No evidence is provided for the safety of THC vaping products. An NYT article that was clearly biased against THC was picked apart instead. The clear implication is that THC vapes were unjustly targeted and readers should assume the contrary of the dishonest NYT article. i.e. That THC vapes are safe. Yet, no direct evidence of that is provided. A possibly fatal lie is told purely with true facts.
Here's why that matters: THC is a recreational product. It's relatively recent legalization in only some jurisdictions is why we're just starting to get good data on it. Vaping is even newer and less well studied.
Okay, so let's say there's no clear evidence that THC vapes are harmful. I'm being a dishonest fear-monger. Or am I?
What should be the default position on recreational drugs? Specifically, ones that are inhaled? Ask a respirologist. Lungs are delicate and, if you screw yours up, you're really fubar'd. They'll tell you that, if you do want to use a relatively unstudied recreational drug, eat it or shove it up your ass. (Seriously, THC enemas are a thing.) Don't put it in your lungs.
The default position for inhaling drugs should be, "Don't" until they're proven safe. This is my opinion/bias/dishonest-agenda.
Here, the crux is whether we assume that Gwern's uncited Vitamin E Acetate reference is true (i.e., nicotine vapes are fine since they don't have this compound) without any evidence outside a link to wikipedia. I do not [see for example ref 1, with the caveat that we can't really tell if VEA is in use illegally]. We also are four years out from the NYT article and comfortably looking back with knowledge unavailable at the time (to wit, Gwern's assertion that EVALI has fallen with the reduction in VEA use).
I accept the point that the NYT article in question[2] may be wrong in equating damage linked to THC vapes and nicotine vapes. However, what should we do when a new recreational drug category is associated with disease? Accept manufacturer-provided explanations ("Well, this opioid is actually less addictive than others and shouldn't be regulated the same!")? Or take categorical action while awaiting new information? Medicine takes the latter approach. I accept that we should all be able to do what we wish to our bodies, but reject that the State should abet us in these efforts.
As an aside, teens falling ill (the subject of the original article) leads to a lot more social impact than would occur if an adult takes up a recreational drug. There's the actual illness, lost education, potential developmental delay, impacts on the teen's friend group, moral injury to the medical team, and likely more. This would be a separate reason to be more strident in regulating new recreational drugs targeted at minors.
1. https://www.trillianthealth.com/market-research/studies/eval...
2. https://www.nytimes.com/2022/03/08/health/vaping-fda-nicotin...
also, the first reader comment literally says:
“Vaping hasn’t been shown to be unsafe scientifically“
I grew up reading NYTimes on the weekend with my parents. I held them in extreme high regard when it came to their news and journalistic integrity. Over the years, I've shifted to think of them as another data point. For the industries that I'm most familiar with (Tech, Finance, and Pharma), I find their reporting often shallow, lacking in nuance, or intentional/unintentional misreporting. And I often wonder if their reporting of other areas is similarly lacking.
Now, they are just another data point, which is sad.
Public health officials are throwing their credibility into a bonfire when they land on a fixation and use heavy handed strategies to pursue their goals, without a sense of proportionality or efficacy.
> An NYT article that was clearly biased against THC
This was an NYT article clearly biased against nicotine. One of us is confused here. Maybe I can't follow your particular idiom.
Does that make more sense to you now?
i would much rather read this collation directly, give me bullet points. in such a structured format it would also be easier to analyze if a given statement is too specific or has too many qualifiers. it would also be easier to notice what's missing.
I've been trying to find a place where people write down these tricks so that I can at least name and classify them for myself. There's one that particularly gets me, a kind of false aggregation. Say breast cancer is 99% treatable and costs $1m and prostate cancer is 1% treatable and the most you'd spend is $1k. Suppose someone said "cancers can be as bad as 1% treatable while attempts can be up to $1m to do". Well, that makes it sound like there's a cancer where you spend a mil and it's 1%. This kind of false aggregation obscures the truth.
It would be useful to me so I can concisely name this kind of thing and then work with it to preserve epistemic hygiene.
0: The distinctively beautiful website is brand enough haha
Gwern's evidence that NYT succeeded in their deception campaign is... riled-up internet commentators in the comments section who think vaping is evil. Which doesn't mean much because [pardon my cheekiness here] a) every comments section on every article everywhere on the internet is full of riled-up people, and b) we all know no one reads the article before commenting, therefore these outraged commentators must have developed their opinions without the aid of the NYT.
Wanna jump out of an airplane with no parachute and see if one of your buddies can strap one on you before you hit the ground? Totally fine with me.
Wanna base-jump off a skyscraper in NYC with a wing-suit ? Fuck off. You’ll probably hurt someone else who didn’t sign up for that.
That said, I’d also like the CPSC to look into whether products like this are safe and hold manufacturers accountable for their consequences.
I’d also very much appreciate it if the FTC and FDA actually did thorough random testing of drugs and supplements (recreational or therapeutic) to ensure that the actual ingredients and doses match the label. The FDA requires drug manufacturers to be in compliance, but doesn’t actually test drugs themselves, they mostly just look over paperwork to see if the processes followed would probably produce the correct product and assume the paperwork isn’t manipulated.
In fact, the FDA actively works to prevent people, even the Pentagon, from doing independent 3rd party drug testing of common pharmaceuticals [0]
0: https://www.bloomberg.com/news/features/2023-12-05/pentagon-... / https://archive.is/eyWSn
That's not the point - gwerns article dismantled the NYT article. If one read (or heard about) the NYT article and used it as "proof" of "vaping is bad", gwern is saying: "not so fast". That's not to say "vaping is healthy", nor even "vaping is not unhealthy" - just that this article isn't the proof you're looking for. Vaping (legal flavoured nicotine (which is what's on trial)) could be horrible - simply citing instances of why this is so isn't actually done in the article.
If it matters, I'm not condoning vaping or smoking at all.
The critique is: "This article uses a rhetorical device (THC vapes with vitamin E acetate are harmful) to suggest that nicotine vapes are harmful, when there's nothing in common other than being a vape product"
It's goal isn't to refute the evidence, but to suggest the editors and writers of the articles did not provide a sufficient connection between the THC-vape incidents and the harm caused by nicotine vapes, yet spent the entire article convolution any distinctions between the two, to implicate nicotine vaping as equally harmful as the THC infused vitamin-e lung damage incidents.
Had the writers & editors at the NYT had any nicotine vape related direct harm, that would have connected the THC-vape incidences. But just writing this sentence, you can see how continually repeating THC-vape incidences biases you to understanding that there's a difference.
And that's the point, NYT article went out of it's way to convolute direct harm incidences to a broader vaping category when there's no evidence to suggest nicotine vaping is susceptable to the same direct harm. It's like saying bob drove his car drunk & crashed, therefore, driving cars is dangerous. We know it's dangerous but the "driving drunk" doesn't prove they're dangerous. You can do lots of dangerous things while drunk.
Similarly, THC-infused vitamin E acetate in vapes caused lung damage. Is the operable cause the Vape or the THC-infused vitamin E acetate; no evidence is presented that it's anything other than the vape liquid by all other sources. That is to say, no evidence by NYT is presented that some other substance in a vape is equally harmful.
If you want to get into the science, go ahead, a vape is vaporizing things. So it matters what those things it's vaporizing is. And if it's incomplete vaporization, then it's possible harmful chemicals are being generated. So perhaps the article needed to present the basic facts about vapes.
I'm not exactly going to get outraged at the NYT's rhetorical tactics against vaping.
Unlike the author I’m not claiming that they did it deliberately, but that’s what their article ends up doing.
The NYT article was suppose to be about nicotine vapes and in it, they used an example that only appears related because it's a vape. The harm caused by the illegally marketed/unapproved incidence doesn't prove the new york times summary: nicotine vapes are harmful.
The fact presented about the THC vape incidences arn't categorically related to the use and marketing of nicotine vapes.
The point of the article is to showcase how examples can be technically correct (vaping superset) but not actually provide relevance (THC vapes w/vitamin E acetate caused lung damage).
> So perhaps the article needed to present the basic facts about vapes.
The whole last third of the NYT article is about how we don't (or did not at the time) know what substances may be at play, with several specific agents called out.
In this way, the harms of lying compound while the benefits do not. For this reason I believe it highly unwise to allow it to be normalized.
>Wanna base-jump off a skyscraper in NYC with a wing-suit ? Fuck off. You’ll probably hurt someone else who didn’t sign up for that.
Are they not the same?
Also the aeroplane itself is a highly regulated piece of this system
Michael Crichton said it best:
“Briefly stated, the Gell-Mann Amnesia effect is as follows. You open the newspaper to an article on some subject you know well. In Murray's case, physics. In mine, show business. You read the article and see the journalist has absolutely no understanding of either the facts or the issues. Often, the article is so wrong it actually presents the story backward—reversing cause and effect. I call these the "wet streets cause rain" stories. Paper's full of them.
In any case, you read with exasperation or amusement the multiple errors in a story, and then turn the page to national or international affairs, and read as if the rest of the newspaper was somehow more accurate about Palestine than the baloney you just read. You turn the page, and forget what you know.”
This concern is addressed in the article.
> it would be possible to write this story without bringing in irrelevant THC-contaminated anecdotes or EVALI, by focusing on legitimate criticisms of nicotine vaping. (You could discuss teen access, flavor marketing, age checks, FDA jurisdiction, statutory drafting, the economics of disposable devices, and the adult harm-reduction case without ever mentioning EVALI which you know is not related to teen access to legal anything.)
You are not heating up the atomizer anywhere near that temperature with (2) 18650 cells. Coils are replaced when the cotton that surrounds them gets dirty and the vapor starts tasting bad.
gwern’s writing (including on nicotine) was formative for me; it showed me how and why the internet the was important: it let me read good, well written thinking I had never seen from the NYTs or my parents.
I first saw a link to gwern.net on HN. And I trusted the NYTs as an institution then, and do to this day… and I’m sure I clicked through, and took the gwern post seriously in part because comments weren’t universally negative.
You can point to bounded trust problems, or talk more about how “The Media Very Rarely Lies”…
But please don’t take up the first comment on a gwern post to cheap shot the NYTs
Probably not much more healthy but I don’t really see how you would be ingesting much more metal from that compared to your metal frying pan for example.
On the flip side I can literally type "vape shop" into Google and get a handful of options in walking distance that I could stroll into legally and purchase whatever I wanted, as long as it was not flavored. That too is something Google is happy to share with me.
It shows us that we are strong, and others are weak, and that we need to attack the weak before they become strong and destroy us.
This sort of shit sells like hotcakes.
Also the first example (jumping out of plane with no parachute at all) is perfectly legal.
Very respectfully, as pre-teen at the time, I recognized that there was no real reason for going from 9/11 to Afghanistan or Iraq... based on my then daily reading of NYT. And I am sure there were opinion articles in that same paper that said we were rushing towards something that demanded deeper reflection.
Fundamentally, I don't think the job of a newspaper is to think for us.
All the absurdities of that time were, in fact, news. What wasn't present at the time was a link to justify the inane war we began. And that link is still absent, which we are all collectively realizing.
If you need nic, snus is by far the best for you.
It boils down to an obvious disparity in the standard of proof they demand for "pet" topics versus what they need for everything else. You can do this kind of ultra-nitpicky "rational inquiry" to undermine anything you don't like. You can use it to argue against seatbelts. Or against the ban on lead paint. Was lead paint really all that bad?... and I mean, really? Are there studies? Are they high quality enough?... Double-blind? Confounding factors? Correlation or causation? Even if they look solid, I bet they contain enough errors to cast doubt. Cui bono? What was the role of the titanium dioxide lobby in all this?
For nicotine specifically, I've been around enough people seriously addicted to nicotine to just roll my eyes at this stuff. I had things thrown at me by a visibly jittery relative when I refused to smuggle cigarettes into a hospital. Do I have a published double-blind study showing that it's worse than coffee? No. But again, neither do rationalists for 99% of the stuff they believe in.
Do I think that vapes are a noteworthy problem to be focusing on? Maybe not, but public policy is always to some extent vibe-based. And the harm of being too heavy-handed on vapes is really not something that keeps me up at night.
On a deeper level you have several interested parties (vaping companies, tobacco companies, public health interests that get funding for whatever reasons) that stand to lose or gain alot of money depending on how it's regulated.
Or you you might even have politicians looking for donations from the people that are selling vapes or more likely, politicians that are seeing a potential new tax revenue source and our feeling out the level of opposition or support for it.
I don't think the NYTs goes for scare stories for the most part.
anyhow, as other people and myself said already, the metal never gets hot enough to incandesce, not even remotely close!
The coil becomes brittle from interacting with the liquid and usually breaks contact when refilling or if dropped. what actually happens is the wick goes bad or burns, and won't "wet" the coil anymore; or you use an e-liquid/e-juice with a lot of sweeteners and the coil gets caked with burnt sweetener and can't fire anymore.
But that's if you're negligent with a DIY or "hand wound" or "drip" vape, where you're using the same coil for a very long time (weeks, depending), and it depends on the liquid, the liquids that taste/smell like bakery/confections absolutely cover coils with gunk that you have to remove the wadding (usually cotton or silicone wicking material, unbleached), and do a dry-fire to burn all the junk off. This smells awful and i usually did it by hanging the thing out a car window and firing it just so i didn't have to smell it. I personally used specialty "wire" that's real thin wire that's twisted to make it thicker, both to make it handle more heat (lower resistance means more voltage can be put in) and last longer, due to less heat stress. 90% of the time when a coil broke for me, it broke where the coil connects to the leg that goes to the terminal block, and rarely the leg would snap at the terminal block instead of the coil, and maybe 2 times the coil broke somewhere along the length. in a little over a decade of use of "rebuildable drip atomizers."
The disposable and pod-based vapes don't have any of these issues because say 9000-18000 "puffs" of 0.5s or longer and you're supposed to dispose of it. With one of the RJR or PMJ vape brands, they're not refillable, so you just throw the pod away; with the "bar" vapes, you throw the whole bar, battery and all, in the trash.
I really advocate for the "refillable pod" and "drip" or "drip tank" vapes, just from an ecological standpoint. Uwell, VodPod(stylized and possibly spelled 'voopoo') make decent pod-based ones, where the device, a pack of 2 pods, and a bottle of e-liquid to fill it with cost about the same as a Vuze device and a 6-pack of pods for the Vuze. And if you're a "heavy user" a 6 pack is < 1 week of vaping; so hands down doing it with your own device and liquid is cheaper, for sure. additionally there's a difference between "mouth to lung" and "Direct to lung" vape devices/pods. MTL is like a cigarette, you draw into your mouth, then inhale into your lungs. DTL is like a hookah or bong, you "breathe" in through the device. I used to prefer DTL but i use MTL now. the vuze and other tiny pod disposable vapes are Mouth to Lung devices.
TL;dr: No. Generally the disposable ones from the two big tobacco companies are "safe" given the GP and your queries. the "bar" ones, like "elf bar" or whatever, i am not sure. There's been QC issues and other reported problems with that type, but they're generally <18000 "puffs" and that, in my opinion that borders on being "dumb". The big vapes you see people using? those are probably safer than even the RJR/PMJ ones, unless the tank is metal. Then you can't be sure, that's up to the user!
Note: the closest thing to vaping prior to vaping was a hookah vis-à-vis nicotine, and a nebulizer, vis-à-vis vaporizing "drugs." They even make things that vaporize marijuana, straight from a grinder, these days. But heating something to create a vapor to inhale isn't "new"!
In fact, the first "e-cig" i ever saw was used by a friend in 2009 or so, and he said it was sold as an "Portable Electronic Hookah". It was a DTL device, with a tank and replaceable wick/coil "cartridge". Most DTL are "replaceable cartridge coil/wick" tanks, and most MTL are "pods"
Meth, with varying levels of fentanyl adulteration, you can get delivered or buy from the street corner, depending on your neighborhood. From where I am, I'd estimate about 10 minutes to get a hold of the meth; 20 minutes to get a hold of any vape; and Juul probably an hour (place in Daly City sells them; I'd have to drive).
Vaping is (compared to actually smoking tabacco) definitely harm reduction and significantly less harmful (which doesn't mean its healthy and you should do it). Yet it is treated like smoking cigarettes by law. For example in Germany you have to pay tabacco tax on the base liquid (which doesn't even contain nicotine) if it is intended to be used in a vape (17 cents per milliliter) which increased the price of the base liquid from around 10€ to 170€. But the base liquid only consists of two things (propylene glycol and glycerol) and both those substances you can by cheaply in a vet doctors online shop for maybe 5€ each liter. It's ridiculous.
"7 countries in 5 years; Iraq Syria Lebanon Libya Somalia Sudan and finishing off with Iran"
well here we are 25 years later finally getting around to that last one...
and if you’d only read the first headlines on the frontpage during that time?
or…less?
Like the majority of voters?
In other words, uninitialized intellectuals are just plebs with a degree or browse HN or worse reddit. They become nice "mouth pieces" for the businesses to mobilize the masses in the name of "science" or "social justice".
Could you point out to some examples? Is there any "rational inquiry" that shows a worldview bias from the rationalists, in your opinion?
I agree that the broader smarty-pants community may have this issue, just curious to read your examples.
I think this nicely pointed out in "The Big Bang Theory", where Sheldon Cooper says something like "If I would be wrong, don't you think I would know about it?" That sounds like something Elmo M would say with a serious face.
I wasn't voting as a 12 year-old!
> and if you’d only read the first headlines on the frontpage during that time?
But I was reading the entirety of the articles :-)
In this case, for example, I doubt that Gwern is seeking to mislead, but I have heard (hearsay, I know) that there are people who read this, start vaping, and legitimately end up with nicotine additions from much worse stuff. Sure, there's nothing false said here, but you can definitely say only true things about vapes and neglect to mention that your readers of this have ended up more likely to die of lung cancer than they might have had you not published this. I think someone who was truly rationalist would find that in itself an interesting topic of conversation but it seems to rarely come up that being super pedantic often leads to negative outcomes because presumably this would make them shine a mirror at themselves in a way that they are almost intentionally incapable of discussing.
anyhow, i buy juice now, too, but mine was better. I never used sweeteners. My current go-to is Naked Euro Gold 12mg, but i am on the hunt for a 25ml nicotine salt version of a similar flavor. (nicotine salt vs freebase nicotine, salt is more "mellow" and lets you put a higher concentration in, which translates directly to less use, as you're satiated much faster.)
My point was: that’s how they get away with manufactured consent.
Technically they reported on every nuance: but on page G8 lol
An exercise in spotting agenda journalism: dissecting a 2022 New York Times article on teen vaping sentence by sentence to show how it pins an EVALI hospitalization on legal nicotine vapes while never quite saying so—since the actual cause was illegal THC products. Every misleading sentence is technically true.
The 2019–2020 EVALI lung injury crisis was caused by illicit THC vapes adulterated with vitamin E acetate, but it became a public justification for restrictions on legal nicotine vaping.
This essay looks at a 2022 New York Times article about teenage vaping which juxtaposes synthetic nicotine, flavored vapes, Lizzie Burgess’s hospitalization, and nicotine addiction without ever quite saying that legal flavored nicotine vapes caused her lung injury.
Sentence by sentence, the article’s misleading effect comes from technically true phrasing: “vaping”, “vaping THC and nicotine”, “vaping-related lung injury”, and post-hoc narrative order.
The case is a useful example because the ground truth is clear, the article was high-profile and edited, and the manipulation is grammatical and selection rather than simple falsehoods.
The 2019 nicotine vaping moral panic was one of the more striking ones of our era, where illegal black-market THC marijuana vapes poisoned with vitamin E acetate that caused severe “EVALI” lung injuries were a major justification for unprecedented bans on legal nicotine vaping products. Despite no lab-verified instance of a nicotine product with the vitamin E acetate adulteration (only THC products), and nicotine vapes produced by large businesses which had sold countless billions of doses to millions of people beforehand, with no EVALI epidemic before (or since) 2019–2020, and the phenomenon subsiding after lawsuits and prosecutions of vitamin E acetate sellers, it somehow became common knowledge that nicotine vapes were deadly.
How did this happen?
One way it happened was via a conflation of THC and nicotine vaping, driven in part by inaccurate reporting by victims and by the difficulty of proving a negative—after all, any given case could have been due to nicotine vaping, somehow, how would one prove it wasn’t? This was then amplified by activists and journalists working together to palter, by selectively reporting and describing true facts. (I call this strategy “paltering” as phrases like “propaganda” or “sins of omission” do not capture this phenomenon.)
I was particularly struck by an instance in the New York Times in March 2022, which paints a compelling picture of legal nicotine vapes causing severe lung problems in one young woman, Lizzie Burgess:
This article appears to have been successful in persuading readers. In the NYT comment section (mirrored below in full), most comments agreed with the article, often going as far as to claim that “addict and kill people—including children”/“here they are exploiting a legal loophole to addict millions more young adults to their lethal products” or “Young people especially become easily addicted to the nicotine…The damage to their lungs resembles the worst pneumonia you can get and still be alive.” or “The purveyors of these drug delivery systems are killing our children with intent. They should all be thrown in jail, and the import of these products should be banned.” (The import of THC vapes contaminated with vitamin E acetate is, of course, already banned or adult ID required etc.) Indeed, only a single NYT commenter (who no one responded to) appeared to get it right in their reply a quarter down the comment section:
The illness described in the article was clearly caused by using an adulterated, illegal, THC-containing vaping product, not the nicotine-based e-cigarettes being criticized here. That should have been made clearer.
The article might have convinced me too if I hadn’t already known better.
The NYT has always been my favorite newspaper, even as a kid using money from my part-time job to subscribe to the Sunday Times1, and I was perplexed why it would lie like that, as the article clearly said repeatedly that nicotine vaping was to blame.
I had thought that it was now uncontroversial and consensus that the moral panic had framed nicotine vaping (albeit unpopular to acknowledge now that the ‘issue-attention cycle’ had moved on and the activists gotten what they wanted). Was it just wrong, or had I misunderstood something? Perhaps I had skimmed over a smoking gun, like finally finding fatal levels of vitamin E acetate in lab testing of a Juul pod, there or elsewhere?
So I went back to excerpt the article—and while rereading, realized that in every case I thought might be a lie, rereading showed it had been so carefully worded as to be technically correct and to simply be misleading.
After this, I was in awe of the rare artistry of the piece, which elevated it from merely misleading to a wonderful example of “bounded distrust” (cf. “no evidence”) in journalism and how selective quotation and mere juxtaposition can lead astray the insufficiently skeptical reader.
It’s a great example because it is:
A controversy with a ground-truth objective answer, known then, and even more clearly confirmed by years of followup:
The sudden EVALI vitamin E acetate crisis, which lead to a sudden spike in severe lung problems across the USA in 2019–2020, was caused by adulterated THC products. There is no hard lab-tested evidence that any legal nicotine products, the subject of the article, had vitamin E acetate contamination. The general removal of vitamin E acetate from THC products was followed by the crisis subsiding, even as legal nicotine vaping remained extremely widespread.
Longform (~1,800 words) high-profile piece in one of the most prestigious newspapers in the world:
meaning that it passed editing and fact-checking
Purely textual/grammatical:
phrases like “vaping products” or “vaping THC and nicotine” are suspiciously worded and violate ordinary norms of writing to be specific and informative—if a young woman has been hospitalized by a nicotine vaping product, why not say just so? If vitamin E acetate had been found in legal nicotine vaping products, why not just name the test result and product specifically?
Unnecessary to the core of the article:
it would be possible to write this story without bringing in irrelevant THC-contaminated EVALI anecdotes, by focusing on legitimate criticisms of nicotine vaping. (You could discuss teen access, flavor marketing, age checks, FDA jurisdiction, statutory drafting, the economics of disposable devices, and the adult harm-reduction case without ever mentioning vitamin E-caused EVALI which you know is not related to teen access to legal anything.)
Deliberate: the phrasing is so consistently and carefully done that the author almost certainly knew what they were doing—if they hadn’t, they would have slipped up at least once, and joined two sentences with a comma, or some other easy writing mistake which would have been incorrect.
Well done: often, paltering requires highly unnatural ‘lawyer-ese’ phrasing to be misleading but still technically correct. This kind is inherently unconvincing because people can sense and distrust it, even if they can’t verbalize their unease
I kept thinking about what a great example it was and that at some point I should fisk it. Finally, I did.
The article’s misleading chain of logic is synthetic nicotine → vaping flavors → “vaping-related lung injury” → Lizzie Burgess; and in an anecdote demonstrating this: “flavored vapes” → “vaping THC and using a device” → “vaping-related lung injury” → “nicotine addiction” → ban “flavored vapes”.
But nowhere does it say anything like:
Her lung injury was caused by legal flavored nicotine vapes.
It is always ‘vaping caused lung injury’ (true! vaping THC products did) or ‘vaping THC and nicotine’ (the ‘and’ does a lot of work there), or juxtaposition like ‘she was soon in the ICU…She’s struggled to end her nicotine addiction’.
It just carefully arranges the sequence of facts to encourage the ordinary causal inference of post hoc ergo propter hoc, downplaying or omitting the THC, while using supersets like ‘vaping’ or ‘vaping THC and nicotine’ so the article technically contains the relevant information (the informed reader would interpret this correctly as Lizzie Burgess having almost surely been hospitalized by the THC vaping, but the ordinary reader has already been led down the wrong path—and confirmation bias does the rest).
It serves as a good exercise for the reader: how do you handle science journalism like this, where the author is not careless or egregiously lying, but where the author appears to know exactly where the line is and never quite crosses it? Or readers who ask only, “is each sentence technically true and lets me believe what I want to believe?” Would you have noticed the suspiciously specific wording, or the omission of how it never quite says, despite its length, a simple statement like “nicotine vapes caused all EVALI”? Or the implied (and falsified) predictions like “the EVALI crisis spike will continue until legal vaping products are fully banned”? Or would you have fallen for a good Narrative?
Below are some key excerpts, with weasel words or rhetoric highlighted in bold:
Scientists are just beginning to look at the unknown health impacts of new, tobacco-free nicotine products, even as research is expanding into the harmful effects of vaping and its flavor ingredients.
…Scientists are just beginning to study the unknown health effects of synthetic nicotine, even as research is expanding into the harm caused by vaping and flavor ingredients alongside continuing cases of devastating vaping-related lung injury. To many public health advocates, new trends in the vaping industry are thwarting the FDA’s efforts to protect a new generation from nicotine addiction.
…FDA enforcement actions have had little effect on Lizzie Burgess’s ability to get vapes over the last 4 years. “I think the FDA should take it all off the market now”, she said.
…Vaping is still popular among teenagers. Rani Dhiman, 16, said it is highly visible in the bathrooms and stairwells of her high school in the Detroit suburbs.
…She said the stress and loneliness of the pandemic might have been a trigger for some teenagers to start. It’s also portrayed glamorously, she pointed out, in “Euphoria”, a popular HBO series about a teenager kicking drug addiction.
…The FDA’s efforts to limit teenagers’ access to flavored vapes had little effect on Lizzie Burgess’s ability to get them over the last 4 years in the Indianapolis suburbs. Within weeks of starting to vape at 16, she said, she was addicted. There was always a gas station, older friend or website selling e-cigarettes in flavors like banana ice cream or sour apple, she said.
…At 19, she said, she was vaping THC and using a device—now advertising tobacco-free nicotine—that has as much nicotine as two packs of cigarettes, every 2–3 days. She said she fell ill with what started like a cold, which progressed to rapid breathing, almost-gray lips and feeling depleted. By the time she went to the emergency room, her oxygen saturation was 67, far below the normal range of 95 or higher. Burgess said she was soon in the ICU with vaping-related lung injury.
[photo of young woman in ICU with face covered by a medical ventilation mask]
[Burgess in the ICU last year. When she arrived at the hospital, her oxygen saturation was 67, far below the normal range of 95 or higher. Credit: Lizzie Burgess]
[X-ray scan of two pairs of lungs. Top: “Liz’s Lungs”, off-color and shrunken. Bottom: “Healthy Lungs”, white and large.]
…She’s struggled to end her nicotine addiction and is down to two cigarettes a day.
…“I think the FDA should take it all off the market now”, Burgess said of the flavored vapes. “I think it will be very very hard for them to reel it all in. It’s so big and there are so many companies now.”
…[Sales data] released by the CDC Foundation shows that since the FDA stepped up e-cigarette enforcement in February 2020, sales of disposable fruit-flavored and candy-flavored devices have grown by 290%, to 6.46 million devices a month by November 2021. Sales of the FDA-targeted flavored pod and cartridge devices have nearly vanished.
…The unregulated vaping market at this point is a problem of the FDA’s making, said Gregory Conley, president of the American Vaping Association, an industry trade group. He said the agency fueled the problem by over-regulating a product used by millions of adults who find vaping a safer alternative to smoking.
…“This country should learn some lessons from past prohibitions that failed miserably”, Conley said. “If you don’t fairly regulate a market where there is a great deal of demand from legal adults, you will fuel gray and black markets where the operators are not concerned with checking IDs before selling.”
…Recent research has focused in on the chemicals used to simulate butter, which is linked to lung damage, and vanilla, which is associated with birth defects in zebrafish.
By Christina Jewett
March 8, 2022
[image of assorted vaping products on a white table]
Scientists are just beginning to look at the unknown health impacts of new, tobacco-free nicotine products, even as research is expanding into the harmful effects of vaping and its flavor ingredients.
The Food and Drug Administration’s crackdown on flavored e-cigarettes in 2020 was meant to be a comprehensive, aggressive strategy to curtail the epidemic of teenage vaping.
But two years later, sales of disposable, flavored e-cigarettes have soared. Some companies have moved just beyond the reach of the FDA by swapping out one key ingredient. They have circumvented federal oversight of tobacco plant-derived nicotine by using an unregulated synthetic version.
The agency had nearly wiped out the use of flavors in devices like Juul, once the teenage favorite, that could be refilled with pods in flavors like creme brûlée and mango. Jumping into the breach, though, companies like the teen favorite Puff Bar are selling disposable devices filled with candy flavors and tobacco-free or synthetic nicotine.
Scientists are just beginning to study the unknown health effects of synthetic nicotine, even as research is expanding into the harm caused by vaping and flavor ingredients alongside continuing cases of devastating vaping-related lung injury. To many public health advocates, new trends in the vaping industry are thwarting the FDA’s efforts to protect a new generation from nicotine addiction.
“These companies like Puff Bar and others are deliberately driving their trucks of poison through this huge loophole”, said Meredith Berkman, a founder of Parents Against Vaping E-Cigs. She recently hosted a webinar about synthetic nicotine attended by 700 people. “We think we need to regulate these products.”
Lawmakers on Tuesday proposed language that they want inserted in the Congressional omnibus budget bill that would give the FDA authority to regulate synthetic nicotine, although it is unclear if the issue will be included in the final bill.
Representative Frank Pallone Junior Democrat of New Jersey and chairman of the House Energy and Commerce Committee, said the provision would be a public health victory over “bad actors” who circumvented the FDA’s authority.
“That ends with passage of this bill, which will close this loophole and clarify FDA’s authority to regulate all tobacco products, including those containing synthetic nicotine”, Pallone said in a statement on Tuesday.
Sales of synthetic or tobacco-free nicotine went from virtually nonexistent in 2020 to taking up shelf space in 2⁄3rds of US vape shops in 2021, according to market research. Those stores said such products accounted for nearly 20% of sales, according to ECigIntelligence, which surveys hundreds of the shops each year. The company projected that the US vape market, web sales included, would be nearly $6 billion this year.
FDA enforcement actions have had little effect on Lizzie Burgess’s ability to get vapes over the last 4 years. “I think the FDA should take it all off the market now”, she said.
[Photo of young white woman in a bomber jacket and jeans, looking sad.]
[Credit: Lee Klafczynski for The New York Times]
Federal officials have been in a cat-and-mouse game with some e-cigarette makers. Spurred by a court order, the FDA forced thousands of e-cigarette companies, including Juul, to apply in 2020 for authorization to remain on the market. With the agency focused on the most popular devices, like Juul’s, that used insertable cartridges, makers of disposable vape pens in flavors like gummy bear and candy cane flooded the market. The agency then responded with a stern warning and even product seizures aimed at some of those companies, including Puff Bar.
By late last year, more than a million tobacco-sales applications had been denied. Applications to remain on the market by Juul and myriad other companies are pending.
By early 2021, Puff Bar returned to the market with “tobacco-free” or synthetic nicotine that didn’t fall under FDA oversight, loaded with the fruity flavors prohibited in vapes with tobacco-based nicotine. Other companies imported similar devices containing synthetic or tobacco-free nicotine from factories in Shenzhen, China, according to industry experts.
Patrick Beltran, who has identified himself in news reports as one of two executives of Puff Bar, did not respond to requests for comment.
Sales data released by the CDC Foundation shows that since the FDA stepped up e-cigarette enforcement in February 2020, sales of disposable fruit & candy-flavored devices have grown by 290%, to 6.46 million devices a month by November 2021. Sales of the FDA-targeted flavored pod and cartridge devices have nearly vanished.
Since early 2020, overall e-cigarette sales are up nearly 50% to about 22 million units per month, according to Information Resources, a data tracking consultant. The National Youth Tobacco Survey conducted in early 2021, when many students were learning via Zoom, reported that, overall, about 11% of high school students used e-cigarettes.
New e-cigarette suppliers can go into business easily: They contract with a manufacturer in China, set up a website and get space in a warehouse to store and ship devices, said Samantha Shusterman, a senior counsel supervising e-cigarette enforcement for the Massachusetts attorney general’s office. They use shell companies and can quickly withdraw the profits if they face scrutiny.
“It’s a whack-a-mole situation”, said Shusterman, whose state banned all flavored e-cigarettes, except in licensed smoking bars. “They’re not following any of the laws.”
Mitch Zeller, director of the FDA’s Center for Tobacco Products, said the agency recognized the problem.
“Disposable e-cigarettes made only with synthetic nicotine pose a particular challenge for the FDA when it comes to our tobacco authorities”, Zeller said in an email. “The FDA is actively investigating this issue and considering how to best address such products.”
[photo of young woman in ICU with face covered by a medical ventilation mask]
[Burgess in the ICU last year. When she arrived at the hospital, her oxygen saturation was 67, far below the normal range of 95 or higher. Credit: Lizzie Burgess]
[X-ray scan of two pairs of lungs. Top: “Liz’s Lungs”, off-color and shrunken. Bottom: “Healthy Lungs”, white and large.]
[A scan of Burgess’s lungs, top, compared with healthy lungs. Credit: Lizzie Burgess]
Vaping is still popular among teenagers. Rani Dhiman, 16, said it is highly visible in the bathrooms and stairwells of her high school in the Detroit suburbs.
She said the stress and loneliness of the pandemic might have been a trigger for some teenagers to start. It’s also portrayed glamorously, she pointed out, in Euphoria, a popular HBO series about a teenager kicking drug addiction.
“Sometimes so many people are vaping in the bathrooms, it’s hard to do anything about it”, Dhiman said, adding that she doesn’t vape.
The FDA’s efforts to limit teenagers’ access to flavored vapes had little effect on Lizzie Burgess’s ability to get them over the last 4 years in the Indianapolis suburbs. Within weeks of starting to vape at 16, she said, she was addicted. There was always a gas station, older friend or website selling e-cigarettes in flavors like banana ice cream or sour apple, she said.
At 19, she said, she was vaping THC and using a device—now advertising tobacco-free nicotine—that has as much nicotine as two packs of cigarettes, every 2–3 days. She said she fell ill with what started like a cold, which progressed to rapid breathing, almost-gray lips and feeling depleted. By the time she went to the emergency room, her oxygen saturation was 67, far below the normal range of 95 or higher. Burgess said she was soon in the ICU with vaping-related lung injury.
She’s struggled to end her nicotine addiction and is down to two cigarettes a day.
“I think the FDA should take it all off the market now”, Burgess said of the flavored vapes. “I think it will be very very hard for them to reel it all in. It’s so big and there are so many companies now.”
Synthetic nicotine remains far more expensive than the tobacco-derived product, leading some industry experts to question whether a device label of “synthetic” is accurate.
The unregulated vaping market at this point is a problem of the FDA’s making, said Gregory Conley, president of the American Vaping Association, an industry trade group. He said the agency fueled the problem by over-regulating a product used by millions of adults who find vaping a safer alternative to smoking.
“This country should learn some lessons from past prohibitions that failed miserably”, Conley said. “If you don’t fairly regulate a market where there is a great deal of demand from legal adults, you will fuel gray and black markets where the operators are not concerned with checking IDs before selling.”
[Photo of professorial old white man sitting on desk]
[Dr. Robert Jackler of Stanford University created a “synthetic teenager” named Joe, who used gift cards to buy flavored synthetic nicotine products online and have them shipped. Credit: Ian C. Bates for The New York Times]
Dr. Robert Jackler, who studies tobacco company advertising at Stanford University, has also noted major tobacco retailers entering the synthetic nicotine market with flavored gums called “pouches.” He said his tobacco research group could pose as a teenager and use gift cards to easily buy the flavored synthetic nicotine gums from major retailers and have them shipped to a home in California.
“When we buy them, there’s no age gating”, Dr. Jackler said.
The loopholes are many with synthetic nicotine, he said, allowing the products to avoid hefty tobacco taxes and remain affordable and to evade the algorithms that online retailers use to weed out underage sales of tobacco products. The ease of purchasing was also concerning, Dr. Jackler said, given how little is known about the health effects of flavored, synthetic nicotine.
Recent research has focused in on the chemicals used to simulate butter, which is linked to lung damage, and vanilla, which is associated with birth defects in zebrafish.
Dr. Sven-Eric Jordt, an associate professor at Duke University who has studied synthetic nicotine, said it posed many unknowns.
About 99% of tobacco-derived nicotine is a psychoactive molecule called S-nicotine, he said. But a mirror-image molecule, known as R-nicotine, makes up 50% of most types of synthetic nicotine. He said the R-nicotine molecule appears to be less addictive, but very little research has been done on it in animals or humans.
“It could alter nerve transmission in the brain in different ways from classic nicotine”, Dr. Jordt said, “but we don’t understand that at this time.”