WEBVTT

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All right, you ready? Yes, sir. All right. Yes.

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Three, two, one. Well, howdy, y 'all. Welcome

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back. to another episode of Your Mom on Drugs.

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We have today, the son, Josh Klaus, got my master's

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in public health, hopefully gonna use that today.

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And we have the mom on drugs. Can you introduce

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yourself? I'm Jennifer Seltzer. And I'm just

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seeing, I'm watching, I'm looking at Josh's t

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-shirt and his t -shirt says data greater than

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feelings. I'm like, he's a data guy. He's a data

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guy, so. I'm a very feelings -based guy too.

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He is, yes. Sometimes you just got to follow

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the data. And even though you have this strong

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intuition that you believe in something, if the

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data doesn't support your belief, you got to

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abandon your belief. And that's the beauty of

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science. So today we are going to be talking

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about a topic that my mom and I don't know. We

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didn't know too much about just because it's

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the topic of vaping and e -cigarettes. Neither

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of us are smokers. We never smoked in our life.

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But if you've ever walked around lately. You've

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probably noticed the big, puffy, white clouds

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that people are emitting from these e -cigarettes

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as opposed to tobacco cigarettes. And because

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they've gotten so much more popular over the

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years, and I believe it was inspired by you with

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either a family member. or a friend that had

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done it. I don't know how you got curious and

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wanted to do this. And, you know, I think because

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we've done some other topics that were like,

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I don't know much about that. I think that's

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because you do see, you know, every time you

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go to the ice house to pick up something, they're

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right there and stuff. You're like thinking,

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I don't know. Or, or there's also, there's these

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vaping stores, you know, that you'll see in your

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towns and stuff. And I'm like thinking. what

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do people do in there? I don't really want to

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go in. So I thought, well, I'll just research

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it instead. Yeah. Instead of going into the store,

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we'll just spend copious hours of research on

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the topic. Looking for that data. Yeah. Looking

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for that data. So I think we'll start off with

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maybe just kind of some basic information of

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what vaping is. I think maybe people might have

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some misperception of what it is. I definitely

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did. So maybe you can kind of lead off and talk

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about what vaping and e -cigarettes are and maybe

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a little bit of background of how we got here

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as well. Yeah. And actually, I'd like to take

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it one step back from that to talk about really.

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tobacco use in general and stuff. And so what,

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you know, so we, it was really interesting researching

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this. Anytime you, you know, do a presentation

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or collect data, you always learn something new.

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So we started using tobacco or tobacco was initiated

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for use in the United States. I believe it was

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in the 1700s, the late 1700s and stuff. So, and

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it's now the most preventable. cause of death

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in the United States. And so what we've seen

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over the last four decades, approximately, is

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that the smoking prevalence in adults has decreased

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by about 65%. So, you know, pretty significant

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drop in smoking combustible cigarettes. Right.

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And by combustible, we just mean that you have

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a material, like... tobacco right in a piece

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of paper that will combust when you put a flame

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to it right and then that flame will heat up

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that tobacco become combined to some type of

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smoke and then go inside of your lungs right

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which gets into your body right and i looked

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up a stat too at the height of smoking's popularity

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which is i think in 1965 42 percent of people

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Yeah. Cigarettes. I mean, it's almost half the

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population. I mean, both my parents smoked, which

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was so weird, you know? So, so yeah. So, yeah.

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So now it's really interesting. There are more

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people who formally smoked. cigarettes than actually

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smoke them now and stuff. But we still have about

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11 % or so of our population who smoke. That

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translates to about 28 million people. But again,

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that rate of smoking cessation has declined over

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the last decade. But there are still about, there's

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over 480 ,000 deaths associated with cigarette

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smoking or secondhand smoke per year in the United

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States. So that calculates to about... one in

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five deaths annually associated with tobacco.

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Man, I kind of want to piggyback off that point

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because it's amazing like how small behaviors

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every day will lead to deleterious effects in

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the future. Almost kind of like financial responsibility.

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Like if you want to save for retirement or have

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a good savings account. You save a little bit

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each day. You'll have a decent -sized savings

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account. It feels very boring in the moment.

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Same thing with bad things. So Harvard did this

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longitudinal study, like a prospective study,

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of following a certain group of people over time

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and seeing what are some things that make people

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healthy in the long term versus not healthy in

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the long term. It doesn't really determine causality,

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but there were associative factors. And the five

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that they really stood out were social interactions

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uh minimal alcohol use um lack of smoking uh

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daily exercise like 30 minutes of exercise um

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and i'm trying to remember the last thing maybe

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sleeping or no i don't know what it was what

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is the last one oh it's a healthy diet so basically

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and obviously that's that's you know i think

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what that means is they don't over indulge like

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eat within moderation um And if people did these

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five things that I just mentioned, they had an

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average extension of their lifespan by 14 years,

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which is insane. Like when you think about living

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from 70 to 84, so smoking plays a huge role in

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that. Like mom talked about, it really increases

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the risk of certain types of cancer and cardiovascular

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disease, which we're going to get into. But I

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think a lot of people don't understand how bad

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smoking is sometimes. And I think One of the

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reasons we did a massive public health campaign

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from the 60s onward is because, like mom said,

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it's such a preventable behavior and it causes

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such carnage in somebody's body and their life.

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And obviously it has knock on effects for the

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rest of society. Right. Right. So. And not only

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does it have health effects, but it has an economic

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impact as well, too. So there are from the I

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have data from 2010 to 2014, where 11 .7 percent

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of all U .S. health care spending went to adult

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cigarette smoking. So that means taking care

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of people with adverse consequences of smoking.

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and stuff so that's crazy you know and then in

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2018 the estimated cost of loss of productivity

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due to cigarette smoking in the united states

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was 185 billion dollars so a lot of people didn't

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show up for work you know so crazy um so but

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and interestingly too and this is not hard to

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understand tobacco use is greater in the economically

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disadvantaged because there's a lot of reasons

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i mean they may not be able to afford the uh

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the uh nicotine patches and things to help the

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therapies that would help you to stop smoking.

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Or it just may just be just easier. I didn't

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really delve into all the reasons why that's

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the case. I'm sure there are copious reasons.

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I mean, one of the things that I imagine if you're

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economically disadvantaged, you're just looking

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for little wins. And I think sometimes things

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like a puff of a cigarette or a drink or will

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just feel good if you feel like your life is

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stressed and you're not going anywhere. um i

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mean psychologically i'm just trying to think

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about that way um if you have no hope in long

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-term goals why not focus on the short -term

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ones because at least they'll deliver something

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yeah so The other thing, too, that came out with

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this is that there are about 1 ,600 young persons

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under 18 years of age that will try their first

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cigarette every day in the U .S. And nowadays,

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and so this is going to be our great transition

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into our topic for today, a lot of that is due

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to what we call electronic nicotine delivery

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cigarettes. Electronic... nicotine delivery systems

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or e -cigarettes. And the availability of these

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systems in pediatric populations could increase

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their risk of future combustible cigarette smoking.

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So regular cigarette smoking. Yeah, I think that's

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the worry is like, is this a gateway drug to

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future tobacco smoking? We also want to, just

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as a caveat, even though they're called e -cigarettes,

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there's no tobacco, at least in some of these.

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Pods, it's very variable, this definition. But

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most of the time, it is just a nicotine delivering

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mechanism with some other things that we'll talk

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about that come along for the ride. So the biggest

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difference here between regular cigarettes and

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e -cigarettes is that one delivers just nicotine,

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plus some other flavors that you've probably

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heard about. And tobacco cigarettes obviously

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deliver, not aerosolized, but smoked tobacco

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into your lungs. And it's mainly like the tar

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is from that tobacco that have been associated

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with increased cancer risk. rather than the nicotine

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itself. But nicotine itself does have some effects

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in the body, which Dr. Seltzer will talk about.

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There you go. The biggest thing about nicotine

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is it's very addictive and it's very difficult

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to quit smoking. So one of the reasons that we

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would hopefully to encourage our young people

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not to start. So let's transition a little bit

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into what vaping is. And so the definition of

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vaping, the official definition that was recorded,

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is that it's the use of a handheld electronic

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device to breathe a mist or a vapor into your

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lungs. Usually it contains nicotine and flavoring.

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So that's what vaping is. It simulates smoking,

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but like Josh said, it's not an actual tobacco

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-containing cigarette. It does have... like nicotine

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in it and then some flavorings. Names of things

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that are considered e -cigarettes, it's an e

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-cigarette or a vape pen or a modifiable device.

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Interestingly, these modifiable devices are,

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I think they were more popular. earlier on with

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vaping but i they still exist there and you can

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you can um customize what you put inside your

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vape pen and stuff uh so uh as far as the amount

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of nicotine and and stuff like that so um so

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that's why they're called mods okay that makes

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sense um Vaping is similar to smoking a combustible

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cigarette, but the difference is it heats tiny

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particles out of a liquid rather than burning

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tobacco. And the way that a vape pen works is

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it's a battery -powered device. That heats the

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liquid and it produces an aerosol that resembles

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water vapor, but it's not water vapor. It's an

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aerosol. And this aerosol, which is tiny particles,

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are inhaled into the lungs of a user. And the

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aerosol can contain nicotine for sure. And it

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contains flavoring. And then it can contain a...

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there's greater than 30 different types of chemicals

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that can be in this liquid as well, too. There

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can be carcinogens in it, potential carcinogens.

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There can be chemicals that could be associated

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with lung disease. Some people can put cannabis

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or marijuana. in the device. There's also more

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of a stabilizing agent called vitamin E acetate

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that's been linked to lung injury, some heavy

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metals in there, and then the ultrafine particles

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can deeply penetrate into the lungs. And so we'll

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talk about that in a little bit as far as some

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adverse effects associated with vaping. Yeah,

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that's a good point. I think a lot of times too

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is like just because you find certain chemicals

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in something, you always want to compare it to

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a relative standard. So when I looked at the

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amount of carcinogens, specifically formaldehyde

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that's inside of that vapor in a low voltage

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simulation, which is essentially the, so if you

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think about these vape pens, literally like a

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pen. And think about the base of the pen. That's

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where the battery is. And that is going to provide

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the current that supplies the electrical energy

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up towards the tip of the pen, which is where

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you're going to be putting your mouth and drawing

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in. And then in between there is the reservoir

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where the nicotine is. And so the current is

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providing heat just due to Ohm's law, V equals

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IR. And then the resistance creates the heat,

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which heats up the liquid. And if you remember

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from basic physics or chemistry, if you heat

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up a liquid, what does it become? A gas. Oh,

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my gosh. And then the gas obviously is a great

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thing to go inside of your lungs. And your lungs

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essentially are these really, really, really

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tiny, tiny, tiny branches with an amazing amount

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of surface area. These things called alveoli,

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which essentially facilitate gas exchange. So

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as you breathe in air, you take in that air.

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They go inside of your lungs. Those tiny little

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alveoli, which are literally one cell thick,

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they will then exchange into the bloodstream

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of your body. And then that newly diffused blood

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will then go to your heart and then pump. throughout

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your body. It's amazing. But if it's small enough,

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it'll go across those alveoli and it's not just

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oxygen that gets into your blood, which is what

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we need. Some of these other things that are

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small enough, like nicotine, will get inside

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of your blood and obviously cause the effects

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that they do. But things like formaldehyde, what

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I was going at is like, if you look at just the

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average concentration of formaldehyde in just

00:14:20.090 --> 00:14:22.409
regular air, there's a small concentration of

00:14:22.409 --> 00:14:26.210
it. It's about similar. So in a low voltage environment,

00:14:26.450 --> 00:14:29.309
in a vape pen. But if you're going to be doing

00:14:29.309 --> 00:14:32.450
that 300 times a day, that is when it gets problematic.

00:14:32.750 --> 00:14:34.669
So if essentially just think about it as like

00:14:34.669 --> 00:14:38.169
maybe one puff, not too bad. But if you're breathing

00:14:38.169 --> 00:14:40.909
in 300 puffs in like the span of a couple of

00:14:40.909 --> 00:14:44.409
hours, then you're increasing the risk of accumulating

00:14:44.409 --> 00:14:47.230
more formaldehyde in your body. And obviously

00:14:47.230 --> 00:14:49.429
the more you do it, the more it increases and

00:14:49.429 --> 00:14:52.570
the more you turn up that voltage. the more likely

00:14:52.570 --> 00:14:54.429
some of those things like formaldehyde are going

00:14:54.429 --> 00:14:56.250
to get into your system. So it really does depend

00:14:56.250 --> 00:14:59.009
on how often you're doing these vape pens and

00:14:59.009 --> 00:15:01.929
how high you're turning up the voltage. But what

00:15:01.929 --> 00:15:04.190
users have reported is like the higher voltage

00:15:04.190 --> 00:15:07.070
actually kind of gives this burnt taste and they

00:15:07.070 --> 00:15:09.750
don't normally do that. So it's really this low

00:15:09.750 --> 00:15:12.549
voltage environment that most users are doing

00:15:12.549 --> 00:15:14.870
because that delivers the flavorable smoke. It's

00:15:14.870 --> 00:15:17.970
not too harsh on the lungs. But yeah, it can

00:15:17.970 --> 00:15:21.279
produce a higher amount. um later on so just

00:15:21.279 --> 00:15:23.559
want to kind of give that caveat is like you'll

00:15:23.559 --> 00:15:25.460
see a lot of times in studies not just with vape

00:15:25.460 --> 00:15:27.700
pens it's like oh my gosh there's mercury and

00:15:27.700 --> 00:15:29.980
fish it's like well you kind of have to compare

00:15:29.980 --> 00:15:32.899
that to first of all what type of mercury is

00:15:32.899 --> 00:15:35.440
it you know there's there's organic versus inorganic

00:15:35.440 --> 00:15:38.519
mercury and what is that compared to a normal

00:15:38.519 --> 00:15:40.659
diet that you're getting so a lot of times you

00:15:40.659 --> 00:15:43.120
really want to think about the dose makes the

00:15:43.120 --> 00:15:45.460
poison and the more you're consuming of that

00:15:45.460 --> 00:15:47.570
obviously the more poison in you but If it's

00:15:47.570 --> 00:15:50.210
kind of normal to your average diet, then not

00:15:50.210 --> 00:15:51.809
too much to worry about. So just wanted to give

00:15:51.809 --> 00:15:56.029
that as a caveat for vapors. Perfect. The other

00:15:56.029 --> 00:16:00.169
point to make too is we've all heard of secondhand

00:16:00.169 --> 00:16:04.090
smoke with cigarette smoking. You can also, bystanders

00:16:04.090 --> 00:16:06.830
can also breathe in the aerosol that's been exhaled

00:16:06.830 --> 00:16:09.769
by the e -cigarette user as well too. And again,

00:16:09.809 --> 00:16:11.789
we're going to talk a little bit about what does

00:16:11.789 --> 00:16:15.950
that mean in just a few minutes. Josh kind of...

00:16:16.139 --> 00:16:17.980
talked about this already, but as far as the

00:16:17.980 --> 00:16:21.220
structure of an e -cigarette is concerned, the

00:16:21.220 --> 00:16:24.299
earlier ones looked more like a cigarette. Now

00:16:24.299 --> 00:16:27.440
they look more like a USB flash drive and stuff.

00:16:27.500 --> 00:16:30.879
So they're very small. And they contain a battery

00:16:30.879 --> 00:16:33.759
with a lithium rechargeable, the ion battery,

00:16:34.080 --> 00:16:37.580
which provides enough current to heat the atomizer,

00:16:37.679 --> 00:16:40.460
which is the atomizer is the heating element

00:16:40.460 --> 00:16:43.139
coil in the e -cigarette that's going to help

00:16:43.139 --> 00:16:46.179
it convert to the tiny air. born droplets that

00:16:46.179 --> 00:16:48.620
you can breathe in. An atomizer is like a, it

00:16:48.620 --> 00:16:50.440
doesn't turn it into atoms, but like you've,

00:16:50.460 --> 00:16:52.240
you've definitely used it. If you've used perfume,

00:16:52.340 --> 00:16:54.759
it's like that spray, we call that an atomizer.

00:16:54.779 --> 00:16:56.779
Cause it looks like these tiny little droplets

00:16:56.779 --> 00:16:59.120
that are just kind of nasal spray. Nasal spray

00:16:59.120 --> 00:17:01.039
is a great one. Yeah. And I think that's a great

00:17:01.039 --> 00:17:03.200
analogy to what the thing that's going in your

00:17:03.200 --> 00:17:04.859
lungs. It's not really water vapor. It's kind

00:17:04.859 --> 00:17:08.200
of more of this, like almost like a sticky. vapor

00:17:08.200 --> 00:17:12.319
like substance right so um yeah it just but you

00:17:12.319 --> 00:17:14.019
think about it's on a really small scale sorry

00:17:14.019 --> 00:17:15.940
keep going no no no worries the battery will

00:17:15.940 --> 00:17:19.000
heat that atomizer up to 400 degrees fahrenheit

00:17:19.000 --> 00:17:22.039
so that it'll get hot so that it will it will

00:17:22.039 --> 00:17:24.720
atomize or aerosolize so that you can breathe

00:17:24.720 --> 00:17:27.940
it in then that there are some e -cigarette containers

00:17:27.940 --> 00:17:32.740
uh that have a an on -off switch. And if it has

00:17:32.740 --> 00:17:34.660
an on -off switch, it'll have a sensor on it

00:17:34.660 --> 00:17:37.920
so that it senses that you're pressuring it to

00:17:37.920 --> 00:17:40.259
turn on. But other ones don't have that and it'll

00:17:40.259 --> 00:17:42.980
just turn on when you take your first puff. And

00:17:42.980 --> 00:17:45.200
then I said the atomizer is what converts it

00:17:45.200 --> 00:17:48.000
to the aerosol liquid. And then it's the cartridge,

00:17:48.200 --> 00:17:52.500
which is the... Either it's pre -filled or refillable.

00:17:52.519 --> 00:17:55.200
So it's either a one and done or you can refill

00:17:55.200 --> 00:17:59.880
your vape pen. The cartridge holds the e -liquid

00:17:59.880 --> 00:18:02.559
and most of the time it's combined with the atomizer.

00:18:02.579 --> 00:18:04.960
So the atomizer and the liquid are in that cartridge.

00:18:05.140 --> 00:18:07.019
And then you've got a mouthpiece to breathe in.

00:18:11.039 --> 00:18:14.900
Other names that e -cigarettes go by are, there's

00:18:14.900 --> 00:18:16.920
e -hookah, there's hookah sticks, and there's

00:18:16.920 --> 00:18:19.539
personal vaporizers as well too. And they're

00:18:19.539 --> 00:18:22.240
collectively called electronic nicotine delivery

00:18:22.240 --> 00:18:27.759
systems or ENs. The most common products. I've

00:18:27.759 --> 00:18:30.680
got a couple. I'm not going to read this whole

00:18:30.680 --> 00:18:32.779
list. I've got a little table here, but views

00:18:32.779 --> 00:18:35.019
is one. Jewel is probably the one that most people

00:18:35.019 --> 00:18:37.519
see. When I was doing some literature, there

00:18:37.519 --> 00:18:40.140
was something called an elf bar, but then that

00:18:40.140 --> 00:18:42.940
got removed because there was some sort of weird,

00:18:43.079 --> 00:18:47.220
illegal things China was doing with elf bars

00:18:47.220 --> 00:18:51.400
as far as. tariffs or something. And so now they,

00:18:51.440 --> 00:18:54.859
they it's now it's EB create is another form

00:18:54.859 --> 00:18:56.579
that you may see as well too. And that, that

00:18:56.579 --> 00:18:58.700
tended maybe a number of years ago or several

00:18:58.700 --> 00:19:00.599
years ago, that was the most common one to be

00:19:00.599 --> 00:19:02.960
used in younger people like middle schoolers,

00:19:03.000 --> 00:19:05.559
high schoolers and stuff. So enjoy is another

00:19:05.559 --> 00:19:07.940
one and stuff. So, so you, you will have seen

00:19:07.940 --> 00:19:10.619
them if you've been in any, you know, ice house,

00:19:10.640 --> 00:19:14.039
you know, or convenience store. So grocery store

00:19:14.039 --> 00:19:18.299
too. So. Vape terms that you may hear are jeweling,

00:19:18.400 --> 00:19:21.680
which is obviously using a jewel brand or a similar

00:19:21.680 --> 00:19:26.180
type of a small vape device. And it's the top

00:19:26.180 --> 00:19:31.460
-selling pod -based device, and it looks like

00:19:31.460 --> 00:19:34.160
a USB flash drive, and it first became available

00:19:34.160 --> 00:19:39.220
in 2015. Another way that people might use e

00:19:39.220 --> 00:19:41.680
-cigarettes or vape is that they'll take the

00:19:41.680 --> 00:19:46.089
liquid from their... uh, the cartridge and you

00:19:46.089 --> 00:19:49.130
can drip it on the actual heating mechanism.

00:19:49.210 --> 00:19:51.430
And from what I understand, you can get a higher

00:19:51.430 --> 00:19:54.390
dosage of nicotine, um, if you want by doing

00:19:54.390 --> 00:19:57.829
it that way. Um, and then a person who vapes

00:19:57.829 --> 00:20:01.289
is called a vapor, you know, not VAPOR, but VAPER.

00:20:01.369 --> 00:20:07.289
So, so anyway, so. And as with everything, practically,

00:20:07.670 --> 00:20:10.230
there's always some adverse effects that go along

00:20:10.230 --> 00:20:12.609
with what we do, including vaping. So the things

00:20:12.609 --> 00:20:15.309
that you'll probably, if you know somebody that

00:20:15.309 --> 00:20:18.329
vapes, the most common complaints that they may

00:20:18.329 --> 00:20:21.769
cite are going to be coughing, shortness of breath,

00:20:22.049 --> 00:20:25.470
they can have eye irritation, headaches, a dry,

00:20:25.569 --> 00:20:27.890
irritated mouth and throat, or nausea. And some

00:20:27.890 --> 00:20:29.960
of that's going to, a lot of that's... going

00:20:29.960 --> 00:20:32.460
to be, I would say, like headaches are most likely

00:20:32.460 --> 00:20:35.079
due to the nicotine component. Other things might

00:20:35.079 --> 00:20:37.740
be due to the aerosolization of the material

00:20:37.740 --> 00:20:39.799
so that your eye irritation and stuff, because

00:20:39.799 --> 00:20:41.460
of what you're breathing, it could be due to

00:20:41.460 --> 00:20:46.819
that as well. Often, Josh and I always talk about

00:20:46.819 --> 00:20:50.079
the risks and benefits of whatever we're discussing.

00:20:56.430 --> 00:20:58.690
When I looked at the literature, there's a lot

00:20:58.690 --> 00:21:01.009
of risks to vaping and there's not a whole lot

00:21:01.009 --> 00:21:03.589
of benefits. I'm going to start with the benefits

00:21:03.589 --> 00:21:06.269
first because it's a fairly short list. And basically,

00:21:06.309 --> 00:21:11.349
there was a perceived benefit that e -cigarettes

00:21:11.349 --> 00:21:14.849
can assist in smoking cessation, but it really

00:21:14.849 --> 00:21:17.710
hasn't been proven true because at least one

00:21:17.710 --> 00:21:21.440
study has shown that while vaping can... It's

00:21:21.440 --> 00:21:24.500
more effective than nicotine replacement therapies

00:21:24.500 --> 00:21:27.599
like the gum or the patch in helping people stop

00:21:27.599 --> 00:21:30.680
smoking combustible cigarettes. But what seemed

00:21:30.680 --> 00:21:33.400
to happen is that the people would continue using

00:21:33.400 --> 00:21:35.420
the e -cigarette and they wouldn't stop it. So

00:21:35.420 --> 00:21:37.059
that means that they're still getting nicotine.

00:21:37.359 --> 00:21:42.259
So while they're not getting burned tobacco and

00:21:42.259 --> 00:21:45.359
inhaling actual smoke, which has got its long

00:21:45.359 --> 00:21:51.690
list of... adverse events associated with it,

00:21:51.769 --> 00:21:55.269
they're still using nicotine long -term. So it's

00:21:55.269 --> 00:21:58.470
like, wasn't that the idea was to get rid of

00:21:58.470 --> 00:22:00.470
the nicotine ultimately and stuff. And so some

00:22:00.470 --> 00:22:02.069
people just, it's like I said, it's a really

00:22:02.069 --> 00:22:04.750
hard thing to stop doing. Yeah. I think we'll

00:22:04.750 --> 00:22:06.829
probably get into this a little bit later as

00:22:06.829 --> 00:22:10.109
well, because, you know, from my ears, that sounds

00:22:10.109 --> 00:22:12.869
great. You know, it's like, and we'll get into

00:22:12.869 --> 00:22:14.990
some of the numbers of why I think that's great.

00:22:15.069 --> 00:22:19.380
But if you can get people to quit. cigarette

00:22:19.380 --> 00:22:22.680
smoking and get them to do e -cigarette smoking,

00:22:22.779 --> 00:22:24.779
and they're just getting the nicotine rather

00:22:24.779 --> 00:22:28.420
than the nicotine plus the carcinogenic chemicals

00:22:28.420 --> 00:22:32.220
from tobacco and some of the other deleterious

00:22:32.220 --> 00:22:35.759
lung effects, then I say, yeah, let's go ahead

00:22:35.759 --> 00:22:38.960
and do that. That's a great trade for me. But

00:22:38.960 --> 00:22:40.460
we're going to talk about some of the numbers

00:22:40.460 --> 00:22:43.000
later and why that might not reflect reality.

00:22:44.440 --> 00:22:47.930
But I mean, just like what mom said earlier,

00:22:48.089 --> 00:22:52.589
it's like there are 480 ,000 deaths per year

00:22:52.589 --> 00:22:55.470
associated with cigarette smoking and it costs

00:22:55.470 --> 00:23:01.009
11 % of our healthcare expenditure. So I don't

00:23:01.009 --> 00:23:04.829
think that vaping has that high of a medical

00:23:04.829 --> 00:23:07.089
cost. So if we can get those costs down and those

00:23:07.089 --> 00:23:09.779
deaths down. And if this seems to be a good replacement

00:23:09.779 --> 00:23:11.759
for it, I think that's the thing in question

00:23:11.759 --> 00:23:14.839
is like, is it a good replacement? And I don't

00:23:14.839 --> 00:23:16.859
think we really know for sure yet. There have

00:23:16.859 --> 00:23:19.920
been some preliminary studies, but yeah, I think

00:23:19.920 --> 00:23:23.000
at the end of the day, this sounds very similar

00:23:23.000 --> 00:23:25.220
to, we can come to this later too. It sounds

00:23:25.220 --> 00:23:29.980
like sex education, like abstinence versus safe

00:23:29.980 --> 00:23:33.299
sex versus non -safe sex, right? So in a perfect

00:23:33.299 --> 00:23:36.720
world, you would have people abstain from sex.

00:23:37.309 --> 00:23:40.430
to limit the risk of sexually transmitted diseases,

00:23:40.730 --> 00:23:44.950
unwanted pregnancies, and potentially have a

00:23:44.950 --> 00:23:48.170
monogamous relationship if you want one with

00:23:48.170 --> 00:23:49.910
a person that you love and are committed to.

00:23:51.250 --> 00:23:54.150
But that's not realistic. So in lieu of that,

00:23:54.230 --> 00:23:56.049
it's like, okay, if people aren't going to be

00:23:56.049 --> 00:24:00.130
abstinent, then let's at least educate them on...

00:24:00.400 --> 00:24:04.660
preventative measures like condoms and Plan B

00:24:04.660 --> 00:24:07.640
or birth control so that we can at least mitigate

00:24:07.640 --> 00:24:11.079
some of those secondhand side effects. For me,

00:24:11.099 --> 00:24:14.720
I see vaping very much in that space. There are

00:24:14.720 --> 00:24:16.720
some other things like nicotine patches and gum

00:24:16.720 --> 00:24:21.240
as a way to be like, okay, let's live in reality.

00:24:21.559 --> 00:24:23.720
There are people out there who are going to smoke

00:24:23.720 --> 00:24:26.980
things. What do we want them to smoke? I don't

00:24:26.980 --> 00:24:28.460
know if you have any response to that, but that's

00:24:28.460 --> 00:24:31.259
kind of how I see it. Yeah, I understand where

00:24:31.259 --> 00:24:33.180
you're coming from. You know, I'd like to, I

00:24:33.180 --> 00:24:35.180
want to talk about the risks associated with

00:24:35.180 --> 00:24:37.559
vaping so that we've got a whole picture of what,

00:24:37.700 --> 00:24:41.339
you know, it's not like, oh, let me start e -cigarettes.

00:24:41.380 --> 00:24:44.240
There's no problems because there are some. Yeah,

00:24:44.279 --> 00:24:47.119
I agree. Okay, let's do that. So when we compare

00:24:47.119 --> 00:24:50.240
vaping to a regular or a combustible cigarette

00:24:50.240 --> 00:24:53.440
smoking, both involve inhaling nicotine and other

00:24:53.440 --> 00:24:56.349
substances into their lungs. Like we've talked

00:24:56.349 --> 00:24:58.950
about e -cigarettes heat liquid, whereas cigarettes

00:24:58.950 --> 00:25:02.210
burn tobacco and create smoke. So there are differences

00:25:02.210 --> 00:25:04.789
as far as risks associated with both of those.

00:25:04.890 --> 00:25:08.289
So I give that to Josh as far as better to inhale

00:25:08.289 --> 00:25:10.710
what's going on with an e -cigarette most likely

00:25:10.710 --> 00:25:13.410
than the tar that you get from burning tobacco

00:25:13.410 --> 00:25:15.410
that you inhale with a cigarette. Because we've

00:25:15.410 --> 00:25:17.890
got a lot of data that supports cardiovascular

00:25:17.890 --> 00:25:20.829
disease, lung cancer associated with cigarette

00:25:20.829 --> 00:25:25.130
smoking. Both vaping and combustible cigarette

00:25:25.130 --> 00:25:28.289
smoking are addictive. And it's that nicotine

00:25:28.289 --> 00:25:31.380
component. It's just hard to say no. And both

00:25:31.380 --> 00:25:33.460
can bring potentially dangerous chemicals into

00:25:33.460 --> 00:25:37.460
the body. It is unknown what long -term damage

00:25:37.460 --> 00:25:39.940
vaping may cause due to the limited time available.

00:25:40.119 --> 00:25:41.819
It was really interesting. I looked back, like

00:25:41.819 --> 00:25:44.180
I talked about at the beginning of this podcast,

00:25:44.460 --> 00:25:48.740
it was in the late 1700s that tobacco was first

00:25:48.740 --> 00:25:51.339
used in the United States. And it took until

00:25:51.339 --> 00:25:54.900
the 1900s when we had mass production of cigarettes

00:25:54.900 --> 00:25:58.579
that we started seeing the potential carcinogenic

00:25:58.579 --> 00:26:04.220
effects of uh, combustible cigarettes. So vaping

00:26:04.220 --> 00:26:08.660
hasn't been out that long, maybe 10 years. Well,

00:26:08.759 --> 00:26:11.180
the first e -cigarette was developed in China

00:26:11.180 --> 00:26:15.380
in 2003, 2003. Okay. So we've got 15 years, maybe,

00:26:15.420 --> 00:26:18.000
well, no, I can't do math. 22, 22, 20, sorry.

00:26:18.119 --> 00:26:20.920
But to be mass produced and available, I would

00:26:20.920 --> 00:26:24.329
say. I would say 10 years. I would say like it's

00:26:24.329 --> 00:26:26.269
definitely gotten more popular between probably

00:26:26.269 --> 00:26:29.390
the 2010s to now, like over 10 to 15 year period.

00:26:30.910 --> 00:26:32.990
So yeah, I mean, you're comparing a couple hundred

00:26:32.990 --> 00:26:38.130
years. And I would say even, because we should,

00:26:38.170 --> 00:26:39.609
I mean, we could have a whole podcast on this,

00:26:39.670 --> 00:26:44.309
but like medicine was not scientific until it's

00:26:44.309 --> 00:26:47.890
still, I mean, it's still maybe. the early 1900s.

00:26:47.890 --> 00:26:50.569
Like medicine was considered an art. It was very

00:26:50.569 --> 00:26:55.049
much like folk wisdom. Apothecaries. Yeah. Like

00:26:55.049 --> 00:26:58.289
medicine has taken a, I think we always think

00:26:58.289 --> 00:27:01.130
of like, oh, it's, you know, lab coats and hospitals

00:27:01.130 --> 00:27:04.849
and, you know, very, you know, regimented procedures.

00:27:05.009 --> 00:27:07.470
And it's so hard to imagine that medicine was

00:27:07.470 --> 00:27:11.549
nothing like this in pre -industrial revolution

00:27:11.549 --> 00:27:16.359
and pre -enlightenment. And it has taken time

00:27:16.359 --> 00:27:18.740
to catch up. And as you probably observed in

00:27:18.740 --> 00:27:20.380
the medical space, there's a lot of different

00:27:20.380 --> 00:27:22.059
types of ways that people like to heal people,

00:27:22.200 --> 00:27:26.339
whether it be the traditional or the modern medical

00:27:26.339 --> 00:27:29.359
system or homeopathy or alternative medicines

00:27:29.359 --> 00:27:31.539
or functional medicine. Now, there's so many

00:27:31.539 --> 00:27:34.140
people, obviously, you want to feel better. And

00:27:34.140 --> 00:27:37.119
it is very normal for a lot of these modalities

00:27:37.119 --> 00:27:40.779
to exist because for the longest time, there's

00:27:40.779 --> 00:27:44.049
a difference between feeling better and objectively

00:27:44.049 --> 00:27:46.950
being better. Like I think a great example of

00:27:46.950 --> 00:27:51.269
this is when you take chemotherapy, like chemotherapy

00:27:51.269 --> 00:27:55.390
makes you feel awful, but you objectively can

00:27:55.390 --> 00:27:58.569
diminish the size or sometimes even eliminate

00:27:58.569 --> 00:28:01.529
the cancer inside of you. So by that metric,

00:28:01.569 --> 00:28:03.450
it's like, this is a terrible thing. Chemotherapy.

00:28:03.529 --> 00:28:06.220
It's like, well, It's a risk to reward ratio.

00:28:06.319 --> 00:28:07.900
Are you willing to take that risk to potentially

00:28:07.900 --> 00:28:10.279
get this reward? Whereas there's other things

00:28:10.279 --> 00:28:13.380
out there like homeopathy, which is you're literally

00:28:13.380 --> 00:28:17.740
diluting a substance sometimes by a million to

00:28:17.740 --> 00:28:20.279
10 million fold. It's equivalent to taking like

00:28:20.279 --> 00:28:23.460
a piece of Tylenol, like one little pill, and

00:28:23.460 --> 00:28:27.539
then dissolving it in the ocean. And that is

00:28:27.539 --> 00:28:29.519
the dose that you're getting from homeopathy.

00:28:29.680 --> 00:28:31.279
And some people swear. It's like, oh my gosh,

00:28:31.380 --> 00:28:33.950
I feel so much better by doing it because it

00:28:33.950 --> 00:28:36.430
feels good to take something placebo effect exactly

00:28:36.430 --> 00:28:38.490
it takes it feels good to take something that

00:28:38.490 --> 00:28:41.109
you think works so i think it's really good to

00:28:41.109 --> 00:28:43.609
differentiate just because something feels good

00:28:43.609 --> 00:28:45.809
it doesn't necessarily mean it's good for you

00:28:45.809 --> 00:28:47.609
just think about all those people on crack cocaine

00:28:47.609 --> 00:28:51.170
and uh but and then sometimes taking a little

00:28:51.170 --> 00:28:53.009
bit of medicine even though it doesn't feel good

00:28:53.009 --> 00:28:56.210
to do it it's or even exercise for that example

00:28:56.210 --> 00:28:58.630
or abstaining from that extra dessert that you

00:28:58.630 --> 00:29:00.859
want to have it's like But in the long run, it

00:29:00.859 --> 00:29:02.480
might be healthy. So I think it's really good

00:29:02.480 --> 00:29:04.460
to differentiate between something that feels

00:29:04.460 --> 00:29:06.880
good. I went on a long rabbit hole to talking

00:29:06.880 --> 00:29:09.039
about the history of medicine and things like

00:29:09.039 --> 00:29:10.880
that. Which we're really talking about the fact

00:29:10.880 --> 00:29:12.880
is that we don't really know what the long -term

00:29:12.880 --> 00:29:14.660
effects of vaping are going to be. Thanks for

00:29:14.660 --> 00:29:16.059
landing that point. There you go. I appreciate

00:29:16.059 --> 00:29:18.660
that. So, yeah. So, but, you know, and again,

00:29:18.740 --> 00:29:21.380
too, I don't know how long it is. I mean, I think

00:29:21.380 --> 00:29:25.599
about my late father -in -law. He smoked cigarettes,

00:29:25.960 --> 00:29:29.799
you know, until he was 50. And he lived until

00:29:29.799 --> 00:29:32.880
he was 95 and developed lung cancer. And he had

00:29:32.880 --> 00:29:35.819
not smoked in 45 years. And so it's like, woo,

00:29:36.079 --> 00:29:37.759
you know, and stuff. So that's crazy and stuff.

00:29:37.859 --> 00:29:40.480
So, um, so you just don't know how long it's

00:29:40.480 --> 00:29:42.819
going to take to see some potential adverse effects

00:29:42.819 --> 00:29:45.460
from the vaping mechanism. So, yeah, I think

00:29:45.460 --> 00:29:47.460
maybe later on in the podcast, we'll talk about

00:29:47.460 --> 00:29:50.480
a little bit about basic, basic cancer dynamics.

00:29:50.599 --> 00:29:52.440
Cause I think it's important to tell people that

00:29:52.440 --> 00:29:54.720
cancer is not one of those things that like you

00:29:54.720 --> 00:29:57.000
just suddenly get, it's like a cascade event

00:29:57.000 --> 00:30:00.220
that happens, um, from little things over time,

00:30:00.259 --> 00:30:03.539
but I'll save my other long, so willow clay for

00:30:03.539 --> 00:30:05.799
later in the podcast. This is the Josh hour.

00:30:05.940 --> 00:30:08.900
So yeah. Um, so anyway, okay. So let's get back

00:30:08.900 --> 00:30:11.220
to some of the other risks associated with vaping.

00:30:11.220 --> 00:30:16.559
If you have asthma, which is a, um, uh, uh, restrictive

00:30:16.559 --> 00:30:20.940
air disease, um, it affects your breathing. Vaping

00:30:20.940 --> 00:30:24.069
can make that get worse. It can also cause lung

00:30:24.069 --> 00:30:26.789
inflammation. So it can cause scarring. It can

00:30:26.789 --> 00:30:30.710
narrow or irritate your bronchi or your bronchioles

00:30:30.710 --> 00:30:33.089
inside your lungs, which are part of the air

00:30:33.089 --> 00:30:34.990
sacs inside your lungs that help you breathe.

00:30:35.109 --> 00:30:37.549
So when you get scarring or irritation of those

00:30:37.549 --> 00:30:39.089
or narrowing, then it makes it more difficult

00:30:39.089 --> 00:30:40.730
to breathe. So you can get shortness of breath

00:30:40.730 --> 00:30:42.970
and that's a kind of a scary feeling and stuff.

00:30:43.089 --> 00:30:46.869
So you can also get lung scarring due to some

00:30:46.869 --> 00:30:50.490
of the components inside the liquid that you're

00:30:50.490 --> 00:30:52.930
using. that you have for these e -cigarettes.

00:30:53.490 --> 00:30:57.009
And so that can cause a popcorn lung and it can

00:30:57.009 --> 00:30:58.930
cause some permanent lung scarring as well too.

00:30:59.109 --> 00:31:01.609
Now, again, the incidences of these, I don't

00:31:01.609 --> 00:31:04.970
have, but, and again, we don't, again, we don't

00:31:04.970 --> 00:31:06.930
have as many people vaping as we do cigarette

00:31:06.930 --> 00:31:09.589
smoking. So it's going to be lower numbers, but

00:31:09.589 --> 00:31:11.730
it can happen. So it's just something to be aware

00:31:11.730 --> 00:31:13.930
of. That's a good point. Yeah. I think the epidemiology

00:31:13.930 --> 00:31:16.430
is a little in its infancy stage at the moment

00:31:16.430 --> 00:31:18.450
due to, for this. So there's probably been observations

00:31:18.450 --> 00:31:20.950
like, Oh, here's a person who vaped. they have

00:31:20.950 --> 00:31:24.430
popcorn lung but like compared to other populations

00:31:24.430 --> 00:31:27.769
yeah we might not have that data yet right um

00:31:27.769 --> 00:31:31.089
you can have other organ damage uh you can have

00:31:31.089 --> 00:31:32.930
damage to your heart or your brain especially

00:31:32.930 --> 00:31:36.490
in adolescents that are using nicotine because

00:31:36.490 --> 00:31:40.069
nicotine affects and adversely the brain development

00:31:40.069 --> 00:31:43.470
it can it affects the areas that control attention

00:31:43.470 --> 00:31:48.410
learning mood impulse control so um that's you

00:31:48.410 --> 00:31:53.180
know you can as your young person is continuing

00:31:53.180 --> 00:31:55.960
to develop their, you know, brain functioning,

00:31:56.059 --> 00:31:59.160
you don't want to put anything, you don't want

00:31:59.160 --> 00:32:00.900
them using something that could adversely affect

00:32:00.900 --> 00:32:04.359
that. Nicotine, the nicotine contained inside

00:32:04.359 --> 00:32:06.720
e -cigarettes can also increase your blood pressure

00:32:06.720 --> 00:32:09.740
and it can also narrow arteries. So that can,

00:32:09.740 --> 00:32:14.000
that can cause issues long -term. There was,

00:32:14.019 --> 00:32:17.819
there, there was a condition called e -cigarette

00:32:18.589 --> 00:32:21.710
or vaping product use associated lung injury.

00:32:21.869 --> 00:32:24.710
And it was a serious lung condition that was

00:32:24.710 --> 00:32:27.750
possibly caused by that vitamin E acetate that's

00:32:27.750 --> 00:32:33.109
inside that e -cigarette liquid. And it would

00:32:33.109 --> 00:32:36.130
cause widespread lung damage with symptoms like

00:32:36.130 --> 00:32:38.410
cough, shortness of breath, chest pain, fever,

00:32:38.529 --> 00:32:42.809
vomiting, diarrhea, and a rapid heartbeat. But

00:32:42.809 --> 00:32:47.319
the case, it was associated with In the early

00:32:47.319 --> 00:32:52.559
2020s, but now I think that the cases have been

00:32:52.559 --> 00:32:54.880
declining. I think they've just, maybe they've

00:32:54.880 --> 00:32:59.019
improved the techniques for making e -cigarettes.

00:32:59.180 --> 00:33:02.000
Well, some places have banned selling vitamin

00:33:02.000 --> 00:33:06.779
E acetate along with some of these packs as well

00:33:06.779 --> 00:33:09.700
as it's also THC. Those are the two things that

00:33:09.700 --> 00:33:13.119
were associated with these EVALI events or EVALI,

00:33:13.119 --> 00:33:16.910
which is the acronym that mom talked about. Um,

00:33:17.250 --> 00:33:19.450
and it was kind of causing these pneumonia like

00:33:19.450 --> 00:33:22.769
symptoms and there was something. So vitamin

00:33:22.769 --> 00:33:24.490
E, we often think it's like, oh, that's a great

00:33:24.490 --> 00:33:26.210
thing. You put it on your skin, you know, promote

00:33:26.210 --> 00:33:29.069
skin health, but inhaling it as a very different

00:33:29.069 --> 00:33:31.730
story. It's this, if you've ever used that, it's

00:33:31.730 --> 00:33:34.750
a fat. So if you've ever thought about, I don't

00:33:34.750 --> 00:33:35.990
know if you've ever tried to wash your hands

00:33:35.990 --> 00:33:39.509
with fat on without soap. it's not coming off.

00:33:39.650 --> 00:33:41.789
So as you think about that inside of your lungs,

00:33:41.970 --> 00:33:44.410
and if that gets on your lungs, then it's not

00:33:44.410 --> 00:33:46.910
going to be able to do proper gas exchange. And

00:33:46.910 --> 00:33:49.089
you're going to get some of these chronic conditions.

00:33:49.170 --> 00:33:51.190
You might have these immune events because your

00:33:51.190 --> 00:33:53.490
body's obviously trying to heal itself. So it's

00:33:53.490 --> 00:33:55.509
going to attack the lungs and that's going to

00:33:55.509 --> 00:33:58.529
cause the scarring. And yeah, so some of these

00:33:58.529 --> 00:34:01.869
substances that are dissolved in these cartridges

00:34:01.869 --> 00:34:04.210
can be worse than others, which leads to some

00:34:04.210 --> 00:34:05.890
of these events. And I think probably they've

00:34:05.890 --> 00:34:08.219
declined because some of these I think some people

00:34:08.219 --> 00:34:09.739
have caught on, be like, oh, don't do it with

00:34:09.739 --> 00:34:11.659
vitamin E. And also some places have outright

00:34:11.659 --> 00:34:13.820
banned the sale of that. So it's harder to get.

00:34:14.019 --> 00:34:19.239
Okay. Okay. Addiction, we've mentioned, as well

00:34:19.239 --> 00:34:22.159
as e -cigarette. If you start with an e -cigarette,

00:34:22.300 --> 00:34:25.920
you could transition to smoking regular combustible

00:34:25.920 --> 00:34:29.380
cigarettes. The secondhand exposure that may

00:34:29.380 --> 00:34:31.360
potentially be associated with e -cigarettes

00:34:31.360 --> 00:34:34.019
as well as combustible cigarettes. Interestingly,

00:34:34.179 --> 00:34:36.820
and I... I apologize that I don't have an incidence

00:34:36.820 --> 00:34:39.880
of this, but because your e -cigarette is battery

00:34:39.880 --> 00:34:41.739
operated, there have been some cases of that

00:34:41.739 --> 00:34:46.880
battery, the vape pen exploding. And so it can

00:34:46.880 --> 00:34:49.480
cause a burn or an injury to a person and stuff.

00:34:49.559 --> 00:34:51.900
Yeah, I would say that's true of lithium ion

00:34:51.900 --> 00:34:54.059
batteries in general because it's also happened

00:34:54.059 --> 00:34:57.039
in tablets and in phones as well as computers.

00:34:57.820 --> 00:34:59.760
So if you're going to buy something with a lithium

00:34:59.760 --> 00:35:03.119
ion battery in it, if it's not well made. I mean,

00:35:03.139 --> 00:35:05.099
it's true of any manufacturing, like you're always

00:35:05.099 --> 00:35:06.860
going to get some type of defect and you might

00:35:06.860 --> 00:35:09.619
be the unlucky person who gets the defect. Um,

00:35:09.960 --> 00:35:12.360
but yeah, I mean, if your, your, your cigarette's

00:35:12.360 --> 00:35:15.019
not going to explode, but yeah, this, this e

00:35:15.019 --> 00:35:16.579
-cigarette might just cause it has a battery

00:35:16.579 --> 00:35:19.760
inside it. Um, we talked about cancer as well

00:35:19.760 --> 00:35:22.800
as who is a potential risk. And then, uh, the

00:35:22.800 --> 00:35:27.539
death rate that I could find with, um, e -cigarette

00:35:27.539 --> 00:35:31.519
smoking were 2019, 2020 data. So now we're five

00:35:31.519 --> 00:35:34.119
years out, but there were 68 people that had

00:35:34.119 --> 00:35:37.219
died from those E -Valley lung injuries. So,

00:35:37.340 --> 00:35:41.239
you know, not the rest of them, but this was

00:35:41.239 --> 00:35:43.500
just specifically the E -Valley that was the

00:35:43.500 --> 00:35:45.639
most significant lung damage that was found with

00:35:45.639 --> 00:35:48.079
vaping. Yeah. And that's why I would argue that's

00:35:48.079 --> 00:35:51.190
less people that would die in one week. From

00:35:51.190 --> 00:35:54.989
smoking cigarettes. Yeah. So even if you, like

00:35:54.989 --> 00:35:57.250
mom said, we don't know entirely the long -term

00:35:57.250 --> 00:36:00.789
harms. As we know from living, sometimes death

00:36:00.789 --> 00:36:02.690
isn't the worst thing. Like you can definitely

00:36:02.690 --> 00:36:04.730
get some long -term consequences that are not

00:36:04.730 --> 00:36:07.070
fun to be alive. So that's why we have morbidity

00:36:07.070 --> 00:36:09.630
and mortality. So sometimes even the morbidity,

00:36:09.769 --> 00:36:12.030
which means like the symptoms that you have to

00:36:12.030 --> 00:36:14.849
live with could be slightly worse. I was just

00:36:14.849 --> 00:36:20.360
looking to see if I had a new death rate. for

00:36:20.360 --> 00:36:24.340
vaping, but it's still that 68 number, 68 people

00:36:24.340 --> 00:36:30.960
number. So you can also develop, so there's poisoning

00:36:30.960 --> 00:36:33.380
and toxicity associated with vaping as well too,

00:36:33.400 --> 00:36:39.000
because those containers that are inserted inside

00:36:39.000 --> 00:36:42.579
of a vape pen are concentrated amounts of nicotine.

00:36:42.699 --> 00:36:49.559
And if a kiddo got it or you, accidentally spilled

00:36:49.559 --> 00:36:52.119
it all over your skin. It can have irritant effects

00:36:52.119 --> 00:36:54.800
to your skin, but it could cause nausea and vomiting

00:36:54.800 --> 00:36:57.679
and it could potentially cause serious effects

00:36:57.679 --> 00:37:00.539
for a kiddo because it's nicotine. And so it

00:37:00.539 --> 00:37:02.440
could increase heart rate and blood pressure.

00:37:02.500 --> 00:37:04.860
And so it'd be a significant thing. So you got

00:37:04.860 --> 00:37:06.739
to be careful. If a kid accidentally drinks it.

00:37:06.760 --> 00:37:08.360
Accidentally drinks it because it's a liquid.

00:37:08.480 --> 00:37:11.639
Yeah. Because, you know, kids are curious. So

00:37:11.639 --> 00:37:13.199
that is one of the things too that could come

00:37:13.199 --> 00:37:16.179
with that as well too is that if you use large

00:37:16.179 --> 00:37:19.619
nicotine doses, so a kiddo ingests a whole bottle

00:37:19.619 --> 00:37:23.219
of an e -cigarette liquid, they could develop

00:37:23.219 --> 00:37:26.900
seizures as well too. So an average vape pod

00:37:26.900 --> 00:37:29.940
contains the equivalent of 20 cigarettes. Yeah,

00:37:30.420 --> 00:37:32.519
this is an important point because I think it's

00:37:32.519 --> 00:37:36.179
really one of the hard things to recognize too

00:37:36.179 --> 00:37:39.440
is this concept called bioavailability. So what

00:37:39.440 --> 00:37:43.610
I mean by that, is that when you ingest a substance

00:37:43.610 --> 00:37:48.050
inside of you, it can either be dissolved and

00:37:48.050 --> 00:37:50.489
go into your bloodstream and be available for

00:37:50.489 --> 00:37:54.409
use inside of your body, or it can be bound to

00:37:54.409 --> 00:37:57.550
something else and then not be able to be used

00:37:57.550 --> 00:37:59.449
to your body. So the bioavailability is this

00:37:59.449 --> 00:38:01.670
thing that can essentially be used by yourselves

00:38:01.670 --> 00:38:07.190
or using something else. Due to the delivery

00:38:07.190 --> 00:38:12.010
mechanism of cigarettes, versus e -cigarettes.

00:38:12.110 --> 00:38:15.349
And also just using another source of tobacco

00:38:15.349 --> 00:38:18.230
that delivers nicotine is this stuff called a

00:38:18.230 --> 00:38:21.809
snooze, which is essentially like a little tobacco

00:38:21.809 --> 00:38:24.309
pack. They're also called zins in the United

00:38:24.309 --> 00:38:26.849
States. And you put them on the bottom of your

00:38:26.849 --> 00:38:29.409
lip or the top of your lip. Saw them at the ice

00:38:29.409 --> 00:38:31.150
house this morning. You can get everything at

00:38:31.150 --> 00:38:34.610
the gas station here in America, especially Doritos,

00:38:34.630 --> 00:38:38.599
which I love. But you put that in and it's a

00:38:38.599 --> 00:38:41.900
slow, it's a slow drip. But we're going to talk

00:38:41.900 --> 00:38:44.380
about this too. Okay. I know that's the gut reaction,

00:38:44.440 --> 00:38:48.139
but data is greater than feelings. But so when

00:38:48.139 --> 00:38:52.219
you are taking nicotine into your body, let's

00:38:52.219 --> 00:38:54.219
just use the tobacco, the one that you put on

00:38:54.219 --> 00:38:58.679
your upper lip. That is about a 30 to 50 % bioavailability.

00:38:58.679 --> 00:39:01.000
So only the amount of nicotine that's in that

00:39:01.000 --> 00:39:06.079
pack, only about 30 to 50 % gets into your. bloodstream.

00:39:06.079 --> 00:39:08.760
With e -cigarettes, let's just talk about cigarettes.

00:39:08.900 --> 00:39:11.280
Cigarettes, it's a lot cleaner. Essentially,

00:39:11.400 --> 00:39:14.980
if you take in a cigarette, about 90 % of that

00:39:14.980 --> 00:39:16.679
nicotine will get inside of your bloodstream.

00:39:18.199 --> 00:39:20.559
Crazy enough, cigarettes are really well regulated,

00:39:20.800 --> 00:39:23.059
meaning that you kind of know exactly what you're

00:39:23.059 --> 00:39:25.260
getting when you're smoking a cigarette. E -cigarettes,

00:39:25.500 --> 00:39:29.119
crazy. I mean, the amount of variability of nicotine

00:39:29.119 --> 00:39:31.539
that you get. I looked at these studies where

00:39:31.539 --> 00:39:35.019
these people essentially did simulated e -cigarettes.

00:39:35.019 --> 00:39:36.760
So essentially they got a machine that kind of

00:39:36.760 --> 00:39:39.460
like artificially puffed an e -cigarette and

00:39:39.460 --> 00:39:42.539
the amount of nicotine that they got from different

00:39:42.539 --> 00:39:45.980
brands and different types of e -cigarettes was

00:39:45.980 --> 00:39:52.519
essentially between like 0 .025 milligrams for

00:39:52.519 --> 00:39:55.380
every 15 puffs that you like take from the e

00:39:55.380 --> 00:40:00.059
-cigarette to 0 .75 milligrams. I know those

00:40:00.059 --> 00:40:01.920
are tiny numbers, but if you think about like

00:40:01.920 --> 00:40:07.239
that is almost a That is more than a tenfold

00:40:07.239 --> 00:40:10.880
difference. I think it's like a 30 -fold difference.

00:40:11.480 --> 00:40:15.320
And it just depends because this industry is

00:40:15.320 --> 00:40:19.099
so young and it is not well -regulated, especially

00:40:19.099 --> 00:40:22.860
in the United States. So essentially, it's kind

00:40:22.860 --> 00:40:25.699
of deemed as like a supplement. And you just

00:40:25.699 --> 00:40:28.420
don't need to do any testing to determine what

00:40:28.420 --> 00:40:32.769
dose is in there. You really don't know how much

00:40:32.769 --> 00:40:34.909
nicotine you're getting. So if you buy like a

00:40:34.909 --> 00:40:38.550
Juul versus a Vuze versus, what was the other

00:40:38.550 --> 00:40:40.849
brand that you told me? The one that rebranded.

00:40:41.750 --> 00:40:45.849
Elf Bar, but now it's like EB Create. EB Create.

00:40:45.969 --> 00:40:50.969
Enjoy. They are not required to do formalized

00:40:50.969 --> 00:40:54.150
testing to basically talk about how much nicotine

00:40:54.150 --> 00:40:56.590
is in these pods. And it could be incredibly

00:40:56.590 --> 00:41:00.380
variable. That being said. Even if we did the

00:41:00.380 --> 00:41:03.960
upper bounds of what these are, you're probably,

00:41:04.019 --> 00:41:09.260
if you consumed one Juul pack a day, you'd get

00:41:09.260 --> 00:41:11.599
about 40 milligrams of nicotine inside of your

00:41:11.599 --> 00:41:15.679
body. So to get that kind of seizure threshold

00:41:15.679 --> 00:41:18.699
that Dr. Seltzer was talking about, you would

00:41:18.699 --> 00:41:21.019
need to do like two of those a day. And you'd

00:41:21.019 --> 00:41:22.679
have to do it in pretty rapid succession. So

00:41:22.679 --> 00:41:25.239
if you're a parent and you see your kid or if

00:41:25.239 --> 00:41:27.889
you are a person who vapes, If they're doing

00:41:27.889 --> 00:41:30.429
two of these a day, that really increases your

00:41:30.429 --> 00:41:32.650
risk of nicotine toxicity. That can increase

00:41:32.650 --> 00:41:35.110
the risk of a seizure and some of these other

00:41:35.110 --> 00:41:38.510
deleterious effects. So doing it quickly and

00:41:38.510 --> 00:41:40.469
as well as doing it a lot is obviously going

00:41:40.469 --> 00:41:42.090
to increase the amount of nicotine that's in

00:41:42.090 --> 00:41:44.670
your body. One Juul pod can, oh, 20 cigarettes.

00:41:44.809 --> 00:41:46.550
Okay. So it's 20 cigarettes per one Juul pod.

00:41:46.670 --> 00:41:50.269
So yeah. Okay. So, and the amount of nicotine

00:41:50.269 --> 00:41:58.019
in one standard Juul. Wait, wait. I'm just saying

00:41:58.019 --> 00:42:01.400
the reason that they say that is because. It's

00:42:01.400 --> 00:42:04.099
200 puffs. 200 puffs. Yeah, 200 or 300 puffs.

00:42:04.480 --> 00:42:07.739
Because people going off cigarettes, because

00:42:07.739 --> 00:42:11.679
like mom said, nicotine is so addictive. In order

00:42:11.679 --> 00:42:14.239
to get the equivalent of the nicotine delivery,

00:42:14.639 --> 00:42:17.739
they have to make it 20 times more concentrated

00:42:17.739 --> 00:42:20.840
because the bioavailability in a vapor is very

00:42:20.840 --> 00:42:23.769
different than tobacco smoke. Yes. So. Even though

00:42:23.769 --> 00:42:25.590
that's a bit misleading to say it's like, oh,

00:42:25.610 --> 00:42:27.489
they have 20, it's like 20 times the cigarette.

00:42:27.610 --> 00:42:29.630
It's like, well, you have to do more puffs. That

00:42:29.630 --> 00:42:31.530
makes a lot of sense. To get the same amount

00:42:31.530 --> 00:42:33.969
of nicotine because if you're already addicted

00:42:33.969 --> 00:42:35.610
to nicotine, let's say you're a smoker and you're

00:42:35.610 --> 00:42:37.610
trying to move to e -cigarettes. Right. You're

00:42:37.610 --> 00:42:39.909
going to have to smoke more of the e -cigarette

00:42:39.909 --> 00:42:42.909
to get the same nicotine concentration. Right.

00:42:42.929 --> 00:42:44.409
And you know what would happen too is that if

00:42:44.409 --> 00:42:48.260
you, if they didn't do it that way. You would

00:42:48.260 --> 00:42:49.780
just give up. You would just go back to cigarettes

00:42:49.780 --> 00:42:51.179
because you're like, oh, I'm not getting the

00:42:51.179 --> 00:42:53.099
effect I need. So I'm just going to go back to

00:42:53.099 --> 00:42:55.559
my regular cigarettes. Yeah, exactly. So, yeah.

00:42:56.179 --> 00:42:59.579
One other issue that's associated with not only

00:42:59.579 --> 00:43:03.260
what is associated with e -cigarettes as well

00:43:03.260 --> 00:43:05.980
as combustible cigarettes is that nicotine itself

00:43:05.980 --> 00:43:08.840
causes fetal toxicity and adverse pregnancy outcomes.

00:43:08.980 --> 00:43:11.739
And that's been noted for a long time. So nicotine

00:43:11.739 --> 00:43:13.940
damages the fetal brain and the lungs, and it

00:43:13.940 --> 00:43:15.880
can also result in low birth weight and preterm

00:43:15.880 --> 00:43:17.800
birth. So you want. You don't want to use it

00:43:17.800 --> 00:43:21.579
in pregnant women. So, okay, we're going to move

00:43:21.579 --> 00:43:24.260
now to talking about, and we've kind of alluded

00:43:24.260 --> 00:43:26.340
to this, about using e -cigarettes in youth.

00:43:27.579 --> 00:43:31.019
So, and as we've kind of alluded to, using e

00:43:31.019 --> 00:43:34.119
-cigarettes or vaping is much greater than other

00:43:34.119 --> 00:43:37.699
tobacco products in the U .S. youth. In 2024,

00:43:38.139 --> 00:43:42.219
there were 1 .63 million students in the United

00:43:42.219 --> 00:43:45.559
States using e -cigarettes. That's 5 .9 % of

00:43:45.559 --> 00:43:49.099
our students. 410 ,000 were middle school students,

00:43:49.320 --> 00:43:53.539
whereas 1 .21 million were high school students.

00:43:54.480 --> 00:43:56.559
And out of all of the students who have used

00:43:56.559 --> 00:44:00.260
e -cigarettes, there were 43 % that report current

00:44:00.260 --> 00:44:03.260
use. And those with current use are reporting

00:44:03.260 --> 00:44:06.659
that they use mostly the flavored e -cigs. And

00:44:06.659 --> 00:44:10.000
then about a third of those used an e -cig on

00:44:10.000 --> 00:44:13.739
at least 20 out of the last 30 days. And about

00:44:13.739 --> 00:44:17.599
one -fourth used an e -cig every day. And disposable

00:44:17.599 --> 00:44:20.079
e -cigarettes were used in a little over half.

00:44:21.000 --> 00:44:23.500
Females being greater than males as far as using

00:44:23.500 --> 00:44:27.860
e -cigs. Juul is the most common brand of e -cig

00:44:27.860 --> 00:44:30.880
used in youth. It contains what they call a protonated

00:44:30.880 --> 00:44:35.860
nicotine, which... The company claims is associated

00:44:35.860 --> 00:44:39.900
with reduced issues with taste, smell, and throat

00:44:39.900 --> 00:44:43.500
irritation, which I think that was the deal with

00:44:43.500 --> 00:44:45.760
when you'd start, if you were trying to learn

00:44:45.760 --> 00:44:48.679
how to smoke a cigarette, you'd breathe it in

00:44:48.679 --> 00:44:50.460
and it was really irritating and stuff. So you

00:44:50.460 --> 00:44:53.039
had to acquire the ability to do that. And so

00:44:53.039 --> 00:44:57.800
I'm sure that maybe other e -cigs. may have that

00:44:57.800 --> 00:44:59.780
associated with it, but Juul promotes that they

00:44:59.780 --> 00:45:02.000
have less associated with that. And they have

00:45:02.000 --> 00:45:05.039
a variety of tastes associated with it, mango

00:45:05.039 --> 00:45:08.260
and mint. And so, you know, they make it like

00:45:08.260 --> 00:45:11.280
really enticing to get these kiddos hooked on

00:45:11.280 --> 00:45:15.800
this stuff. So it increases their desire to experiment.

00:45:16.840 --> 00:45:20.420
And like I said, it resembles a USB drive. So

00:45:20.420 --> 00:45:23.000
it's really a lot easier to hide from authority

00:45:23.000 --> 00:45:26.639
figures or to use in areas where smoking is forbidden.

00:45:27.079 --> 00:45:30.480
So they call that stealth vaping. Okay. I mean,

00:45:30.480 --> 00:45:32.820
what's not stealthy is that big cloud of vapor

00:45:32.820 --> 00:45:35.539
that's going to come out of your lungs. So even

00:45:35.539 --> 00:45:37.539
though the device could be hidden, I mean, he's

00:45:37.539 --> 00:45:39.260
like, yeah, I see what you're doing. Yeah. Yeah.

00:45:39.539 --> 00:45:45.039
New kind of gum. Yeah. So most interestingly.

00:45:45.739 --> 00:45:49.360
I found this very interesting. A lot of middle

00:45:49.360 --> 00:45:51.860
school and high school students who vape want

00:45:51.860 --> 00:45:55.179
to quit and have tried to quit. 2020 data show

00:45:55.179 --> 00:45:58.519
us that those who wanted to quit were about 64

00:45:58.519 --> 00:46:01.840
% of users and those who have tried to quit is

00:46:01.840 --> 00:46:06.840
about 67%. And many use practice dual usage.

00:46:06.880 --> 00:46:09.940
So they're using vapes plus cigarettes and or

00:46:09.940 --> 00:46:13.039
cigars. That was 2024 data with one in three

00:46:13.039 --> 00:46:16.070
middle and high school students doing both. And

00:46:16.070 --> 00:46:22.190
also e -cigarettes, depending on the device that

00:46:22.190 --> 00:46:27.929
you have, may allow you to be, it may be a delivery

00:46:27.929 --> 00:46:30.730
system for other substances like cannabis, like

00:46:30.730 --> 00:46:33.349
we talked about, so marijuana as well, too. In

00:46:33.349 --> 00:46:36.889
2016, one in three medical school students and

00:46:36.889 --> 00:46:39.230
one in four high school students reported ever

00:46:39.230 --> 00:46:42.590
using cannabis in their e -cigarette. So, yeah.

00:46:45.380 --> 00:46:51.059
Economically, vaping from 2020 to 2024, the unit

00:46:51.059 --> 00:46:56.380
sales increased by 34 .7 % from 15 .7 million

00:46:56.380 --> 00:47:00.059
units to 21 .1 million units. These were only

00:47:00.059 --> 00:47:02.159
brick -and -mortar data. That does not include

00:47:02.159 --> 00:47:04.960
online purchases, so it's going to be more than

00:47:04.960 --> 00:47:08.440
this. And the percentage of disposable e -cigs

00:47:08.440 --> 00:47:13.380
doubled. Over 80 % of the sales are for flavors

00:47:13.380 --> 00:47:15.860
other than tobacco. Tobacco is not the favorite

00:47:15.860 --> 00:47:19.460
flavor. Usually it's mint or menthol. And the

00:47:19.460 --> 00:47:23.400
total cost of e -cig sales in June of 2024 was

00:47:23.400 --> 00:47:28.559
$488 .9 million. But you compare that to cigarette

00:47:28.559 --> 00:47:36.119
sales from 2023. 2023, you had 7 .6 billion packs

00:47:36.119 --> 00:47:40.800
sold for a... price of approximately 106 billion

00:47:40.800 --> 00:47:45.219
dollars so what is that um well you think about

00:47:45.219 --> 00:47:49.260
it wait i'm not doing math right so think about

00:47:49.260 --> 00:47:51.159
it so five it's like let's just round up that

00:47:51.159 --> 00:47:53.280
first number it's 500 million that's half a billion

00:47:53.280 --> 00:47:56.920
dollars yeah so yeah whoa it's like way less

00:47:56.920 --> 00:48:01.360
yeah that's like 2 000 times more yeah and uh

00:48:01.360 --> 00:48:05.480
interestingly vaping accounts for about 22 billion

00:48:05.480 --> 00:48:09.539
dollars in output or the or 0 .1 % of our gross

00:48:09.539 --> 00:48:15.099
domestic product. So they've got about 134 ,000

00:48:15.099 --> 00:48:19.639
Americans employed creating vaping devices and

00:48:19.639 --> 00:48:22.239
vaping materials. Yeah, you think about not just

00:48:22.239 --> 00:48:25.639
the packs, but also the devices. Also, there's

00:48:25.639 --> 00:48:27.960
like the shops that people go to. There's like

00:48:27.960 --> 00:48:30.179
these vaping bars that you can just kind of hang

00:48:30.179 --> 00:48:33.300
out at. So there's a lot of different ways to

00:48:33.300 --> 00:48:36.219
do it. Very similar to alcohol. Right. So it's

00:48:36.219 --> 00:48:40.340
not providing jobs for a lot of people, but it

00:48:40.340 --> 00:48:43.619
does provide jobs for some. Yeah, the growing

00:48:43.619 --> 00:48:48.059
industry. Yeah. So we always look at myths and

00:48:48.059 --> 00:48:52.320
misunderstand... Myths? and misunderstandings

00:48:52.320 --> 00:48:55.099
about our topics. And so vaping is no different.

00:48:55.260 --> 00:48:59.039
So like we've talked initially, one of the myths

00:48:59.039 --> 00:49:01.539
is that vaping helps stop smoking. And this is

00:49:01.539 --> 00:49:04.119
not necessarily true. And the Food and Drug Administration

00:49:04.119 --> 00:49:07.800
has showed that people may stop smoking combustible

00:49:07.800 --> 00:49:10.280
cigarettes, but they will continue smoking with

00:49:10.280 --> 00:49:13.079
an e -cigarette so that people are still subject

00:49:13.079 --> 00:49:16.719
to being exposed to nicotine. Yeah. And I think

00:49:16.719 --> 00:49:19.420
this is where Dr. Seltzer and I might not see

00:49:19.420 --> 00:49:24.440
eye to eye because I don't really, I don't really

00:49:24.440 --> 00:49:26.940
care that much if people are addicted to nicotine

00:49:26.940 --> 00:49:31.860
because I just think that being addicted to something

00:49:31.860 --> 00:49:35.340
is not as, it sounds bad, but there are different

00:49:35.340 --> 00:49:37.860
things to be addicted to. So if, if I'm going

00:49:37.860 --> 00:49:41.219
to be addicted to smoking, I'd rather be addicted

00:49:41.219 --> 00:49:43.539
to the thing that just gives me the addictive

00:49:43.539 --> 00:49:47.449
chemical nicotine as opposed to nicotine plus

00:49:47.449 --> 00:49:52.130
the tobacco tar. I drink coffee every morning.

00:49:52.210 --> 00:49:55.090
I would argue that I'm addicted to coffee. Some

00:49:55.090 --> 00:49:57.510
might say I'm addicted to caffeine, but I don't

00:49:57.510 --> 00:50:00.809
seek caffeine out in any other variety. I'm sure

00:50:00.809 --> 00:50:03.230
there is a way to get caffeine that's less healthy

00:50:03.230 --> 00:50:08.210
than coffee. I'm okay with my caffeine addiction

00:50:08.210 --> 00:50:10.670
because I know that long -term health -wise,

00:50:10.809 --> 00:50:14.670
it's not too bad for me. Whereas if you told

00:50:14.670 --> 00:50:16.559
me that there's caffeine in a cigarette, I'd

00:50:16.559 --> 00:50:19.019
be like, that's okay. I get my caffeine somewhere

00:50:19.019 --> 00:50:22.460
else. So for me, it's all about, can you replace

00:50:22.460 --> 00:50:24.820
one thing for another? But I did look up a study

00:50:24.820 --> 00:50:26.699
and there was one done in Southern California

00:50:26.699 --> 00:50:32.519
where they found students who had never done

00:50:32.519 --> 00:50:35.579
e -cigarettes before. And they followed them,

00:50:35.659 --> 00:50:39.300
I think over a two -year period. And then they

00:50:39.300 --> 00:50:43.199
asked them, have you started smoking regular

00:50:43.199 --> 00:50:46.619
cigarettes now? And comparing the students who

00:50:46.619 --> 00:50:49.400
had, basically both groups had never done e -cigarettes

00:50:49.400 --> 00:50:52.000
and then one started to do e -cigarettes. And

00:50:52.000 --> 00:50:53.719
they followed those two groups who never did

00:50:53.719 --> 00:50:56.300
an e -cigarette, only did e -cigarettes. Compared

00:50:56.300 --> 00:50:58.760
to those two, did you try a cigarette? If you

00:50:58.760 --> 00:51:00.960
did try an e -cigarette, you were more, I think

00:51:00.960 --> 00:51:04.460
six times more likely to do tobacco cigarettes.

00:51:05.460 --> 00:51:07.780
It just seems to be a culture, like people who

00:51:07.780 --> 00:51:11.679
smoke together, stick together. And so if you

00:51:11.679 --> 00:51:13.019
are going to smoke, you're probably going to

00:51:13.019 --> 00:51:16.500
be around other people who do smoke. So I'm not

00:51:16.500 --> 00:51:19.320
saying that if you do e -cigarettes, you're never

00:51:19.320 --> 00:51:22.739
going to smoke tobacco cigarettes. But for those

00:51:22.739 --> 00:51:24.920
of you who are already doing tobacco cigarettes,

00:51:25.239 --> 00:51:28.619
can we get you to switch to doing just e -cigarettes?

00:51:29.800 --> 00:51:32.059
And even though you might be addicted for life,

00:51:32.219 --> 00:51:34.480
if we're going to assume the worst case scenario,

00:51:34.820 --> 00:51:37.230
I would much rather that. I don't know if you

00:51:37.230 --> 00:51:38.849
have any response to that. I do have a response

00:51:38.849 --> 00:51:42.869
to that. So while we know that tobacco smoking

00:51:42.869 --> 00:51:47.239
can be associated more, we have. data that support

00:51:47.239 --> 00:51:50.440
the relationship between tobacco smoking and

00:51:50.440 --> 00:51:54.199
lung cancer development. Nicotine also has an

00:51:54.199 --> 00:51:56.800
adverse output on cardiovascular disease. So

00:51:56.800 --> 00:51:58.760
if you already have cardiovascular disease and

00:51:58.760 --> 00:52:01.820
you take nicotine in, you can worsen it. Or you

00:52:01.820 --> 00:52:04.199
could, if you just happen to be predisposed,

00:52:04.219 --> 00:52:06.619
taking daily nicotine could also worsen that.

00:52:06.699 --> 00:52:09.679
So that's my argument against using nicotine,

00:52:09.719 --> 00:52:12.079
you know, on a regular basis and stuff. So even

00:52:12.079 --> 00:52:15.539
if you switch from, now. I understand your argument.

00:52:15.800 --> 00:52:18.280
We don't know how much, and maybe they're getting

00:52:18.280 --> 00:52:20.699
less nicotine with an e -cig. It's hard to say.

00:52:20.800 --> 00:52:24.099
Maybe so. So yeah, if you're taking in less and

00:52:24.099 --> 00:52:26.579
then you can handle that, that's fine. But it's

00:52:26.579 --> 00:52:29.880
not without any risk at all. Yeah, so what you're

00:52:29.880 --> 00:52:32.079
saying is you would like people to do neither

00:52:32.079 --> 00:52:34.780
behavior. Right. Just from a health standpoint.

00:52:34.940 --> 00:52:37.820
Right. But I think all I'm saying is I agree

00:52:37.820 --> 00:52:40.360
with you. I think that neither should be done.

00:52:40.440 --> 00:52:42.820
But if we had a choice. Right. I would definitely

00:52:42.820 --> 00:52:45.179
say just nicotine rather than nicotine plus,

00:52:45.239 --> 00:52:48.840
you know, tobacco. Right. Because that has obviously

00:52:48.840 --> 00:52:52.300
been shown to cause massive amounts of harm to

00:52:52.300 --> 00:52:56.019
people. Cool. That kind of leads us to the second

00:52:56.019 --> 00:52:59.860
myth that vaping is safer than smoking. And we

00:52:59.860 --> 00:53:02.760
talk about that, but don't forget too that the

00:53:02.760 --> 00:53:07.690
liquid that is the solvent for these... the nicotine

00:53:07.690 --> 00:53:10.429
for the e -cigarettes contains chemicals and

00:53:10.429 --> 00:53:13.710
we're not exactly sure the long -term impact

00:53:13.710 --> 00:53:15.670
of those. So we just need to be aware of that.

00:53:15.769 --> 00:53:19.349
I agree. Yeah. And that kind of goes to with

00:53:19.349 --> 00:53:21.730
the fact that vaping produces harmless water

00:53:21.730 --> 00:53:24.949
vapor. It's not water. It's an aerosol that contains

00:53:24.949 --> 00:53:28.090
stuff in it, different types of chemicals. So

00:53:28.090 --> 00:53:30.650
it's, it's not just, even if you breathe water

00:53:30.650 --> 00:53:32.929
inside your lung, that's not going to, that's

00:53:32.929 --> 00:53:35.230
not what your, your lungs are not. built for

00:53:35.230 --> 00:53:38.130
that so um think about when you like inhale water

00:53:38.130 --> 00:53:40.030
from the swimming pool it's not a pleasant experience

00:53:40.030 --> 00:53:44.170
so yeah um vaping doesn't create secondhand smoke

00:53:44.170 --> 00:53:48.369
and that's not true um it contains it's not smoke

00:53:48.369 --> 00:53:50.670
per se but it's an aerosolized vapor that people

00:53:50.670 --> 00:53:54.090
can also breathe in it can also land on surfaces

00:53:54.090 --> 00:53:58.670
and clothing and it can be breathed in through

00:53:58.670 --> 00:54:00.670
that as well too and again we just don't know

00:54:00.670 --> 00:54:03.920
what that's going to cause long term Um, it's

00:54:03.920 --> 00:54:07.019
easy to quit vaping. It's not easy to quit vaping.

00:54:07.039 --> 00:54:09.119
If you, you know, once you start with nicotine,

00:54:09.239 --> 00:54:13.219
it, um, it, you, you tend to crave more nicotine.

00:54:13.500 --> 00:54:16.440
Um, so it's, uh, that's especially concerning

00:54:16.440 --> 00:54:19.400
in our, in our teenagers, uh, that start at such

00:54:19.400 --> 00:54:21.780
an early age. Yeah, I agree. And I think that's

00:54:21.780 --> 00:54:23.920
why we have a lot of these like replacement therapies.

00:54:24.099 --> 00:54:25.780
If you did do cigarette smokes, you have to say

00:54:25.780 --> 00:54:29.260
nicotine gum, nicotine patches. Um, actually

00:54:29.260 --> 00:54:33.460
I just read the FDA. This is like this past week.

00:54:33.619 --> 00:54:37.619
They approved the, not that it's not FDA approved,

00:54:37.820 --> 00:54:41.539
but the FDA approved the sale of basically those

00:54:41.539 --> 00:54:43.360
pouches that I was talking about. They're called

00:54:43.360 --> 00:54:48.579
Zins. Basically as a way to be like a safer alternative

00:54:48.579 --> 00:54:52.960
to smoking cigarettes and potentially e -cigarettes

00:54:52.960 --> 00:54:55.500
as well. So because what they found, what they

00:54:55.500 --> 00:54:57.539
found a lot in Scandinavian countries where that's

00:54:57.539 --> 00:55:01.019
this type of. Actually, zins are just nicotine.

00:55:01.039 --> 00:55:06.800
It's not tobacco. It's very similar to an e -cigarette

00:55:06.800 --> 00:55:09.559
where it's just liquid nicotine. There's basically

00:55:09.559 --> 00:55:12.960
liquid pouches and you suck on them rather than

00:55:12.960 --> 00:55:14.840
smoke them, which sounds weird, but some people

00:55:14.840 --> 00:55:19.440
like it. Whatever. Anyways, they have found in

00:55:19.440 --> 00:55:21.119
the Scandinavian countries where it's much more

00:55:21.119 --> 00:55:23.579
popular there that that has been shown to be

00:55:23.579 --> 00:55:26.960
a great replacement therapy because people get

00:55:26.960 --> 00:55:30.690
addicted to these. They call them snus in Scandinavia.

00:55:30.929 --> 00:55:34.150
And they're very hard to give up. People love

00:55:34.150 --> 00:55:35.969
them because obviously they're nicotine. But

00:55:35.969 --> 00:55:39.010
they find that it's a good replacement for when

00:55:39.010 --> 00:55:41.530
they're switching from smoking. But they can

00:55:41.530 --> 00:55:44.050
still get that nicotine high, which is really

00:55:44.050 --> 00:55:46.329
the thing that they want. So they'll essentially

00:55:46.329 --> 00:55:48.409
substitute one for the other. So the states have

00:55:48.409 --> 00:55:50.809
caught on to this. And the FDA just announced,

00:55:50.949 --> 00:55:53.670
I think it was like January 16th. And we're recording

00:55:53.670 --> 00:55:58.170
this on the 23rd of January. uh 2025 and uh so

00:55:58.170 --> 00:55:59.809
i thought that was really cool that is interesting

00:55:59.809 --> 00:56:02.550
uh you know i think two thoughts i have on that

00:56:02.550 --> 00:56:05.110
let's see if i can remember my two thoughts um

00:56:05.110 --> 00:56:11.039
one is um Oh, yes, I can. Amazingly, I can remember

00:56:11.039 --> 00:56:13.539
my two thoughts. First of all, if you do substitute

00:56:13.539 --> 00:56:15.219
it with that, then you're not going to have the

00:56:15.219 --> 00:56:19.800
secondhand smoke issue or aerosolized for bystanders

00:56:19.800 --> 00:56:21.900
and stuff. So that's interesting. My concern,

00:56:22.000 --> 00:56:24.079
and I'm thinking the FDA, and again, because

00:56:24.079 --> 00:56:26.179
I did not look into this, I saw it, but I thought

00:56:26.179 --> 00:56:28.019
we're talking just about e -cigarettes today,

00:56:28.059 --> 00:56:30.309
but I appreciate you bringing this up. I know

00:56:30.309 --> 00:56:35.489
with snuff, which is pouch tobacco in your gum

00:56:35.489 --> 00:56:37.710
line, it does increase mouth cancer. Correct.

00:56:37.829 --> 00:56:40.349
So I'm hoping then that it's the tobacco part

00:56:40.349 --> 00:56:42.250
of that that does it and not the nicotine part.

00:56:42.250 --> 00:56:43.730
That is correct. Because I would be concerned

00:56:43.730 --> 00:56:48.460
then with these. pouches of nicotine in your

00:56:48.460 --> 00:56:50.860
mouth that we don't want mouth cancer. Yeah,

00:56:50.860 --> 00:56:52.719
and it doesn't. If you look at the epidemiology

00:56:52.719 --> 00:56:55.400
in Scandinavia where they're done, yeah, especially

00:56:55.400 --> 00:56:58.079
if they're ones that are not, they're just nicotine

00:56:58.079 --> 00:57:00.820
pouches, yeah, the rate of cancer doesn't increase.

00:57:01.039 --> 00:57:04.420
So it's mainly tobacco. Yeah, very interesting.

00:57:04.760 --> 00:57:07.940
So you still have the nicotine issue, but yeah.

00:57:08.239 --> 00:57:11.800
So it's getting to be a safer, you know, if you

00:57:11.800 --> 00:57:14.880
can consider safer. Yeah. It's just lowering,

00:57:14.940 --> 00:57:18.800
it's lowering the hazard or risk. It's like,

00:57:18.800 --> 00:57:22.179
if I still get my nicotine, can I lower the threshold

00:57:22.179 --> 00:57:24.519
of the risk of causing a long -term health outcome?

00:57:24.639 --> 00:57:26.199
Yeah. And I think a lot of times people want

00:57:26.199 --> 00:57:28.300
to avoid things like mouth cancer and lung cancer

00:57:28.300 --> 00:57:31.280
and. Heart disease. Heart disease. Yeah. Cardiovascular

00:57:31.280 --> 00:57:33.260
events. Strokes, stuff like that. Also just like.

00:57:34.030 --> 00:57:35.650
I don't know if you've ever had a day where you

00:57:35.650 --> 00:57:37.550
got an infection, like a lung infection, but

00:57:37.550 --> 00:57:39.849
just like not breathing well. It's just like

00:57:39.849 --> 00:57:43.070
a really drag on your life. You can't exercise

00:57:43.070 --> 00:57:45.610
as well. It just really limits your quality of

00:57:45.610 --> 00:57:48.150
life. And you only get two of these little sacks

00:57:48.150 --> 00:57:50.730
inside of your body to facilitate gas exchange.

00:57:50.829 --> 00:57:53.809
So take care of them. Yeah. Also too, I mean,

00:57:53.829 --> 00:57:56.489
I personally hate cigarette smoke and walking

00:57:56.489 --> 00:57:58.590
in rooms that are full of cigarette smoke. So

00:57:58.590 --> 00:58:00.610
that, you know, would reduce that as well too,

00:58:00.670 --> 00:58:02.869
because I mean, it affects me adversely, you

00:58:02.869 --> 00:58:04.989
know, and so that's, you know, anyway. I think

00:58:04.989 --> 00:58:06.710
one of the greatest public health things we did

00:58:06.710 --> 00:58:09.670
is that we created the smoking section only or

00:58:09.670 --> 00:58:11.730
banned people from smoking in restaurants, which

00:58:11.730 --> 00:58:13.829
I couldn't believe. Yeah. And on the airplanes.

00:58:14.090 --> 00:58:17.090
Yeah. It's insane. Yeah. So yeah. Hallelujah.

00:58:17.409 --> 00:58:20.289
So. And in hospitals, you used to be able to

00:58:20.289 --> 00:58:22.030
smoke in hospitals and now you can't do that

00:58:22.030 --> 00:58:25.510
anymore. Thank goodness. So let's talk about

00:58:25.510 --> 00:58:28.510
quitting vaping because I don't think it would

00:58:28.510 --> 00:58:30.090
be complete without talking about that because

00:58:30.090 --> 00:58:34.199
nicotine is addictive. And so. If you want to

00:58:34.199 --> 00:58:35.579
know whether or not you're potentially addicted

00:58:35.579 --> 00:58:38.719
to nicotine, here's some symptoms or some signs

00:58:38.719 --> 00:58:41.500
that might indicate that. First of all, you crave

00:58:41.500 --> 00:58:43.679
it, that you're like, I've got to have it. I've

00:58:43.679 --> 00:58:46.000
got to have my Diet Coke every day. So I think

00:58:46.000 --> 00:58:49.179
I'm addicted to the caffeine in it or the carbonation,

00:58:49.239 --> 00:58:51.360
one or the other and stuff. But I don't want

00:58:51.360 --> 00:58:54.420
to give it up. But, you know, well, anyway, that's

00:58:54.420 --> 00:58:57.519
another story for another day. If you feel like

00:58:57.519 --> 00:58:59.719
you're unable to stop using nicotine, you know,

00:58:59.719 --> 00:59:01.539
then that's going to be a sign of addiction.

00:59:02.650 --> 00:59:05.329
Also, interestingly, too, if you develop a tolerance

00:59:05.329 --> 00:59:08.449
to it, that means you need more to get the same

00:59:08.449 --> 00:59:10.090
effect. And that's going to kind of indicate

00:59:10.090 --> 00:59:13.469
an addictive type of a situation. There are symptoms

00:59:13.469 --> 00:59:16.050
with nicotine withdrawal. And so it's kind of

00:59:16.050 --> 00:59:18.449
tough to go through. So if you stop vaping, you

00:59:18.449 --> 00:59:20.670
could have some withdrawal symptoms, such as

00:59:20.670 --> 00:59:24.230
feeling irritable or jumpy or restless, feeling

00:59:24.230 --> 00:59:27.610
sad or down, having trouble sleeping, having

00:59:27.610 --> 00:59:30.849
a hard time concentrating, feeling hungry or

00:59:30.849 --> 00:59:33.650
craving nicotine. But those withdrawal symptoms

00:59:33.650 --> 00:59:36.929
will go away over time as your brain gets used

00:59:36.929 --> 00:59:40.250
to not having nicotine. If you do want to stop,

00:59:40.389 --> 00:59:44.989
then have a plan to quit with goals. Make a list

00:59:44.989 --> 00:59:48.670
of reasons to quit vaping. Set a quit date. Talk

00:59:48.670 --> 00:59:50.630
to your health care provider so they can help

00:59:50.630 --> 00:59:52.690
you. And tell your friends and family so they

00:59:52.690 --> 00:59:55.150
can be accountability partners for you as well.

00:59:55.610 --> 00:59:58.349
Avoid any temptations or triggers. So don't go

00:59:58.349 --> 01:00:00.650
places where you know that people are vaping

01:00:00.650 --> 01:00:02.889
so that you would get drawn back into that as

01:00:02.889 --> 01:00:06.010
well too. Get some exercise. Getting those endorphins

01:00:06.010 --> 01:00:09.480
going helps you to have have a good feeling and

01:00:09.480 --> 01:00:11.460
helps your body feel good. So that would be a

01:00:11.460 --> 01:00:15.199
good thing. And if you are having some cravings

01:00:15.199 --> 01:00:17.820
and experiencing some side effects, you could

01:00:17.820 --> 01:00:20.099
use the nicotine gums or patches as well too

01:00:20.099 --> 01:00:22.500
to help with that as well too. And then you could

01:00:22.500 --> 01:00:25.820
utilize your favorite relaxation technique, either

01:00:25.820 --> 01:00:28.579
prayer or meditation or yoga or deep breathing

01:00:28.579 --> 01:00:31.940
to help you get through those toughest moments

01:00:31.940 --> 01:00:34.019
and withdrawal as well too. Yeah, that's well

01:00:34.019 --> 01:00:37.539
said. I think it might. prove useful to talk

01:00:37.539 --> 01:00:42.780
why nicotine is so addictive. Okay. So you essentially

01:00:42.780 --> 01:00:46.800
have this area in your brain called the ventral

01:00:46.800 --> 01:00:50.280
tegmental area, which has a lot of neurons that

01:00:50.280 --> 01:00:53.019
secrete this thing called dopamine. Dopamine

01:00:53.019 --> 01:00:55.139
is this thing called a neurotransmitter. You

01:00:55.139 --> 01:00:56.840
might've heard it in the literature. It's been

01:00:56.840 --> 01:00:59.780
known as like the pleasure chemical or the reward

01:00:59.780 --> 01:01:02.539
chemical. It's not exactly how it works. It's

01:01:02.539 --> 01:01:05.400
actually the anticipation of reward. That is

01:01:05.400 --> 01:01:11.139
what It's like the anticipation reward that develops

01:01:11.139 --> 01:01:15.980
that feeling because dopamine drives you towards

01:01:15.980 --> 01:01:18.820
a goal. So it's essentially wanting you to eat

01:01:18.820 --> 01:01:21.159
food. It's wanting you to procreate. It is wanting

01:01:21.159 --> 01:01:23.920
you to do the things that an organism does. So

01:01:23.920 --> 01:01:28.300
what nicotine does is that it attaches to these

01:01:28.300 --> 01:01:32.199
neurons and it basically... releases tons of

01:01:32.199 --> 01:01:35.199
dopamine into your system, getting you that feeling

01:01:35.199 --> 01:01:36.880
of like, Oh, I'm going to, I'm going to get a

01:01:36.880 --> 01:01:39.179
reward. I'm so excited. I'm about to be rewarded.

01:01:39.500 --> 01:01:42.440
Um, but it does it so much, um, that essentially

01:01:42.440 --> 01:01:45.599
your body can't make more of it. Um, and so that's

01:01:45.599 --> 01:01:47.179
kind of the depleted feelings that you're getting,

01:01:47.219 --> 01:01:49.199
like what mom, mom is saying, feeling sad or

01:01:49.199 --> 01:01:50.880
feeling down or trouble sleeping. It kind of

01:01:50.880 --> 01:01:53.630
throws off your. your natural rhythms of these

01:01:53.630 --> 01:01:56.329
reward chemicals. There's this great book called

01:01:56.329 --> 01:01:59.329
dopamine nation by Anna Lemke that I highly recommend

01:01:59.329 --> 01:02:01.769
reading. If you are a person who suffers from

01:02:01.769 --> 01:02:03.849
addiction or know someone who does, because I

01:02:03.849 --> 01:02:07.530
think it really talks about of all this stuff

01:02:07.530 --> 01:02:09.329
that we're saying is like limiting addiction.

01:02:09.530 --> 01:02:11.750
It makes a lot of sense. And it makes a lot of

01:02:11.750 --> 01:02:13.610
sense that all those kids that they interviewed,

01:02:13.630 --> 01:02:15.670
like, do you want to quit? And they go like almost

01:02:15.670 --> 01:02:18.110
70 % of them said, yeah, of course I do. But

01:02:18.110 --> 01:02:21.260
saying you want to quit and quitting. is so hard

01:02:21.260 --> 01:02:23.599
and because it requires a lot of willpower and

01:02:23.599 --> 01:02:26.360
it requires a lot of like rewiring your brain

01:02:26.360 --> 01:02:29.460
to want something it doesn't want and that takes

01:02:29.460 --> 01:02:31.659
a really long time be asking mom to give up her

01:02:31.659 --> 01:02:33.900
diet coke it'd be asking me to give up my coffee

01:02:33.900 --> 01:02:37.380
and it's like no absolutely i know i could but

01:02:37.380 --> 01:02:39.420
it would take a lot of work and it would be like

01:02:39.420 --> 01:02:43.239
do i really want to give this up um and i i think

01:02:43.239 --> 01:02:48.530
a lot of times um with these chemicals And I

01:02:48.530 --> 01:02:49.690
think it's true of a lot of addictive behaviors.

01:02:49.849 --> 01:02:52.030
I think we look at people and we think, oh, you

01:02:52.030 --> 01:02:56.469
have no willpower. It's your fault. But this

01:02:56.469 --> 01:02:58.849
is how your brain was made. And this is how it

01:02:58.849 --> 01:03:00.369
does. So I think a lot of times when you see

01:03:00.369 --> 01:03:02.630
someone who's addicted to anything, realize that

01:03:02.630 --> 01:03:04.690
could have been you. You just have your own addiction

01:03:04.690 --> 01:03:06.650
that's more socially acceptable, whether it be

01:03:06.650 --> 01:03:11.269
exercise, Diet Coke, or coffee. And when someone's

01:03:11.269 --> 01:03:13.570
trying to quit, I think the thing that they need

01:03:13.570 --> 01:03:16.150
the most is support. and accountability because

01:03:16.150 --> 01:03:19.630
a lot of times like being encouraged, like making

01:03:19.630 --> 01:03:23.230
these small steps towards coming through is a

01:03:23.230 --> 01:03:24.989
really important thing. So I just wanted to lay

01:03:24.989 --> 01:03:27.250
that out because you had some of these chemicals,

01:03:27.309 --> 01:03:30.789
things like cocaine and nicotine are really,

01:03:30.949 --> 01:03:33.130
really powerful releasers of dopamine in the

01:03:33.130 --> 01:03:35.929
brain. And that's why they're incredibly addictive.

01:03:36.449 --> 01:03:40.909
Yeah. So, so to wrap up our talk today about

01:03:40.909 --> 01:03:44.789
vaping, the conclusions that i've come to after

01:03:44.789 --> 01:03:46.829
looking at the literature is that really no tobacco

01:03:46.829 --> 01:03:49.869
product is completely safe safe including e -cigarettes

01:03:49.869 --> 01:03:53.090
but we've talked about that e -cigarettes may

01:03:53.090 --> 01:03:57.170
provide a less risky exposure to nicotine than

01:03:57.170 --> 01:03:59.070
a regular combustible cigarette right because

01:03:59.070 --> 01:04:01.389
they're technically not a tobacco product right

01:04:01.389 --> 01:04:05.619
that that's true so um Nicotine is contained

01:04:05.619 --> 01:04:08.019
in most e -cigarettes, and it is highly addictive,

01:04:08.159 --> 01:04:10.059
and it is a health danger for pregnant women,

01:04:10.179 --> 01:04:12.599
including developing fetuses and the youth. So

01:04:12.599 --> 01:04:15.460
we want to minimize use in those patient populations.

01:04:16.619 --> 01:04:19.440
The aerosol from e -cigarettes could be harmful

01:04:19.440 --> 01:04:22.719
to those standing by, so we want to be respectful

01:04:22.719 --> 01:04:25.219
of the people that are around us as well. So

01:04:25.219 --> 01:04:30.320
trying to... to encourage youth and young adults

01:04:30.320 --> 01:04:33.619
to not start using an e -cigarette so that they

01:04:33.619 --> 01:04:38.260
may avoid nicotine addiction in the future and

01:04:38.260 --> 01:04:42.760
the transition toward combustible cigarette use

01:04:42.760 --> 01:04:47.500
and maybe cannabis use as well is a goal, I think,

01:04:47.519 --> 01:04:51.579
as well, because e -cigarettes can be a springboard

01:04:51.579 --> 01:04:54.119
for those other mechanisms. So maybe encouraging,

01:04:54.219 --> 01:04:56.760
you know, other activities other than e -cigarette

01:04:56.760 --> 01:05:02.440
use. And then we don't know really what the long

01:05:02.440 --> 01:05:05.219
-term effects of e -cigarette use are. So I think

01:05:05.219 --> 01:05:08.199
we just need to be cognizant and be wise and

01:05:08.199 --> 01:05:15.960
just be aware of what people are finding out

01:05:15.960 --> 01:05:18.380
as far as it's concerned. Because I tell you,

01:05:18.440 --> 01:05:21.579
you know, you think about things that you did

01:05:21.579 --> 01:05:24.519
when you were younger and then you... reap the

01:05:24.519 --> 01:05:26.760
consequences of it when you're older. I think

01:05:26.760 --> 01:05:31.219
about me laying out in the sun and as a teen

01:05:31.219 --> 01:05:33.300
and listening to my father tell me I'm going

01:05:33.300 --> 01:05:35.739
to be sorry. And, you know, now I'm in my 60s

01:05:35.739 --> 01:05:37.300
and I wish I'd listened to him, you know, stuff.

01:05:37.380 --> 01:05:39.539
So, you know, now I get a, you know, at least

01:05:39.539 --> 01:05:41.599
an annual visit to the dermatologist to check

01:05:41.599 --> 01:05:43.159
me out for skin cancers because I've already

01:05:43.159 --> 01:05:45.219
had one. So, I mean, it's the same thing. It's

01:05:45.219 --> 01:05:48.179
like, so we just, you know, we want to be smart

01:05:48.179 --> 01:05:51.070
as far as using these products. Yeah, that's

01:05:51.070 --> 01:05:53.030
really well said. And especially with something

01:05:53.030 --> 01:05:56.730
that has an unknown risk, I think there's going

01:05:56.730 --> 01:05:58.989
to be certain persons like, what's the big deal?

01:05:59.030 --> 01:06:00.510
We don't know. And then there's going to be the

01:06:00.510 --> 01:06:03.010
opposite side of that. I'm going to be extremely

01:06:03.010 --> 01:06:05.809
cautious. But I really love the point that you

01:06:05.809 --> 01:06:08.949
made about how young people could potentially

01:06:08.949 --> 01:06:12.409
become cigarette users from this behavior. And

01:06:12.409 --> 01:06:14.510
I think that really hints at an interesting nexus

01:06:14.510 --> 01:06:17.099
point with e -cigarettes is that I think what

01:06:17.099 --> 01:06:19.619
we want to do is that we want to get adult cigarette

01:06:19.619 --> 01:06:24.079
users to start using e -cigarettes as a preferable

01:06:24.079 --> 01:06:27.019
alternative. But we also don't want young kids

01:06:27.019 --> 01:06:31.900
to start smoking at all. So having policies from

01:06:31.900 --> 01:06:35.119
our government or even within our corporations

01:06:35.119 --> 01:06:39.099
of like, can we not sell to kids, but can we

01:06:39.099 --> 01:06:43.179
sell to adults? And especially adults who are

01:06:43.179 --> 01:06:46.710
making the switch from cigarettes. It seems like

01:06:46.710 --> 01:06:48.469
a really unique public health problem because

01:06:48.469 --> 01:06:51.150
you want to demonize e -cigarettes to young people,

01:06:51.250 --> 01:06:53.750
but you also want to highlight their benefits

01:06:53.750 --> 01:06:56.829
to adults who are already smoking. And I think

01:06:56.829 --> 01:06:59.909
as humans, we have a really hard time being nuanced

01:06:59.909 --> 01:07:02.789
and seeing two truths at once. So I'm really

01:07:02.789 --> 01:07:05.070
hoping that we can kind of thread that needle.

01:07:06.230 --> 01:07:11.230
Because I can't remember the exact survey, but

01:07:11.230 --> 01:07:14.460
there's a survey. I think it was one -fourth

01:07:14.460 --> 01:07:17.079
or 25 % of people think that e -cigarettes are

01:07:17.079 --> 01:07:21.420
more harmful than tobacco cigarettes. So there's

01:07:21.420 --> 01:07:24.039
this really kind of anti -vaping campaign going

01:07:24.039 --> 01:07:27.320
around because I think it's being targeted to

01:07:27.320 --> 01:07:29.280
kids and people think it's being targeted to

01:07:29.280 --> 01:07:31.699
kids. And I think rightly so. But I think it's

01:07:31.699 --> 01:07:34.099
also missing the bigger message of like, if we

01:07:34.099 --> 01:07:38.300
just universally demonize this, we might be causing

01:07:38.300 --> 01:07:40.320
more harm because we're going to push adults

01:07:40.320 --> 01:07:43.880
back into. uh, traditional cigarette smoking.

01:07:43.880 --> 01:07:46.579
Yeah. And you know, we also, we also discovered

01:07:46.579 --> 01:07:49.380
too, I mean, again, I, I'm a kind of, I'm pretty

01:07:49.380 --> 01:07:53.659
naive. I mean, I, I, I, I lived in a protective

01:07:53.659 --> 01:07:55.840
world growing up and I, maybe I still do now,

01:07:55.880 --> 01:07:58.079
but you know, in tech and the state of Texas,

01:07:58.320 --> 01:08:03.800
uh, vaping materials are not, they're not they're

01:08:03.800 --> 01:08:05.719
not supposed to be sold to anyone under 21 years

01:08:05.719 --> 01:08:08.420
of age. So then you think, okay, how do you get

01:08:08.420 --> 01:08:11.039
all these middle schoolers and high schoolers

01:08:11.039 --> 01:08:14.639
started on these things? So those of you that

01:08:14.639 --> 01:08:17.520
are providing these to those young people, maybe

01:08:17.520 --> 01:08:19.819
you shouldn't do that. So, you know, and I'm

01:08:19.819 --> 01:08:22.260
sure, I'm sure there's all kinds of loopholes

01:08:22.260 --> 01:08:24.420
and stuff that I just don't even know about because

01:08:24.420 --> 01:08:27.680
I'm kept in the dark. But so anyway, so just,

01:08:27.739 --> 01:08:31.319
just, you know, be wise. Listen to your mother,

01:08:31.359 --> 01:08:34.319
y 'all. Your mom on drugs. Well, we so appreciate

01:08:34.319 --> 01:08:37.380
y 'all coming in and joining us for this episode.

01:08:37.600 --> 01:08:39.720
I feel like it was a mixture of your mom on drugs

01:08:39.720 --> 01:08:42.579
and your son on risk. Yes. It was definitely

01:08:42.579 --> 01:08:46.380
a combo today. But we hope that you tune in for

01:08:46.380 --> 01:08:49.180
our next episode. And we hope you check out our

01:08:49.180 --> 01:08:51.140
back catalog because it's full of good material.

01:08:51.659 --> 01:08:56.239
But until next time, I'm the son, Josh. And I'm

01:08:56.239 --> 01:08:59.119
the mom, Jenny. And we'll see you next time.

01:08:59.539 --> 01:09:00.359
Bye. Bye.