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

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kristin

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As a relevant side point, can anyone reading this sit down today and have informal chat with board members of CASAA? I ask this because a) it is relevant to the larger point and b) because I find it rather impossible. "They're busy" - is patent response, and I understand this. Is not Zeller busy? Can he afford time daily for the millions that would love to have an informal chat with him?

Yesterday I returned a call from a member who had left a message on our voicemail and chatted with her for nearly 45 minutes. She wanted to tell her story and asked for advice on how to be more involved in advocacy. I was happy to speak with her. A few weeks ago I had a conversation with another member for over an hour. Elaine, Julie and talk to members all of the time. We also answer a lot of emails and private messages here on ECF, on Skype and on Facebook. We also attend a lot of national and local vape meets. If you wanted to talk to one of us and didn't, it's because you didn't try very hard, lol. ;)

And Mr. Zeller has been present at some of the TPSAC hearings where CASAA testified, but that isn't the same as "one-on-one."

But what the pro-vaper is either reluctant to discuss or refuses to acknowledge is that cold turkey is still the best method around, when taking into account the overall public health position. And as long as our side downplays that, then we leave door wide open for criticisms and controversy.

Cold turkey is only the best method for those who want to quit. E-cigs are the best for those who don't want to quit. I personally know hundreds of smokers who quit "unintentionaly" using e-cigs, but none who unintentionally quit cold turkey.

Only a small number of smokers make an actual attempt to quit each year, so having a product that causes smokers to quit or cut down without that intent could be seen as better for overall public health. If cold turkey is a seat belt that someone may not use, e-cigarettes are air bags.
 
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kristin

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I hope you didn't take this as a dig against yourself or CASAA. It truly wasn't meant to be - I know you've tried.

No, it's absurd that this is the situation, but I've just been informed that the FDA estimates there to be approximately 140 individual businesses involved in the e-cigarette industry. Well, we have 625 (yes, 600) US ecig ONLINE businesses registered at ECF! And over 1600 registered in total (including many that are no longer trading). At a push, I'd say we have 900 actively trading businesses registered - and that's only the ones who registered with ECF.

SFATA estimate 14000 vapestores nationwide. Some businesses clearly own multiple stores - but still....

So, where does the FDA get its information from? I think Carl's right - it's only interested in the "bound volumes" of academic publications.

Not at all, Smokey! I wasn't responding to your posts. :)
 

Jman8

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But even if someone drops down to (say) one cigarette a week after years of vaping from 3 PAD, we will lose both the mortality and the morality ("they're still smoking") argument on this.

Who would we lose this argument to? I'd challenge anyone on this and pretty sure I'd win the argument. For sure would win on the morality argument, and fairly sure I'd win on the mortality one.

The other picky point here is that without complete cessation, the ANTZ can argue that relapse is more likely. The FDA has already signaled its intention to to make that argument about vaping in one of the PDFs that was recently posted - which is why we probably need to be able to show that (complete) cessation is long-term.

I disagree. You wanna please ANTZ and FDA personnel that are ANTZ, then show how vapers can go cold turkey from nicotine after taking up vaping. Thinking there's an argument to be had and won with ANTZ whereby an individual gets to ingest nicotine for the rest of their life, and that will be deemed 'good policy' from ANTZ perspective, is simply preposterous. That person would need to have at least 3 credible doctors all agree that this individual cannot survive without nicotine, and even then, I'd be surprised if they went along with it.

I realize we think we need to play a political game right now and emphasize cessation or somehow vaping as we know it will be done. IMO, this is very similar to the whole indoor vaping discussion. We want to please ANTZ and show up as PC on this topic, while rolling over on our principles, our science, our livelihood. I sometimes think the dual user is best person to make the case for vaping and public health, but also realize that such a person would be deemed entirely too controversial from within vaping community and thus have little support. ANTZ would despise such a person and many, if not most, vapers would be wary of them. All because cessation, through vaping, is put on some pedestal that is wonderful in this transition period we are in, but not so wonderful when you realize that once BT is gone, ANTZ will not cease to be ANTZ and will make BV the boogeyman that must be taken down. For the children.

This is why I think we're going to have to hang our hat on the cessation peg without arguing reduction - at least until we have that kind of more nuanced data. (We might, someday.)

When you have actual reasons for hanging the proverbial hat on the cessation peg, do let me know. Until then, cold turkey/willpower will be squarely on that peg, making the most sense to non-users, aka the majority.
 
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<snip>
Cold turkey is only the best method for those who want to quit. E-cigs are the best for those who don't want to quit. I personally know hundreds of smokers who quit "unintentionaly" using e-cigs, but none who unintentionally quit cold turkey.

Only a small number of smokers make an actual attempt to quit each year, so having a product that causes smokers to quit or cut down without that intent could be seen as better for overall public health. If cold turkey is a seat belt that someone may not use, e-cigarettes are air bags.

I like the seat belt vs. air bags analogy, insofar as it helps explain harm reduction, and references the significance of volition.

Personally, I feel a tad uncomfortable telling people that vaping is for dual users.

I'd just as soon point to the fact that all these vapers have quit, without talking about their motives for beginning to vape in the first place.

To me, this looks too much like the ads which imply that vaping is for smokers who want to "evade" smoking bans. Or as the inimitable Sen. Kathy Sheran (Manteko, MN) put it in a rather unpleasant-to-watch Twin Cities PBS interview - to "practice their addiction in public." (Which, is a line she may have picked up either from Clearway MN or Legacy.) Mind you, I don't blame the cigAlike manufactuers for using this appeal, because they aren't even allowed to mention that vaping doesn't involve the use of combustible tobacco :facepalm:

But I feel as if that gives unnecessary ammo. to Gantz and the other ANTZ.

The longer someone has vaped, the more likely it is that they've quit. Now we have the population studies to show something like this in several European countries. Simple, easy to understand.

Speaking of cars - I want a bumper sticker that reads: Vapers are Quitters.
 
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Katya

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Tom is right to point out that the FDA isn't fundamentally evil (especially simply by virtue of being a government agency). Like the police force, it was designed to, and often does, serve a crucial protective function; we'd in fact be fairly screwed without it. I don't see our issue as part of a broad scheme by our current administration to destroy individual freedom and the American way of life - there's lots of that in here, it's over-familiar nonsense and I try to ignore it.* I also agree that a reasoned, amicable confrontation, armed with facts and a willingness to recognize the opposition as human is a crucial starting point in any negotiation. That's Activism 101.

(snip)
*On the other hand, we're all shaped by our experience. Right or left, the most passionate and credible amongst us have been deeply and personally burned by government power run amok. Our values and goals are sometimes diametrically opposed, as is our take on nearly every damned issue (to the delight of our real overlords, who have exploited 'divide and conquer' to the max here - we are severely played, all of us; we can't even agree on who's playing us), but the instinct that questions and challenges entrenched and overweening authority is crucial.

I agree with you, Aubergine. I don't believe that any organization is evil--per se. Not the FDA, or ALA, or CDC, or BP. I don't believe that anybody wakes up in the morning and goes to work with a goal to do something vile and horrible. The VA is a great and honorable organization also and is lead by a 4-star general, a war hero who certainly cares for our veterans and nobody will convince me otherwise. How about Pentagon and their $640 toilet seats...

The problem is the structure--the shear size of those government bureaucracies and the myriad of idiotic laws that bind them that make them so inefficient and prone to failure and abuse and corruption. I don't know what the solution is... I can only hope that somehow the truth will prevail.
 

Kent C

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I agree with you, Aubergine. I don't believe that any organization is evil--per se. Not the FDA, or ALA, or CDC, or BP. I don't believe that anybody wakes up in the morning and goes to work with a goal to do something vile and horrible. The VA is a great and honorable organization also and is lead by a 4-star general, a war hero who certainly cares for our veterans and nobody will convince me otherwise. How about Pentagon and their $640 toilet seats...

The problem is the structure--the shear size of those government bureaucracies and the myriad of idiotic laws that bind them that make them so inefficient and prone to failure and abuse and corruption. I don't know what the solution is... I can only hope that somehow the truth will prevail.

Yeah but ....where was "I also agree that a reasoned, amicable confrontation, armed with facts and a willingness to recognize the opposition as human is a crucial starting point in any negotiation. That's Activism 101."... when it came to GWB?

I don't think he would have gotten away with the "I'm mad as hell" routine we're seeing weekly.
 
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<snip>
When you have actual reasons for hanging the proverbial hat on the cessation peg, do let me know. Until then, cold turkey/willpower will be squarely on that peg, making the most sense to non-users, aka the majority.

I googled "smoking kills 400000" and the first site that comes up is CFTFK:

"Tobacco use is the leading cause of preventable death in the United States, imposing a terrible toll in health, lives and dollars on families, businesses and government. Tobacco kills more than 480,000 people annually – more than AIDS, alcohol, car accidents, illegal drugs, murders and suicides combined."

Of course they deceptively do not qualify the word "tobacco" with "combustible." Nor do they imply anywhere that vaping is not included in this death toll.

"Smoking kills" - it's easy to understand. And in messaging, the simpler you keep it, the better.

We can argue that vaping improves the quality of life for dual users.

But I'd rather argue that vaping saves the lives of those who quit smoking tobacco cigarettes entirely, and will eventually all-but-eliminate tobacco cigarettes.
 

Katya

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Yeah but ....where was "I also agree that a reasoned, amicable confrontation, armed with facts and a willingness to recognize the opposition as human is a crucial starting point in any negotiation. That's Activism 101."... when it came to GWB?

I don't think he would have gotten away with the "I'm mad as hell" routine we're seeing weekly.

I agree. I know. I understand...

And I'm mad as hell, also!
 

Jman8

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Cold turkey is only the best method for those who want to quit. E-cigs are the best for those who don't want to quit. I personally know hundreds of smokers who quit "unintentionaly" using e-cigs, but none who unintentionally quit cold turkey.

Only a small number of smokers make an actual attempt to quit each year, so having a product that causes smokers to quit or cut down without that intent could be seen as better for overall public health. If cold turkey is a seat belt that someone may not use, e-cigarettes are air bags.

In my experience of going cold turkey, and of using eCigs, I would say eCigs are easier. And without knowing for sure, I would think going cold turkey from vaping would be easier than going cold turkey from smoking. Or even easier to reduce to zero nic, and keep on vaping.

I would still say cold turkey is the better method for the 'risk-reward' it carries. Not way better, cause I find that debatable. But a debate that would be challenging to have with ex-smoker who has gone cold turkey, discussing the topic with an ex-smoker who is now a vaper. Other than the "benefits of nicotine" points, I'm not sure what the vaper would win on.

I think a bunch of things help put this in perspective, but near the top would be why many vapers don't want non-smokers to take up vaping. That right there is saying staying away is better than getting into it. Me, I'm very okay with non-smoker taking up vaping (nicotine).
 

Katya

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That's the point... although you're not a low information voter - his target audience.

:D

H-L-Mencken.jpg
 

Jman8

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I googled "smoking kills 400000" and the first site that comes up is CFTFK:



Of course they deceptively do not qualify the word "tobacco" with "combustible." Nor do they imply anywhere that vaping is not included in this death toll.

I think we know vaping is not included, and know that the 400K number is grossly inflated. If we don't know the latter, then we are not thinking.

"Smoking kills" - it's easy to understand. And in messaging, the simpler you keep it, the better.

I can get behind smoking harms, but the other one would mean all us ex-smokers are actually dead. We might appear alive, but we can't possibly be, because, ahem, smoking kills.

Once a vaper or 2 (thousand) die, they'll be able to claim vaping kills. Won't that be nice?

We can argue that vaping improves the quality of life for dual users.

But I'd rather argue that vaping saves the lives of those who quit smoking tobacco cigarettes entirely, and will eventually all-but-eliminate tobacco cigarettes.

To whatever degree vaping saves lives, I would argue it does the SAME THING for dual users. Perhaps not all, but the ones smoking a pack a week or less, and thus smoking in moderation... yeah I'd have that discussion.

Your view reads like we can just throw those silly dual users under the bus, and tout the vaping exclusive persons and somehow ANTZ leaning people will see our logic. I'm not saying that we ought to emphasize dual users (who are likely a minority), but am saying that dual users have likely accomplished most of the same benefits that a 'quitter' has achieved. This world really has no clue what a moderate smoker looks like. If they did, it would change almost everything that is currently 'known' about smoking.
 
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I can get behind smoking harms, but the other one would mean all us ex-smokers are actually dead. We might appear alive, but we can't possibly be, because, ahem, smoking kills.

Once a vaper or 2 (thousand) die, they'll be able to claim vaping kills. Won't that be nice?

Not even Glantz nor even Matt Myers of CFTFK will say that tobacco cigarette smoking kills all tobacco cigarette smokers immediately, as I'm sure you well know. That is quite obviously not what is meant by the phrase "smoking kills." (Were you aware of that? Because if you were, then I have to wonder why you wrote what you just did.)

I believe the operative phrase is "causal link." In other words, there has to be evidence that there's something about vaping that's currently killing people. What they're saying right now is that the only thing they can pin on vaping is that vapers are less likely to quit smoking than the general propulation of smokers. That was exactly the point of Grana, Popov and Ling's paper in JAMA Internal Medicine published in March. I'm sure we all remember this media frenzy.

One reason why the West toolkit is so helpful is that it rebuts that junk study in spades. That's what moved Deborah Kotz of the Boston Globe - even after she dismissed Siegel's objections to Grana et al. as mere "fighting words" (see my thread in media that I started today).

***

To whatever degree vaping saves lives, I would argue it does the SAME THING for dual users. Perhaps not all, but the ones smoking a pack a week or less, and thus smoking in moderation... yeah I'd have that discussion.

Great, be my guest. Please have the discussion with Dr. Siegel, who believes that the mortality rates of smokers are largely independent of how much they smoke: Anti-Smoking Advocate Incorrectly and Irresponsibly Tells Public that Smoking Half Pack Per Day is No Better than Smoking Two Packs Per Day

***

Your view reads like we can just throw those silly dual users under the bus, and tout the vaping exclusive persons and somehow ANTZ leaning people will see our logic. I'm not saying that we ought to emphasize dual users (who are likely a minority), but am saying that dual users have likely accomplished most of the same benefits that a 'quitter' has achieved. This world really has no clue what a moderate smoker looks like. If they did, it would change almost everything that is currently 'known' about smoking.

I am not conerned about whether anyone is or isn't "thrown under the bus." I am looking for the points that give us the best chance of defending vaping in the public policy arena. And the best one I can find is: "Vapers are Quitters."

You are more than welcome to argue with people like Siegel (see above link) and question every single piece of scientific data that has ever been proffered regarding tobacco cigarette smoking. Far be it from me to stop you. However I do not see this as an effective approach to getting what vapers want and need in the public policy arena.

BTW I think we may have reached the point where this discussion is no longer productive. So unless you come up with something that's new, I think I've had enough of this particular debate.
 
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aikanae1

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I'm not entirely sure where both of you are going with this, bur I've read that FDA/CDC think 2/3 rds of vaper are dual users. They claim that people are using vaping to use nicotine where they wouldn't be able to smoke, circumventing bans which means they are using nicotine more - their current habit + vaping.

To my knowledge that is 100% hypothetical and not real world. I'm sure there's a few that might increase their daily nic intake that way, but it's like teens picking up ecigs and develop a nicotine habit. It's not the norm.

I think in the real world, 70% of smokers want to quit (and maybe more) which stats do seem to prove. Using NRT / cold turkey (I think there's a minor difference between the two per studies) the rate of actually quitting at the 6 month mark is between 3% - 6% (a few say as high as 10% but I think they are reaching) and that's for ALL quit attempts. NRT/cold turkety. Those aren't good odds.

But smokers want to quit. That phrase "unwilling or unable" to quit has somehow morphed it's way into blaming the smoker for not quitting. Any time a FDA approved cessation product fails, it's blamed on the smoker. It's not our fault that non-smoker's develop lousy products for quitting They really know very, very little about cigarette addiction beyond nicotine and even nicotine research is limited.

Every time I listen or read criticism against ecigs there is always some comment about "successful cessation products that WE know works" and that is pure BS. They are not successful. They don't even reach the medical minimums for "success" treating another illness based on medical standards. Can you imagine spending hundreds a month on a treatment with 3% success rate?

Most vapers have more than one quit attempt already. Many of them have tried approved products and failed. Most people want to quit so if they see their nicotine needs increase, they probably are NOT going to continue, unlike the hypothesis that the FDA/CDC is falsely believing. People stop using patches and gums if they don't reduce smoking. Same for vaping.

Ecigs were developed and evolved by smokers who wanted to quit, found what was successful and promoted to other smokers that also wanted to quit. The fact there are people who pick up vaping for alternative reasons (save money, vape where they can't smoke) and "acciedently quit" is nothing short of a miracle. We can customize nic delivery to fit our needs - the FDA/CDC considers that a fault. Most of the things we appreciate, they have a problem with. They have no clue what a smoker needs to quit with.

So is vaping and smoking 3 or 4 a day better than smoking a whole pack a day? I'd say yes. It's obvious the gains from quitting won't be as great, but comparing that to cold turkey is stupid because if cold turkety were an option, it would have happened.

It is far more likely that partiall vaper will find their way to 100% vaping than someone who returns to smoking because they weren't successful immediatley with vaping. It's also much easier to give up those few straggler cigarettes than it is to give up the full pack a day. Every day they vape, they are still trying to quit.

2/3rds of the ecigs sold are cigalikes such as Blu. Isn't that odd that figure mirrors the number of dual users? That doesn't mean they are connected but there's no way for anyone to know if their not. This was one reason that I tend to support seperating ecigs into 2 categories; mass produced cigalikes and another for premium devices or pv's. I think it'd be possible to get much cleaner results from surveys and studies because I don't think the useage between them is the same. A person with a $200 device is probably much more serious or advanced into replacing smoking with vaping.

Of course cold turkey is best. There's no argument. If someone could quit cold turkey then they probably are not buying an ecig. I have never heard a single person boast about what an acheivement it was to go from 6mg nicotine to 24mg or 36mg. NEVER. Everyone talks about reducing nicotine levels. I think one of the attractions of dripping/sub-ohming is the drop in nicotine level needed. Someone vaping 18mg needs to drop to 6mg. A number of eliquid companies are putting out new lines of low nicotine levels just for that purpose. Again, innovation follows what people want - and they want to quit.

I think some of the confusion is that the FDA/CDC doesn't recognize 0mg vaping and I'm pretty sure they wouldn't like it. Again, the limited imaigination from them is astounding.

The idea that non-smokers can develop something smokers want to use is insanity. That's like asking my car mechanic to develop a heart implant. The medical community didn't think AA would work for alchoholics either and in over 50 years, it reamains the primary program that DOES work. They can't match it.

That's their problem, not ours. Most smokers want to quit. That's why the growth in ecigs has been so explosive. It proves that fact.



I like the seat belt vs. air bags analogy, insofar as it helps explain harm reduction, and references the significance of volition.

Personally, I feel a tad uncomfortable telling people that vaping is for dual users.

I'd just as soon point to the fact that all these vapers have quit, without talking about their motives for beginning to vape in the first place.

To me, this looks too much like the ads which imply that vaping is for smokers who want to "evade" smoking bans. Or as the inimitable Sen. Kathy Sheran (Manteko, MN) put it in a rather unpleasant-to-watch Twin Cities PBS interview - to "practice their addiction in public." (Which, is a line she may have picked up either from Clearway MN or Legacy.) Mind you, I don't blame the cigAlike manufactuers for using this appeal, because they aren't even allowed to mention that vaping doesn't involve the use of combustible tobacco :facepalm:

But I feel as if that gives unnecessary ammo. to Gantz and the other ANTZ.

The longer someone has vaped, the more likely it is that they've quit. Now we have the population studies to show something like this in several European countries. Simple, easy to understand.

Speaking of cars - I want a bumper sticker that reads: Vapers are Quitters.
 
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