FDA Why Isn't Vaping the FDA Center for Tobacco Product's Biggest Ally?

[tombaker]

No. I have been saying for many posts now that we first prove that vapers quit at a higher rate than smokers who do not vape. After that, we can either argue that those who are dual users are either better positioned for cessation, or at the very least reducing their harm. (Because the overall mortality population effects of vaping - as compared to no vaping - will still be on the side of vaping. Dual users are obviously in no worse position than smokers who continue to smoke unabated.)

What I have been saying for many posts now is that the simplist, most powerful, and most effective message that we can send about adult vapers is that "Vapers are quitters." (I.e. we quit at a higher rate than smokers who do not vape.)

The West study doesn't perfectly establish that, but I am confident that if regular vapers (not just 'ever-vapers') were compared to non-vaping smokers, that vaping would do just fine, too.

Now we win the reduced-mortality argument on a population basis (at least for adults), because we can show that restrictions on vaping will increase mortality.

Lafayette: The only person talking about mortality is you. If you have some sort of study on mortality that reflects X amount of usage = X amounts of death, please link it up. Without commentary.

Why your theories on Mortality as useless: death does not describe quality of health, and the number of years is not reflective of impact of harm. A smoker gets 3/4ths of their lungs removed, cancer cured, they have to be hooked up to an oxygen machine all the time, and lives on for years and years. How does their ultimate death at 86 mean anything. How does a smoker getting hit by a car reflect the impact of them having cancer.

Mortality rate have no way of being useful in the debate, and I see no one suggesting it other than you. The mortality argument you think can be won, is not being made by anyone except yourself. I will prepared to be amazed by one of your "Would you believe"s

THEN Lafayette says
the West Study does not establish that vapers quit at a higher rate than non-vapers. Well it actually does. Even Glantz says so.

He first states the results: "in England that shows that, among smokers who made at least one quit attempt in the last year, smokers who used ecigs as part of their quit attempt were statistically significantly more likely to no longer be smoking cigarettes than smokers who used unassisted NRT or no aids."

He then gives his own spin.

"Putting all 6 studies together (the 5 we reviewed plus West's study) suggests that ecigs both discourage quit attempts among smokers in general but increase success for the (smaller number of) people who use them to quit, resulting in a net negative effect of the presence of e-cigs on overall quitting in the population. "

The bold is Glantz conceding the conclusions of West. The unbolded part is his spin, believing that E-Cigs reduce the number of attempts, so he creates a false product of the two variables. But he concedes the West conclusion.

"Putting all 6 studies together (the 5 we reviewed plus West's study) suggests that ecigs increase success for the people who use them to quit.. Per Glantz

Why you think that it remains in question?

 

[Katya]

I always like this message when it is expressed.

Also glad to hear the update to CDC tangent. Glad you were able to connect with them and have a dialogue. Good job!

The dialogue ain't over. I just sent them more studies.

You should have seen what I faxed to our CA Appropriations Committee. And to the governor and the AG and my senators.

Drip, drip, drip.

 

[Kent C]

Yup, he said that during the Senate hearings. Very skilfully prompted by Sen. Burr, I may add.

He also said that nicotine doesn't kill.

Exact quotes below:

"If we could get all of those people [who can't or wont quit smoking conventional cigarettes] to completely switch all of their cigarettes to the non-combustible products that would be good for public health."

And immediately after that quote: (@39 minutes in)

"But our job as the regulator is to figure out what is going on at the population level and it includes the much larger group of smokers not like the first group I defined, a much larger group of smokers who are concerned about their health and who are interested in quitting and what happens instead of those people completely substituting with a non-combustible product, they start using both, and then along the way they wind up becoming less interested in quitting. So then we would say that might not be good for public health, and our job is to figure out what is the net of all of those possible behaviors including any initiation which would not be good for public health and then try to make public policy on top of that."

Again, this (the net) is the flawed* utilitarian ethic of "the greatest good for the greatest number" (vs. what rights individuals have, and what choices they can make of their own free will) and the greater number for him is not the 'small subset of hard core smokers' from your quote, but the "much larger group" who are interested in quitting, and if they become just satisfied with vaping, they aren't going to quit nicotine or end their addiction. And as a result of that, in his eyes, more harm is being done and it would not be good for public health - what he believes is his purpose to avoid.

And it also shows that his focus is on nicotine addiction, not smoking tobacco. And that somehow, nicotine addiction over a larger group of people, even though vaping eliminates the truly harmful effects from combustible tobacco use, is harmful.

And the true fallacy of the idea that dual use will lead back to smoking is shown in his own understanding of the people in the 'larger group': those "who are concerned about their health and who are interested in quitting." But those who are 'concerned about their health' would be those who already know that they should be concerned and about what, they are concerned about. IE. that smoking combustible tobacco can lead to illness and early death. If they've found their way to ecigarettes and choose that as an alternative, they do that for the very reason why they are 'concerned about their health!' and have likely done a bit of research on it.

But Zeller ignores the obviousness of the above and of the implications of what he says. He invalidates his own premise: of 'those who are concerned' and concludes by saying they will go back to smoking and what? forget about what they were concerned about?

The "syllogism" would look something like this:

A large group is very concerned about their health.
Quitting smoking would eliminate that concern.

Therefore: The will continue to smoke.

*post 43 http://www.e-cigarette-forum.com/fo...er-e-cigs-its-complicated-5.html#post13224463

 

[Katya]

The "syllogism" would look something like this:

A large group is very concerned about their health.
Quitting smoking would eliminate that concern.

Therefore: The will continue to smoke.

*post 43 http://www.e-cigarette-forum.com/fo...er-e-cigs-its-complicated-5.html#post13224463

Yup! That's Zeller's logic.

But you have to cut him some slack--he didn't make those statements that I quoted above willingly; I suspect he had never planned on making them. Alas, the good Senator Burr masterfully manipulated him with his innocent-sounding questions and pretty much forced him to admit the obvious... Poor Zeller. I'm sure he regrets making those proclamations--everyone quotes him now. I started all my letters to the CA legislators with Zeller's quotes.

He can't unring that bell! It's on tape! The press is quoting him. The pro-vape people are quoting him.

Uma just posted this in the News Forum:

http://www.engadget.com/2014/05/23/vaporizers-explainer/

We don't 100 percent know if it's safe. Studies to determine the potential health and safety issues long-term need time; vaping is so new that this time hasn't elapsed yet. But the fact that you're not burning tobacco and breathing in the smoke "feels" like it should be healthier, right? In fact, Mitch Zeller, director of the United States Food and Drug Administration's Center for Tobacco Products said in mid-May 2014, "If we could get all of those people [who smoke] to completely switch all of their cigarettes to non-combustible cigarettes, it would be good for public health." That's something right? That aside, the only other recent blessing comes from a very recent study on its ability to be used as a tool to quit smoking. It appears that the University College London's 6,000 person, seven-year research shows it is much more successful than other nicotine replacement tools or cold turkey.

 

[aubergine]

Yup! That's Zeller's logic.

But you have to cut him some slack--he didn't make those statements that I quoted above willingly; I suspect he had never planned on making them. Alas, the good Senator Burr masterfully manipulated him with his innocent-sounding questions and pretty much forced him to admit the obvious... Poor Zeller. I'm sure he regrets making those proclamations--everyone quotes him now. I started all my letters to the CA legislators with Zeller's quotes.

He can't unring that bell! It's on tape! The press is quoting him. The pro-vape people are quoting him.

Uma just posted this in the News Forum:

http://www.engadget.com/2014/05/23/vaporizers-explainer/

That's the thing. Truth to power. Not that truth always triumphs, but it has a way of rising to the surface. And it has sharp elbows, if not always a deep pocket. Sigh. (This is nice clarifying thread, BTW.) Have a wonderful holiday, everyone!

 

[Jman8]

The "syllogism" would look something like this:

A large group is very concerned about their health.
Quitting smoking would eliminate that concern.

Therefore: They will continue to smoke.

Uh.. I'm not afraid to admit that if you magically made all vape stuff disappear, I'd be off to the nearest convenience store for some smokes pretty quickly, even if I had to "walk a mile" (it's actually more like 2-1/2 miles from here).

My apologies to Rossum for quoting what may appear like I'm singling out Rossum. On the contrary, I feel many vapers express themselves in this way.

"If vaping disappears, I will smoke, guaranteed."

Hence, it makes for a very challenging issue to understand going forward.

To the dual user, like myself, I feel I can answer any challenge put forth and feel confident about what I'm up to based on my general feelings of good health. Deny this at your own peril.

To the vaper that has ceased smoking, I think they feel they can answer all challenges put forth, feel confident about what they are up to when it comes to now exclusively vaping nicotine, based on general feelings of good health. Deny this, at your own peril.

To the regulator who sees tobacco/nicotine as epidemic that is costing lives of Americans, and that sees substitution as one vape away from full on smoking, feels confident that strict control over all forms of nicotine derived from tobacco is best way to counter the epidemic. Saving users (in denial) from themselves.

To me, what makes this challenging is those who hang the proverbial hat on claim that cessation is king, or best/only path forward. Who intentionally downplay all instances of moderation, particularly as that relates to smoking. I feel very confident that FDA has little to no idea what that experience is like. And is my opinion that many vapers have no idea what that is like. Though, if they were once smokers themselves, process it as 'just more of the same when it comes to smoking.' And if someone like myself were to pass away next week, those two generalized groups of people (both of whom downplay moderate smoking) might be all too willing to attribute my death to, 'well of course he died, he was still smoking right?'

Smoking, like vaping (and many other tobacco products, or most other products on this planet period) aren't just going to magically disappear tomorrow. Nor 5 years from now. Nor 50 years from now. Yet, knowing this reality, cessation is still seen by some as ideal peg to hang the hat on. Why, because the meme 'smoking kills' is so ingrained, and so unchallenged, and so over sold that many, otherwise critical thinkers, have lost sight of viable/practical goal. Moderation, thru substitution, is achievable and will lead to set that seeks cessation (from all things tobacco/nicotine). But strictly controlling one or more of these things that are popular will lead those who represent aspect of 'high product demand' to spite regulators and get what they desire and which was indeed working for them (i.e. in an underground market). And this absolutely includes smoking.

Which a segment of our minors' population has been showing all those paying attention to such things, for as long as I've been alive.

 

[Rossum]

My apologies to Rossum for quoting what may appear like I'm singling out Rossum. On the contrary, I feel many vapers express themselves in this way.

"If vaping disappears, I will smoke, guaranteed."
[...]
To the regulator who sees tobacco/nicotine as epidemic that is costing lives of Americans, and that sees substitution as one vape away from full on smoking, feels confident that strict control over all forms of nicotine derived from tobacco is best way to counter the epidemic. Saving users (in denial) from themselves.

What exactly does this hypothetical regulator think we're in denial of? I'm not denying anything by making the above statement, but I am making a rather strong implication, which perhaps we should state explicitly: It is not possible to make vaping disappear. If you regulate, control, or tax vaping too much, I will find a way around whatever barriers you erect. Why? Because those general feelings of good health give me a very strong incentive NOT to return to being a smoker (and dual users like Jman8 a very good incentive not to return to smoking full time). I never had any intention of giving up nicotine, and I still don't, nor can any nanny-state regulator or politician force me to.

 

[aubergine]

Smoking kills. Well, it does. We could argue that for a long time but I think the data's in on that one, and making that dead-in-the-water controversy our focus seems lose/lose to me. A no-brainer.

That said, less smoking probably kills less. I understand the games being played around that one, but it also seems a no-brainer to me.

Nicotine isn't the killer in any case. That distinction matters. Because there you have the distinction between ecigs and cigarettes health-wise.

All of the rest seems unbalanced and convoluted to me. And, frankly, somewhat tangential.

I like to think that I'd not go back to smoking if ecigs disappeared or required too many hoops to acquire (my daughters are all teachers - they're not going to be breaking any job-threatening laws and I was in public health, ditto; many of us aren't in a position to exploit a black market), but quite honestly I think it would take one exhausting personal crisis for me to be saying FI and heading for Quikmart. Which is one of the most disgusting, depressing things in the world for me to consider. Freedom from cigarettes has been a huge, huge life-changer for me. And that's just me (though also many others), not some moral admonishment. I'd never look down upon a dual user or presume to suggest that they do things differently, and even though I believe that cigarettes are wretched and dangerous, I'd not press for some sort of doomed and oppressive drug war. To me, though, that's a different battle and what's needed is to sharply distinguish the two products. Fat chance.

 

[wv2win]

What exactly does this hypothetical regulator think we're in denial of? I'm not denying anything by making the above statement, but I am making a rather strong implication, which perhaps we should state explicitly: It is not possible to make vaping disappear. If you regulate, control, or tax vaping too much, I will find a way around whatever barriers you erect. Why? Because those general feelings of good health give me a very strong incentive NOT to return to being a smoker (and dual users like Jman8 a very good incentive not to return to smoking full time). I never had any intention of giving up nicotine, and I still don't, nor can any nanny-state regulator or politician force me to.

But can they make it unprofitable or too time consuming for most vendors to stay in business, which vastly limits choice, creates a severe reduction of new vapers, further crippling the industry. Whether we DIY or not, we are all vested in the industry growing to promote more vapers, better products, more innovation and more competitive pricing.

 

[aubergine]

Jman, I agree with you.

In a part Puritan and part totalitarian mindset of any zealot, moderation is never an option. It's always, somehow, about total abstinence. Quit or die.

But it's not true that all ECF members are like this. I'm not. And I always warn vaping neophytes about the dangers of becoming militant, intolerant, obnoxious ex-smokers. When new members complain about having a hard time quitting, the ECF mantra is, "don't count the cigarettes you smoked, count those you avoided." We always tell them to have a smoke if they absolutely have to because it's all about harm reduction. Anyway, that's what I've been preaching here for 4.5 years. And nobody will convince me that smokers who went from smoking three packs a day to a pack a week are not better off--because they are.

The Soterra ruling classified e-cigarettes as a recreational tobacco product--and we cheered that decision. I have absolutely no problem with that. And I have no problem with people vaping and smoking, snusing, using WTAs, NTRs, whatever. It's all legal and we are all adults. If they happen to quit paper cigs--they are cheered! If they don't--they are cheered also and encouraged not to give up because they had a stupid smoke. Not the end of the world.

And you are spot on wrt the CDC study--as you know, I sent them an email and they responded. They are beginning to understand that they are wrong--but they have their bloody directives and there's nothing they can do--yet. We just have to bugger on and provide evidence that vaping is way less is harmful than smoking and (accidentally) it also happens to be much more effective than all of their FDA-approved NRTs. Come to think of it, I don't see why BP shouldn't explore e-cigarettes as an inspiration for a new NRT. Heck, if they make a good one, I'll be willing to try it. Let them make a safe and effective e-cigarette! Competition is good! Win-win! The more the merrier!

Live and let live.

Don't hurt people and don't take their stuff.

That's gonna need a BIG T-shirt...

 

[aubergine]

Jman, I agree with you.

In a part Puritan and part totalitarian mindset of any zealot, moderation is never an option. It's always, somehow, about total abstinence. Quit or die.

But it's not true that all ECF members are like this. I'm not. And I always warn vaping neophytes about the dangers of becoming militant, intolerant, obnoxious ex-smokers. When new members complain about having a hard time quitting, the ECF mantra is, "don't count the cigarettes you smoked, count those you avoided." We always tell them to have a smoke if they absolutely have to because it's all about harm reduction. Anyway, that's what I've been preaching here for 4.5 years. And nobody will convince me that smokers who went from smoking three packs a day to a pack a week are not better off--because they are.

The Soterra ruling classified e-cigarettes as a recreational tobacco product--and we cheered that decision. I have absolutely no problem with that. And I have no problem with people vaping and smoking, snusing, using WTAs, NTRs, whatever. It's all legal and we are all adults. If they happen to quit paper cigs--they are cheered! If they don't--they are cheered also and encouraged not to give up because they had a stupid smoke. Not the end of the world.

And you are spot on wrt the CDC study--as you know, I sent them an email and they responded. They are beginning to understand that they are wrong--but they have their bloody directives and there's nothing they can do--yet. We just have to bugger on and provide evidence that vaping is way less is harmful than smoking and (accidentally) it also happens to be much more effective than all of their FDA-approved NRTs. Come to think of it, I don't see why BP shouldn't explore e-cigarettes as an inspiration for a new NRT. Heck, if they make a good one, I'll be willing to try it. Let them make a safe and effective e-cigarette! Competition is good! Win-win! The more the merrier!

Live and let live.

Don't hurt people and don't take their stuff.

That's gonna need a BIG T-shirt...

I miss your old sweetly inquisitive bird, though. That one scares me, has flown at the head of too many monstrous crusades. How about an nice fierce owl?

 

[Rossum]

That's gonna need a BIG T-shirt...

The last two lines are all that's really needed:

Live and let live.
Don't hurt people and don't take their stuff.

 

[Rossum]

But can they make it unprofitable or too time consuming for most vendors to stay in business, which vastly limits choice, creates a severe reduction of new vapers, further crippling the industry. Whether we DIY or not, we are all vested in the industry growing to promote more vapers, better products, more innovation and more competitive pricing.

Although I understand that choices might be limited, and prices might be higher, I wonder how much that would reduce the number of new vapers. We do have some historical precedent to look at: Did alcohol prohibition produce a severe reduction in new drinkers? Has the prohibition against other_stuff produced a severe reduction in new other_stuff users? I believe vaping has reached critical mass and is pretty much unstoppable at this point, no matter what they do. That said, I'd certainly like to have as much choice and innovation as possible at free (rather than black) market prices, but stop it? No they won't, and I think it's important they understand that.

 

[Kent C]

To me, what makes this challenging is those who hang the proverbial hat on claim that cessation is king, or best/only path forward. Who intentionally downplay all instances of moderation, particularly as that relates to smoking. I feel very confident that FDA has little to no idea what that experience is like. And is my opinion that many vapers have no idea what that is like. Though, if they were once smokers themselves, process it as 'just more of the same when it comes to smoking.' And if someone like myself were to pass away next week, those two generalized groups of people (both of whom downplay moderate smoking) might be all too willing to attribute my death to, 'well of course he died, he was still smoking right?'

I'm with you on this. My post was about the type of thinking of the regulators and the flaws in that thinking. And I agree, some ex-smokers, who have their own personal interest stories (I have a few myself who seem to be of the same mind (of which I am not .

And while I may also look at the practical aspects of dual use, my focus is more on the right to do so, and what follows from that is that I really don't care why someone would dual use or why someone thinks they shouldn't, but only that they have a right to as long as it hurts no other. Our former 'regulators' (before regulatory agencies) used to have that same type of thinking.

But since that is no longer the case, one can still argue 'in their terms' as I think I did above, and still point out the weakness of their arguments. And then hope enough people see the effects of such regulation in all aspects of their lives where they change the present make up of the gov't to where in the future, they and others don't have to battle those intruders to maintain their otherwise peaceful lives.

 

[Kent C]

I miss your old sweetly inquisitive bird, though. That one scares me, has flown at the head of too many monstrous crusades. How about an nice fierce owl?

...as we approach Memorial Day and D-Day

At least your still free to say that.

 

[Katya]

...as we approach Memorial Day and D-Day

At least your still free to say that.

One of those crusades liberated Europe... and my family, or rather, whatever was left of it in 1945. I'll be forever grateful.

 

[Kent C]

One of those crusades liberated Europe... and my family, or rather, whatever was left of it in 1945. I'll be forever grateful.

You and millions if not billions of others, both here and abroad.

 

[aubergine]

For that one I'm deeply, deeply grateful too. And the last thing I meant to do was seem flippant on this particular weekend. I hate to lose our sons and daughters in stupid, ill-advised adventures, and I tend to think of those first; I know some very angry vets. Apologies, Katya, and deepest respect.

 

[Kent C]

For that one I'm deeply, deeply grateful too. And the last thing I meant to do was seem flippant on this particular weekend. I hate to lose our sons and daughters in stupid, ill-advised adventures, and I tend to think of those first; I know some very angry vets. Apologies, Katya, and deepest respect.

Yep.

Sen. John McCain hears vets complaints over VA | Mail Online

 

[Katya]

For that one I'm deeply, deeply grateful too. And the last thing I meant to do was seem flippant on this particular weekend. I hate to lose our sons and daughters in stupid, ill-advised adventures, and I tend to think of those first; I know some very angry vets. Apologies, Katya, and deepest respect.

I know...

Happy Memorial Day!