Vape stores are the new Stop Smoking Services

Well, according to ‘science’ vape store owners and their staff members are likely to be far more effective and have more health information for current and potential new vapor product users.

Even more amusingly, our sociologist Simone Clapman who we all know can’t truly understand the science behind vapor products had this to say:

Chapman

 

The poor benighted fool, he’s been so anti-ecig that he blocks anyone on Twitter that disagrees with his anti-ecig stance, or if you mention wind farms. No, just no. I am not going there. Yet. Let’s get back to Simone’s quoted study shall we?

Electronic cigarettes are most often used by current and former adult smokers to help them reduce or quit smoking. How electronic cigarette use will impact health has yet to be determined.

Well yes, this we already knew. Next.

Vaping may extend nicotine addiction in smokers trying to quit or provide a mechanism for non-smokers to develop a nicotine addiction, thus re-establishing a social norm of smoking.

Really? We all know that there is no such thing as nicotine addiction nor is there such a thing as the “re-normalistion of smoking”. But these two paragraphs give me an idea of what to expect from the study author for the conclusion. It is pretty clear that the author already has some strong pre-conceptions when it comes to vaping and vapor products, especially when they write “It is also not known if vaping promotes cigarette use in adolescents and young adults”. As in the ludicrously debunked gateway theory. So much skewing and before the main course of methods or discussion.

AwarenessOf course awareness has increased, who do you think has been doing the most “promotion” in Australia ? It certainly isn’t the vendors or the users, at least not those within borders. Most of the “information” surrounding vapor products is actually coming from the tobacco control folks.

Oh, don’t forget if a smoker even sees an ad for a vapor product, that smoker will be more inclined to try it, that is a good thing! Harm reduction folks, right there and this is what you crazies in Australia and everywhere else are trying to ban! What is actually a little worrying is the following statement:

As a result, the growing body of research shows that most e-cigarette users felt that vaping was less harmful to their own health and the health of others than smoking.

PerceptionThe tone of that sentence to me reads as “Despite our best efforts to demonise these things, folk still believe they are less harmful”. We know from a whole host of research that vaping is substantially safer than smoking, and there is also evidence of harm reversal in some cases. So why in Seven Hells does that one sentence read so badly?

In fact, the whole paragraph reads as though the authors are trying to say how bad vapor products are because smokers may be more inclined to give them a try given a whiff of a suggestion that they are better/healthier/safer than smoking. Really does beggar belief.

So what did these researchers actually do?

Interview questions were developed based on prior observations in vapor stores and through conversations with vapor store staff and current vapor users.

So not a study then. These researchers conducted Q&A sessions with vape store staff and users. Stores were found using a little bit of Google-Fu and 64 were chosen, but only 44 agreed to participate.

Starting off with a phone call and followed up by a 1 or 2 person “research team” to talk to the store owner in a face to face interview, or if the owner did not have “extensive contact with customers” the general manager of the store was interviewed instead.

The general theme of the discussions were along the lines of:

  • Beliefs about vaping
  • Safety
  • Health Impacts

Pretty broad terms there. I mean “beliefs about vaping” can cover pretty much anything from public perception to perceived nicotine effects. In a way I feel a little bit sorry for the interviewees as they had to put up with this for an hour. It’d be interesting if any of those interviewees read this, if you do please drop me a note with the types of questions you were specifically asked!

StoreLocale

I’m sure there is some kind of point to characterising the store locations, possibly so these surly researchers can go on to claim that outlying stores are less informed due to some random factor that they’ll dream up one drunken night. It’s all about that next “study”!

The author has kindly broken down a collection of responses in the survey for me, which makes my life even easier:

Information about vaping

Here the author classifies vapor store owners described their attempts to learn more about electronic cigarettes and vaping. Most owners reported learning about vaping from the internet. As with any information, the vast majority of information on vaping is internet based.  Sure you can get brochures and leaflets from outlet stores and Government buildings and so forth, but frankly those methods of disseminating information often contain old or useless information, often with a web address with a note along the lines of “for more information, check out this site” *facepalm*

Some of the owners/managers responses are, shall we say a little thin?

  • they have websites that can help you and YouTube videos, stuff like that; that can kind of help teach you
  • there are a lot of [e-liquid] recipes online.
  • Everybody on Facebook thinks they know the best. A lot of it, the problem is choosing what to believe and what not to. Facebook is possibly the worst place to go for information and that’s where most people are getting it
  • The EC [Electronic Cigarette] Forums that I’ve been getting on my, on my phone I just filled out a deal saying I would like to be informed about you know everything that comes out so when that pops up on my computer or iPad or phone I just read the material.

CASAA gets a mention or two with store owners stating that it is a good resource (well it is!) for information, “they have information on tests that somebody run…I find most of that is reliable and most of its done by like Drexel University or Harvard University and places like that and I don’t think that they would put their name on something that, that wasn’t truthful in my opinion but I mean you know everybody’s got their own idea of what the truth is” 

The “measurement” that the researchers used here is comparing the perceptions of the interviewee, such as feeling healthier and better, against the actual research, that seems to be a little hit and miss. User perception of anything is purely conjecture with little solid factual basis, trying to stack that perception up against factual science will end in disaster, especially when the author may have pre-conceptions of their own.

Health benefits of vaping

Owners consistently promoted messages that vaping is better than smoking.

Well yes they would and from two different stand points. The overriding one is of course, they are running a business; however that shouldn’t have much bearing in this instance because the owner is not trying to sell to the interviewer at all, which leaves the second standpoint. Facts. As we know most vape store owners are in fact vapers themselves, indeed most of them open a store to provide the same availability and service they received to their local area. They themselves have felt the benefits of vaping and simply want to encourage other smokers to make the switch.

These are some of the transcribed answers given by vape store owners to the interviewer(s)

  • Would I recommend to somebody that doesn’t vape? No, but if you are smoking, I think it is a lot better choice.
  • what I tell everybody that they come in like is this safe, I’ll tell them it’s safer than smoking cigarettes but it’s not as safe as breathing air.
  • all we are hearing about this is how dangerous these unknown vapors are when actually this is the cure for f—king cancer right here.
  • I was on the inhaler for a long time and I haven’t used it since I started vaping…it’s actually like a breathing treatment.
  • It’s just like steam in a shower.
  • And that’s really the biggest thing I like to convey to people is like it, we don’t know really how safe it is, but it is definitely safer than smoking.
  • But the main thing that I found about propylene glycol … since the 1950’s and 60’s it has been used it’s been pumped into things like ICU units as an air sanitizer … it has over 60 years’ worth of inhalation established in the medical community history that has established that component of the liquid as safe to vape, safe to inhale.

Notice just how varied the answers are? How can anyone quantify these answers other than say “generally positive”?

Vapor ingredients are safe in other things

Yes, that really is a sectional breakdown title. No doubt some of the responses prompted that. The “generally recognised as safe” statements. Here’s why:

Vapor owners linked the safety of their ingredients to their use in other products. Multiple participants also described their products as “kosher” and containing FDA approved ingredients. Owners reasoned that a safe food was a safe vape.

Look, just because I have two ingredients that are “FDA Approved” doesn’t mean that when I mix them together the resulting mix will be “FDA Approved”. Mix a squash concentrate with water for instance, the end result is completely different to the original ingredients. Let’s see what prompted this section shall we?

  • vegetable oil [referring to vegetable glycerin (VG)], people eat it every day. Why not suck it down your lungs? It don’t hurt you.
  • Propylene glycol is used in everything – drinks, candy bars I mean you breathe it every day,
  • there, there’s 2 main ingredients in it and its vegetable glycerin which is you can go to Wal-Mart and buy a big bottle of it for 2 bucks, they use it to make cake icings and stuff, it’s a sugar liquid basically, the other ones propylene glycol which is in every air freshener in the world. It’s in coffee creamer, you can pick up a coffee creamer, those MIO’s, you pick it up and one of the very first things in it, it’s a food preservative. But it also helps to atomize it so that’s why it is in all that. It’s in Febreze. It is in everything.

WowJustWow

OK people stop it right there. These are responses to questions that are going to be used against you and the best you can come up with is “Why not suck it down your lungs? It don’t hurt you”. STOP IT. There is a whole host of crap coming down around our collective heads, stop handing them the weapons.

Health impact messages and beliefs

Owners believed that vaping did not endanger people around them,

Well it doesn’t, we have strong compelling evidence that it doesn’t. It is not a belief it is a fact. But we do see some common sense here:

  • We feel like they are safe. You know we don’t know — nobody really knows. I mean nobody has come out of a study and said hey they are going to kill you or I think they would shut it down right now. Anything you take in your lungs I think you got to consider the risk. (emphasis mine)
  • As soon as I take an inhale on this, as soon as I put it into my mouth the nicotine is automatically absorbed in the mouth. There’s no nicotine in second-hand smoke, just carcinogens. And we have eliminated carcinogens in ours.
  • So there is absolutely there is no studies that have been done to prove it but I can say in my personal belief there is no second-hand smoke with the vaping it dissipates too fast. Nobody is going to get the nicotine from it because your body has already absorbed it.
  • With vapor cigarettes, all you’re doing is blowing out water vapor. It’s nothing more than going into a bathroom that has steam in it. Same thing. Same idea. You’re not hurting anybody around you. I can blow it right in your face, all you’ll smell is the watermelon that I have in it.

I’ll leave you to draw your own conclusions on that lot, but the wide variety of responses tells me once again that there is a lot of fragmentation within the industry, not everyone gives the same information when it comes to these sections. We have hard evidence on the health impacts and general information yet different people say completely different things. It may just be different interpretations of the same thing, but to me it sounds and looks wildly different.

Messages and beliefs about Nicotine

When I saw this section I groaned. Loudly. For good reason too.

Owners frequently compared nicotine to caffeine.

So far so good, research shows us that the ‘addiction’ originates more from the additives within cigarettes than nicotine on its own. This we know, and can attest to. How many of you often “forget to vape” ? Plenty I’d wager. I do hope you haven’t made a large hole in your desk yet as I haven’t listed out some of the store owners responses, see if you can spot the truly groan-worthy.

  • nicotine is safer than caffeine, most people don’t know that.
  • Nicotine is no more harmful than caffeine. It’s just what made the cigarettes addictive.
  • Right now they get most of the nicotine from vegetables and vegetable by-products: tomatoes, potatoes, asparagus, eggplant so you can actually extract all that nicotine from something other than tobacco. Once you start extracting it from tobacco that’s when you start getting all those other deadly chemicals mixed in there with it and once again you’re supporting the big tobacco companies.
  • Our nicotine does not come from tobacco plants, it comes from eggplants and eggplant actually has more nicotine in it than a tobacco plant.
  • the amount of nicotine in a exhaled vapor realistically the amount of nicotine that it would pass on to you would be somewhere in the vicinity of you having some french fries or some eggplants.

Owners did not see nicotine in e-liquid as creating another addiction. Rather a common theme heard from many owners was that smokers are actually addicted to all the other chemicals in cigarettes, not nicotine.

Despite some of the weird statements, the overall response is exactly what I expected; the additives in the cigarettes enhanced any addictiveness but nicotine on its own didn’t.

I’m almost there I promise, there’s just so much to cover in this one.

Exchanging one addictive behavior for another

I wondered when this one would crop up. We see in various comments on news stories that we vapers are just “exchanging one addiction for another”, mostly these types of comments come for the religiously anti-fun zealotry crowd. When I saw it in this survey, I’ll admit to popping an eyebrow.

Vaping still serves some of the same functions as smoking such as hand-to-mouth and other sensory motor characteristics.

The hand-to-mouth action is a big part of smoking and the whole idea behind vaping is to mimic that as much as possible in a substantially safer way. We know that there are some that view vaping as a means to fully stop smoking, including the ritualist hand-to-mouth action and that is absolutely fine. Once you start vaping you can go your own way, it is the biggest draw vaping has, the ability to fully customise the experience. Smoking tobacco simply cannot do that.

Multiple owners described an attachment to their vaporizor as a way to calm their anxiety in the absence of cigarettes.

I’ll admit, I laughed here when I saw some of the responses but then I stopped and had a good hard think about it. The level of dependence on the ritualistic motions, varies wildly from person to person. It is not outside the realm of possibility that some users view their device as some kind of physical life-line, and some may even feel anxious when they aren’t holding it. This isn’t an addiction or dependence thing at all. This may even stray into the realms of a possible mental health issue, and is in fact very serious stuff.

Many owners described vaping as a habit rather than a different addictive behavior.

  • I think one reason vaping does work for people is because of this habit. I think that’s a huge factor on why it works for people. The ritual or routine and that’s one of the things people they need that and they get that too.
  • They’re not addicted to the nicotine. Most people find they’re addicted to the habit.

Two very interesting comments that the author highlighted here. I went over addiction and habit myself in a previous post and I concluded through my ramblings that vaping is not an addictive habit; however seeing these comments has certainly made me reflect on that conclusion. I still believe that I personally am not addicted to nicotine, nor am I addicted to any particular habit. I am open to the possibility that I may indeed by dependant on the habit to an extent. Something to consider in a future post.

So what did our budding researchers conclude from their interviews?

Electronic cigarettes are growing in popularity every year, far ahead of research regarding their impacts on health and smoking behaviors. Most research on e-cigarette health messages has focused on national sources, particularly web-based media. This study showed that local vapor stores can also be a source of information and misinformation about vaping. In-store messages, paired with how owners market their product in the community, could influence what customers think about vaping and their judgments about how e-cigarettes impact their health.

Yes ‘Big Vapor’ is light years ahead of research because the scientific community is too damn slow. Any new product innovates at a substantial pace, we saw that in the development and innovation of computing and cellular technologies and we are seeing it in the vaping industry too. Eventually there will come a point when innovation will slow down to the point where the glut of new devices entering the market will slow from a flood to a trickle, but we are years away from that.

The majority of store owners were former smokers who used electronic cigarettes to quit smoking and continued to rely on vaping to keep them from smoking. This may indicate an emotional investment in the product they are promoting to others, which could influence owner beliefs about health and safety information of e-cigarettes. Vapor store owners attempted to learn about the health benefits and safety of their products. Owners actively searched for information about vaping on the internet but did not have the education or training to evaluate published studies. The availability of information on the internet provided owners with information on mixing e-liquids and how to operate e-cigarettes, but could also spread misinformation about safety and health impacts.

Tacit acknowledgement that the store owners are former smokers thanks in large part to vapor products, although the author takes great care in stating that the owners continue to rely on vaping. In more or less the same breath, the author then goes on to thoroughly dismiss the claims made by the owners as having “emotional investment” in the product which “could” influence their beliefs. Well duh, there is bound to be some influence if the bloody products work you simpletons. I’m not even going to touch on the “lack of education” thing, that’s just such a holier-than-thou attitude.

but could also spread misinformation about safety and health impacts.

Interesting that the author raises this point considering the vast majority of the misinformation is coming from the bloody Governments and elements of public health, who’s job it is to know these things.

Recent reports call for more information on how risks of using e-cigarettes can be effectively communicated to consumers. As information becomes available in this emerging field, translating findings into clear summaries or talking points in lay language will help owners provide consistent and current information to customers. A format such as patient information pages created for health care practitioners could help customers make informed decisions, and would help store owners without medical or science-based training to keep abreast of current research.

Oho! An acknowledgement that the science is a little hard to follow, well we knew that but to suggest that it needs to be “dumbed down” is taking it a little too far. The big thing for me is not the tough time I have reading the science, it’s the accessibility. This particular study was tweeted by Chumpman, but was stuck behind a paywall. As someone with a vested interest in the emerging evidence on vapor products I want access to it, not have to pay for it. The current journal systems need to be looked at in my opinion to allow those such as myself and many others with interests in various scientific fields, access to the information they need.

In sum, local vapor stores are providing health and safety messages about vaping that may lead customers to beliefs about health impacts that have not been supported by research to date. How these messages will impact some groups of users more than others, such as dual users, young adults, never-smokers, or less educated has not been determined. This is an important area for future public health research to explore as vaping continues to grow in popularity.

In short, the vape stores are a key point to provide information to potential and existing customers about the benefits of vaping as a means of harm reduction or cessation (the choice of which is entirely up the customer), yet there is no plan of action or proposal in place to enhance that potential where stop smoking services liaise with or refer to vape stores. There are two in the UK, and as far as I know they are the only two worldwide.

Utilising an asset such as a vape store to help smokers doesn’t cost the Government anything, in fact they get paid for it via the property and commercial taxes. Using both SSS and vape stores will have a huge benefit, but they just cannot see it.