[neaden]

I think it is very important for everyone to keep in mind that vaping is probably safer than smoking. But it might not be, we don't know for sure. And it is certainly worse than not consuming any tobacco product. So trying to encourage active smokers to switch to vaping is probably beneficial, but increasing overall tobacco consumption rates is bad.

[lemonberry]

My father's been smoking for over 50 years. I got him to switch to mostly vaping last year. The difference in his health has been profound. It almost eliminated his coughing, increased his ability to walk distances. His doctor was amazed at his last checkup. She said she couldn't recommend it to patients due to the uncertainties, but encouraged him to keep doing whatever it is that he's doing.

Edit: I bought him the vape after a friend that's been smoking for a long time made the switch and raved about the benefits. I don't doubt that the best course of action is to quit altogether, but a 50+ year addiction is pretty difficult to quit. It can be done but you really have to want it. I don't think my dad really wanted to quit. I know that seems silly, but given his circumstances I can understand.

[Symbiote]

The UK's NHS says "particularly if you've already tried other methods of quitting smoking without success, you might want to give e-cigarettes a go" and "according to current evidence on e-cigarettes, they carry a fraction of the risk of cigarettes."

https://www.nhs.uk/Livewell/smoking/Pages/e-cigarettes.aspx

[refurb]

Wow. Hats off to the NHS.

Is vaping harmless? Unlikely. Based on current understanding is it likely much less harmful than smoking tobacco? Yes.

[Houshalter]

Why is this even controversial? Vaping removes almost all of the known dangers from smoking. We know smoke inhalation itself is incredibly bad for health. It was never about the nicotine. Wood smoke and general pollution is highly associated with cancer and bad health and no better than tobacco smoke. There's some evidence humans have been evolving resistance to it since the invention of fire. Suggesting it's actually been a significant source of death in our species. Smokers houses are covered in foul smelling yellow residue, of course it's hurting their lungs. Smokers are actually exposed to more radiation from tobacco than the legal limit for radiation workers.

[refurb]

It's controversial because smoking has become the 20th century temperance movement, at least in the US.

Some people are so offended by the idea of smoking that even doing something much less harmful, like vaping, is enough to cause them to panic for the future of our children.

[code_duck]

Don’t half of smokers die of heart disease, not lung disease? Vaping has no effect on that - it might be even delivering more nicotine and jolting the heart more than a normal cigarette. Not sure how much heart damage comes from the stimulant decreasing blood oxygen and how much is from lung damage decreasing blood oxygen, and so forth, but it seems likely vaping is bad for your heart.

[Houshalter]

Yes, but what is the evidence it's the nicotine that's damaging the heart? The heart is part of your respiratory system. Inhaling regular wood smoke damages your heart:

https://samharris.org/the-fireplace-delusion/

>There is no amount of wood smoke that is good to breathe. It is at least as bad for you as cigarette smoke, and probably much worse. (One study found it to be 30 times more potent a carcinogen.) The smoke from an ordinary wood fire contains hundreds of compounds known to be carcinogenic, mutagenic, teratogenic, and irritating to the respiratory system. Most of the particles generated by burning wood are smaller than one micron—a size believed to be most damaging to our lungs. In fact, these particles are so fine that they can evade our mucociliary defenses and travel directly into the bloodstream, posing a risk to the heart. Particles this size also resist gravitational settling, remaining airborne for weeks at a time.

And Heart disease is associated with pollution from burning fossil fuels: http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStro...

[LordKano]

I smoked for about 18 years and I made the switch to vaping a few years ago. I haven't completely given up tobacco smoking but I have cut back tremendously.

I tried to quit several times, I tried the gum, the patches, Chantix and cold turkey. None of them allowed me to successfully quit. Vaping was good enough to temper the nicotine cravings enough that I could otherwise function without regular smoking. I have cut back on nicotine content over the years. Now, I'm using the lowest nicotine content liquid that I find readily available. The next step is to mix it with 0 nicotine liquid until I can make another attempt at quitting.

I agree that non-smokers (especially children) shouldn't do it because it can lead to nicotine addiction but for smokers, it's a miracle product.

[jfoutz]

Three weeks no tobacco. Stepping down nicotine today. I don’t like vaping much. But it has made it much easier to ramp down.

I still want a cigarette every once in a while, but I think that’s going to pass in the next month or two. At least enough for me to quit the vape as well.

I’d never recommend one to a nonsmoker. But, for me, it has been an effective way out of a vice. If anyone wants out, it has been working for me. Definitely worth considering.

[ShabbosGoy]

The key is moderation. 1 mg of nicotine can provide really positive benefits, making it a nootropic with a decent risk profile. Granted, the downsides are addiction and temporary downregulation of dopamine receptors. A spray or lozenge is better than vaping though, mainly because we don’t know the long term effects of inhaling chemicals like propelyne glycol, for instance.

[jfoutz]

oh yes. yes there are better ways to ingest nicotine. I, however, don't have the self control to avoid smoking a pack a day. If you're the kind of person that can handle small situational doses to improve whatever you're optimizing for, go for it. Me, on the other hand, i'm a chump. Lozenges didn't really meet the need of the vice i'd set up for myself. No plans for long term vaping. In the short run, i haven't screamed at anyone. I quit once before long ago and used an ssri. Of the set lozenge, patch, gum and ssri, this seems the least painful. It's effective without me checking out from reality. The ssri's made me kind of disconnected from reality. That worked, and worked well, but the blast radius was quite a bit little larger than i really wanted. this feels much more like i can separate the specific smoking impulse without affecting my other impulses.

so, yeah. n=1. not data, just an observation. I think unrestrained smoking will kill me. Perhaps the damage is done, at it will kill me regardless. That said, continuing smoking only expands the risk profile. Vaping likely narrows the risk profile. Even if it does not, vaping is a temporary thing for me. I'll be done soon.

[LordKano]

I've been vaping for 4 years. I still want a cigarette sometimes but it's becoming less frequent that I feel like I need one.

[reitanqild]

Another benefit I've seen a number of times is that people seems to have an easier time quitting. (Based on my sample of < 5 coworkers that switched to vaping.)

The pattern, as explained to me and IIRC, was as follows:

Started vaping insteadof smoking.

Tried vape with less nicotine. Worked equally well.

Tried with half strength.

Tried with even less. Also worked.

At this point it just felt silly so they just stopped.

(Note that these where young people.)

[paulmd]

Cigarette companies devote significant resources to building the positive feedback loop to increase the addictiveness of their products (the experience of unwrapping the cellophane packaging is a classic example). Vapes are a much more straightforward delivery method that lack these enhancements.

Of course there's some parallels there for the software world, like the endless A/B testing social-media sites do to maximize the amount of time people spend glued to their product.

[lemonberry]

I also think it's kind of a controlled dose thing. When one smokes a cigarette it tends to be the whole cigarette, whereas with a vape you can take a couple of hits, get a fix and put it down.

[corobo]

When looking for this I think it's useful to note that immediately after switching the amount of vaping can be huge. I was actually experiencing nicotine rushes and nausea in some cases when I first started

The problem I had was that a cigarette has an obvious stop point - it runs out - whereas a vape will go on as long as you have juice and power.

Over the 6 months or so getting used to it I've been vaping it's started to fizzle out. I know, n=1, but I think it's something worth noting in case people see an increase in nicotine intake immediately after switching

[miragle]

When I first tried a disposable cigalike this happened to me. I was previously smoking just under a pack a day, but without an obvious stopping point I found myself using the whole thing in a few hours, when it was supposed to be equivalent to a pack. Because of this, when I started using a sub-ohm tank, I only bought 3mg liquids (the lowest available). I could vape it as much a I wanted and it took pretty much constant vaping for 10 minutes to feel slightly unwell from the nicotine, so this worked very well for me.

[code_duck]

That is basically how it went for me. I tried vaping, liked it, and substituted it for cigarettes. I liked the effect but found it easier to forget about. Eventually I bought some juice I didn’t enjoy, and simply stopped using it.

[chillwaves]

This is how people taper off of addictive drugs.

A proven strategy.

[mathgeek]

> I don't doubt that the best course of action is to quit altogether, but a 50+ year addiction is pretty difficult to quit. It can be done but you really have to want it. I don't think my dad really wanted to quit. I know that seems silly, but given his circumstances I can understand.

Much as your physical health is probably best by quitting, mental health certainly has to be considered as well.

[agumonkey]

got my mom had a device, before she had a heart attack, then she stopped smoking for a while, but she hates tech so much, she got back to smoking instead of vaping to fill nicotin craves.

it's hard to convince people some times (also not helping that things are still fuzzy and depending on your friends, you can also hear horror stories like lung cancer due to weird vaping byproducts ..)

[berberous]

Yeah, I'm highly skeptical it's overall safe. You have all sorts of metals, liquids, plastics, flavoring compounds, wicks, etc. Some people try to select 'healthy' choices (like organic cotton for the wick); maybe that's healthier, maybe it's not. But then you also have tons of cheap devices on the market, made in China, with who knows what as the cheapest metal/fabric, and then literally tons of unregulated flavoring compounds on top of PG/VG. Any one of those components could be harmful.

[LyndsySimon]

> You have all sorts of metals, liquids, flavoring compounds, wicks, etc

Metal content is negligible unless you dry hit. No one likes that so it's pretty much a self-limiting problem.

Flavoring compounds, though... there are liquids out there that contain diacetyl (a "buttery" flavoring). It's relatively common in foods, but is known specifically to cause issues when heated and inhaled.

ETA: I just saw that this is mentioned in the article.

> Any one of those components could be harmful.

Yep. The best harm reduction strategy at the moment seems to be to stick to well-known and establish manufacturers of eliquid.

[srslack]

While I certainly tried to avoid any flavorings, or vendors that couldn't tell me what was in their flavorings when I did use a vaporizer, the diacetyl scare is overblown. Regular cigarettes contain diacetyl in orders of magnitude greater concentrations.[1]

We're talking about exposures to ten micrograms in various e-liquids, versus 7,000 micrograms for smokers. On a daily basis, in both cases.

Even more curious, traditional smoking has not been shown to be a risk factor for bronchiolitis.[2] Should those flavors be avoided? Yeah, but I honestly wouldn't get hysterical over it. We're talking about fractions of micrograms in the end product. You certainly are exposed to far more diacetyl in second-hand smoke than a vaper is exposed to in a day, on average, in liquids that contain this flavoring.

FYI: I quit smoking completely using e-cigarettes, and quit using e-cigarettes last year. I wrapped my own coils and built my own atomizers at one point, so I'm probably biased, but the numbers speak for themselves.

To say nothing of my opinion on the hysteria over nicotine, which has never been shown to have strong reinforcing properties in any study. Nicotine, by itself, has simply never been shown to be more addictive than caffeine.[3]

[1] http://onlinelibrary.wiley.com/doi/10.1002/tox.20153/abstrac...

[2] http://www.tandfonline.com/doi/abs/10.3109/10408444.2014.882...

[3] http://www.jneurosci.org/content/25/38/8593

[ThrowawayR2]

> Flavoring compounds, though... there are liquids out there that contain diacetyl (a "buttery" flavoring).

That name rang a bell; diacetyl is the compound behind "popcorn lung", so called because its use for its buttery taste in microwave popcorn was common but is damaging to the lungs if the fumes were inhaled; e.g. https://nyti.ms/2h7ls4G. Interesting to see that it's being used as a vaping flavorant.

[cctt23]

Oh my god, popcorn lung is real! I thought that was a name for some fibrotic illness thst made your lungs look like popcorn, but it’s actually from popcorn.

https://en.m.wikipedia.org/wiki/Bronchiolitis_obliterans#Dia...

I... I... need get to bed.

[verylittlemeat]

If you vape also consider making the liquid yourself. The base is just 2 ingredients and you can carefully source your flavoring agents. Making your own can be 50-100x cheaper than buying premade.

But as other people here said - diacetyl / popcorn lung has been known on the popular vaping scene for almost a decade now. Not to speak in absolute terms but I think it would be hard to find a retailer these days that carries any liquid with diacetyl in it.

[TFortunato]

Sorry to be "that guy", but could you explain what you mean by metal content being negligible unless you dry hit?

I assumed when people were talking about metal content, they were referring to metal vapors from the heating elements or something, but I'll admit that I don't know enough about this, or what a dry hit is vs. normal use, or how we know when metal vapors or whatever are/aren't a concern.

(I feel so old right now, hah!)

[Humdeee]

You're not "that guy" at all. It's quite the opposite. Most people (myself included) have no clue what a dry hit is as well. In fact, people who vape often have the reputation of being "that guy".

[berberous]

I don't know enough about how these things work to verify his comment that metal is only a concern if you dry hit, but a dry hit just means it ran out of juice and you didn't notice, so you accidentally inhale a disgusting taste of burnt metal/fabric, rather than vaporized liquid. Normally though, you have liquid sitting in a tank touching metal, glass and/or plastic. Maybe glass and good metals don't leach into the liquid, but there are tons of cheaply made devices out there, and I wouldn't bet my health without seeing better studies that some sort of metallic or plastic compounds couldn't leach into the liquid, to then be vaporized and inhaled.

[LyndsySimon]

My understanding is that the metal doesn't get hot enough to bind to end up in the vapor in any quantity as long as the heating element is immersed in liquid. A "dry hit" is when you take a drag on the device when there is no liquid or not enough liquid in contact with the heating element. It tastes terrible, burns out coils faster, and burns your throat.

The only study I've seen that shows that heavy metals in vapor is an issue used conditions that are unlikely to occur in "real life" because of this. The argument seems to be that one could become accustomed to it through the cravings associated with nicotine withdrawal, but I honestly find that unlikely. In reality, you'd burn your coil up in short order, and if you can afford a new coil you'd have been buying more liquid in the first place.

[hapless]

The nichrome heating elements in vapes have been proven to leach considerable amounts of manganese and chromium into your vape fluid and vapor.

https://www.jhsph.edu/news/news-releases/2017/study-toxic-me...

[mistermann]

It's almost always easy to spot deliberate cherry picking and dishonest statistics in order to come to an alarmist conclusion.

"For their study, the researchers selected five leading brands of so-called first generation e-cigarettes, which are referred to as cig-a-likes because they resemble traditional cigarettes. (Newer ones look like small cassette recorders with a mouthpiece. In the newer devices the liquid is added from a dispenser prior to use. In contrast, the liquid in first generation e-cigs is stored in the cartridge together with the coil, which increases the liquid’s exposure to the coil even in the absence of heating.) The five brands are sold across the United States in big-box retail stores, convenience stores and gas stations, as well as online. Three of the five brands constituted 71 percent of total market share in 2015. If a brand came in more than one flavor, the researchers chose one flavor for consistency’s sake."

Almost no one uses this piece of junk cig-a-likes. Try and find a person using one on the street, compared to people using proper high powered mods, which their "market share" statistic most certainly does not include.

"This study was funded by the Institute for Global Tobacco Control, Johns Hopkins School of Public Health."

Shocking.

I have yet to read a negative study that does not contain obvious blatant lies.

[hapless]

71% of the market is "almost no one" ?

Who do you expect to investigate tobacco products, if not the institute of tobacco control at America's #1 medical college?

edit: also, if your "high power mod" still uses a nichrome heating element, you will have the same problems. Chemistry is chemistry.

[mistermann]

> 71% of the market is "almost no one" ?

71% of the market of product sold in big-box retail stores, convenience stores and gas stations, as well as online. That market is perhaps 10% (that's being generous) of the overall ecig market, because those tiny things suck.

I'm less worried about metal leeching in higher end mods, the juice doesn't sit for months on end with significant surface area touching metal as the juice is typically vaped in << 24 hours, and the physical designs are quite different.

That said, there is still an element of unknown risk, both with the metals used, as well as the wicking materials, but it seems reasonable to expect high end products where they have better margins and more concern with reputation to put much more emphasis on safety and quality.

EDIT:

I think I will have to eat some crow, after doing some googling it seems there are in fact thorough real studies being performed on real world equipment:

https://ehp.niehs.nih.gov/ehp2175/

I mostly just skimmed this article, figuring out whether these detected levels are beyond what is considered "safe" or how they compare to both regular cigarettes and background environmental exposure I suppose would be nice to know, but based on this article I am going to change my stance to believe that yes, in fact I am exposing myself to heavy metals even when using a high end mod. I think I'm going to do some more research later as I would expect this report would have gotten a fair amount of publicity in the enthusiast community, will be interesting to see how honest their reaction is to this.

[babygoat]

If I had a vaping problem, a "buttery" flavoring would probably make me sick enough to quit.

[skybrian]

You could say the same about food and the equipment used to cook it; how do you know the food you buy is safe?

Maybe there aren't enough regulations around vaping ingredients? If so, the solution is to regulate it (much like food). In the meantime, it's up to the buyer to find reliable suppliers who use good ingredients. This isn't impossible.

[bspn]

I agree that for traditional tobacco smokers it is likely a net-positive, and it is potentially a tool they can use to reduce their nicotine intake and even eliminate it altogether. The concern with the latest explosion in schools, however, is the significant number of kids getting addicted to nicotine who may not otherwise have tried smoking traditional cigarettes. The nicotine level in a Juul pod is incredibly high, and it doesn't take long for these kids to get hooked. That's something we should be concerned about IMO.

[neaden]

I definitely agree with this, the ideal would be current tobacco users switching to vapes while no non-tobacco user touches them. I just am not sure how we can get to that ideal and how to balance encouraging smokers to switch without encouraging kids to think of vaping as safe.

[Domenic_S]

> The concern [is] kids getting addicted to nicotine

Non-snarky question: why is that a concern? Nicotine -- in the absence of burning tobacco -- isn't bad for you.

[dgacmu]

In general, there are pretty good reasons for suggesting that people avoid addictions before they're at an age where they'll make decisions about it that they'll be happy with over the long term.

https://www.npr.org/templates/story/story.php?storyId=141164...

> AAMODT: So the changes that happen between

> 18 and 25 are a continuation of the process that starts

> around puberty, and 18 year olds are about halfway through

> that process. Their prefrontal cortex is not yet fully

> developed. That's the part of the brain that helps you to

> inhibit impulses and to plan and organize your behavior to

> reach a goal.

If nothing else, there's a monetary cost, a possible convenience cost, etc., and people should choose maturely whether that's something they want to take on.

(And there are some plausible health risks still with vaping, as others have noted.)

[ben509]

Reading between the lines of the various pieces on vaping I've seen, there seem to be two common assumptions at work: 1. vaping is like cigarettes, therefore must be unhealthy or 2. this is a new substance being ingested and therefore must be unhealthy.

I'm entirely supportive of people who want to study this stuff, but the impulse that any new product should be illegal until it's been proven safe to fairly arbitrary standards seems unreasonable to me. And I think there's a bit of a baptist-bootlegger coalition between the medical researchers and tobacco companies.

[YSFEJ4SWJUVU6]

I don't think it's quite that clear – however, I think it is considered clear that nicotine is nowhere near as harmful as tobacco smoke.

[Domenic_S]

We currently think that nicotine has a protective effect on the brain. Research is spotty but promising. Google “nicotine protects brain” to get started!

[YSFEJ4SWJUVU6]

Oh, I'm certainly under no impression that nicotine might not have any health benefits, but with various inconclusive research it's hard to assess the complete picture and net effect. I think it's partly this way because nicotine has been studied quite little disconnected from tobacco research. (It is my understanding that there is indeed no conclusive evidence of nicotine being greatly harmful to health, and I do use nicotine products myself.)

[013a]

Just to be very clear on your use of language: Vaping has nothing to do with tobacco. Period. Calling "vape" a tobacco product is equivalent to calling coca-cola a "coffee product". They essentially share a single active chemical (nicotine), and even then many vapers elect to vape nicotine-free liquid.

[LordKano]

I get your point but as I understand it, the source of the nicotine for those liquids is tobacco.

[013a]

That is generally true; the nicotine in e-liquid is commonly extracted from tobacco. But at the point it is mixed into an e-liquid, assuming we're talking about a reputable organization, it is a completely pure nicotine solution. The only thing it shares with the tobacco it came from is the nicotine itself.

[nixme]

Not all e-juice nicotine is sourced from tobacco. Some are synthesized: https://www.elementvape.com/tobacco-free-nicotine-e-juice-co...

[melq]

To his point, the source of the caffeine in coke is coffee.

[LordKano]

The caffeine is coke is synthetic. Using synthetic caffeine is cheaper than extracting it from coffee.

To the best of my knowledge, the only place where they still use caffeine from coffee is Japan.

[melq]

Ah, didn't realize this. I used to work at a coffee roaster and at the time was told the caffeine removed from decaf beans via the swiss water method was then sold to soda companies.

[portofcall]

Caffeine is cheaply synthesized, and that’s almost certainly what soda manufacturers use in their products.

[jessriedel]

> And it is certainly worse than not consuming any tobacco product.

I don't think we know this. routine use of Nicotine alone is one of the world's most effective and safest appetite suppressants, with robust evidence of sustained weightless. It's quite possible a small decrease in the obesity rate means its net effect is positive.

[jgalt212]

probably the #1 or #2 reason girls in my HS smoked (back in the dizay)

[epmaybe]

Also wanted to point out that the NIH is rolling out a standardized e-cigarette for research, so that all the results in future papers can be compared with one another. The settings otherwise are just too variable otherwise.

https://www.drugabuse.gov/funding/supplemental-information-n...

[overcast]

The unfortunate side effect of getting smokers off of cigarettes, is that non-smokers see it as a safe option to start. It's an unintended consequence, but pretty predictable. With that said, youth will be youth, and I'd rather they experiment with vaping, rather than cigarettes at this point.

[frgtpsswrdlame]

There's the risk that ecigs are an on ramp to actual cigarette smoking. That reflects my experience, first using a friends vape now and then to bumming the occasional cigarette to actual smoking. There's a symmetry we don't like to acknowledge between what makes vapes good for quitting - you can slowly ramp your nicotine - and what makes vapes good for starting. See this study: https://jamanetwork.com/journals/jamapediatrics/article-abst...

[notvplez]

As someone who quit smoking thanks to vaping I cannot fathom why anyone would go the other direction. Why not just continue vaping instead?

[frgtpsswrdlame]

Well they're dumb kids for one. But also smoking feels better than vaping. From what I've looked into it seems that tobacco smoke contains not just nicotine but also MAOIs which amplify the addictiveness and pleasure of the nicotine. Do note that I've quit now, through cold turkey though.

[shermanyo]

I disagree from personal experience. Smoke is harsh and never tasted appealing to me. Vaping at a low nicotine level is a much more enjoyable experience.

[DanBC]

They enjoy the experience of nicotine, and don't realise that the habits of smoking make it a bit more psychologically addictive than vaping.

[notvplez]

Sure, but that first cigarette you light up is going to taste absolutely disgusting, whether compared to vaping or not. I just don’t get why anyone would think it would be better to continue smoking instead of vaping, unless they’re somehow into the taste of campfires.

[zamalek]

Because you only realize how terrible smoking is once you've been stuck with it for a few years.

[TFortunato]

Not sure why people are downvoting w/o commenting. It seems like the study concluded what you are saying - that vaping / eCigs do increase the likelihood you will start smoking actual cigarettes.

[babygoat]

> e-Cigarette use was associated with greater risk for subsequent cigarette smoking initiation and past 30-day cigarette smoking.

How about: Nicotine users more likely to use nicotine.

[TFortunato]

Right, which was that parents point - that it cuts both ways. There are people who get off cigarettes by moving to vaping, which is great! But you don't often hear people talking about the opposite, that vaping can also lead people to smoking cigarettes.

[agumonkey]

beside some deep science the biggest risk is eliquid content, but so far, beside relying on internet boards and users I couldnt find a standard test for safety

[jordan801]

Vaping isn't tobacco, though.