Vaping Regulation Threatens a Lifesaving Smoking Alternative

“Electronic cigarettes, which deliver nicotine without tobacco or combustion, are the most important harm-reducing alternative to smoking ever developed, one that could prevent millions of premature deaths in the U.S. alone. Yet bureaucrats and politicians seem determined to negate that historic opportunity through regulations and taxes that threaten to cripple the industry.”

“Survey data indicate that the vast majority of teenagers who vape regularly are current or former smokers. That means the FDA’s fear that ENDS are causing an “epidemic” of adolescent nicotine addiction is overblown—especially since vaping by teenagers dropped substantially in 2019 and 2020, a development the agency prefers to ignore.”

” In an August American Journal of Public Health article, 15 prominent tobacco researchers warned that “policies intended to reduce adolescent vaping,” including flavor bans, “may also reduce adult smokers’ use of e-cigarettes in quit attempts.” They emphasized that “the potential lifesaving benefits of e-cigarettes for adult smokers deserve attention equal to the risks to youths.”

That article summarized “a growing body of evidence” that “vaping can foster smoking cessation.” Yet Rep. Raja Krishnamoorthi (D–Ill.), who wrote a bill he called the END ENDS Act, insists “there’s simply no evidence that vapes help [smokers] quit.” He also claims to believe “adults can do what they want,” which is likewise demonstrably false given the severe restrictions he favors.”

More And More Americans Are Smoking Pot. What Does That Mean For Their Health?

“Many of pot’s effects are tangled in contradictory research, but there are a few clear health risks to consuming the drug. Smoking cannabis regularly can cause bronchitis-like symptoms, and research published last month found that chronic cannabis users, defined as people who used pot at least four times a week for more than three years, had impaired pancreatic function. There have also been cases of daily cannabis users developing pancreatitis without having any other obvious risk factors.

Regular pot use has also been associated with higher rates of depression, anxiety and poorer life outcomes like being unemployed, but causality has not been established because other factors could predispose someone both to using cannabis and having a mental illness or not having a job.

There’s also evidence that cannabis can be dangerous when used in certain situations, like during pregnancy or while driving a vehicle. A recent study linked increasing rates of childhood leukemia to an increase in cannabis use, and a separate study found a correlation between women using cannabis while pregnant and their children having higher rates of anxiety. There’s also evidence that using pot while pregnant can lead to lower birth weights, although that evidence is still considered limited. And driving a car while high has been shown to moderately increase the risk of getting into a motor vehicle accident.

Addiction can be an issue as well. Some people who smoke pot develop what’s called cannabis use disorder (CUD), a clinical diagnosis of problematic and uncontrollable cannabis use. There’s evidence that CUD rates have increased since 2008, but Dr. Kevin Hill, an addiction psychiatrist and professor at Harvard Medical School, told FiveThirtyEight in an email that “it is still important to point out that most people who use cannabis don’t have a problem with it.”

The 2020 NSDUH found that 4.1 percent of people ages 12-17 met the criteria for CUD,1 13.5 percent of people ages 18 to 25 had the disorder, and 4 percent of people over age 26 had the disorder. Yet those numbers were below rates of alcohol use disorder across all age groups in 2020’s survey.

Deborah Hasin, an epidemiologist at Columbia University, said she is very concerned about adults’ increasing use of cannabis because CUD is associated with poorer quality of life, cognitive decline and impaired educational and occupational employment. Hasin’s research has found that 19.5 percent of people who use cannabis met the criteria of CUD in their lifetimes.

“It’s clear that not everybody who smokes marijuana has all of these problems, but the risk is there, and it’s a greater risk than people assume,” Hasin said.

Using cannabis frequently increases the risks of developing CUD, and frequent pot use is growing among adults. Monthly use for 26-to-34-year-olds has more than doubled since 2008, and the share of people getting at least five days a week increased from 5.8 to 13.8 percent between 2008 and 2019, according to NSDUH survey results.”

“A 2016 study that followed a group of New Zealand adults for 20 years found that cannabis use was associated with worse gum health, but better cholesterol levels, lower BMI and reduced waist circumference.

Those results were further substantiated in a 2020 study that looked at cannabis use among people over the age of 60. Cannabis users in the study exercised more often and had a significantly lower BMI than non-users.

While there’s evidence that BMI, which measures only weight and height, is not the best way to gauge health for people who are normal weight or are slightly overweight, very high BMI scores are significantly associated with mortality.”

The good and bad news about the omicron variant

“The omicron variant, the latest curveball in the pandemic, may lead to less severe cases of Covid-19 than earlier strains of the coronavirus, according to one of the largest real-world studies of omicron released so far.

That’s good news, but it could be overshadowed by other data showing that the variant is far more contagious than any version of the virus to date — and that it can evade some immune protection from vaccines and prior infection.

Taken together, these traits make for a counterintuitive situation: Omicron poses a lower risk to most individuals, at least for those who are vaccinated, but the threat to the overall population is high. The question now is whether omicron will infect so many people that it overwhelms the health care system and drives up hospitalizations and deaths — in spite of the smaller percentage of people who come down with severe disease.

The answer is partly in our hands. The strategies that have contained Covid-19 throughout the pandemic still work against omicron, but governments, institutions, and individuals have to be willing to use them.”

The U.S. Is Relying On Other Countries’ Data To Make Its Booster Shot Decisions

“Israeli presenters provided slide after slide showing the power of booster shots. But not all of the FDA advisors were convinced. “What they’re seeing in Israel is not necessarily what we’re seeing here in the U.S.,” said Dr. Archana Chatterjee, dean of Chicago Medical School and member of the advisory committee, during the meeting. In an interview with FiveThirtyEight, she explained that Israel’s data is “interesting and very compelling,” but that Israel differs from the U.S. on key characteristics: Namely, a higher share of the Israeli population is inoculated, and a larger proportion of breakthrough cases in Israel led to hospitalization prior to the booster shot rollout. As a result, she said, Israel had a clear need for additional shots to bump up immunity. In the U.S., meanwhile, the vaccines were still highly protective against severe COVID-19 disease and death.

Chatterjee said that her eventual votes — in favor of booster shots — were not based on data from Israel. Still, the Israeli scientists’ very presence at the meeting demonstrated the shortcomings of the U.S. health system. If the U.S. doesn’t comprehensively track its own data, it has to rely on other countries to tell it how to keep Americans safe. Meanwhile, without clear evidence that they can refer to in making their own COVID-19 decisions, many Americans have been confused about whether they are eligible for — or even need — a booster shot.

Israel has a universal health care system for all citizens and permanent residents. So does the U.K., another country that the U.S. looks to for COVID-19 data. Beyond the health care benefits that such policies provide to residents, universal health care has a clear advantage for data scientists seeking to answer medical questions. When every person in the country is plugged into the same health care system, it’s very easy to standardize your data.”

“In the U.S., vaccine research is far more complicated. Rather than one singular, standardized system housing health care data, 50 different states have their own systems, along with hundreds of local health departments and thousands of hospitals. “In the U.S., everything is incredibly fragmented,” said Zoë McLaren, a health economist at the University of Maryland Baltimore County. “And so you get a very fragmented view of what’s going on in the country.””

“Without a unified dataset allowing U.S. researchers to analyze how well the vaccines are working, policymakers are left with limited information to make crucial decisions, such as determining who should be first in line for a booster shot.”

Climate scientists should pay more attention to fish poop. Really.

“The story goes something like this: Tiny marine organisms called phytoplankton absorb carbon from the water and air around them. As the plankton are eaten by increasingly larger creatures, the carbon then travels up the food chain and into fish. Those fish then release a lot of it back into the ocean through their poop, much of which sinks to the seafloor and can store away carbon for centuries. The scientific term for carbon storage is sequestration.

“We think this is one of the most effective carbon-sequestration mechanisms in the ocean,” Bianchi told Vox. “It reaches the deep layers, where carbon is sequestered for hundreds or thousands of years.”

Carbon that’s stored in the deep sea is carbon that’s not making the oceans more acidic or trapping heat in the atmosphere. In other words, fish poop could be a bulwark against climate change.

The problem is that commercial fishing has sliced the global fish population to a fraction of its former level. As scientists figure out the importance of fish poop, they’re also recognizing a new danger of large-scale fishing. Beyond putting ecosystems at risk, the industry is messing with big nutrient cycles — and perhaps eating into an important carbon sink.”

A better way to legalize marijuana

“Marijuana is nowhere as dangerous as alcohol. You can quite literally drink yourself to death; the same doesn’t apply to marijuana. So it’s almost certain that legalizing marijuana the same way won’t lead to all the same bad outcomes.

Still, there are some risks. A thorough review of the research, by the National Academies of Sciences, Engineering, and Medicine, found that marijuana poses a variety of possible downsides, which can include a higher risk of respiratory problems (if smoked), an increased risk of developing schizophrenia and other psychoses, an increased likelihood of car crashes, a general decrease in social achievement, and, potentially, some harm to fetuses in the womb.

There’s also the real risk of addiction and overuse. As Stanford’s Keith Humphreys put it to the Atlantic, “In large national surveys, about one in 10 people who smoke [marijuana] say they have a lot of problems. They say things like, ‘I have trouble quitting. I think a lot about quitting and I can’t do it. I smoked more than I intended to. I neglect responsibilities.’ … People will say, ‘Oh, that’s just you fuddy-duddy doctors.’ Actually, no. It’s millions of people who use the drug who say that it causes problems.”

None of that is to make the argument for prohibition, which produces its own problems”

“An obvious question is: If the standard commercial model works for alcohol, why can’t it work for a newly legal drug like cannabis, too?

But this model doesn’t work well for alcohol. The nation’s second-most popular drug (after caffeine) is linked to nearly 100,000 deaths a year in the US — about the same as all overdose deaths, and more than the combined death tolls of car crashes and murders.

A different model could help. Previous research, for example, found that states that maintained a government-operated monopoly for alcohol kept prices higher, reduced access to youth, and cut overall levels of use”

Scientists Fight a New Source of Vaccine Misinformation: Aaron Rodgers

““Aaron Rodgers is a smart guy,” said David O’Connor, a virus expert at the University of Wisconsin-Madison and a Packers fan. But, he added, “He’s still vulnerable to the blind side blitz of misinformation.”

In the interview, Rodgers suggested that the fact that people were still getting, and dying from, COVID-19, meant that the vaccines were not highly effective.

Although imperfect, the vaccines provide extremely strong protection against the worst outcomes of infection, including hospitalization and death. Unvaccinated Americans, for instance, are roughly 10 times more likely to be hospitalized and 11 times more likely to die from COVID-19 than vaccinated Americans, according to a study by the Centers for Disease Control and Prevention.

“As far as the people who are in the hospital with COVID, overwhelmingly, those are unvaccinated people,” said Angela Rasmussen, a virus expert at the Vaccine and Infectious Disease Organization at the University of Saskatchewan. “And transmission is being driven overwhelmingly by unvaccinated people to other unvaccinated people.”

Rodgers also expressed concern that the vaccines might cause fertility issues, a common talking point in the anti-vaccine movement. There is no evidence that the vaccines affect fertility in men or women.

“Those allegations have been made since the vaccines first came on the scene, and they clearly have been addressed many, many times over,” said Dr. William Schaffner, a vaccine expert at Vanderbilt University. He added, “The vaccines are safe and stunningly effective.”

There are a few potentially serious adverse events that have been linked to the vaccines, including a clotting disorder and an inflammation of the heart muscle, but they are very rare. Experts agree that the health risks associated with COVID-19 overwhelmingly outweigh those of vaccination.

Rodgers said he ruled out the mRNA vaccines, manufactured by Pfizer and Moderna, because he had an allergy to an unspecified ingredient they contained.

Such allergies are possible — a small number of people are allergic to polyethylene glycol, which is in the Pfizer and Moderna vaccines — but extremely rare. For instance, there were roughly 11 cases of anaphylaxis, a severe allergic reaction, for every 1 million doses of the Pfizer vaccine administered, according to one CDC study.

The public health agency recommends that people with a known allergy to an ingredient in one of the mRNA vaccines not get those vaccines, but some scientists expressed skepticism that Rodgers truly had a known, documented allergy. Even if he did, he may have been eligible for the Johnson & Johnson vaccine, which relies on a different technology.”

Unfortunately, Ivermectin Is Not a Miracle Cure for COVID-19

“So what do researchers know about the effectiveness of ivermectin, approved for human use but best known as a horse deworming medicine, in treating COVID-19? At the beginning of the pandemic, scientists around the globe began testing thousands of existing medications in test tubes to see if they could be repurposed to fight against the novel coronavirus. In very preliminary research, researchers found that ivermectin significantly inhibited COVID-19 coronaviruses in cell cultures.

Encouraged by these petri dish findings, some desperate clinicians began administering ivermectin to their COVID-19 patients. The result was a number of hopeful observational studies by clinicians reporting that ivermectin appeared to be effective—in some cases, highly effective—in preventing COVID deaths. Observational studies are notoriously subject to researcher biases and confounders that can mislead clinicians into thinking an intervention works when actually a third factor is responsible.

Nevertheless, a prominent group of American physicians calling themselves the Front Line COVID-19 Critical Care Alliance (FLCCC) combined these preliminary observational and epidemiological studies into a November 13, 2020, preprint meta-analysis asserting that ivermectin “has highly potent real-world, anti-viral, and anti-inflammatory properties against SARS-CoV-2 and COVID-19.” Among other findings, the FLCCC pointed to reports that widespread distribution of ivermectin in Peru had correlated with steep declines in COVID-19 cases and mortality there. According to the group, cases and deaths began to rise dramatically in the same country after the government ceased distributing the drug.”

“research on ivermectin’s efficacy in treating COVID-19 has been ongoing. Has this subsequent research validated Kory’s claim that ivermectin is a miracle drug against COVID-19? It’s complicated, but the answer is largely no.

First: Those dramatic Peruvian results are highly confounded. The steep rise in COVID-19 cases and deaths in that country can most likely be blamed on the breakout of the highly infectious lambda variant rather than to a halt in ivermectin distribution. Meanwhile, the newly reported results of a highly anticipated randomized controlled study of ivermectin in next door Brazil finds that the medicine had “no effect whatsoever” on the disease.

A lot of the hope that ivermectin would be a COVID-19 silver bullet arose from the findings of various meta-analyses, including the one conducted by the FLCCC, that combined the results of various observational studies and small randomized controlled trials. One of the more prominent recent ones was posted as a preprint in May by a team of British public health researchers led by the Newcastle University statistician Andrew Bryant. But other scientists have faulted that study for significant methodological failures.

Also, though it’s not the preprint’s researchers fault, one of the most important studies bolstering their conclusion has been withdrawn because its results appear to be fraudulent. Once the data from that study are removed, the Bryant meta-analysis finds essentially no efficacy for treating COVID-19 with ivermectin.

On July 28, 2021, the authors of a more painstaking meta-analysis of ivermectin COVID-19 treatment studies, published by the Cochrane Library, concluded:

“Based on the current very low‐ to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.”

The FLCCC folks are surely sincere, but the best evidence suggests that they are sincerely wrong. The bottom line is that while ivermectin might have some marginal efficacy, it is certainly not a “miracle drug” when it comes to treating COVID-19.”