maanantai 29. helmikuuta 2016

Part 5: Meet me, my road to becoming a vaper and more personal thoughts

An important part of writing this is my personal story, the “deconversion” from the conventional wisdom surrounding nicotine use and nicotine products. The attitudes surrounding this extraordinary spread of electronic cigarettes and vaping are very varied and often are based on simple prejudices: the fact that smoking cigarettes is highly addictive and destructive and vaping is superficially similar.

That kind of thinking is hindering progress into avenues that could be used to gain major advances in public health, due to resistance towards tobacco harm reduction ideas and products as well as the demonization of nicotine itself, which almost certainly plays a part in the fact that most people still try to quit smoking using the least effective method. Going the so called “cold turkey” way, without any kind of help has proven to be a hugely limiting factor in reducing smoking as most of those attempts inevitably fail when smokers relapse. Personally, I would suggest trying any and all help available, especially counceling and peer support.
Quitting smoking is one of the biggest positive health impacts a person can achieve, no matter how you do it. So, please don’t fear nicotine, smokeless products, vaping or whatever else is available to get there. Preventing relapse is a goal that possibly should be the major focus of efforts intended to reduce tobacco related mortality and disease.

As for me, I tried multiple kinds of nicotine replacement therapy, reducing consumption and hated all of it. The options just weren’t appealing enough for me, personally. I started smoking when I was 14, the last ten years or so of my 17 year smoker career I wanted to quit. Until I picked up an electronic cigarette I didn’t think I was going to quit at all, even though I wanted to be able to do so.
What made me finally connect the dots was a double blind smoking cessation trial I took part in the summer of 2014. It included some lozenges that were sweetened, quite tasty and the idea was that you have one while you are smoking and the pill had a simple compound in it that would bind to specific parts of smoke and render them inert. What really happened was it actually made smoking more enjoyable, when the act was associated with candy essentially, one that even masked the taste of smoke and ash.

That lit a lightbulb for me: This is more or less what electronic cigarettes do, without the actual smoke too!

So I picked one up and ordered some liquids with nicotine, which were deemed to be medicinal so I was forced to get them from abroad. I did have some previous experiences with nicotine free that failed, but add the throat hit and suddenly my smoking habit was more or less gone. Dropped off from over a pack a day to one in the mornings, eventually just deciding I don’t really need that habit either


It was incredibly easy. Thinking back on that, it’s becoming increasingly clear that there’s more to smoking cessation than getting nicotine. Dependence is a very complex function that involves a lot of sensory and motor actions and experiences, not just the rewarding effects of the drug itself. Clearly, for me it was the habit itself, inhalation and various social aspects that I needed to retain.
These simple realizations have started a chain-reaction for me, and since then I have learned incredible amounts about nicotine and dependence. Including a lot of myths, prejudices and counter-productive thinking. I think a lot of the credit should go to Carl V Phillips for these permanent changes in my brain, reading his work has been a huge eye-opener. Though I'm sure he'd be likely to disagree with a lot of my thoughts :) I'm a layman after all, not really qualified to analyze the science at a precise level.

It really does feel like a deconversion of sorts, going from “wait, if this is true these other things I used to believe don’t make much sense” to “If these things don’t make sense, there must be other explanations” and ultimately “Things are really not as simple as people think and things could be much better if perceptions were accurate”. A sort of continuum of thinking that is apparent in quite a lot of other areas of inquiry. Conventional wisdom and common sense are just not very useful when we need to think about specifics of complex phenomena.
Hence, why I’m writing this.

I truly, honestly believe that instead of pretending behaviour can be eliminated by prohibition, we would be better off not trying to bend to the morals of those trying to tell us things we should not do, but rather think of ways we can choose to do things that offer us benefits in a way that’s as safe and as enjoyable as we can make it, while also minimizing risks to human life and health without infringing on fundamental rights.
Harm reduction is an essential part of human evolution and success as a species.


We have done this with so many things already, why not nicotine?

lauantai 27. helmikuuta 2016

Part 4: Personal thoughts on addiction and dependence

Continuing again on this topic, in the midst of translation projects. There's a lot to addiction and dependence, so I'm sure I won't run out of random thoughts to run out any time soon.

One argument (almost using scare quotes here) I keep constantly running into while working on the legislation in Finland and discourse surrounding it, is the assertion that vaping supposedly enables people to continue their addiction, or that "you're just switching one addiction for another". On their face, both claims are not just absurd based on the radical difference of health risks associated with each product, but I would assert that they are a result of very counter-productive thinking on the issue in combination with the claim that vaping would not help smokers to quit.

People seem to think that nicotine dependence and tobacco addiction are interchangeable phenomena, when in reality they are substantially different in terms of intensity. Cigarettes are designed to be as addictive as possible and are a result of highly sophisticated engineering and other scientific efforts, so there's no way a few components put together by mostly hobbyists could possibly achieve the same level of dependence. Even suggesting that undermines just how purposeful the cigarette really is.

So the reality is that when somebody switches to an electronic cigarette, they are not really continuing their addiction at all. Trading one addiction for another has slightly more merit, though even then they are barely even comparable.

The part that's counter-productive comes in when you consider the fact that most vapers tend to be the ones that are by far the most dependent, usually failing cessation attempts with various other forms of available products, nrt and such.

First, this obviously suggests that the effects nicotine, much slower speed of delivery or preventing the effects of nicotine alone is not enough to make them switch. Or to put it bluntly, the new product is not enjoyable enough, which appears to be one huge factor. The others being sensory experiences, social aspects and various other things nicotine alone cannot provide.

Second, addiction or dependence in itself cannot be considered a harm. It's just the pattern of behavior that results in harm if the product used is causing harm. However, that should not be a concern if the product is relatively safe and the person recognizes and accepts the risks, like say nicotine gum, snus or vaping.

Third, even IF we consider that the assertion would be true that vapers continue their dependence or switch one addiction to another, isn't that still a good thing? The fact that the new product might cause some harm, even if it's measurable and noticeable, is not exactly anything to be concerned about in comparison to the devastating effects smoking has. It's highly likely that past smoking has caused more harm than continued nicotine use will, especially if that use is preventing relapse.

Fourth, if it's the case that vaping could possibly cause the same level of addiction or dependence, wouldn't that suggest it's actually easy switching from smoking to vaping? I don't see a reason why ecigs could not help in cessation if that is true. The claim about not being effective at cessation usually comes in very close proximity to claims about continued or even increasing addiction, which seem to be quite mutually exclusive.

It does really seem to me that the discourse on vaping is riddled with insular one-liners about this and that problem that supposedly exists, asserted as facts.
Is nobody stopping to think about the big picture and actual health outcomes of real people?

Apparently the only thing that matters is personal sense of morality, that nicotine is some evil demon that possesses people and needs to be eradicated.
We've already had enough judgmental treatment, thanks. Sex, drugs, alcohol, nicotine, gambling, whatever else is next on the agenda.
Bullying, penalizing, patronizing and demonizing people just doesn't work.

Addiction is not a matter of morality, but a matter of helping them minimize risks in a way that does not infringe on their personal rights.

keskiviikko 24. helmikuuta 2016

Translation: Bordering on libel, Finland ASH chairman pitches in on ecigs

This is something I felt I had to get out, again just a translation unaltered. The specific part about the PHE report will be also sent to the authors of the paper. This is not some random guy off the street, he's a prominent figure in the field of tobacco control. I feel like disparaging your colleagues in public in a language they cannot understand is just unacceptable behavior. Ofcourse they need to be regulated, that doesn't even need justification.. But blatant lying about the issue is only going to do more HARM.
Original here: http://www.suomenash.fi/fin/ajankohtaista/2016/02/miksi-sahkosavukkeita-on-saadeltava/


---------------------------
Why electronic cigarettes must be regulated?

Chairman of Suomen ASH ry, professor Pekka Puska speaks out on the regulation of electronic cigarettes.

Stopping the acquiring, trying and using nicotine containing electronic cigarettes has not been possible. The products are also tried by non-smokers and on the other hand seem to be appealing especially to youth who already use other tobacco products.
Youth interest in electronic cigarettes has been increasing significantly in the last few years: only five percent of 12-18 year olds do not know, what an electronic cigarette is. Half of the youth who have tried electronic cigarettes has used nicotine containing liquids in them. Most commonly electronic cigarettes are used by boys in polytechnic schools, seven percent is vaping daily, 13 percent occasionally.
Electronic cigarette liquid flavoring agents (like strawberry, chocolate and vanilla) and the appearance of the device are important factors in their attractiveness to youth.

Electronic cigarette can impede quitting smoking

Some electronic cigarette users experience help in smoking cessation, but there is no evidence of their effectiveness in quitting smoking on a population level. On the contrary: According to a recent American study electronic cigarettes undermines the users’ chances of getting rid of smoking. According to another study youth who try electronic cigarettes, are more sensitive to starting smoking regular tobacco.
Nicotine causes strong dependence and changes the structure and function of the brain permanently. If electronic cigarettes are marketed as smoking cessation aids, nicotine containing electronic cigarettes should be regulated under the medical legislation like other nicotine containing medical products. This way their marketing and use would have oversight.
Compared to nicotine replacement products, like nicotine gum or patch, electronic cigarettes have been studied relatively little. Information on the impact of electronic cigarettes on for example lung diseases and subsequent mortality can be obtained only after years, even decades.

The effects of inhaled flavoring is unknown

Electronic cigarette liquids form vapor from chemicals, such as glycerol and propylene glycol, which have been classified as safe for food- and hygiene products. However, there is no systematic, longitudinal study based information on how these substances affect when vaporized and inhaled. There are indications that the flavorings used in electronic cigarettes have harmful effects on health. Vapor from nicotine free electronic cigarettes also contains harmful substances, although less than cigarettes.

Electronic cigarette vs cigarette

Almost any product is safer than a cigarette, since cigarettes kill more than half of their users. Electronic cigarettes are broadly a form of smoking, which is forcefully advocated by the industry. However, electronic cigarettes are both harmful in many ways and suited to sustain a society favorable to smoking.
According to a report Public Health England (PHE) published less than a year ago, electronic cigarettes are 95 percent safer than regular cigarettes and an effective aid to quit smoking. However, this conclusion is based on only a single study, which is funded by electronic cigarette and cigarette companies.
Execution, results and the expertise of the authors of the report has been disputed by many prestigious parties, like medical journals Lancet and British Medical Journal, British Medical Association, the United States National Institutes of Health and the World health organization WHO. WHO has also recommended, that electronic cigarettes would not be used until their safety has been verified.

(sidebar)
-          Nicotine contained in electronic cigarette causes strong dependence
-          Electronic cigarettes are also marketed to children and youth, which can lead to a new generation of nicotine addicts
-          Nicotine dependence also often leads to mixed use of different tobacco products, also including cigarettes that is
-          Nicotine is a powerful poison and even a small amount can be fatal to a small child
-          Scientifically sound evidence of the efficacy and safety as a smoking cessation aid does not exist
-          Electronic cigarette flavorings can be dangerous to health when inhaled

More information:

Pekka Puska
Professor
Chairman, Suomen ASH ry

Sources:


Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii. Tobacco Control 25.11.2015
E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. The Lancet Respiratory Medicine. 14.1.2016
Nicotine as a Health Risk. Deutsches Krebsforschungszentrum 2.12.2015
UK report claiming e-cigs 95% safer than cigs based on one industry-linked report raises questions PHE’s scientific dredibility. University of California, 16.9.2015
Evidence about electronic cigarettes: a foundation built on rock or sand?The British Medical Journal, 15.9.2015
E-cigarettes: Public Health England's evidence-based confusion, The Lancet, 29.8.2015
E-cigarette industry funded experts who ruled vaping is safe: Official advice is based on research scientists in the pay of manufacturers. London Daily Mail, 28.8.2015
E-cigarettes: an evidence update A report commissioned by Public Health England. PHE 2015.
Sähkösavukkeet eivät ratkaise tupakointiongelmaa. Terveyden ja hyvinvoinnin laitos. 3.9.2015
Tupakkatuotteiden yhteiskäyttö yläkouluissa ja toisen asteen oppilaitoksissa 2000–2015. Tutkimuksesta tiiviisti 2/2016. Terveyden ja hyvinvoinnin laitos, Helsinki.
Sähkösavukkeiden terveyteen liittyvät vaikutukset ja teho tupakoinnin lopettamisessa. Tutkimuksesta tiiviisti 19, kesäkuu 2015. Terveyden ja hyvinvoinnin laitos.
Sähkösavuke-sivut. Terveyden ja hyvinvoinnin laitos
12 ways to reduce your cancer risk. IARC 2015.
16th World Conference on Tobacco or Health

Tupakka ja sairaudet. Duodecim 2014.
Nuorten terveystapatutkimus. Sosiaali- ja terveysministeriö 2015.
Nuuska ja sähkösavuke –esite. Suomen ASH.
Luonnos: Hallituksen esitys eduskunnalle tupakkalaiksi ja laeiksi eräiden siihen liittyvien lakien muuttamisesta. Sosiaali- ja terveysministeriö, 11.8.2015

sunnuntai 21. helmikuuta 2016

Part 3: Personal thoughts on addiction and dependence

Increasingly common phrases among vaping communities in Finland nowadays seem to be something along these lines:

"This can't be so easy, can it?"
"I never thought I'd be able to quit smoking"

And so on.
I found myself wondering those exact things after about a year and a half ago, when I decided to give vaping a proper go as an alternative to smoking. Suddenly my 25 cigs a day habit was down to one in the mornings, rest of the time I was very much happy just vaping, eventually dropping that last one too.

For me, the alternative quickly became the much better option because the intrinsic qualities of the technology made it much more satisfying:
- It's much more convenient. I can take a puff, three or more if I feel like it, meaning the use is much more precise than smoking.
- It's controllable. Virtually every variable in the experience can be tailored to fit specific preferences, from volume to strength to temperature and so on. There's none of that in smoking.
- It's a lot more enjoyable. Flavor variety and intensity is the major selling point of the behavior for me. The taste of cigarettes is mostly ash.
- While cigarettes are much more efficient in nicotine delivery in general, that's only true for naive users. Vaping can deliver nicotine equally well, but has the added benefit of specificity. Vaping is the first product to show that users have wildly differing preferences for nicotine both in dose and frequency, making the ability to control these two aspects precisely to suit personal preference a very valuable quality.

So in hindsight, it's not really surprising that it was easy to switch. Dependence, just like any continuous behavior, is a phenomenon that relies on the reward of the behavior.
It's entirely logical that when offered an option that inherently has more potential to be rewarding specifically on an individual level and use turns out to be more satisfying, the choice is not really a choice at all, but an inevitability.
This of course, is largely mediated by the fact that users so far have decided what they want, instead of others imposing their view what the standardized option should be. Though standardization does exist for a valid reason, the fact still remains that people are not standardized. Human beings have exceedingly differing preferences, there really is no one-size-fits-all to pleasure, enjoyment and having a satisfying experience.

I would even go as far as present a hypothesis, based on my personal experience and observations, that vaping is not the alternative.
It's the primary option. A true kodak moment.

But the real question is, how do we get the tailored option to the majority of smokers who have not yet found their "sweet spot", so to speak?

keskiviikko 17. helmikuuta 2016

Part 2: Personal thoughts on addiction and dependence

Continuing on my thoughts on the issue of addiction and dependence, I got to thinking about the measures by which dependence and addiction are quantified. Again, going with my personal perspectives as a sort of baseline for my thought experiments to avoid even pretending to be able make generalized statements, though I am trying to perhaps provoke some thoughts.

Considering most of the criteria for nicotine addiction (again, using the substance abuse disorder from DSM 5 as a guideline, since that's what seems to be the conventional wisdom) are more or less predicated on the perception of harm, I can't help but wonder.. are people choosing the behavior, getting addicted instead of choosing the behavior or is the behavior painted as an addiction by manipulating their perception of harm, thus forcing the person to fit the definition of addiction?

So hypothetically, how does one go about creating an addict out of a person?

Take for instance a hypothetical product, which is completely benign but offers a noticeable benefit in the form of pleasure. Now mr A and mr B are essentially identical, both using the same product in exactly the same amounts and ways.

- Somebody manages to convince Mr A that the product is actually very harmful, which leads to him really wanting to quit use. Now, the product offers an actual benefit and no tangible costs, so A does continue the behavior while "knowing" there are harms, still wanting to quit but not being able to and experiencing cravings for those benefits when trying to abstain and using the substance longer than he intended.

- Mr B uses the product in the same amount, but experiences none of the negative aspects.

The only real difference between these two then is that mr A fits the description of moderate addiction after twelve months, while B does not since the criteria do not include benefits.
Thus, A identifies as an addict without any kind of impact from the substance itself.

This ties into vaping quite closely. While it's certainly not completely benign, it's close enough to fit the above example.
If I were suddenly convinced that vaping causes meaningful harm, leading me to suffer the negative consequences of that perception, would I be an addict?
What if I continue to be convinced there is no meaningful harm (that would prompt me to want abstinence) is it even possible for me to be an addict, as my tolerance and withdrawal are both not issues?

This leads me to believe it's almost impossible substance abuse disorder even exists for vaping, snus or other low risk products until one of two things happens: either evidence emerges that they really are substantially harmful or people are manipulated to believe so.

The latter seems to be a goal for some people that like to assert that dependence is something that needs to be avoided at all costs.


Translation: Level of harm reduction discourse in Finland.

http://www.suomenash.fi/fin/ajankohtaista/blogi/2016/02/nikotiinikauppiaiden-uudet-vaatteet/ here's the original, in finnish. Below is a translation of the text. I won't analyze this for now, so just reporting it as is.

Nicotinemerchants’ new clothes

Why public health experts are opposed to electronic cigarettes, which according to the current knowledge are less harmful than tobacco after all? Medical specialist Kristiina Patja answers.

Electronic cigarettes are defended furiously. One of the premises is that it helps smokers of smoke containing tobacco quit smoking. It has now been shown as false information in many studies, most recently in the prestigious Lancet-journal.
Another premise is that the aerosol-like electronic cigarette is less harmful than smoke containing tobacco (sic, the finnish phrase is essentially the opposite of “smokefree”). Studies, in which this harmlessness has been measured, are however few. Electronic cigarettes have been brought on the market without studying it’s health effects. Smoke containing tobacco contains 50-60 carsinogens, snus 20-30 and apparently electronic cigarettes a few. Then however we should ban at once the most harmful ones and with strict oversight only leave a few products on the market. This was done when lead was no longer needed in fuel.
Why then those opposing tobacco industry and tobacco products are also opposed to electronic cigarettes? Why are they not celebrating a harmful, but less harmful new product? The reason is that people who have been following the actions of the tobacco industry for a long time know the drill. There’s no need to go back to the light cigarettes of the 1970s anymore, but we can see what happened with snus.
Bringing snus to Finland followed the exact same paths as electronic cigarettes.  It was told to be less harmful than regular cigarettes. In addition it was supposed to help to stop smoking, for good that is. Marketing snus as a cessation product enabled Sweden to decrease smoking cigarettes.
Health people tried to resist and reported how new nicotine products enticed new users. In fact, this has happened in Sweden already: over 40 percent of men were tobacco product users, when the number in Finland was closing in on 20 percent. Snus was not effective in cessation, but smokers simply switched to using it. In addition, snus was more addictive and systemic nicotine doses were larger. Physiologically it led to stronger dependence than before.
We tried to warn that the phenomenon starts with children and youth, as in those who we were trying to protect from nicotine addiction. We reported that snus is even more addictive than cigarettes and nicotine doses are larger. We reported that snus is not harmless: it’s a cancer hazard and in addition strains the heart. Teeth suffer. Epidemiological study had already shown this, even though data is accumulating slowly.
The pace has been even more wild with electronic cigarettes. Stores enable minors to get equipment and candyliquids (word used is a derogatory version, no idea how to translate it properly) and then off they go online shopping with friends. Half of teenagers have already tried electronic cigarettes. Many of them would not have tried smoke containing tobacco, since it has been out of fashion for a long time now – even before electronic cigarettes.
Where in the world can we need 500 different electronic cigarette brands and over 7000 different flavorings? Why are popstars marketing electronic cigarettes specifically in Instagram, that’s popular with youth? New products have been directed at youth, they play music and blinking lights. Liquids taste like marshmallow, vanilla and strawberry. Not likely they are directed at <sic> (term meaning set in their ways) adult smokers.
It’s known that nicotine dependence can be formed already by using two smoke containing cigarettes a week. Electronic cigarette nicotine content varies a lot, so the number of experimentation instances can be a little larger, but is it worth it to take the risk? Are we supposed to study separately, if nicotine in this form is somehow addictive in a different way?

If our goal is a tobacco free Finland, is increasing the prevalence of nicotine addiction the correct way? You electronic cigarette user, how many more new nicotine dependent children do you want in this country?

tiistai 16. helmikuuta 2016

Part 1: Personal thoughts on addiction and dependence


So far, this blog has been basically a placeholder for personal things that do not necessarily fit under my capacity as a reporter for the finnish vaping association Vapers Finland RY, but I've been thinking about dependence and addiction lately and thought I might as well write down some of my own personal experiences as a thought exercise instead of a more official article. So don't expect anything polished or even necessarily coherent :)

I've always considered myself as a sort of "addictive" personality, prone to hyper-focusing on things and of course, while I was a smoker it was fairly clear that it was a major addiction (using that term subjectively here, mind you. Actual coherent definition is needed, but I'm sure most of the current versions would include what I did as a smoker). But after I found vaping and got rid of the smoking dependence issue.. I've been thinking about the issue a lot more and maybe even more analytically than before. When I smoked, it was just sort of something I did. I had all the usual signs: irritability while abstaining, irresistible cravings after an hour or so, pack a day without fail, really really really wanted to quit but was unable to.

What I never really experienced is the euphoria that's supposedly an integral part of the process and mechanisms of addiction. No sense of a supposed "nicotine-rush", only the occasional dizziness that's almost certainly attributable to carbon dioxide exposure. So what was the benefit I was getting from cigarettes then? The moment of relaxation of going out on the balcony and inhaling deep perhaps? Just the pleasure of the behaviour itself?
Clearly there was something to it that kept me doing it for over a decade.
Now, most people you would present this scenario to would instantly answer that "obviously you are just addicted to nicotine".

But in all honesty, is that even true?

The difference now is almost not even comparable. My vaping experience has totally transformed my thinking on the whole concept of dependence, since none of the classic signs are really present. I do use nicotine all the same, inhaling like I used to, but all the cravings and withdrawal effects are just gone. The major difference now I actually find pleasure in the behavior, especially since I can really fine tune the experience to match my preferences of throat hit, flavor, warmth and volume.

So am I still addicted?

For example, the DSM5 criterion list:
Use longer and larger amounts than intended. Not really. I never really thought about how long and how much should or should not use nicotine. I vape when I feel like it, so unless there's an objective measure for this it does not even apply.
Wanting to cut down or quit and not being able. Not really, no. Neither option is appealing to me, the benefits are much larger than abstinence.
Spending a lot of time obtaining nicotine. Definitely not, though I do enjoy a lot of flavors so designing recipes is a part of the habit. Maybe that counts, kinda? I don't really know.
Cravings or strong urges. This happens on occasion, depending on my liquid. Takes most of the day, but I can easily avoid this by using flavorings like rhubarb, chili or others that simulate the throat hit from nicotine. So clearly even the withdrawal is not caused by nicotine itself, but rather the sensory experience.
Activities, responsibilities, interpersonal relation problems and such only really apply to drug abuse I think. Even most smokers don't seem to experience these. So no, none of this.
Recurrent use in hazardous situations. Noo.. don't think so? Pretty sure I don't need to take out my mod regardless of the situation.
Consistent use despite acknowledgement of physical and psychological harm. Unlikely, I'm fairly confident these are not present in vaping. I do however acknowledge the inherent risks in inhalation exposure, so maybe this applies? But again, benefits are much larger so I'm making the informed choice to do so.
Tolerance. Decreasing steadily, I actually need to drop nicotine volume in liquids slightly from time to time, because I get the feeling it's too strong even though I'm absolutely sure it's not actually stronger. Enough said I think.
Withdrawal. See cravings, it's the only classic symptom I have experienced.

Apparently, I'm not addicted. Then when did I get cured, since I never actually stopped using nicotine but just changed the delivery method? Clearly I was highly dependent on smoking, but none of that is apparent with vaping.. So what gives? Logically it was NOT the nicotine in cigarettes, as conventional wisdom would suggest, but something else entirely.

Is nicotine actually addictive or not? Was I ever really even dependent on nicotine?
Nowadays I'm leaning heavily on "no".

torstai 11. helmikuuta 2016

Translation: Finnish doctor with blatant lies about snus

Just a short piece from a Finnish doctor publicly spreading blatant lies about snus. Absolutely incredulous. A minor note, "tobacco" obviously means smoking cigarettes. Just a little more dishonesty there. EDIT: Also worth nothing that Yle is a national network, who gets their funding entirely from a mandatory "media-tax". It used to be a fee, where people voluntarily gave notice they own a tv set so they can pay the government for the pleasure. There was even an enforcement agency to check peoples' homes if they had TVs. One would imagine that resorting to this level of leaning on the public, the least they could do is NOT print lies.

Sports doctor astonished by athlete snus use – No better than tobacco


Finnish hockey doctors’ chairman Markku Arvela is astonished by the habit of finnish athletes to use snus. Snus does not affect the lungs like tobacco, but nicotine diminishes performance also while using snus.
(pic of a snus box)
Snus use is increased according the national health survey. Most snus use is among young men.

Chairman of the association of finnish hockey doctors and among other things, the doctor for the hockey team SaiPa Markku Arvela considers snus and tobacco to be equally bad options.

-          - A special characteristic here in Finland, is that minors and young athletes use snus. It’s often perceived as a better option than tobacco, but it is not.

Many snus users perceive snus as a healthier option, since it does not affect lung health like tobacco. However, a snus user may get more nicotine than a smoker. Nicotine in turn constricts blood vessels and muscles will not get oxygen and nutrients normally.

-          - Oxygen in the lungs is no use if the circulation does not deliver it to the muscles, summarizes Arvela

maanantai 8. helmikuuta 2016

Email to the Finnish Parliament members (In Finnish)


Hallituksen esitys tupakkalain muuttamisesta lähestyy, joten otin itsekkin henkilökohtaisesti yhteyttä kansanedustajiin:
Hei!
Olen 32 vuotias entinen tupakoitsija, nykyinen höyryttelijä (aka sähkösavukkeen aktiivinen käyttäjä), sekä höyryttelijöiden yhdistyksen toimittaja (vapers.fi).
Kirjoitan useimmiten toimittajan roolissa asiasta, mutta nyt kuitenkin ihan yksityishenkilönä koska halusin kertoa oman tarinani ja ajatukseni höyryttelystä.
Poltin noin 17 vuotta, ja kuten iso osa tupakoitsijoista halusin lopettaa sekä kokeilin monenlaisia keinoja. Korvaushoitotuotteet eivät yksinkertaisesti toimineet halusta huolimatta, sen huomasi hyvin nopeasti etenkin purkan ja inhalaattorin kohdalla. Ne ovat erittäin epämiellyttäviä tuotteita käyttää. Kyvyttömyys lopettaa voimakkaasti vaikutti mielialaani.. Kunnes hommasin kuriositeettina sähkösavukkeen ja jäin sille tielle. Perjantaina poltin 25 savuketta, lauantaina päätin kokeilla tosissani vaihtaa ja maanantaihin mennessä sekä siitä eteenpäin seuraavan kuukauden poltin vain yhden savukkeen aamuisin. Loppuajan käytin höyrytintä, koska se oli huomattavasti miellyttävämpi ja nautinnollisempi.. Ja tiesin että sen terveysvaikutukset ovat vain murto-osan tupakasta, joten mielialakin koheni huomattavasti. Makuaineet olivat erittäin kriittisessä roolissa onnistumisessa.. Nyt puolitoista vuotta myöhemmin huomaan että tupakkariippuvuus on ollut jo pitkään täysin historiaa, enkä edes kärsinyt liiemmin vierotusoireista.
Lainsäädäntö uhkaa nyt rajoittaa höyryttelyn toimivuutta radikaalisti.. Vastustajien retoriikka on lainattu suoraan yhdysvalloista ja sen takana on hyvinkin yksinkertainen agenda, yksityisten ihmisten tietoisten valintojen paheksunta.. Toimintaperiaatteeksi on muodostunut huonontaa tuotteiden laatua niin että saadaan aikaiseksi laillinen tuote jota kukaan ei halua, johon ehdotetut lakimuutokset selkeästi tähtäävät.
Vastustuksen väitteet ovat pitkälti tieteellisesti kestämättömiä, vailla näyttöä tai jopa täysin harhaanjohtavia. Tutkimuksissa ei ole pystytty osoittamaan merkittäviä haittoja.
Faktoja on kuitenkin mahdoton kiistää:
- Höyryttely on huomattavasti turvallisempi vaihtoehto
- Jotkut ihmiset haluavat käyttää nikotiinia, samaan tapaan kuin kofeiinia, yms
- Tuhansia, jopa miljoonia ihmisiä euroopassa on vaihtanut onnistuneesti sähkösavukkeeseen
Lisäksi se ajatus että kokonaan ilman oleminen olisi turvallisin vaihtoehto. Näin ei kuitenkaan ole, lopettamisessa perinteisin keinoin on merkittävä repsahduksen riski. Edes muutaman kuukauden tupakoinnin jatkaminen on pahempi kuin se että käyttäisi matalan riskin tuotteita kuten sähkösavukkeita tai nuuskaa loppuelämänsä. Tupakoitsijoita tulisi siis kannustaa vaihtamaan, riippumatta siitä haluavatko he lopettaa tupakoinnin tai jatkaa nikotiinin käyttöä.
Julkisesti esillä oleva lakiehdotus on huomattavan harhaanjohdettu, heti alusta lähtien. Nikotiinituotteiden käytön loppuminen ei ole terveydellisesti merkityksellinen lain tarkoitus, vaan savuhaittojen poistaminen.
Jos savusta aiheutuvat haitat saadaan eliminoitua, nikotiininkäytöstä jäljelle jäävät riskit ovat pitkälti merkityksettömiä lainsäädännön ja lääketieteen kannalta. Siihen pyrkiminen on siis täyttä resurssien hukkaan heittoa.
Antakaa siis äänestäville kansalaisille vapaa mahdollisuus valita itselleen turvallisempi vaihtoehto tupakoinnin sijaan, niin saadaan suomesta oikeasti savuton!
(PS: Tässä vielä yhdistyksen infolehtinen http://vapers.fi/tietoa_sahkosavukkeista.pdf)
//J.Orelma