most people whom are medical caregivers DO care about the people they help , it's hard to do this and not . But we have in the last century put doctors on a pedistal as though the power of life and death makes you different than a carpenter . Doctors are people to , have the same weakness that the rest of us meer mortals have . That the reason you hear "HOW DARE YOU QUESTION MY MOTIVES" . I wan't my medical care done right , on time , and it not cost me a big house and a Porsche . I also want my car fixed the same way .

 

[drsocal]

its probably becuz it has to do with tobacco.

 

[kristin]

And the FDA is full of ex big tobacco execs. So we know where that ends up.

No, the FDA is full of ex BIG PHARMA execs and big pharma is filled with ex-FDA execs.

Most doctors don't recite the Hippocratic Oath, they recite the Declaration of Geneva. In any case, not recommending e cigs does not violate either. The fact is - nobody knows what the long term effect of vaping nicotine is. There havent been enough credible studies. A doctor may *believe* it's better - but that's thier own belief and, if they recommended it and turned out to be wrong, it would be more of a violation of thier oath than not recommending it in the first place.

Personally, I don't plan to disclose to my doctor that I vape. He will either approve or disapprove of it and I will continue to vape - until either a study comes out that proves it's harmful or I personally start to feel it isn't good for me.

(Bosco, this isn't directed at you - just using your post as a jumping off point.)

Then the Hippocratic Oath should be called the Hypocritical Oath. The premise as to why the medical community doesn't support or recommend e-cigarettes to their smoking patients include: 1) There are no long-term studies proving safety; 2) They are not approved for use as smoking cessation devices by the FDA; 3) We are required to "do no harm." Nicotine still causes harm and we don't know if e-cigarettes could be harmful.

Let's get to the facts:
1) The FDA approved Chantix without any SHORT-term population-based studies involving "real world use." Short, clinical studies with a very select cohort reported a 44% success rate and no adverse health affects. Once the drug was released into the general population, the FDA had to issue warnings of increased health risks regarding heart attacks, strokes and suicide AND a 2012 population-based study showed the true smoking cessation rate to be at 6.5% at 12 months. Therefore, 93.5% of patients taking Chantix were exposed to significant health risks without any significant health benefits because they returned to smoking.

No drug is required to undergo 25 years of study before being approved. The FDA bases its approvals on short-term studies that show no reasonable concern for significant health risks and then unleashes the drug onto the unsuspecting public to see what happens. And Chantix was a NEW drug with which there were NO known studies. E-cigarettes contain pre-existing chemicals of which the FDA is quite familiar and would be very easy to meet the criteria of "no reasonable concern." It is completely disingenuous to expect e-cigarettes to meet a level of scientific study not required even of completely new drugs. All of that, of course, ignores the fact that the "intended use" of e-cigarettes determines the regulatory requirements. If the manufacturer does not market them as a treatment for smoking/nicotine addiction, then they are regulated as a tobacco product. There is plenty of science showing that smoke-free tobacco products are orders of magnitudes less harmful than smoking.

2) The idea that doctors only prescribe drugs per FDA recommendations and only approved use is not true. Doctors commonly tell smoking patients to continue to use NRT longer than the recommended time if it will keep them from relapsing. Nearly 40% of NRT users have been using the product for years - far longer than the recommended 12-week period. Doctors also commonly and can legally prescribe drugs for "off-label use." However, e-cigarettes are NOT a drug treatment, so doctors should be able to recommend using them in lieu of smoking if the patient informs them that they fear relapse because medical treatments are not working. The doctors would not be recommending an "unapproved medical treatment," they'd be recommending a reduced harm tobacco alternative, since the FDA intends to regulate e-cigarettes as "tobacco products." This is no different than recommending a low-fat diet for an obese patient with an eating disorder in lieu of weight loss chemicals. It is recommending a change in the type of product being used rather than a way to treat the addiction.

3) Oh, but doctors cannot do that! They can't even recommend using a smoke-free tobacco to their COPD smoking patient because then they would be breaking the Hippocratic Oath, right? Wrong. Let's go back to Chantix and those warnings the FDA now requires. Chantix is now KNOWN to be UNSAFE, however, the FDA stated that the benefits of quitting smoking outweigh the health risks (and we already saw how there are NO health benefits for the vast majority of users.) So, that means that there is no rule that medical professionals must NEVER expose their patients to ANY risk. Chemotherapy pretty much blows that theory out of the water - injecting toxic and carcinogenic chemicals into a patient to treat cancer anyone? Doctors are clearly within their ethical boundaries when choosing to prescribe products with LOW RISKS compared to the greater risks a patient faces. And let's think about what a doctor is telling a smoking patient who has informed them that NRT, Chantix and other smoking cessation treatments are not working and they tell the patient not to try or continue using e-cigarettes. They are essentially telling the smoker to keep smoking and exposing themselves to the toxic chemicals instead of using a product shown by the FDA's own testing not to contain anything worse than what is found in FDA-approved NRT. Where is that "do no harm" sentiment now?

I would not do it in front of patients out of respect for antz

You lost me at "respect for ANTZ." LOL!

As far as the rest of your post about doctors must recommend only FDA-approved treatments for smokers, I completely disagree. Obviously. There is nothing keeping the doctor from giving appropriate warnings or expressing concerns about the e-cigarettes when recommending them to a patient who cannot or will not quit smoking and then documenting those warnings in the patient's file. If I found out my doctor had knowledge of a product that contained only ingredients generally regarded as safe, had tests showing no reasonable concern and/or that the product had been used successfully by possibly millions of smokers for the past 4 years without any reports to the FDA MedWatch of significant adverse affects (compared to thousands of adverse events reported due to Chantix and NRT use in the same time period); and then I got sick because I couldn't quit smoking, I'd be just as inclined to sue for malpractice (if I was the suing type.) So, I guess doctors are really damned if they do and damned if they don't. But if I was a doctor who truly cared about helping people, I think my preference would be to be sued for trying to help and doing what I knew was right rather than being sued for withholding information from my smoking patients because I feared a lawsuit.

Nicotine is known to erode or thin the lining of the disks in your back making a person more susceptible to disk herniation.

I have been a tobacco harm reduction advocate and researched study after study for the past 3 years and have never come across this study either. I would be interested in having that link, as well. Regardless, one study does not mean there is conclusive evidence.

I'm surprised no one has picked up on this.... The doctor is trying to get you to take the DRUG chantix..... then proceeds to tell you nicotine is a drug?!?!?! Trying to wrap my brain around the idiocy of this statement.... Chantix has caused great problems in people even so far as suicidal thoughts..... Nicotine in the relatively small amounts... Seriously?!?!?!

I'm sorry but there really seems to be something wrong here... That blows my mind, what little there is left of it...

I agree. The idea that doctors must "do no harm" means never recommending a patient use anything with risk is ridiculous. Doctors can and frequently do make the "benefits outweigh the risks" call. As I mentioned earlier, Chantix and e-cigarettes have been available to the public for roughly the same number of years. In that time period, there have been hundreds, if not thousands, of adverse affects reported from Chantix, including over 200 deaths and not one death or even significant adverse affect reported for e-cigarette use. Yet, while the benefits of Chantix still outweigh the risks of smoking, e-cigarettes are still considered an unreasonable risk. It truly boggles the mind.

 

[kristin]

Folks may find these handouts from CASAA helpful to give to medical professionals:

http://casaa.org/uploads/CASAA_Medical_infograph.pdf

http://casaa.org/uploads/CASAA-Ecig-TriFold-Brochure.pdf

The Medical Infograph was designed by a doctor - CASAA's former Medical Director.

 

[Racehorse]

My physical therapist, AT the hospital, vapes.

 

[Tail11]

No, the FDA is full of ex BIG PHARMA execs and big pharma is filled with ex-FDA execs.

I stand corrected. Please accept my apology for making such a mistake. I confused them with the lobbyists that are full of big tobacco executives and their lawyers. Regardless of my mistake, I think we can all agree that the FDA and BP are full of people armed with hidden agendas.

 

[kristin]

I stand corrected. Please accept my apology for making such a mistake. I confused them with the lobbyists that are full of big tobacco executives and their lawyers. Regardless of my mistake, I think we can all agree that the FDA and BP are full of people armed with hidden agendas.

Seriously, no need to apologize! But we should know our true "enemies." Yes, the FDA and BP are full of people armed with agendas - they are true ANTZ. And some tobacco companies have used influence on the FDA - there is no denying that. The FSPTCA was partially engineered by Philip Morris to placate the ANTZ, by banning flavored cigarettes they did not sell, while keeping the most popular flavor - menthol - legal. It was completely self-serving but nothing different than BP supporting increased regulation of the supplement industry so they can take it over. The ANTZ were also fully-aware that the FSPTCA was self-serving in that it made them look like they were saving lives with it (they aren't) and keeping those donations and grants rolling in.

But in the end, those tobacco lobbyists and lawyers may just be what saves the e-cigarette industry. Because tobacco companies are investing in smoke-free alternatives and e-cigarettes, while BP is fighting them to protect their profits from NRT & other smoking cessation drugs and treatments for smoking-related diseases that smokers get when the "safe and effective" smoking cessation drugs fail for 93.8% of them.

 

[Tail11]

But in the end, those tobacco lobbyists and lawyers may just be what saves the e-cigarette industry. Because tobacco companies are investing in smoke-free alternatives and e-cigarettes, while BP is fighting them to protect their profits from NRT & other smoking cessation drugs and treatments for smoking-related diseases that smokers get when the "safe and effective" smoking cessation drugs fail for 93.8% of them.

What scares me about BT getting into the ecig market is that they might decide to throw a few of their toxic chemicals into the juice and make them as bad or worse than tobacco cigarettes already on the market.

 

[kristin]

What scares me about BT getting into the ecig market is that they might decide to throw a few of their toxic chemicals into the juice and make them as bad or worse than tobacco cigarettes already on the market.

That is a common concern, but I think that would kind of defeat the purpose of offering a safer alternative to their customers, wouldn't it? What reason would they have to add anything?

The e-cig market is ready-made of former smokers who mostly don't really want to quit, but didn't want to get sick or die from smoking, which is why they choose e-cigarettes rather than quitting cold turkey or some other way. E-liquid already comes in varied nicotine strengths and the profit margin is much larger compared to cigarettes, so it's better to keep customers on them instead of going back to smoking. The profitable thing for BT to do would be to gain consumer confidence by keeping their liquids the purest and highest quality on the market, giving them no reason to want to quit.

The quit rate for smokers using NRT is less than 7% and even with smokers dying off, the new smokers keep the smoking rate level. Big Tobacco does not fear NRT competition for that reason. But they would see an increase in profits if they can get smokers living longer when they convert them only by ensuring that their smoke-free products are relatively safe. If BT e-cig users started getting sick and found out the tobacco companies were making e-cigarettes more toxic then the companies would be destroying the whole reason for getting into the market in the first place. BT adding in toxic chemicals to e-cigs would be like Kraft buying a successful organic food company and then using all GMO and non-organic food in the products. Why make that kind of investment to attract those consumers only to lose them because you took away the one reason they were popular in the first place?

 

[Tail11]

I agree with you Kristen. I hope that if BT would get involved, they would keep everything the way it is. But given their history, I'm sure you understand my skepticism. I also hope they don't "Walmart" the current industry to kill off the shops that I support now.

I hope one day vaping is commonplace as smoking was in its prime!

 

[vsummer1]

Kristin, with the comment I made about "respecting the ANTZ", it was part of a sentence which I gather didn't portray the true meaning of what I was trying to say. It was an idiom and meant to be taken as such.

To clarify:
The antz are the ones who will complain about my vaping, and if the patients/clients are bothered by anything about their health care provider/location/experience etc. they DO COMPLAIN and loudly. So, due to the antz complaints, I must not put myself in a position where their complaints would then harm staff's ability to vape.

 

[mitzeli]

yes I know but this was a little different in that she was plainly anti smoking of any sort.

Yes but you can't blame the whole medical profession based on her attitude. I realize you were upset with her as I also would have been miffed. But I definately agree with vsummer. I am so sick of people blaming other people instead of themselves for their actions and expecting to be compensated.

 

[mitzeli]

As a vegan, you may need to take some supplements, to make sure you body get all the vitamins, minerals and essential fatty acids that your body requires to be healthy. Just saying this b/c a lot of vegans have issues b/c they didn't realize that they were missing something that the body requires and can't be produced by the body.

She may, but it is totally possible to get what you need without those. I have know sickly vegans who eat only junk, and very healthy vegans who eat a well balance varied plant based diet.

 

[mitzeli]

What scares me about BT getting into the ecig market is that they might decide to throw a few of their toxic chemicals into the juice and make them as bad or worse than tobacco cigarettes already on the market.

Exactly!!!