I highly suspect these young vapers would have picked up smoking instead if products like this didn't exist.
I don't know what more the industry can realistically do. The sales of their products is already limited to adults, and I don't know why advertising flavorings is supposed to be about targeting children (why would adults not like strawberry flavoring?) so unless there is an epidemic of B&M or online stores that keep selling to minors, they're already doing what they can.
Maybe I'm missing something, but as an outsider, the FDA seems dead set on killing your vaping industry by all means necessary.
>I highly suspect these young vapers would have picked up smoking instead if products like this didn't exist.
personal observation, not data, but I don't think this is so. I work on a university campus, and the proportion of people on campus that smoke has cratered this decade. The only reliable smoking populations are foreign students, and they seem to taper off over their undergrad years, which I can ascribe only to peer pressure against smelling horrible -- and maybe easy access to "study aids" like adderall.
edit: i should add that juul use has jumped just this year alone, and with less focused of a user group.
it does, loosely. However, box mods are still quite rare, so it's not super clear that the narrative of "people stopped smoking and started vaping" really holds -- or held until Juul took over, which is quite recent.
It's fairer to say that an age cohort basically just stopped consuming nicotine at all, and that a new, younger generation has picked up again but switched delivery methods.
> I don't know what more the industry can realistically do.
Stop selling poison.
> Maybe I'm missing something, but as an outsider, the FDA seems dead set on killing your vaping industry by all means necessary.
Well, yeah. The FDA Mission, which is defined by statute:
"The Food and Drug Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation.
FDA also has responsibility for regulating the manufacturing, marketing, and distribution of tobacco products to protect the public health and to reduce tobacco use by minors.
FDA is responsible for advancing the public health by helping to speed innovations that make medical products more effective, safer, and more affordable and by helping the public get the accurate, science-based information they need to use medical products and foods to maintain and improve their health.
FDA also plays a significant role in the Nation's counterterrorism capability. FDA fulfills this responsibility by ensuring the security of the food supply and by fostering development of medical products to respond to deliberate and naturally emerging public health threats."
Then what's the alternative for smokers that want to stop, then? These highly ineffective smoking cessation patches/gums they already had? If you want to be anywhere near consistent, cigarettes should be banned as well, as all the damn data points to vaping being far less dangerous that smoking.
Wouldn't a less short-sighted alternative be to just damn regulate the market properly?
Treating it as a medical issue would be one way to regulate the market, then. Outright banning them but keeping cigarettes is just a plain double standards.
Countless smokers stopped using cigarettes because of vaping. Vaping is not about eliminating risk but risk reduction. Long-term effect research is lacking by simple lack of long-term data due to how new the market is, but the overwhelming majority of data there is for now points towards it being a far safer alternative to smoking cigarettes.
Want to ban vaping? Ban goddamned cigarettes too, then, if you want to be anywhere close to consistent.
I am consistent. I don't see a distinction between companies that sell cigarettes and vaping equipment. They are the same industry. And that industry should just close down. It has no useful purpose and is additionally extremely harmful.
Outright banning cigarettes won't and never happened anywhere, as far as I know. I don't see why vaping should be treated differently, if you think they're similar industries (which I agree on).
Regulate the market like cigarettes are, but damn, why outright ban it?
I didn't say banning cigarettes. The question was "what else could the industry do?". And I wrote the best they could do is to shut down and do something useful.
Well that's bad faith if I've ever seen it. Not every industry out there has to be "useful", some are there for convenience. One could also argue that allowing people to switch from vaping to smoking is a huge plus in risk reduction and potentially (for now, with the data we have, more than likely) health.
Its a combination of a few different things. The flavors make it more attractive to kids. The non-combustible method of inhalation means it can be safely/cleanly vaped indoors, say in school bathrooms, and you don't have to waste a whole cigarette just for one puff. They're also ridiculously easy to find online under 18; Juul themselves does digital age verification, but plenty of retailers don't.
They're being asked to prove that the device helps adult smokers more-so than it hurts new smokers. The keyword is "more-so", because if these statistics suggest that Juul's uptake in adult users is lower than the FDA's statistics on high school usage, or if Juul can't prove that the vast majority of their users were former smokers rather than new users at any age, or if Juul can't present evidence that vape devices (especially their ultra concentrated 5% nic salt formula) are safe, they're finished. And they'll take the rest of the vape industry down with them.
Still waiting on that data, then. Super bummed about the industry going down if that happens, as it's what made it possible for me to stop smoking cigarettes.
Up here in Canada, online vape stores are behind age walls, are required to ship with age verification. Quebec shops can't even sell nor advertise online.
Vaping is a gateway for some who would not have smoked to begin doing so. Some of them would have picked up smoking if the products did not exist.
Not all; some who vape would not have smoked. And it's also a release for some who do smoke to quit.
It's very difficult to measure these populations and movements, and also difficult to make statements about the magnitude and worth of their effects.
Regardless, the goal is to reduce the ingress of new smokers, and if possible to increase the success rate of those who wish to quit smoking. The FDA can make progress on this by policies that reduce kids picking up vaping and using proven methods to stop them from picking up smoking.
> The FDA can make progress on this by policies that reduce kids picking up vaping and using proven methods to stop them from picking up smoking.
Thing is, these "proven methods" (gums/patches) are extremely ineffective - last time I checked it was something along the lines of 20-something% success rate. Vaping has been also pretty much proven at this point to be way less damaging than smoking at short-to-medium term.
I don't know about studies on effectiveness as a smoking cessation tool, but just the risk reduction alone makes it worth consideration, and would make it pretty damn dangerous and short-sighted to outright ban...
Sorry, I wasn't referring to gums/patches or other tools to help people quit smoking. By "stop them from picking up smoking" I was referring to cigarette taxes, extreme social stigmas and heavy peer pressure against smokers, laws banning smoking within public places and private businesses, medical warnings, advertising restrictions, and so on.
These do little to help the situation of current addicts - and actually make their lives miserable - but do a lot to help those who would have become smokers in the future. If the FDA can prevent people from starting smoking, then even if they do nothing to help people who are currently addicted the problem will eventually be solved. If they ineffectively help people to quit, but in so doing generate new addicts, the problem will persist.
It ought to come down to a data-driven question of quality-adjusted life years and results now vs. results later, but people are bad at shutting up and doing the math. It's easer to imagine the choice between helping one member out of a group of 5 old smokers who just can't seem to give up the habit he picked up in the 70s but might be helped by vaping, and the alternative of an anonymous high school kid who might pick up vaping this school year, eventually pick up smoking and become that old man someday in the 2060s. I'd rather help the kid.
Do you really think people will ever really stop smoking? I picked up smoking as a young adult cause parties and peers. My father is an MD, I fully knew the risks associated with smoking. Reducing the amount of people that want to pick it up through taxes and social stigma, sure, that obviously worked. We'd rather have a bunch of vapers than a bunch of smokers, though. For now, with the data available today, we can safely say it's way, way less impactful on one's health.
> high school kid who might pick up vaping this school year, eventually pick up smoking
The "gateway" argument is far-fetched. The smoking numbers are still going down as of today. How do we even know it's a gateway? The data is just not there to back this up. It's like saying we should ban pot in currently legal states cause they might all gateway to crack.
It's not moral panic. Vaping is just as harmful as smoking. Combustion is still the main chemical reaction, and the resultant compounds are just as toxic. They only smell nicer.
There’s no evidence of this. Everything I’ve read indicates that vaping is likely (and dramatically) less harmful. The levels of toxins are orders of magnitude lower or nonexistent in vapor.
Also, there’s no combustion when liquid-based nicotine solution is atomized.
I grant that vaporization occurs at a lower temperature than combustion, but it is still a chemical reaction that relies on a heating element. Proponents of e-cigs have always argued that this makes e-cigs safer, and it does not produce the same compounds that yobacco burning does. What is not clear is whether the compounds produced are safer.
This runs contrary to everything I've read. Vaping is much less harmful than smoking. Vaping does not rely on combustion but rather vaporization. The resulting compounds aren't just as toxic.
While there isn't much research on long term effects of vaping, there are a lot of studies which examine the parts of vapor and almost all, especially when testing under normal conditions, find that they contain much less of the carcinogens that normal cigs do precisely because they aren't combusted.
It's not a moral panic, in the sense that people don't like kids smoking. It's a public health issue. Juul is bad for kids' health, it causes similar problems as cigarettes, even though it's relatively safe. [1] You can't sell cigarette replacements in 2018, half the price, in a nice package, deceiving kids who have absolutely no idea what the heck they're doing, and expect to profit legally and morally from this.
I have long been confused how Juul manages to avoid getting taxed into oblivion.
A cart has ~2x packs of cigarettes worth of nicotine, yet is regularly sold for ~$15 in my state, which is a 50% or greater savings over traditional cigarettes. I don't entirely understand how this is legal.
The FDA is in an interesting regulatory bind here, too -- I think nicotine is unique in their regulatory scope in that the FDA is concerned with efficacy and safety and tobacco products are known to be unsafe and ineffective therapeutic agents.
A package of Juul pods contains 4 cartridges which each contain approximately 1 pack of cigarettes worth of nicotine. In NYC these sell for ~$20, while 1 pack of cigarettes sells for ~$13.
> The FDA is in an interesting regulatory bind here, too -- I think nicotine is unique in their regulatory scope in that the FDA is concerned with efficacy and safety and tobacco products are known to be unsafe and ineffective therapeutic agents.
Thr tobacco industry tried this approach, claiming tobacco is an "agricultural product". Congress fixed that by passing a law specifically authorizing the FDA to regulate tobacco, which includes smokeless nicotine products.
Perhaps at some regulatory point it would make sense for Juul and others to extract nicotine from tomatoes and eggplants to bypass the tobacco restriction, or synthesize it from organic precursors?
Not arguing your main point at all, but I wanted to correct your last statement. While not considered safe, cigarettes have proven to be remarkably protective against the development of Parkinson's disease in a slew of studies spanning decades of research. This is relatively little-known outside of the field. I did my PhD in Parkinson's drug discovery, and it was one of those findings that is frustrating due to the lack of other effective therapies for PD prevention and the obvious deleterious effects of smoking on heart disease, lung cancer, etc. Here's a relatively recent review paper on the topic: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5494127/.
Relevant excerpt:
"Population-based studies have shown that smoking was associated with approximately 40–50% reduced risk of developing PD. [10, 11] This inverse relationship between smoking and PD was dose-dependent: age-adjusted relative risks (RRs) of PD were 0.8, 0.6, 0.5, and 0.4, for 1-9, 10-24, 25-44, and 45+ pack-years, relative to never-smokers, as shown in a large prospective cohort study [9]. There is also a temporal relationship between cigarette smoking and PD risk [9, 17]. Individuals with more years of smoking, older age at quitting smoking, and fewer years since quitting smoking had lower PD risk. Researchers prospectively observed a significantly lower risk of PD for smoking as early as 15 to 24 years before symptom onset, but not for smoking 25+ years before onset (n = 143,325) [17]."
Not all tobacco/nicotine products are taxed equally. In my state a pack of cigarettes is $10, but you can buy cigarette sized cigars for $2.50 for a 20pk, a 170pk of nicotine gum for $35 (1 gum = 1 cigarette). In defense, chewing nicotine gum is a lot less harmful than smoking a cigarette.
Cigars are a different, less addictive nicotine delivery mechanism.
Juul is problematic because they have an improved nicotine salt that delivers cigarette-like intensity/dosage. The upside is that it's easier to transition from cigarettes. The downside is that it shares the strong addictive quality of cigarettes.
I used to think there is another government agency in charge of alcohol and nicotine - ATF yet FDA makes sense as it is about safety of a thing people consume internally.
It's still amusing to me that Juul markets itself, raises money, and structures its ranks like a technology startup, but they're really a tobacco company. Every trope about "growth hacking" from a traditional startup apply here, except that "growth hacking" is most impactful with getting kids to smoke, which I at least assumed was a non-starter for forward-thinking people in the 21st century. Yet, here we are, with a tech startup that likely needs kids to smoke in order to turn their company's financials right-side-up for a successful exit.
I've heard that a fair few times before about vapes. That they are 'cleaner' than cigs, and therefore better. But I've not yet seen a peer-reviewed study on them that proves they are less bad than cigs. Is there one? I mean, nicotine is itself not a good thing to be exposed to [0].
Nice find! Thanks for the info, the report highlights that vaping is a good vehicle for the stopping nicotine addiction. I'd love to see the followup on flavored vs. non-flavored 'juices'.
Here's a question that I don't see answered in this page though: I'm a non-smoker and asthma patient (was diagnosed at age 7, the cause is most likely second-hand smoke from my father), so I always stay clear of smokers and don't let anyone smoke indoors while I'm around. What is a reasonable policy to assume wrt vaping? Do we have any evidence regarding second-hand vaping? I'm not particularly worried about getting addicted that way, but about whether the smoke from an e-cigarette can be harmful to me as an asthma patient (or to others).
(And while we're at it: What about Marlboro's Iqos? I stood next to someone using one of these a few weeks ago and the reduction in second-hand smoke and stench is remarkable.)
Nicotine has its own risks as a stimulant, for sure, no different than caffeine in a lot of ways.
The biggest issue with smoking is particulate getting into the lungs. Firemen who spend their whole careers breathing non-tobacco smoke have rates of heart disease and cancer similar to regular cigarette smokers.
If you actually read the Wikipedia link you posted you would see that nicotine's effects are minor in adults. Definitely less dangerous than, for example, breathing car waste everyday by living in a city.
This of course regards only nicotine, and not all the other chemicals associated with any kind of smoking/vaping.
But "saving lives" doesn't affect their bottom line, and it's at best an incidental and indirect effect of their business model. And furthermore, it could easily be argued that if their growth model encourages nicotine use by children, it will actually create more smokers.
If people need to sleep well at night (and many don't care), this reasoning is duplicitous. It'd be better to build a service that helps with smoking/nicotine cessation.
Getting kids smoking is indeed morally reprehensible, but is it any more wrong than countless startups that exploit labor via the so-called 1099 "gig economy", who seem to get a free pass?
Is this a trick question? The answer would be a clear, strong "yes". Inducing a permanent, expensive addiction in minors versus giving grownups a moderately shitty job?
Spectrum fallacy. There is no "scale of morality," which goes from 0 to 10. Each of these can be viewed as wrong from different perspectives. Also, "exploit labor," is a leading term - there is labor exploitation going on, but also free association, while at the same time there are companies that engage in almost outright slavery. It's all over the place and you can't loop them together. If you give a 6 year old poison candy, it's clearly indefensible. If it's a 20 year old, "kid" well, most people will think that's his or her choice.
As a former smoker who was only able to quit using Juul, this is disappointing to me. As a father of a one year old, I understand the reasoning behind this.
I think perhaps the answer is to make the Juul and similar products less appealing to youth. How? Of course this is a complex topic but less flashy hardware and marketing could be a small start.
But this is somewhat an admission of using it as medication, which is far from what Juul is being marketed as. It should be next to the nicotine patches at the pharmacy. Can you even buy nicotine patches in bulk? Substances that can be abused for something other than their primary use as medication are heavily regulated by the FDA (think meth ingredients).
Risk reduction vs. risk elimination. Swapping from one to another means reducing risk by a huge margin, according to the huge majority of (short to mid-term) data we have for now.
I, too, am a former smoker and I have questions. Mostly how a device that delivers the addictive substance helps you quit.
Were you taking a "step-down" strategy like with the nicotine gum? Since the gum is carefully regulated and the "juice" isn't, how can you be sure your step-down is actually doing anything? And since the gum is metered out in measured doses, what's to prevent you from just grabbing full-strength juice and falling off the wagon? (Compare with smoking, which means you ostensibly have to go and buy a pack of smokes and a lighter, assuming you followed step 1 in the gum and got rid of your cigarettes and lighter)
I'm not advocating Juul use as a strategy for quitting. I'm merely sharing my own experience, which was that Juul was the only thing that allowed me to quit (after 10 years of many attempts using most available options). Why did it work? I'm not sure. Perhaps it created just the right amount of elasticity in my addiction.
> Nearly 8 of every 100 high school students (7.6%) reported in 2017 that they smoked cigarettes in the past 30 days—a decrease from 15.8% in 2011.
>Nearly 12 of every 100 high school students (11.7%) reported in 2016 that they used electronic cigarettes in the past 30 days—an increase from 1.5% in 2011.
While of course e-cigs aren't harmless, there's a pretty clear replacement effect between them and cigarettes. Kids are going to do stupid things anyways, taking away the more enjoyable of the two isn't going to stop that.
It seems like it might not just be a replacement effect, though. Adding those numbers together, and pretending that 2016 == 2017, you get an increase from 17.3% of kids using either in 2011, to 19.3% in 2016/2017.
Perhaps you can make an argument that, lacking tar and being (purportedly?) less addictive, e-cigs are enough less bad that a net increase in the number of kids consuming nicotine is an acceptable price for halving the number of kids who are smoking cigarettes. That's a more arguable argument, though.
I have friends and family that either quit using vapes or substituted then permanently. As a former half a pack smoker myself, on occasion I would smoke a cigarette at a bar because it’s such a nice feeling, then feel guilty the next day. Juul is the only e-cig that I really like, and since I bought one I’ve yet to smoke a cigarette when drinking. Banning them because “think of the children!” is extraordinarily short sighted. Why not ban fruity alcoholic drinks too? Kids prefer those to beer.
> Banning them because “think of the children!” is extraordinarily short sighted.
Alternatively, prioritizing the needs of the already-addicted vs. keeping a new generation off the product entirely is "short sighted". Statistically, let's be honest: you guys are a lost cause.
The point was that if you trade "make it easier to quit" for "more new addicts from candy nicotine products", you're making a bad trade. You really want me to cite the numbers for how many smokers quit? It's depressingly low -- like 30% over a lifetime or something like that.
According to the article, there are currently 2.1 million underage "candy nicotine" users. How many of them would have been smokers if the alternative didn't exist? If it's banned, how many will switch to regular cigarettes vs. unflavored e-cigarettes? What are the relative risks of each? Unfortunately nobody actually knows the relative risks, which is the most pressing problem here.
Considering there is no definitive proof that vapes cause cancer, there is overwhelming evidence that cigarettes are responsible for a whole array of cancers and diseases, and I see teenagers and young adults smoking cigarettes all around Boston (even elite college kids), allowing Juul and other vapes to advertise and sell at retail seems like a worthwhile and beneficial option for society.
> Considering there is no definitive proof that vapes cause cancer, there is overwhelming evidence that cigarettes are responsible for a whole array of cancers and diseases...
The tobacco industry was able to hold off the "definitive proof" - which they were entirely aware of internally - for decades.
It seems quite likely that inhaling vaporized chemicals multiple times a day will have some health impacts. As with tobacco, the evidence will take a long while to accumulate, and the industry is likely to obfuscate as long as possible.
What does "socially accepted" mean? Both nicotine and alcohol have centuries-old integration into social customs...
More likely there are two factors at play:
1. The alcohol industry is a massive source of tax revenues (unlike guns or tobacco).
2. Educated voters across the spectrum enjoy alcohol but have largely left smoking behind ("people that matter").
Everything about regulating vices falls down when it comes to alcohol. Every indictment of guns or tobacco (dangerous, unhealthy, societal harm) is amplified for alcohol...yet it gets a pass while other vices are condemned.
Juul is the first mass-market e-cigarette product I'm aware of that isn't directly or indirectly owned by a company that was already in the traditional tobacco market.
Then Juul should be put next to the nicotine patches and gum in the pharmacy, and be marketed as a medication. The FDA heavily regulates substances that can be abused when not used as medication (things like meth ingredients).
Frankly, letting a company aggressively market a highly addictive compound to an impressionable segment of society because of a single-use excuse ("it can be used as medication!") is a bit disappointing. It also reads as astroturfing because it's such a limp talking point.
>Why not ban fruity alcoholic drinks too? Kids prefer those to beer.
Sure, why not. Germany for example put a heavy tax on alcopops because they were too popular with teenagers (despite teenagers not being allowed to buy them), which largely drove alcopops from the market [1]
It would’ve been so easy to make these prescription only. That way people who wanted to use them in place of cigarettes or to help them quit would be able to, but it would be much harder for them to become “cool“ and take off the way e-cigarettes/vaping have.
Inexact. A lot of young women prefer those to beer and are getting hooked on alcohol through them. Much to their detriment. (Alcohol consumption causes cancer, especially breast cancer in women.)
Is there anyway to reverse course in the USA and remove power from these alphabet agencies that claim they know what's best for us? What happened to being a free people who could make their own decisions?
Certain things were worse, certain things were better. Unfettered access to opiates prior to the FDA's formation never led to a crisis like we are seeing today.
Literally a century of changes besides the FDA's role also intervened. The FDA is, to be honest, shit compared to how it could be if it were a better run organization. But it's still better than throwing entire industries to the wolves and insisting the free market will save us.
> What happened to being a free people who could make their own decisions?
I'm glad you have the time, knowledge, expertise, and experience to thoroughly investigate the safety and long term affects of every product you use on yourself, second hand effects on others, and the environment. Not everyone is so lucky to be blessed with so much time, energy, and knowledge that they themselves can do what thousands of people so full time.
The point is the government is not consistent about what is permitted and what is banned.
If you are banning vices that cause societal harm, alcohol is far ahead of anything else. DUI victims, destroyed families, physical abuse, homelessness...alcohol is reliably correlated to all of these but since it brings in lots of tax $$$ and educated voters enjoy their Pinot, we look the other way.
> The Food and Drug Administration is threatening to pull flavored electronic cigarettes like Juul off the market if the tobacco industry doesn’t do more to combat growing use of the products by children and teens.
They're not "Outright banning", they're threatening to if the industry is unable to stop advertising to or otherwise making it appeal children. This is par-for-course for how regulation works: you don't comply and refuse to become compliant, you can't do business.
They're not just destroying an entire industry without working with said industry to mutually reach their goals.
Hell yeah. Who wants their "food" and "drugs" regulated? Free pain killers for all! Toxic additives are great!
Your complaint is a classic libertarian whine: you want the stuff you think is important regulated (though in practice you don't recognize how much of it already is), but the stuff on the margin is clearly an infringement on the fundamental rights of "free people".
As long as Congress refuses to write laws with more specificity than 'Foo shall write regulations to prevent all bad things', then no - we're stuck with this.
I think this will change if we can elect more repreesentatives that are more intrested in serving 1-2 terms and writing good law than getting re-elected.
Yes. Go vote for candidates that want to deregulate stuff you want deregulated.
That said, the FDA is really, really far down most people's list of agencies that shouldn't exist. ATF and TSA are generally the agencies that most people would prefer to get rid of.
Why is it the company’s responsibility to stop kids from using their product? This seems like something that parents should be responsible for.
And what is the company to do in the first place? As long as something is available for adults, and teenagers want it, teenagers will find a way to get it.
Long overdue. Vaping should be regulated much like smoking. It has the same deleterious side effects for individuals as smoking, and much the same negative impact on society (through second hand smoke).
Utter rubbish. The research has just begun and it will take a while to conduct epidemiology studies (basically we have to wait for people to die from e-cigs), but the prognosis is already poor. Here's one study from this year:
The Royal College of Physicians strongly disagrees with you. This is the same group that sounded the alarm on cigarettes in 1962 with their groundbreaking report "Smoking and health" [1]. Their 2016 report, "Nicotine without smoke: Tobacco harm reduction" [2] stands in staunch disagreement with your statement.
Sounds like a lot of nice fines or jail terms to be handed out to whoever sold/gave them to the kids. What kind of investigation is being conducted to find out who's responsible?
Most people get stuff like that through friends and family members. Aggressive enforcement of minor laws like that tends to be harmful to society in the long term.
If there was an epidemic of binge drinking in a school, I'm pretty sure the local police would start running sting operations to figure out who's supplying the alcohol.
If there's an epidemic of e-cigarettes, why aren't they doing the same? And I guess I may be ignorant of how the market for these works, but I've never actually seen them in regular shops. Where would I go to buy a Juul? I know there are dedicated vape shops, and also tobacco shops that sell e-cigarettes. Could you run stings there the way many US states run them at stores that sell alcohol?
Last I checked, nicotine isn't carcinogenic. It's the tobacco that kills you. Or, at least, there isn't enough research yet to say that nicotine alone is harmful enough.
So I may be playing devil's advocate here, but isn't this a net improvement over the last few decades? Kids getting hooked on something that's significantly less deadly? It's not ideal, sure, but it's better than a slew of cancer epidemics.
> Kids getting hooked on something that's significantly less deadly? It's not ideal, sure, but it's better than a slew of cancer epidemics.
The whole point is that these are kids who wouldn't be using nicotine products at all. Smoking rates have declined in the US over the last 40 years, and yet there's been an uptick in youth nicotine usage since the introduction of e-cigarettes.
So when talking about youth usage, no, this is clearly not an improvement, by any measure.
The actual numbers matter. Suppose vaping is 20% as harmful as smoking, and out of every 100 children, the availability of e-cigarettes causes 5 to switch from smoking to vaping and 5 others to start vaping who wouldn't have started smoking. That would be a substantial improvement.
> If we don't block the consumption of caffeine in youths, why should we block the consumption of nicotine - a compound with similar effects?
i.e. Why is nicotine so much worse than THC, alcohol, caffeine, guarana, or any number of other stimulants/depressants?
Alcohol and THC are both already restricted to adults. Caffeine is restricted as well, in that many places won't sell caffeine pills to people under 18.
Nobody is talking about preventing kids from buying tomatoes. But when we're talking about concentrated and extracted forms of a stimulant... those are already heavily restricted.
This is just stupid. Until the government wants to ban crap like watermelon vodka, this is just a win for traditional tobacco companies. Should we be encouraging anyone to smoke or Vape? No. But that doesn’t mean shitty retailers breaking the law aren’t the bigger problem. Do parents have no responsibility here anymore?
I'm astonished that there are folks in this thread who believe vaping to be as harmful as smoking cigarettes. Are there any peer reviewed papers supporting this assertion? I've kept an eye on literature as it's been released and everything indicates orders of magnitude less cell death and disruption from nicotine and flavor carrying PG/VG vape juice than cigarette smoke. Linked a DOI supporting this understanding elsewhere, but wondering if folks have papers supporting the opposite?
The amount of misinformation in this thread is worrying. Seems like your American pharmaceutical lobbies, or whoever gains in destroying the vaping industry, have succeeded in spreading the idea that vaping is somehow more damaging than smoking. Now that the science showed pretty clearly it's at least way less dangerous than cigarettes in short-to-mid term, they switched the narrative to "for the kids".
In what I'm sure is unrelated news /s, Altria Group stock has spiked to a 5-month high today [1]. Although there are legitimate reasons to consider banning E-Cigarettes, we should also be cognizant that Big Tobacco sees this as a benefit to their business. That alone makes me very suspicious of the potential benefits of this considered ban.
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[ 3.6 ms ] story [ 242 ms ] threadI don't know what more the industry can realistically do. The sales of their products is already limited to adults, and I don't know why advertising flavorings is supposed to be about targeting children (why would adults not like strawberry flavoring?) so unless there is an epidemic of B&M or online stores that keep selling to minors, they're already doing what they can.
Maybe I'm missing something, but as an outsider, the FDA seems dead set on killing your vaping industry by all means necessary.
personal observation, not data, but I don't think this is so. I work on a university campus, and the proportion of people on campus that smoke has cratered this decade. The only reliable smoking populations are foreign students, and they seem to taper off over their undergrad years, which I can ascribe only to peer pressure against smelling horrible -- and maybe easy access to "study aids" like adderall.
edit: i should add that juul use has jumped just this year alone, and with less focused of a user group.
I tend to think indoor smoking bans had something to do with the decline, but I don't know the timeline for anywhere except my state.
It's fairer to say that an age cohort basically just stopped consuming nicotine at all, and that a new, younger generation has picked up again but switched delivery methods.
We've got plenty of data that shows a steady, large decline in number of smokers since the 1970s.
Stop selling poison.
> Maybe I'm missing something, but as an outsider, the FDA seems dead set on killing your vaping industry by all means necessary.
Well, yeah. The FDA Mission, which is defined by statute:
"The Food and Drug Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation's food supply, cosmetics, and products that emit radiation.
FDA also has responsibility for regulating the manufacturing, marketing, and distribution of tobacco products to protect the public health and to reduce tobacco use by minors.
FDA is responsible for advancing the public health by helping to speed innovations that make medical products more effective, safer, and more affordable and by helping the public get the accurate, science-based information they need to use medical products and foods to maintain and improve their health.
FDA also plays a significant role in the Nation's counterterrorism capability. FDA fulfills this responsibility by ensuring the security of the food supply and by fostering development of medical products to respond to deliberate and naturally emerging public health threats."
Then what's the alternative for smokers that want to stop, then? These highly ineffective smoking cessation patches/gums they already had? If you want to be anywhere near consistent, cigarettes should be banned as well, as all the damn data points to vaping being far less dangerous that smoking.
Wouldn't a less short-sighted alternative be to just damn regulate the market properly?
Tobacco companies don’t have a right to exist.
Treating it as a medical issue would be one way to regulate the market, then. Outright banning them but keeping cigarettes is just a plain double standards.
California tried and the next thing you know literally EVERYTHING is marked as a potential cancer causing agent
You know what causes death?
Living
Tobacco addiction.
I wouldn't mind if they just went out of business and did something useful instead.
Want to ban vaping? Ban goddamned cigarettes too, then, if you want to be anywhere close to consistent.
Regulate the market like cigarettes are, but damn, why outright ban it?
Well that's bad faith if I've ever seen it. Not every industry out there has to be "useful", some are there for convenience. One could also argue that allowing people to switch from vaping to smoking is a huge plus in risk reduction and potentially (for now, with the data we have, more than likely) health.
That's not bad faith, that's arguing over semantics. You two clearly have different definitions of "useful".
They're being asked to prove that the device helps adult smokers more-so than it hurts new smokers. The keyword is "more-so", because if these statistics suggest that Juul's uptake in adult users is lower than the FDA's statistics on high school usage, or if Juul can't prove that the vast majority of their users were former smokers rather than new users at any age, or if Juul can't present evidence that vape devices (especially their ultra concentrated 5% nic salt formula) are safe, they're finished. And they'll take the rest of the vape industry down with them.
Up here in Canada, online vape stores are behind age walls, are required to ship with age verification. Quebec shops can't even sell nor advertise online.
It's very difficult to measure these populations and movements, and also difficult to make statements about the magnitude and worth of their effects.
Regardless, the goal is to reduce the ingress of new smokers, and if possible to increase the success rate of those who wish to quit smoking. The FDA can make progress on this by policies that reduce kids picking up vaping and using proven methods to stop them from picking up smoking.
Thing is, these "proven methods" (gums/patches) are extremely ineffective - last time I checked it was something along the lines of 20-something% success rate. Vaping has been also pretty much proven at this point to be way less damaging than smoking at short-to-medium term.
I don't know about studies on effectiveness as a smoking cessation tool, but just the risk reduction alone makes it worth consideration, and would make it pretty damn dangerous and short-sighted to outright ban...
These do little to help the situation of current addicts - and actually make their lives miserable - but do a lot to help those who would have become smokers in the future. If the FDA can prevent people from starting smoking, then even if they do nothing to help people who are currently addicted the problem will eventually be solved. If they ineffectively help people to quit, but in so doing generate new addicts, the problem will persist.
It ought to come down to a data-driven question of quality-adjusted life years and results now vs. results later, but people are bad at shutting up and doing the math. It's easer to imagine the choice between helping one member out of a group of 5 old smokers who just can't seem to give up the habit he picked up in the 70s but might be helped by vaping, and the alternative of an anonymous high school kid who might pick up vaping this school year, eventually pick up smoking and become that old man someday in the 2060s. I'd rather help the kid.
Do you really think people will ever really stop smoking? I picked up smoking as a young adult cause parties and peers. My father is an MD, I fully knew the risks associated with smoking. Reducing the amount of people that want to pick it up through taxes and social stigma, sure, that obviously worked. We'd rather have a bunch of vapers than a bunch of smokers, though. For now, with the data available today, we can safely say it's way, way less impactful on one's health.
> high school kid who might pick up vaping this school year, eventually pick up smoking
The "gateway" argument is far-fetched. The smoking numbers are still going down as of today. How do we even know it's a gateway? The data is just not there to back this up. It's like saying we should ban pot in currently legal states cause they might all gateway to crack.
Also, there’s no combustion when liquid-based nicotine solution is atomized.
Please do some research! This is blatantly false. Combustion is not involved in vaping, and boiling is not a chemical reaction!
It's very easy to find peer reviewed medical studies showing vape compounds are considerably healthier than cigarette smoke.
30 sec of googling shows https://doi.org/10.3390/ijerph10105146 amongst the relevant docs.
Did you just make that up?
See https://www.gov.uk/government/news/e-cigarettes-around-95-le...
[1]: https://news.psu.edu/story/527326/2018/07/03/impact/medical-...
A cart has ~2x packs of cigarettes worth of nicotine, yet is regularly sold for ~$15 in my state, which is a 50% or greater savings over traditional cigarettes. I don't entirely understand how this is legal.
The FDA is in an interesting regulatory bind here, too -- I think nicotine is unique in their regulatory scope in that the FDA is concerned with efficacy and safety and tobacco products are known to be unsafe and ineffective therapeutic agents.
Thr tobacco industry tried this approach, claiming tobacco is an "agricultural product". Congress fixed that by passing a law specifically authorizing the FDA to regulate tobacco, which includes smokeless nicotine products.
Relevant excerpt: "Population-based studies have shown that smoking was associated with approximately 40–50% reduced risk of developing PD. [10, 11] This inverse relationship between smoking and PD was dose-dependent: age-adjusted relative risks (RRs) of PD were 0.8, 0.6, 0.5, and 0.4, for 1-9, 10-24, 25-44, and 45+ pack-years, relative to never-smokers, as shown in a large prospective cohort study [9]. There is also a temporal relationship between cigarette smoking and PD risk [9, 17]. Individuals with more years of smoking, older age at quitting smoking, and fewer years since quitting smoking had lower PD risk. Researchers prospectively observed a significantly lower risk of PD for smoking as early as 15 to 24 years before symptom onset, but not for smoking 25+ years before onset (n = 143,325) [17]."
Juul is problematic because they have an improved nicotine salt that delivers cigarette-like intensity/dosage. The upside is that it's easier to transition from cigarettes. The downside is that it shares the strong addictive quality of cigarettes.
[0] https://en.wikipedia.org/wiki/Nicotine#Adverse_effects
Here's a question that I don't see answered in this page though: I'm a non-smoker and asthma patient (was diagnosed at age 7, the cause is most likely second-hand smoke from my father), so I always stay clear of smokers and don't let anyone smoke indoors while I'm around. What is a reasonable policy to assume wrt vaping? Do we have any evidence regarding second-hand vaping? I'm not particularly worried about getting addicted that way, but about whether the smoke from an e-cigarette can be harmful to me as an asthma patient (or to others).
(And while we're at it: What about Marlboro's Iqos? I stood next to someone using one of these a few weeks ago and the reduction in second-hand smoke and stench is remarkable.)
That doesn't mean that vaping is harmfree.
But your Wikipedia link tends to say that nicotine (other than being addictive) is mostly not harmful.
The biggest issue with smoking is particulate getting into the lungs. Firemen who spend their whole careers breathing non-tobacco smoke have rates of heart disease and cancer similar to regular cigarette smokers.
https://www.cdc.gov/niosh/firefighters/health.html
This of course regards only nicotine, and not all the other chemicals associated with any kind of smoking/vaping.
If people need to sleep well at night (and many don't care), this reasoning is duplicitous. It'd be better to build a service that helps with smoking/nicotine cessation.
There's always going to be Other things. But that doesn't mean we shouldn't call-out bad things, and try to fix them.
I think perhaps the answer is to make the Juul and similar products less appealing to youth. How? Of course this is a complex topic but less flashy hardware and marketing could be a small start.
Were you taking a "step-down" strategy like with the nicotine gum? Since the gum is carefully regulated and the "juice" isn't, how can you be sure your step-down is actually doing anything? And since the gum is metered out in measured doses, what's to prevent you from just grabbing full-strength juice and falling off the wagon? (Compare with smoking, which means you ostensibly have to go and buy a pack of smokes and a lighter, assuming you followed step 1 in the gum and got rid of your cigarettes and lighter)
> Nearly 8 of every 100 high school students (7.6%) reported in 2017 that they smoked cigarettes in the past 30 days—a decrease from 15.8% in 2011.
>Nearly 12 of every 100 high school students (11.7%) reported in 2016 that they used electronic cigarettes in the past 30 days—an increase from 1.5% in 2011.
While of course e-cigs aren't harmless, there's a pretty clear replacement effect between them and cigarettes. Kids are going to do stupid things anyways, taking away the more enjoyable of the two isn't going to stop that.
[1] https://www.cdc.gov/tobacco/data_statistics/fact_sheets/yout...
So, no it's not obvious that electronic cigarettes are replacing smoking. The upward trend with electronic cigarettes is a huge public health issue.
Perhaps you can make an argument that, lacking tar and being (purportedly?) less addictive, e-cigs are enough less bad that a net increase in the number of kids consuming nicotine is an acceptable price for halving the number of kids who are smoking cigarettes. That's a more arguable argument, though.
Alternatively, prioritizing the needs of the already-addicted vs. keeping a new generation off the product entirely is "short sighted". Statistically, let's be honest: you guys are a lost cause.
The tobacco industry was able to hold off the "definitive proof" - which they were entirely aware of internally - for decades.
It seems quite likely that inhaling vaporized chemicals multiple times a day will have some health impacts. As with tobacco, the evidence will take a long while to accumulate, and the industry is likely to obfuscate as long as possible.
Because alcohol use is much more socially accepted than nicotine use.
More likely there are two factors at play:
1. The alcohol industry is a massive source of tax revenues (unlike guns or tobacco).
2. Educated voters across the spectrum enjoy alcohol but have largely left smoking behind ("people that matter").
Everything about regulating vices falls down when it comes to alcohol. Every indictment of guns or tobacco (dangerous, unhealthy, societal harm) is amplified for alcohol...yet it gets a pass while other vices are condemned.
Frankly, letting a company aggressively market a highly addictive compound to an impressionable segment of society because of a single-use excuse ("it can be used as medication!") is a bit disappointing. It also reads as astroturfing because it's such a limp talking point.
Sure, why not. Germany for example put a heavy tax on alcopops because they were too popular with teenagers (despite teenagers not being allowed to buy them), which largely drove alcopops from the market [1]
1: https://en.wikipedia.org/wiki/Alcopop#Germany
No, they don't, and we do ban advertising those drinks directly to children.
Inexact. A lot of young women prefer those to beer and are getting hooked on alcohol through them. Much to their detriment. (Alcohol consumption causes cancer, especially breast cancer in women.)
I'm glad you have the time, knowledge, expertise, and experience to thoroughly investigate the safety and long term affects of every product you use on yourself, second hand effects on others, and the environment. Not everyone is so lucky to be blessed with so much time, energy, and knowledge that they themselves can do what thousands of people so full time.
If you are banning vices that cause societal harm, alcohol is far ahead of anything else. DUI victims, destroyed families, physical abuse, homelessness...alcohol is reliably correlated to all of these but since it brings in lots of tax $$$ and educated voters enjoy their Pinot, we look the other way.
Also, alcohol sales and marketing are heavily regulated, along with tobacco.
They're not "Outright banning", they're threatening to if the industry is unable to stop advertising to or otherwise making it appeal children. This is par-for-course for how regulation works: you don't comply and refuse to become compliant, you can't do business.
They're not just destroying an entire industry without working with said industry to mutually reach their goals.
But no, it's got to be the smarmy wine drinkers who read actual physical copies of the New Yorker.
Your complaint is a classic libertarian whine: you want the stuff you think is important regulated (though in practice you don't recognize how much of it already is), but the stuff on the margin is clearly an infringement on the fundamental rights of "free people".
I think this will change if we can elect more repreesentatives that are more intrested in serving 1-2 terms and writing good law than getting re-elected.
That said, the FDA is really, really far down most people's list of agencies that shouldn't exist. ATF and TSA are generally the agencies that most people would prefer to get rid of.
And what is the company to do in the first place? As long as something is available for adults, and teenagers want it, teenagers will find a way to get it.
It's funny how the only regulation that gets treated as a sensible status quo is the limited liability extended to investors in corporations.
http://www.pnas.org/content/early/2018/01/25/1718185115
[1] https://www.rcplondon.ac.uk/projects/outputs/smoking-and-hea...
[2] https://www.rcplondon.ac.uk/projects/outputs/nicotine-withou...
If there's an epidemic of e-cigarettes, why aren't they doing the same? And I guess I may be ignorant of how the market for these works, but I've never actually seen them in regular shops. Where would I go to buy a Juul? I know there are dedicated vape shops, and also tobacco shops that sell e-cigarettes. Could you run stings there the way many US states run them at stores that sell alcohol?
Sweet can't browse bloomberg with links. Nice.
So I may be playing devil's advocate here, but isn't this a net improvement over the last few decades? Kids getting hooked on something that's significantly less deadly? It's not ideal, sure, but it's better than a slew of cancer epidemics.
What is the FDA trying to achieve?
The whole point is that these are kids who wouldn't be using nicotine products at all. Smoking rates have declined in the US over the last 40 years, and yet there's been an uptick in youth nicotine usage since the introduction of e-cigarettes.
So when talking about youth usage, no, this is clearly not an improvement, by any measure.
i.e. Why is nicotine so much worse than THC, alcohol, caffeine, guarana, or any number of other stimulants/depressants?
Alcohol and THC are both already restricted to adults. Caffeine is restricted as well, in that many places won't sell caffeine pills to people under 18.
Nobody is talking about preventing kids from buying tomatoes. But when we're talking about concentrated and extracted forms of a stimulant... those are already heavily restricted.
[1] https://www.nasdaq.com/article/altria-group-inc-mo-has-spike...