Wow, thank you for saying that! Your comment seriously just made my day! 
Y’all are such a kind, welcoming bunch. Very glad I found this place!
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There definitely isn’t enough info about vaping yet. Equally as important, and WAY more crucial right now, is that there aren’t really any vaping-specific cessation programs- at least not for adults. Thus far, at most, I’ve found a texting support service, and that was after REALLLLLLY scouring the Internet. This is pretty concerning when it comes to the ban. While there are far more teenagers who vape than teenagers who smoke- still, the majority of people who vape are adults. If we want to be sensible about banning eliquids, we have to acknowledge that by banning them without having vape specific cessation programs for adults, as well as kids, we have been massively irresponsible. That concerns me a lot. I’ve been working with a pharmaceutical researcher at the university of Michigan recently to start thinking about ways to structure a full program. She’s going to guide me through quitting vaping, and try to identify where the differences are, and then we can start to think about what can be changed and adapted to fill in the gaps. The concept of nicotine addiction is the same. Lots of things are similar. But there are some key things that are different. These are the two major ones I’ve discovered so far, and they have made it a little bit complicated for me to use this and other cessation tools:
1. Quantity/dosage.
It’s the second question in the texting program from here. ‘How many cigarettes do you smoke a day?’ I don’t smoke cigarettes. Sure, I could just swap out the word ‘cigarette’ for ‘vape’, as many have suggested. But what’s the question then? ‘How many vapes do you vape a day...?’ Huh? There isn’t a definitive way to measure how much nicotine you’re using every day with vaporizers. Additionally, that question in the text program is a multiple choice answer. (Please don’t take this as an insult to the program- maybe think of it as constructive feedback that can be used to further improve the tool?) right off the bat, question number two, I had to make an arbitrary guess as to how much I’m consuming, which will ultimately be unhelpful, so- no, that tool/this program is by nature, not really intended for vapers, and the results will likely not be the same. There is literally no way to translate amount of nicotine I use in my vape into number of cigarettes.
2. Difference in ritual. Most people don’t use a vaporizer the same way they would use cigarettes. The ritual, schedule, patterns of use, time spent, behavioral patterns... it’s all different. I’ve had a really hard time trying to identify my triggers. Most of them are mindless. And the very nature of how long I use it doesn’t correlate. A cigarette has a start and an end. A single cigarette is a 7-10 minute commitment. I hit my vape randomly throughout the day. I don’t hit it for a specific amount of time, or a specific number of times. What are my triggers? Answer: it’s just always there. It’s rarely a conscious decision. So, in order to really get to the point of the process, a vaper has to change the way they use their device to mimic more of the way a tobacco smoker would- intervals, making it a more conscious decision. Maybe that’s the right way to do it. It’s hard to say. However, the patterns of use that come naturally with tobacco, differ from the patterns of use with vaporizers.
All of that being said- this touches on a pretty important issue, and one that really concerns me a lot lately. Most people don’t know a lot about vaping. Most people trust the CDC reports- as they should- but the follow up actions, conclusions, and current solutions being provided can cause a LOT of collateral damage, and are often coming from a place that lacks understanding of how cape products work. We don’t have enough information about vaping, but... we do have SOME information about it. We have more than just the CDC report. I’m concerned that the ban took place without the political figures making these decisions actually taking the time to understand what they’re talking about, and how these actions could cause problems, especially seeing as there was very little effort to build something that would help prevent the collateral damage. But with that- a fair amount of the information the general public, as well as decision making officials ‘know’ about vaping is sometimes slightly exaggerated, and sometime flat out incorrect.
I understand that we want to do everything we can to discourage using vapes. I don’t think it’s right to exaggerate, withold information or lie in an effort to get people to quit, refrain, or advocate against vaping. That tactic is the same exact tactic that vape lobbyists use, and it can have some pretty damaging side effects. Example: most leading tobacco cessation experts actually DO agree that vaping (as long as there aren’t contaminants present and people are not heavily modifying their devices) is not as hazardous a smoking cigarettes. It’s still terrible for you. It has a lot in common with cigarettes, and vaping has some adverse health effects that tobacco cigarettes DONT have. It’s still bad. Consider this though: we tell teens that vaping is just as dangerous, maybe even MORE dangerous than cigarettes, in an effort to get them to quit, despite the fact that that’s not the full truth. And then this ban happens, and the vaping teens no longer have access to their vapes. If we lead them to believe that those vapes are equally, if not more harmful than cigarettes, then many of them will simply switch to cigarettes instead, thinking, ‘well, at least cigarettes aren’t worse than vaping.’ Unintended consequences that create HUGE problems. We are probably going to see a huge spike in teens smoking cigarettes due to this ban. Don’t get me wrong, I’m not against banning some of the eliquid products- and I say that as someone who uses them and is trying to quit. But we implemented this ban so quickly, and we failed to create a plan ahead of time. There’s going to be consequences to making such a quick decision without much needed planning.
There’s even more concern around what’s IN eliquids and the notion that we have no idea what’s in them. This is partly true. The current idea is that some eliquids might contain contaminants, and in many cases, they’ve found that some eliquids contain some pretty terrible stuff. Your standard eliquids however- contain some concerning stuff, but mostly contain a mix of vegetable glycerin and/or propylene glycol. Liquid designed for modern atomisers is mostly vegetable glycerin, or VG – this can be up to 80% by volume. The glycerine used in e-liquid comes from vegetable oils, which is why it’s called VG. Although it’s processedfrom oils it isn’tan oil.
Lots of common products contain VG. It’s used in the food industry as a sweetener, and also added to some foods to keep them moist. Many medicines contain it too.
Then there’s propylene glycol- PG is in antifreeze, and it’s because of this that we hear ‘e-juice contains antifreeze.’ That’s a pretty large stretch... PG is only one ingredient in antifreeze, and it’s actually there because it’s non-toxic; PG-based antifreeze is less harmful to children and pets. It’s worth pointing out that water is also an ingredient in antifreeze; just because something is used in a product that is poisonous, that doesn’t explicitly mean each ingredient is poisonous.
Water- certain eliquids contain water, but not all of them, and even the ones that do contain water, it’s not much. It’s mostly VG and/or PG. So this notion of ‘it’s just water vapor! It’s perfectly safe!’ Is a huge stretch as well. Yeah, *technically some* of it *might* be water vapor. That’s not particularly reassuring though, lol.
Misconceptions about these products are rampant, and they come from both sides. This has long been a tactic of tobacco lobbyists- taking a fact that is just barely sort of true, and stretching it. Is misleading, it’s wrong, and it’s dangerous.
We can’t stoop to that level though. My aunt was talking to me recently about vaping, and she cited a lot of the misinformation I mentioned, in an effort to encourage me to quit (ok, realistically she was just trying to criticize me for vaping, but I’m going to pretend that she had good intentions lol) I corrected some of her facts, and then brought up the point the tactic of slighted misinformation is the same tactic that tobacco lobbyists use in order to fight tobacco regulations. She said, “well, even if it’s not 100% accurate, the point is that people need to quit. And if the tobacco company uses that tactic, maybe us using that tactic AGAINST them, would give them a taste of their own medicine.” Sure, maybe it would. I care a lot more about the people effected by the tobacco and vape industries- those are the people who are stuck in the middle of this debate, and those are the people we need to do right by. Encouraging people to quit based on misconceptions is sleezy, but it also means that we have to maintain that misconception over time in an effort to assure people that they quit for the right reasons. Giving people the full scope of information, even if it means being honest that vaping is slightly less harmful than cigarettes, empowers them to find their reason for quitting. If school house rock taught me anything, it’s that knowledge is power 
and if working for the tobacco industry and watching the unethical way they operate has left me with any conclusions- it’s that people deserve to have accurate information, free of misconceptions, so that they can choose to take action for themselves, and choose how to take control of their own life, on their own accord. (Ok to be honest, my biggest takeaway from working there is that doing product photography of clear glass bongs is SUPER difficult lol. But the moral lesson is more important! )
Dansky98 wrote:
There definitely isn’t enough info about vaping yet. Equally as important, and WAY more crucial right now, is that there aren’t really any vaping-specific cessation programs- at least not for adults. Thus far, at most, I’ve found a texting support service, and that was after REALLLLLLY scouring the Internet. This is pretty concerning when it comes to the ban. While there are far more teenagers who vape than teenagers who smoke- still, the majority of people who vape are adults. If we want to be sensible about banning eliquids, we have to acknowledge that by banning them without having vape specific cessation programs for adults, as well as kids, we have been massively irresponsible. That concerns me a lot. I’ve been working with a pharmaceutical researcher at the university of Michigan recently to start thinking about ways to structure a full program. She’s going to guide me through quitting vaping, and try to identify where the differences are, and then we can start to think about what can be changed and adapted to fill in the gaps. The concept of nicotine addiction is the same. Lots of things are similar. But there are some key things that are different. These are the two major ones I’ve discovered so far, and they have made it a little bit complicated for me to use this and other cessation tools:
Thanks for your thorough post – you’ve clearly put a lot of thought into this topic!
Truth Initiative runs two programs to help people quit vaping: This is Quitting, for youth and young adults; and BecomeAnEX for adults – this program addresses all types of tobacco, including e-cigarettes. Several other programs have recently become available for young people to quit vaping, including young adults.
Dansky98 wrote:
1. Quantity/dosage.
It’s the second question in the texting program from here. ‘How many cigarettes do you smoke a day?’ I don’t smoke cigarettes. Sure, I could just swap out the word ‘cigarette’ for ‘vape’, as many have suggested. But what’s the question then? ‘How many vapes do you vape a day...?’ Huh? There isn’t a definitive way to measure how much nicotine you’re using every day with vaporizers. Additionally, that question in the text program is a multiple choice answer. (Please don’t take this as an insult to the program- maybe think of it as constructive feedback that can be used to further improve the tool?) right off the bat, question number two, I had to make an arbitrary guess as to how much I’m consuming, which will ultimately be unhelpful, so- no, that tool/this program is by nature, not really intended for vapers, and the results will likely not be the same. There is literally no way to translate amount of nicotine I use in my vape into number of cigarettes.
2. Difference in ritual. Most people don’t use a vaporizer the same way they would use cigarettes. The ritual, schedule, patterns of use, time spent, behavioral patterns... it’s all different. I’ve had a really hard time trying to identify my triggers. Most of them are mindless. And the very nature of how long I use it doesn’t correlate. A cigarette has a start and an end. A single cigarette is a 7-10 minute commitment. I hit my vape randomly throughout the day. I don’t hit it for a specific amount of time, or a specific number of times. What are my triggers? Answer: it’s just always there. It’s rarely a conscious decision. So, in order to really get to the point of the process, a vaper has to change the way they use their device to mimic more of the way a tobacco smoker would- intervals, making it a more conscious decision. Maybe that’s the right way to do it. It’s hard to say. However, the patterns of use that come naturally with tobacco, differ from the patterns of use with vaporizers.
We appreciate your feedback and insight! It sounds like you’re not receiving the text messages designed specifically to help people quit vaping that are available through BecomeAnEX. Text ECIG to the number from which you’re currently receiving messages to start getting those messages, or text QUIT to 202-899-7550 to get started. We agree that quitting vaping is different than quitting smoking! That’s why we have specific text messages for that purpose. In addition, while some aspects of ritual may be different, there are also similarities between cigarettes and e-cigarettes in how they both become conditioned to different internal and external cues. Many of the planning, support, and behavior change strategies available at BecomeAnEX can be helpful for people working to change and re-learn those conditioned responses and successfully stop tobacco or vaping.
Dansky98 wrote:
All of that being said- this touches on a pretty important issue, and one that really concerns me a lot lately. Most people don’t know a lot about vaping. Most people trust the CDC reports- as they should- but the follow up actions, conclusions, and current solutions being provided can cause a LOT of collateral damage, and are often coming from a place that lacks understanding of how cape products work. We don’t have enough information about vaping, but... we do have SOME information about it. We have more than just the CDC report. I’m concerned that the ban took place without the political figures making these decisions actually taking the time to understand what they’re talking about, and how these actions could cause problems, especially seeing as there was very little effort to build something that would help prevent the collateral damage. But with that- a fair amount of the information the general public, as well as decision making officials ‘know’ about vaping is sometimes slightly exaggerated, and sometime flat out incorrect.
You’re right, we don’t know the long-term effects of vaping yet, and we agree with you that we should rely upon good authorities such as the CDC report, and the Surgeon General website. However, we do know that 99% of all e-cigarettes sold (including 100% of all JUUL products, the dominant product in the market) contain very high levels of nicotine and usually ‘flavoring’ and solvents which have unknown and worrisome impact in the lungs when heated and inhaled. A recent article by colleagues at Mayo Clinic published in the NEJM finds that multiple toxins in vaping may be causing severe lung damage. The bottom line is that we have much to learn, and young people right now are experiencing acute lung damage from vaping. And we do know for sure that non-medicinal nicotine is both extremely addictive and damaging to developing brains of young people up to age 25. It is important to take public health steps that minimize harm to young people, including for products that can put them on a trajectory toward severe lung damage, and a lifetime of addiction.
Dansky98 wrote:
I understand that we want to do everything we can to discourage using vapes. I don’t think it’s right to exaggerate, withold information or lie in an effort to get people to quit, refrain, or advocate against vaping. That tactic is the same exact tactic that vape lobbyists use, and it can have some pretty damaging side effects. Example: most leading tobacco cessation experts actually DO agree that vaping (as long as there aren’t contaminants present and people are not heavily modifying their devices) is not as hazardous a smoking cigarettes. It’s still terrible for you. It has a lot in common with cigarettes, and vaping has some adverse health effects that tobacco cigarettes DONT have. It’s still bad. Consider this though: we tell teens that vaping is just as dangerous, maybe even MORE dangerous than cigarettes, in an effort to get them to quit, despite the fact that that’s not the full truth. And then this ban happens, and the vaping teens no longer have access to their vapes. If we lead them to believe that those vapes are equally, if not more harmful than cigarettes, then many of them will simply switch to cigarettes instead, thinking, ‘well, at least cigarettes aren’t worse than vaping.’ Unintended consequences that create HUGE problems. We are probably going to see a huge spike in teens smoking cigarettes due to this ban. Don’t get me wrong, I’m not against banning some of the eliquid products- and I say that as someone who uses them and is trying to quit. But we implemented this ban so quickly, and we failed to create a plan ahead of time. There’s going to be consequences to making such a quick decision without much needed planning.
It's hard to know who the “we” is in your blog post. Our position is that e-cigarettes may be safer than cigarettes, but that doesn’t make them safe. I hope that we do not see young people start smoking if vaping is unavailable, but we are already seeing young people start smoking after starting to vape, and that’s a scary trend. We know that young people who vape are more than 4X more likely to go on to smoke cigarettes than their peers who do not vape.
Dansky98 wrote:
There’s even more concern around what’s IN e-liquids and the notion that we have no idea what’s in them. This is partly true. The current idea is that some e-liquids might contain contaminants, and in many cases, they’ve found that some e-liquids contain some pretty terrible stuff. Your standard e-liquids however- contain some concerning stuff, but mostly contain a mix of vegetable glycerin and/or propylene glycol. Liquid designed for modern atomizers is mostly vegetable glycerin, or VG – this can be up to 80% by volume. The glycerine used in e-liquid comes from vegetable oils, which is why it’s called VG. Although it’s processed from oils it isn’t an oil
Lots of common products contain VG. It’s used in the food industry as a sweetener, and also added to some foods to keep them moist. Many medicines contain it too.
Then there’s propylene glycol- PG is in antifreeze, and it’s because of this that we hear ‘e-juice contains antifreeze.’ That’s a pretty large stretch... PG is only one ingredient in antifreeze, and it’s actually there because it’s non-toxic; PG-based antifreeze is less harmful to children and pets. It’s worth pointing out that water is also an ingredient in antifreeze; just because something is used in a product that is poisonous, that doesn’t explicitly mean each ingredient is poisonous.
Water- certain e-liquids contain water, but not all of them, and even the ones that do contain water, it’s not much. It’s mostly VG and/or PG. So this notion of ‘it’s just water vapor! It’s perfectly safe!’ Is a huge stretch as well. Yeah, *technically some* of it *might* be water vapor. That’s not particularly reassuring though, lol.
Ingredients that have been approved for safe use in food or other products does mean that they have been approved as safe to inhale into your lungs. Also we know that these ingredients change their composition once heated depending upon both the temperature and the make-up of the coil. We simply do not know the extent of the acute or long-term effects of inhaling these ingredients, which is why it’s so important for the FDA to work quickly to evaluate these products for this use case and that we try to protect as many people as possible.
Dansky98 wrote:
Misconceptions about these products are rampant, and they come from both sides. This has long been a tactic of tobacco lobbyists- taking a fact that is just barely sort of true, and stretching it. Is misleading, it’s wrong, and it’s dangerous.
We can’t stoop to that level though. My aunt was talking to me recently about vaping, and she cited a lot of the misinformation I mentioned, in an effort to encourage me to quit (ok, realistically she was just trying to criticize me for vaping, but I’m going to pretend that she had good intentions lol) I corrected some of her facts, and then brought up the point the tactic of slighted misinformation is the same tactic that tobacco lobbyists use in order to fight tobacco regulations. She said, “well, even if it’s not 100% accurate, the point is that people need to quit. And if the tobacco company uses that tactic, maybe us using that tactic AGAINST them, would give them a taste of their own medicine.” Sure, maybe it would. I care a lot more about the people effected by the tobacco and vape industries- those are the people who are stuck in the middle of this debate, and those are the people we need to do right by. Encouraging people to quit based on misconceptions is sleezy, but it also means that we have to maintain that misconception over time in an effort to assure people that they quit for the right reasons. Giving people the full scope of information, even if it means being honest that vaping is slightly less harmful than cigarettes, empowers them to find their reason for quitting. If school house rock taught me anything, it’s that knowledge is power
and if working for the tobacco industry and watching the unethical way they operate has left me with any conclusions- it’s that people deserve to have accurate information, free of misconceptions, so that they can choose to take action for themselves, and choose how to take control of their own life, on their own accord. (Ok to be honest, my biggest takeaway from working there is that doing product photography of clear glass bongs is SUPER difficult lol. But the moral lesson is more important!
The science on what we know about e-cigarettes is rapidly changing, and that can make it hard to sift through what’s true and not true. The best of what we know so far is this:
- Nicotine is addictive and dangerous to the developing brains of young people. No young person should start vaping or using nicotine in any tobacco product.
- There are now more than 1000 cases of acute lung damage associated with vaping, and the specific causes are as yet unknown.
- Vaping may be safer than smoking, but that doesn’t mean it is safe. We do not know the long-term effects of vaping. Non-smokers should not start vaping.
- Vaping might be a way for some people sometimes to quit smoking. There are lots of other ways to quit that are proven safe and effective, and we encourage you to try those first – including using this program at BecomeAnEX.org!
Michael V. Burke, Ed.D
