"I vape e-cigs and they're vastly safer"

While likely and hopefully true, we have little current appreciation as to what "safer" actually means. Thankfully, the e-cig is beginning to force research into health risks associated with cleaner forms of nicotine delivery.

The problem is that, as with cigarettes which doctors in advertisements once suggested were safe, it may take decades before enough of the vaping risk spectrum becomes known, clear, and reliable enough to allow informed decision-making regarding continued use.

Reserving the right to amend as quality risk data becomes available, contrasting long-term smoking to long-term vaping is akin to the risk of jumping from the top of a 5 story building (smoking) versus one that's 2 stories (vaping). Alternatively, imagine an automobile traveling 50 miles-per-hour (80 kph) being driven into a brick wall (cigarette smoking), compared to the same collision at 20 mph or 30 kph (e-cig vaping).

Obviously, contrasting the body's sudden deceleration tolerance to hourly lifetime chemical assaults is night and day. Still, the average long-term e-cig user would be wise to fully expect to sustain harm. They need to vape believing that they will eventually develop one or more vaping related diseases, with some as yet unknown and hopefully very low percentage paying the ultimate price, premature death.

Contrast that to nearly all lifetime smokers developing smoking-related diseases, with roughly half failing to survive the above building fall or collision.

We're now watching as e-cig industry marketing takes as its starting point and builds upon decades of pharmaceutical industry marketing, advertising which continues to falsely imply that quitting without the use of approved products is nearly impossible.

Putting risk, disease, and death aside for a moment, ask yourself, why is nicotine delivery device transfer even necessary?

The underlying and unstated foundation of every e-cigarette advertisement is that you're hopelessly hooked, that you cannot quit, that it's simply too hard, that you're a failure, that a much safer alternative is available, so you should give up on giving up.

Now, now, I hear some of you. "John, you're totally missing the fact that vaping is fantastic!" Respectfully, I'm afraid that's the drug talking.

While clearly, there's no more deadly nicotine delivery device than analog cigarettes, fully arresting your addiction is vastly more do-able[1] and astonishingly more comfortable than your wanting for that next fix will suggest.

As reviewed in Chapter 1, nicotine addiction is a brain wanting disorder.[2] Nearly as unimaginable as giving up food, compromised dopamine pathways have assigned nicotine use the same priority as those pathways assign to eating food.[3]

According to Dr. Nora Volkow, director of the National Institute on Drug Abuse, nicotine addiction is a mental illness, a complex brain disease characterized by compulsive drug craving, seeking, and use.[4]

Not only is nicotine compromised brain circuitry functioning as though nicotine is as crucial to survival as food, neo-nicotine industry marketing and advertising takes direct aim at wanting being generated inside a malfunctioning brain.

By June 2000, the cig industry became aware that replacement nicotine (NRT) undermines successful quitting. By then, it had in its hands a 200 page U.S. government "Guideline" containing evidence tables that combined and averaged the results from hundreds of different "smoking" cessation studies.[5] Those tables shout that over-the-counter NRT is substantially less effective at 6 months than nearly all controls shared in all other study areas (7% vs. 10-11%).[6]

By now, new e-cigarette companies have awakened to the reality that successful cold turkey nicotine cessation threatens their future profits too, that frustrations born of highly ineffective quitting product attempts increase the likelihood of e-cigarette use. Sadly, it's a win-win for everyone but the addict.

Reality is, the tail has been wagging the dog. Only a tiny fraction of successful ex-smokers stopped smoking by using approved products (roughly 8 percent).[7]

Which is wiser, harm reduction or harm elimination?

Nicotine is a natural insecticide.[8] Anyone believing that addiction to inhaling a vaporized poison doesn't generate a host of serious health risks is residing in la la land.

Although nicotine is not believed to cause cancer, animal studies have implicated it in contributing to cancer promotion,[9](including promotion of: breast cancer,[10] cervical cancer,[11] colon cancer,[12] esophageal cancer,[13] kidney cancer,[14] lung cancer,[15] lung cancer via cotinine,[16] oral cancer,[17] pancreatic cancer,[18] stomach cancer[19] and stem cell cancer).[20]

Nicotine is also believed to contribute to circulatory disease,[21] kidney disease and diabetes,[22] decreased sperm counts with DNA damage in men,[23] impaired follicular growth in women,[24] fetal harm,[25] (chromosome damage,[26] attention deficits,[27] impaired lung development,[28] asthma,[29] and impaired offspring ovarian function and fertility)[30] and in causing sudden infant death.[31]

On an emotional level, nicotine addicts live with greater anxiety[32], including stress-induced urine acidification accelerating elimination of the alkaloid nicotine, adding the onset of early withdrawal to stressful situations.[33]

While vaping is clearly safer than smoking, e-cig users deserve warning that they're acting as human guinea pigs.

For example, we know that it takes up to 10 years after ending cigarette use to reduce lung cancer risks by 30 to 50%.[34] What we don't know is the long-term consequences of inhaling vaporized nicotine into lungs and a body already damaged by years of smoking.

The cost of e-cig use promises to rise. While use costs are currently less expensive than smoking, the tobacco industry should be expected to continue to purchase major e-cig companies, in part to protect profits.

Expect both the tobacco and their pharmaceutical industry buddies to demand government regulation of e-cigarettes, nicotine e-juice, and canisters in order to limit competition, slow innovation and to protect existing product lines and profits.

Also expect concerns over e-cig use by youth and illegal drug users (already THC juice is being vaped without smell) to motivate governments to either ban their sale, limit availability or impose sufficient excise taxes to raise prices high enough to discourage use by kids.

The good news is that current pen-type e-cigs are extremely inefficient at nicotine delivery without instruction or practice. Like trying to drink through a straw, they must be primed like a pump. Thus, most kids are able to experiment once or twice without getting hooked. The bad news is that technology (evolving tanks and mods) is a problem solver.

As for you, let's not kid ourselves. E-cig use is not about freedom but about keeping you hooked. It's not about arresting your dependence but about the novelty of using electricity and vapor to feed it.

What would it feel like to journey home, to begin going entire days without once thinking about wanting to use?

Those pushing e-cigs continue to insist on creating confusion. They co-opted the word "quitting" in describing nicotine dependency delivery device substitution, transfer and replacement. Real quitting doesn't involve handing the neo-nicotine industry our money.

In closing, sleep on this. If e-cigs do in fact greatly diminish smoking's premature death risks, if successful in transferring to them, once ready to end e-cig use, what remaining motivation would be sufficient to keep you focused and dedicated long enough to arrive here on Easy Street?

On the positive side, obviously, you'd live longer, but longer as an hourly feeding addict.

There was always only one rule, that we cannot cheat a brain that's already been permanently compromised by nicotine. Like the alcoholic, when trying to break free, just one puff and we lose. The choice is ours: none or all, freedom or feed-em!