Let's Discuss Angels On A Pin

There was an awful article posted at the weekend about vaping entitled "6 Misleading Pro-Vaping Arguments We Should Stop Using". It should more properly have been headlined "Let's discuss angels dancing on the head of a pin" for the usefulness to the cause it presented. That is, on balance negative.

It centred around a whole load of smug pedantry to strike down effective sound bites which are useful to vapers in general when seeking to spread the message about the benefits of e-cigs.

For example, 'misleading' argument number one concerned ingredients.

We’ve all heard it. “Cigarettes contain thousands of chemicals with about 70 carcinogens, whereas e-cigs just contain four: PG, VG, nicotine and flavorings.” In essence, the core point is true – e-cig vapor does contain vastly fewer chemicals than tobacco smoke, and especially less toxic ones – but the specific formulation (“four ingredients/chemicals”) is blatantly incorrect.

No, it's really not. There are four ingredients in e-cigs - nicotine, PG, VG and flavouring. It's true that some make an erroneous comparison between that and the purported "thousands" of chemicals in tobacco smoke, but it's not incorrect that there are four ingredients (as opposed to chemicals) in e-liquid.

If that were the case, we'd have to describe a Big Mac as thousands more words than "two all beef patties, special sauce, lettuce, cheese, pickles and onions, all in a sesame seed bun" and the public would be confused, not better informed. A strawberry included as an ingredient in a dessert is described as a strawberry, not as 279 chemicals.

Because that's what the author was seriously suggesting.

@flamablecharlie @BaughmanGreg To get through to me, come up with a coherent, consistent definition of ingredient which suggests 4 in juice

— Lee Johnson (@JackLebeau) March 28, 2016

Now, that might be OK if you just want to exhibit your intellect to the world - and well done to him for that - but it is crassly damaging when applied to simple messages which resonate with the public. An easily-digestible message should take priority over theoretical moral grandstanding.

The second apparently misleading argument was that “all of the ingredients in e-cigs are generally recognized as safe”. The author admitted that this was "technically true", but only for ingesting not inhaling.

In other words, "we just don't know". Now where have you heard that before?

Inhaling flavorings probably isn’t going to kill you, but it’s one area where we really do lack information about the risks, and saying they’re “generally recognized as safe” is undoubtedly misleading.

No, again it's really not. If the average vaper is asked a question about what is in an e-cig from an interested smoker, the answer is that there are four ingredients (see above) and that they are generally understood to be safe. Saying otherwise is confusing, counterproductive, and really quite silly.

Number three spoke about how the assertion that PG is used in asthma inhalers can't be verified, except that the author admitted that ...

There is one study looking at the potential to use PG as a carrier for an inhaled medicine and another which mentions that PG or ethanol may be used as a cosolvent in nebulizers, but no evidence presented of an asthma inhaler or nebulizer that is actually used today containing PG.

Which quite obviously means that authorities have identified it as safe enough. It is nitpicking of the first water to then go on to say.

We’d love to be proven wrong on this one (and will update/remove this as needed), but it seems like this argument – especially for inhalers – is total bullshit.

No it's not, the only possible tweak could be that it should be stressed PG is approved by incredibly risk-averse regulators to be used in inhalers. The fact it isn't actually used is pretty irrelevant and a result of market forces and pragmatism rather than proof that a sound bite is "bullshit". Especially coupled with the insulting and smarmy denouement.

Much like those who repeat anti-vaping arguments without fact-checking, this one in particular shows that we vapers can do exactly the same thing.

Well, not the vaping author, of course, because he's far cleverer than you.

Number four is quite simply laughable.

“Nobody Has Died from Vaping”

No, they haven't.

But if we twist things enough and add a hell of a lot of speculation not supported by evidence, we can tell vapers they can't use that either.

To see the problem, you can just imagine cigarettes had only been on the market for 10 years or so. Would we be seeing any deaths from smoking? Well, probably not, no.

Yes you would because cancer does not respect time limits and macro epidemiology. To say that we wouldn't have seen a single death from smoking after a decade of use by millions of people with differing metabolisms and susceptibility to disease is utter garbage.

So the image he contemptuously published as an example of this supposed 'misleading' argument is absolutely spot on.

I made this graphic. I believe it is truthful; I stand by it; I will continue to use it, in good faith. pic.twitter.com/XLj9dHDNM7

— Monitored by ANTZ (@AgentAnia) March 28, 2016

It's a powerful and accurate image. The gravedigger patiently waiting for a first client is particularly brilliant. Not for our intrepid pedant though.

In short, after 10 years of smoking, chances are you’ll still be alive, so the lack of deaths from vaping at present means pretty much nothing.

No, it means that there is still no verifiable death from vaping, only theoretical - you know, like those theoretical 'deaths' that tobacco control like to talk about. Hmm.

Number five is even more pointless pedantry. Quibbling over whether diacetyl is 100 or 750 times less prevalent in e-cigs is not even worth the effort of putting fingers to keyboard. I mean, what would someone on the other side say in response? Can you just imagine it?

"You're lying! The lies we told were about something 100 times more invisible, not 750! Yah boo sucks!". No, they simply wouldn't because it would be exposing themselves as pathetically stupid and, as a result, scaremongering liars. This, when advocating e-cigs, is exactly what you do want!

The self-defeating navel-gazing was rounded off with number six.

“Smokers Don’t Get Popcorn Lung from the Diacetyl in Cigarettes”

Yep, that's quite true. They don't. Well not unless you try very hard to create speculation where they do, of course.

So smokers might not be diagnosed with popcorn lung very often, but they are regularly diagnosed with COPD, a more general obstructive lung condition, and this happens a lot more than you’d expect even heavily diacetyl-exposed people to be diagnosed with popcorn lung. Of course, smoke contains tons of bad chemicals, but it’s not exactly easy to say that diacetyl doesn’t contribute to the problems smokers have. Plus, when presented with a smoker with lung problems, is a doctor going to jump to popcorn lung as a diagnosis, or just assume it’s COPD?

All well and good, except Michael Siegel stated categorically that this was not the case in December.

Despite the much higher levels of diacetyl in tobacco smoke than in e-cigarette vapor, smoking has not been associated with "popcorn lung."

And you know how readily tobacco control like to link just about everything with smoking, the fact they don't tells you all you (should) need to know.

Likewise Professor Peter Hajek said the very same two weeks ago. Used the term "never" too.

So who do you believe? It's not a 'misleading' argument to make, it is in fact supported by two different tobacco control academics who - let's face it - make the rules of this game. Carry on using that fact (as in, not a "misleading" argument) at will, because it's true.

Again, what possible benefit is there from dissuading vapers from pointing this out, you can imagine that by this point I was questioning whose side this geezer is on.

So, to sum up.

1) Yes, e-cigs contain four ingredients, just don't compare them with the apocryphal (and probably massively exaggerated) 4,000 or 7,000 in smoke. This is as far as the article was useful.
2) Yes, feel confident to state to people who are thinking about vaping that the ingredients are generally considered safe, because the alternative offered is anal speculation.
3) You can say PG is approved for use in asthma inhalers because it is. Whether it is actually used or not is purely pointless semantics.
4) Nobody has died from vaping. This is a supportable fact, the suggestion that it might not be true is supported only by smug innuendo.
5) Use whichever figure you want about the comparative levels of diacetyl in e-cigs and tobacco - especially if the flavour you use doesn't contain it as most now don't - because ...
6) ... It is irrelevant, diacetyl at much higher levels than in e-cigs has never been linked to popcorn lung even in smokers however much one may try to contort reality.

So if you're one of those who has declared this week that they feel like they can't make these simple arguments to people they meet anymore for fear of being condescendingly termed inaccurate or dishonest from an ivory tower, don't. What you're doing is just fine.

See also: Fergus on the same subject.