[pvnick]

E-Cigarettes are going to save millions of lives in the coming years. They're harmless, and, if you get a brand that feels like the real thing, easy to transition to. I hope the tobacco industry takes a huge financial hit from the sale of these things because they literally prevent people from dying.

That being said, when I switched to e-cigarettes, it was very easy to switch back to regular cigarettes. That "narrow bridge of familiarity" was easy to cross back over, especially when I ran out of vapor cartridges. Ultimately for me to quit it took stopping cigarettes cold-turkey. Nicotine gum and a transition to regular gum helped a lot. It's been one of the hardest but most rewarding things I've ever done in my life.

[hristov]

1. E-cigarettes are not harmless and I wish people would stop perpetuating that lie. It is not clear exactly how harmful they are, but they are not harmless.

2. Ecig marketers are trying to push this story line of e-cigs vs the tobacco industry. It is mostly bs as the major ecig company blu is owned by a major tobacco company and every other major tobacco company has an ecig line now. The ecig industry is the tobacco industry.

I am very happy for you that you were able to quit. And it seems to me that is the only way.

[Alex3917]

> E-cigarettes are not harmless and I wish people would stop perpetuating that lie.

They might be fairly harmless, we don't know. The three biggest risks of smoking are cancer, emphysema, and heart disease. For a casual smoker, heart disease is by far the biggest risk. This is caused by the carbon monoxide, and eCigs have zero of this. There's also no reason to think that they cause emphysema. In terms of cancer, the majority of the carcinogenic effect of cigarrettes is thought to be caused by radiation rather than by the tobacco itself. So with eCigs you can easily wash off the radiation from the tobacco, or else just use synthetic nicotine or other drugs.

Since the industry is completely unregulated I'm sure these things are filled with all sorts of poison, but even still there are no currently known risks. And even if there are risks, which there likely are, it's not clear that they'll be any bigger than, say, drinking the occasional glass of wine. And it's also likely that once we figure out what these risks are, we'll be able to mitigate them.

I certainly wouldn't use these things today, but in twenty or thirty years they may well be a really good bet.

[chimeracoder]

> They might be fairly harmless, we don't know.

They might be less harmless (though we don't know that yet), but we can be fairly certain that they are least somewhat harmful.

This is not like vaporizing cannabis - the desirable compounds in cannabis are not carcinogenic[0] and actually have cancer-fighting properties, and the main drawbacks to smoking cannabis come from the act of smoking, not from the substance.

Nicotine, on the other hand, is harmful in its own right. It is less damaging to consume pure nicotine without the other harmful effects of smoking, but it is certainly a toxic substance, in the medical sense.

[0] Or poisonous in any other way (even overdose, since the LD50 for delta-9-THC, if one even exists, is so high that nobody has ever measured it reliably).

[btilly]

Nicotine, on the other hand, is harmful in its own right. It is less damaging to consume pure nicotine without the other harmful effects of smoking, but it is certainly a toxic substance, in the medical sense.

Citation needed.

Before responding, you might want to read http://www.gwern.net/Nicotine.

[chimeracoder]

> Before responding, you might want to read http://www.gwern.net/Nicotine.

I can assure that this is a topic on which I have done far more research in my lifetime than that blog post. I'm not trying to be snarky; I'm just emphasizing that I have a lot more knowledge on this topic than I can reasonably compress into a 124-word HN post (like my original comment).

> Citation needed.

The post that you yourself link is a citation for my statement. Notice that I worded my post carefully - I did not say that nicotine has only harmful effects, or even that it has no positive effects.

All I stated is that it is a toxic substance in the medical sense - a statement which could also apply to the drugs used in chemotherapy. Therefore, it is correct to say "we can be fairly certain that they are least somewhat harmful."

I make no claim about the situations under which any alleged benefits outweigh the the toxic effects, simply that said toxic effects exist.

[gwern]

> I can assure that this is a topic on which I have done far more research in my lifetime than that blog post. I'm not trying to be snarky; I'm just emphasizing that I have a lot more knowledge on this topic than I can reasonably compress into a 124-word HN post (like my original comment).

Then I would appreciate your links to the studies of the harmful effects of nicotine alone that I have somehow failed to find.

> I make no claim about the situations under which any alleged benefits outweigh the the toxic effects, simply that said toxic effects exist.

So your confident assertions are merely technically correct, since everything has toxic effects under some situations such as high enough doses. But that's OK, since technically correct is the best kind of correct, as any geek knows!

[scardine]

Even pure water can be harmful. A few years ago a couple guys ended up in coma at a nearby Buddhist temple after a "cleanup weekend" where they were fasting and drinking lots of water (this water OD condition is called hyponatremia). Of course nicotine is more dangerous than water, yet I can't recall a death by overdose of it.

[hackula1]

> but it is certainly a toxic substance, in the medical sense.

Excuse me for not accepting the pseudo-science weasel word "toxic". Vitamin C is toxic at certain levels. If you do not bring in more specifics, then what you are saying is meaningless. Just saying "I choose to reserve judgement, but have a gut feeling that it will be shown to be more harmful than cigarettes" is about as far as strong a claim you can make based on the evidence you have presented.

[chimeracoder]

> "I choose to reserve judgement, but have a gut feeling that it will be shown to be more harmful than cigarettes"

Please don't put words in my mouth. I never said anything like that - certainly never that I felt that they would be shown to be more harmful than cigarettes.

> Excuse me for not accepting the pseudo-science weasel word "toxic".

I don't know why you think that a medical term is a "pseudo-science weasel word".

> If you do not bring in more specifics, then what you are saying is meaningless.

It's a lot less meaningless than the original statement "e-cigarettes are harmless", which is backed not by rigorous scientific research on e-cigarettes themselves, but rather (at best) on fairly questionable reasoning based on a misunderstanding of drug toxicology.

[hackula1]

> Please don't put words in my mouth

Putting words in your mouth is typically claiming you said X. I am suggesting that you instead, SHOULD have said Y.

> I don't know why you think that a medical term is a "pseudo-science weasel word".

"Cloud" is a technical word in computing with a specific meaning. This does not stop tech marketers from using it to mean things it does not. "Toxic" and "toxins" are medical words that are abused to the point of being meaningless much like "cloud". You are calling something harmful (to your credit, you do not specify how harmful) without specifying a dosage. Water is toxic at certain levels. Words that give a strong impression one way or the other, but are broad and do not commit to specifics are weasel words.

> It's a lot less meaningless than the original statement "e-cigarettes are harmless", which is backed not by rigorous scientific research on e-cigarettes themselves, but rather (at best) on fairly questionable reasoning based on a misunderstanding of drug toxicology.

I agree that you are "more right" than the OP, however, "harmless" and "toxic" are both just as bad in the context where dosage is not specified. It would be misleading to say that asbestos is harmless, although pretty much accurate at small enough levels. It would also be technically accurate to say that most things are toxic at some sufficiently high level.

In a nutshell, this debate between you and the OP is useless without specifying the amount being consumed.

[GhotiFish]

I'm sorry, I must object to that line of thinking

We can say with near certainty that they are less harmful, because we know what caused harm when smoking cigarettes, and those elements are not present. We also know what is being inhaled is either inert, or the point of smoking.

Also, whether a substance has a measurable LD50 or not is irrelevant. Most medicens have easily measurable LD50's, Some Vitamins have LD50's.

[chimeracoder]

> Most medicens have easily measurable LD50's

Well, most medicines could be considered medically toxic. It's just a matter of dosing and whether their desired effect outweighs any risk (whether negligible or non-negligible) of adverse reactions[0].

LD50 is only one of many ways to express toxicity; water can be considered toxic under some circumstances as well. It all depends on the context in which we're discussing the usage.

We don't say that Advil is "harmless", or aspirin, or caffeine, or any other substance, even in normal dosage. We simply say that any risk of harm is sufficiently small as to fall within tolerable limits, given the expected benefit of using that substance. But we can't say that about e-cigarettes - at least not yet.

In short, the medical impacts of drugs are difficult to predict, and oftentimes counter-intuitive. I'm just rather tired of the refrain that "e-cigarettes are harmless", because frankly,

(A) we don't have sufficient evidence-based research either to support or to reject that claim, and

(B) extrapolating based on existing evidence-based research and fundamental medical principles suggests that e-cigarettes are not "harmless".

Whether they are less harmful than cigarettes is a separate question, as is whether they are harmful enough to recommend avoiding usage (or regulation, or what have you) is a separate question.

I don't object to any logical arguments surrounding either of those two questions; I just object to fallacious interpretations of medical research to support illogical arguments.

[0] Unlike the word "toxic", I do not use the word "adverse" in the medical sense, which also has a very precise definition - I use it in the colloquial sense.

[GhotiFish]

Then I think we are on the same page.

I can understand railing against the statement "e-cigarettes are harmless" because the active ingredients are definitely not.

That said, if you could replace every cigarette in the world right now with an e-cig. Would you not do it? I would. They have their own host of problems, but not so much as inhaling burnt plant matter has. Even with what we know now, we know it is the lesser of two evils.

I understand, you don't like people being imprecise, neither do I frankly. It's rather hard to stop though, one of those human nature thingies.

[djillionsmix]

In casual conversation many people would describe advil as harmless

[Zigurd]

The LD50 of nicotine is low enough that it would be conceivable to die from the toxic effects, and that's not possible with cannabis, but that's already a risk with nicotine patches, and it's not that large a risk.

Nicotine certainly has some distinctive psychoactive effects. I suppose it's a matter of opinion whether you find them beneficial if you are otherwise healthy.

[cabalamat]

> we can be fairly certain that they are least somewhat harmful

Can we? How?

> Nicotine, on the other hand, is harmful in its own right.

Vaping doesn't necessarily involve nicotine.

[pbreit]

If the bar is "somewhat harmful" then almost everything we put in our bodies would comply.

[mistercow]

>The ecig industry is the tobacco industry.

A large part of the ecig industry is small businesses making liquid and selling it out of little shops and small websites. We have two of these shops in my little Podunk town now. It's kind of amazing to see, and I wonder how long it will manage to last.

I doubt that the future of ecigs is going to be these shitty disposable toys and prepackaged cartridges. Everyone I've known who started on ecigs pretty quickly moved on to higher quality refillable deals.

[Semaphor]

Plus the mod makers selling rebuildable atomizers and battery casings.

[Oxxide]

It's pretty clear you only have a surface understanding of the e-cig industry, the big tobacco owned e-cig lines are crappy disposables. You might start with one, but pretty soon you move on to a proper personal vaporizer with a decent battery life.

It's not clear how exactly harmful they aren't, either. The truth is, no one knows. They certainly haven't done any harm to me thus far, and we aren't yet hearing reports of vapers dropping dead, so I think it's safe to assume they're relatively harmless. (at least in the short term.)

[cloverich]

> so I think it's safe to assume they're relatively harmless. (at least in the short term.)

Cigarrettes are basically harmless in the short term as well!

None the less, and contaminants from crappy manifacturers not-withstanding, I'd be surprised if e-cig's turn out to be harmful (in a meaningful way).

[Lambdanaut]

I agree that they're not harmless. They're addictive, and being forced into reliance on a substance is never good.

Though, this is the only detriment we know of.

[Zak]

being forced into reliance on a substance is never good

I find this wording problematic. I'm skeptical that any significant number of people in the developed world today start using nicotine without knowing that it's addictive or that a significant fraction of nicotine addicts developed that addiction through involuntary exposure.

[Zigurd]

> They're addictive, and being forced into reliance on a substance is never good.

How bad is it? Unless I'm exercising hard, I'll get caffeine withdrawal symptoms if I stop drinking coffee. I have read of both beneficial and detrimental effects of caffeine. What's the threshold for considering the accompanying physical addiction a problem?

[DanBC]

> What's the threshold for considering the accompanying physical addiction a problem?

If something is addictive but not physically harmful the threshold is when it starts to affect your day to day life.

Gambling is fun. Some people have a problem with gambling. When you think that gambling is affecting your day to day life it's stopped being fun and turned into a problem.

[pandaman]

I'd like to see any citation for #1.

For #2 you need to prove that if there exists s in S and s has property X then every element t in S also has property X.

[konstruktor]

The burden of proof, in this case, should be on the e-cigarette industry. They are selling an addictive recreational product, consisting of a new combination of substances, with a novel delivery method (that involves deep inhalation). It would be naive to let them play the game the cigarette industry has played for decades, that is trying to dodge the burden of proof for safety and spreading uncertainty.

And let's not forget that, for a novel product, the baseline for safety is not using the product, not using something that is known to be extremely toxic.

[pandaman]

All substances in e-cigaretes are harmless in dozes they are normally taken+. IMHO this is sufficient to claim that a mix of harmless substances is also harmless so the burden of proof is on somebody saying that such a mix suddenly became harmful.

+ I know that nicotine has LD50, so does water and even oxygen is dangerous at high pressure.

[riquito]

#1: they're addictive. It's in my list of harmful things

[praxeologist]

Sugar is addictive and vastly more dangerous than ecigs IMO.

[bmelton]

Conversely, caffeine is addictive, but is otherwise harmless (except in insane doses.) So long as you never try to quit, you'll never experience any negative side effects of caffeine addiction.

[Nursie]

You don't have to use them with nicotine. Then they are non-addictive.

[pbreit]

"harmless" isn't quite right but calling that a "lie" is likewise a stretch. If they are, say, less harmful than sugar, is it OK to call them harmless?

[blankenship]

But are they harmless? If they’re made with chemicals in an unregulated industrial process, it seems unlikely. Less harmful than ”analog” cigarettes, maybe—but completely harmless seems like an unlikely stretch.

[praxeologist]

Ecig advocates take a harm reduction approach, rather than the quit or die approach of anti-nicotine zealots. All evidence suggests that ecigs are vastly safer than burning tobacco.

Here is a recent survey of all available research. We could further extend this by looking at known cancer/cardiovascular risks of the small bits of concern with ecigs then compare to burning tobacco and you are talking about 1% danger comparatively: http://publichealth.drexel.edu/SiteData/docs/ms08/f903492642...

There is some movement for hte industry to regulate itself and suggest sensible rules, but if ecigs are "deemed" under the 2009 Tobacco act, it will potentially wipe out all innovation because of the rule that any new product be "substantially equivalent" to a product on the market before some arbitrary date in 2007 they set. There's all sorts of horrible rules being proposed which go beyond just making sure the liquid isn't contaminated.

[konstruktor]

I as a non-smoker can buy an e-cigarette, so one should judge the safety of the product on its own, not compared to something that is clearly harmful.

Methadone, for example, is used for harm reduction. It's only available as an prescription alternative to a harmful addiction. And still, substitution therapy is treated like any other form of medicine, i.e. the industry has to prove the merits of their product before it can go on sale.

Nicotine patches, which are available OTC to the general public, at least had to be proven as safe in clinical trials.

[Oxxide]

thank you for this level-headed response. some of the vitriol around here is toxic.

[dhughes]

Safer according to what study? People just assume they are safer.

[mistercow]

No. There are numerous studies demonstrating that they are safer. Here's one: http://publichealth.drexel.edu/SiteData/docs/ms08/f903492642... . Here's another: http://tobaccocontrol.bmj.com/content/early/2013/03/05/tobac...

Also, without direct evidence or rigorous analysis it would still be preposterous that a mixture of nicotine, fragrances, propylene glycol, and vegetable glycerine would be anywhere near as harmful to the lungs as cigarette smoke. There is a difference between "just assuming" and applying common sense.

[dhughes]

You would think common sense would say "only put air in your lungs".

[mistercow]

No, the prior for "air is the only safe thing that can go in your lungs" is very low.

[tomjen3]

I must admit I have tolerance for that bullshit. The cigs don't contain any of the dangerous chemical in a cigarette - you don't need a study to prove they are safe, you just need a decent understanding of chemistry.

But a million anti-smoking advocates don't give a shit.

[Iftheshoefits]

The set of chemicals in cigarettes that are dangerous is a subset of all chemicals known to be dangerous. One can conclude something quite important from that fact without any understanding of anything other than basic reasoning skills.

[bashinator]

If nicotine isn't harmful in itself, why does chewing tobacco cause cancers of the mouth?

[radio4fan]

Because there are more than 70 carcinogenic compounds in tobacco.

[jlgreco]

Are nicotine skin patches causing an epidemic of skin cancer where they are placed?

Not all side effects are caused by the active ingredient.

[fbellag]

Yes, I know I do assume they are safer.

If the ecig industry were regulated, then we could make sure the liquid has no or minimal side effects.

In my country it is worse because ecigs are forbidden (given that uncertainity), so we have a black market for ecigs, making the quality of the liquids even more quetionable.

I know tobacco is really bad, and I have doubts about ecig. So, I give the benefit of the doubt, as it is little probability it is worse.

[mistercow]

Honestly, I have doubts that there's much bad going to come of unregulated liquid. They're very simple solutions with few ingredients, and there isn't that much room to screw it up. If you bought ingredients from China, you might end up with VG and PG that weren't actually VG or PG, so there's one avenue. But the same thing happened with toothpaste years back, and toothpaste is regulated.

I'd actually be more concerned about the hardware than the liquid. It would be easy to cut costs by using unsafe materials for heating elements, solder, or the wicks. But even with all of that risk, you're going to have a hell of a time beating the harm of cigarettes.

[unlucky]

"I hope the tobacco industry takes a huge financial hit from the sale of these things because they literally prevent people from dying."

From what I can tell, the tobacco industry is going to eventually own the e-cig market too.

http://money.msn.com/investing/big-tobacco-invests-in-e-ciga... http://www.cbsnews.com/8301-201_162-57588583/

[schrodinger]

That seems to be a sign that they _are_ taking a significant financial hit, or at least are afraid that they will soon. I'd rather see people using e-cigs sold by big tobacco companies than real cigarettes though.

[hackula1]

I tried the patch before using e-cigs to quit. The patch stopped the cravings for me even better than the e-cigs, but gave me horrifying dreams every night, and I would wake up every morning thinking for the first few minutes that they had actually happened the day before. Even if e-cigs are somewhat harmful, I would choose them over cigarettes and over wacky lucid nightmares.

[cloverich]

> horrifying dreams every night

lol please tell me you did not sleep with it, because you are certainly not supposed to!

[Semaphor]

> That being said, when I switched to e-cigarettes, it was very easy to switch back to regular cigarettes.

Not easy at all for me. Cigarettes taste so disgusting, I could never go back to them.