# Heart Surgeon Says VAPING Is SAFER | Unpacking Public Health



## Alex (10/5/18)

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Published on Dec 7, 2017*
Please watch: "FORGOTTEN CRISIS | Smoking continues to KILL more than any other threat—VAPING is answer, CDC doctor" 
https://www.youtube.com/watch?v=4mKtp...
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Forget about the morality and look only at the science and you come to the conclusion that vaping is categorically safer than combustible cigarettes. This is the medical opinion of Dr. Gopal Bhatnagar, Head of Cardiovascular Surgery at Trillium Health Center and one of the leading practitioners of ‘beating heat’ surgery in North America.

In this extended edition of RegWatch we sit down with ‘Dr. Gopal’—just minutes after he finished surgery and as we rushed to the airport to head back west.

We do a deep-dive into the complexities and contradictions of the public health war against vaping; how public health lobbies such as Heart, Cancer, Lung misinterpret or misuse data in an effort to mislead the public about the potential health risks of vaping; And, much more—only on RegWatch by RegulatorWatch.com.

Produced by: Brent Stafford
Released December 7, 2017

Reactions: Winner 7 | Informative 3


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## Pixstar (10/5/18)

I wish our health minister would watch these...

Reactions: Like 1 | Agree 4


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## Pixstar (10/5/18)

Probably the best one I’ve watched.

Reactions: Like 1 | Agree 4


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## Silver (16/5/18)

Thanks @Alex for sharing this

I enjoyed it.

Dr Bhatnagar talks a lot of sense. 

Some snippets that stuck out for me:

Vaping is NOT a tobacco product (and a real pity it is lumped into the tobacco category by many regulators)
Tobacco is the #1 cause of preventable harm to our society
There is nothing to indicate to him or the broader scientific community that vaping is intrinsically dangerous (like combustible cigarettes)
Given he is a heart surgeon, I just wish he would have spoken a bit more about the science and the medical side of things - from his experiences being a surgeon. 

Another interesting part is that he is a co-founder of 180smoke - a vaping retail chain. Interesting, he must be one of the very few practising surgeons who is involved directly in the vaping business.

Reactions: Like 2 | Agree 1


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## RichJB (16/5/18)

I have never understood the opposition to vaping being regulated together with cigarettes under the generic heading of "tobacco products". Smoking and vaping do the same thing: deliver nicotine derived from tobacco in aerosol form to dependent users. So it makes perfect sense to regulate them together. 

Cars and motorbikes are different things but they serve the same purpose: getting the user from A to B. However, we don't have one govt dept for cars and another for motorbikes, nor do we have one Act for cars and another for motorbikes. They are regulated together because they serve the same purpose as forms of transport. Where it is necessary to distinguish between the two in regulatory terms, such as mandatory helmets for bikes or mandatory seat-belts for cars, this can be done by having different clauses within one Act. 

I get why the vaping industry wants it regulated separately. They want to distance themselves from tobacco because that will be good for their image and sales. But regulators don't care about an industry's image and sales, they are focused on regulatory efficiency. Would it be more acceptable if regulators dropped "tobacco products" and replaced it with "nicotine products"?


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## Silver (16/5/18)

RichJB said:


> I have never understood the opposition to vaping being regulated together with cigarettes under the generic heading of "tobacco products". Smoking and vaping do the same thing: deliver nicotine derived from tobacco in aerosol form to dependent users. So it makes perfect sense to regulate them together.
> 
> Cars and motorbikes are different things but they serve the same purpose: getting the user from A to B. However, we don't have one govt dept for cars and another for motorbikes, nor do we have one Act for cars and another for motorbikes. They are regulated together because they serve the same purpose as forms of transport. Where it is necessary to distinguish between the two in regulatory terms, such as mandatory helmets for bikes or mandatory seat-belts for cars, this can be done by having different clauses within one Act.
> 
> I get why the vaping industry wants it regulated separately. They want to distance themselves from tobacco because that will be good for their image and sales. But regulators don't care about an industry's image and sales, they are focused on regulatory efficiency. Would it be more acceptable if regulators dropped "tobacco products" and replaced it with "nicotine products"?



I think the main issue here is that smoking combustibles is causing so many deaths. And that vaping seems to be an alternative with considerably less harm.

So if the regulators want to promote health, they should come up with regulations in a way that entices folk to stop smoking combustibles - and if they can't just quit cold turkey - to encourage them to rather vape. 

So if the exact same regulations apply to vaping and smoking - then it would seem that the regulators think they are equally bad - which is not what the Science is suggesting. 

I like your idea of the same "Act" but with different "sub regulations" for smoking and vaping - like different rules for motorbikes versus cars

Reactions: Like 2 | Agree 1


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## RichJB (16/5/18)

From a regulatory standpoint, a single Act and single department makes more sense. I imagine that as vaping continues to grow, retailers like Spar Tops or petrol station convenience shops will stock both cigarettes and vaping devices. If the regulations for vaping are ring-fenced from smoking - different Acts and different departments - that will cause massive bureaucratic load. A retailer will probably have to work with two different Acts, different departments who might have different requirements for signage/packaging, and so on. It's a lot simpler to lump it all together. Then the retailer gets one permit and implements one set of regs from one department. Those regs don't have to be identical, they can make exceptions or different regs for vaping where applicable. But it doesn't make sense to have separate regs when they are dealing with one demographic group in society, i.e. nicotine users.

Vaping with Vic was incensed when the TPD regs came out, holding up an 18650 and saying "This is now a tobacco product!" Who cares what it's called? I care about what it does and how it performs, not what it's called. If they want to call it a tobacco product, it's no skin off my nose.

The reason the regulators have included every imaginable component is because there is always some manufacturer who will think he's being hugely innovative and clever by claiming that his RTA isn't a "tobacco product", it's a "decorative liquid storage implement, embellished with twisted wire and organic cotton for aesthetic purposes. It serves only a decorative purpose in the home, it is not designed to be used in conjunction with a vaping battery or mod. However, if buyers choose to use it in this way, there is nothing we can do about it." This is not new for regulators, they have the same stunt pulled on them fifteen times a day. They're not going to fall for it so they make the regs absolutely comprehensive up front.

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## Silver (16/5/18)

Thanks for explaining that @RichJB

I think an important sentence there is as follows:



RichJB said:


> Those regs don't have to be identical, they can make exceptions or different regs for vaping where applicable.



I.e. to make exceptions or different regulations for vaping - as part of the same overall Act.

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## RichJB (16/5/18)

Yes, this is what the FDA are doing. They propose that nicotine in cigarettes should be reduced to "non-addictive levels" but that vaping and NRT should not have nic reductions imposed for now. So even though it's one department (FDA) working with one Act, they have different regs and proposals for the different forms of nic.

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## Silver (16/5/18)

RichJB said:


> Yes, this is what the FDA are doing. They propose that nicotine in cigarettes should be reduced to "non-addictive levels" but that vaping and NRT should not have nic reductions imposed for now. So even though it's one department (FDA) working with one Act, they have different regs and proposals for the different forms of nic.



Good to hear
Thanks for sharing that


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## Neal (16/5/18)

Very interesting thread and great to see some healthy and educated debate. Big thanks to @Alex for all of his efforts in researching and bringing our attention to such articles, and also to @RichJB for his (as always) articulate posts. @Silver also raises some very interesting points. This is exactly what a forum on vaping should be.

Reactions: Like 1 | Thanks 2


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## Raindance (16/5/18)

RichJB said:


> I have never understood the opposition to vaping being regulated together with cigarettes under the generic heading of "tobacco products". Smoking and vaping do the same thing: deliver nicotine derived from tobacco in aerosol form to dependent users. So it makes perfect sense to regulate them together.
> 
> Cars and motorbikes are different things but they serve the same purpose: getting the user from A to B. However, we don't have one govt dept for cars and another for motorbikes, nor do we have one Act for cars and another for motorbikes. They are regulated together because they serve the same purpose as forms of transport. Where it is necessary to distinguish between the two in regulatory terms, such as mandatory helmets for bikes or mandatory seat-belts for cars, this can be done by having different clauses within one Act.
> 
> I get why the vaping industry wants it regulated separately. They want to distance themselves from tobacco because that will be good for their image and sales. But regulators don't care about an industry's image and sales, they are focused on regulatory efficiency. Would it be more acceptable if regulators dropped "tobacco products" and replaced it with "nicotine products"?


Sticking my head out here in wanting to contradict the above with a changed analogy.

Let motorcycles and cars be compared to cigarette and pipe smoking. Both contain the same dangers related to speed and risk of use. Motorcycles some higher risk due to more exposure in the event of collisions. Sticking to this theme vaping should be compared to cycling. Yes there is a risk of collision but the effects of such are far less destructive as the speed factor is greatly reduced.
To argue for vaping to be included in tobacco legislation is therefore by extrapolation the same as wanting to include bycicles in the legislation pertaining to motorised vehicles. This would include registration, licensing, number plates, drivers licences, etc. Etc.

The risk in smoking relates to the chemicals released during combustion, not nicotene specifically. To claim any substance containing nicotene is a tobacco product is the same as claiming that because thumbs are fingers all fingers must be thumbs.

Hope i made my logic clear to all.

Regards

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## Adephi (16/5/18)

Raindance said:


> Sticking my head out here in wanting to contradict the above with a changed analogy.
> 
> Let motorcycles and cars be compared to cigarette and pipe smoking. Both contain the same dangers related to speed and risk of use. Motorcycles some higher risk due to more exposure in the event of collisions. Sticking to this theme vaping should be compared to cycling. Yes there is a risk of collision but the effects of such are far less destructive as the speed factor is greatly reduced.
> To argue for vaping to be included in tobacco legislation is therefore by extrapolation the same as wanting to include bycicles in the legislation pertaining to motorised vehicles. This would include registration, licensing, number plates, drivers licences, etc. Etc.
> ...



I believe what you are trying to say is something like

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## Raindance (16/5/18)

Adephi said:


> I believe what you are trying to say is something like
> 
> View attachment 132136


Scary biker:





Regards


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## Silver (16/5/18)

I think what @RichJB is trying to say is that globally, its much easier for the regulators to use the same piece of legislation (i.e. the Act) to cover both smoking and vaping. That is understandable. 

But, as long as they can make some "sub regulations" for vaping that treats it appropriately and not in the identical fashion to smoking - then that would be the sensible thing. 

Not sure of the legal side of things - but if the laws end up discouraging smoking and vaping equally, then that would not be a good thing in my opinion.


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## Adephi (16/5/18)

Silver said:


> I think what @RichJB is trying to say is that globally, its much easier for the regulators to use the same piece of legislation (i.e. the Act) to cover both smoking and vaping. That is understandable.
> 
> But, as long as they can make some "sub regulations" for vaping that treats it appropriately and not in the identical fashion to smoking - then that would be the sensible thing.
> 
> Not sure of the legal side of things - but if the laws end up discouraging smoking and vaping equally, then that would not be a good thing in my opinion.



As with most of @RichJB 's statements, my mind do agree with him 100%. Its my heart that doesnt always agree.

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## Raindance (16/5/18)

Silver said:


> I think what @RichJB is trying to say is that globally, its much easier for the regulators to use the same piece of legislation (i.e. the Act) to cover both smoking and vaping. That is understandable.
> 
> But, as long as they can make some "sub regulations" for vaping that treats it appropriately and not in the identical fashion to smoking - then that would be the sensible thing.
> 
> Not sure of the legal side of things - but if the laws end up discouraging smoking and vaping equally, then that would not be a good thing in my opinion.



Shared legislation to manage a shared risk is acceptable. It is however not applicable in this case.

We may as well claim cooldrinks and alcohol are the same thing. Both are consumed by drinking, look the same, are liquids, so why not? We can call it sugar products act.





Drinking in public, discusting!

Regards

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## RichJB (16/5/18)

Raindance said:


> The risk in smoking relates to the chemicals released during combustion, not nicotene specifically.



That is the vaping industry's view, that the only risk from smoking is a physical risk. Public health has a different view, that addiction to anything entails not just physical harms but a lifestyle hit, social stigma and financial harms too. This is referenced in the Bill. From the Preamble:



> Acknowledging that tobacco use... has caused widespread addiction in society.



And also section 6 "Health warning messages and required information":



> A message relating to either or both of the following, namely:
> (i) the harmful health, social, economic or other harmful effects of using the product
> (ii) the beneficial effects of stopping the use of the product or of not using the product



Although the primary focus is rightly on the physical health harms from smoking, public health also holds that addiction is, of itself and absent any physical harms, an unhealthy state. So they will always oppose it and seek to end it. 



Raindance said:


> We may as well claim cooldrinks and alcohol are the same thing.



If cooldrinks contained alcohol, I'm sure govt would be quite happy to regulate them together with alcohol. If vaping wants to escape being regulated along with tobacco then it's simple: remove nicotine from vaping products. But then there wouldn't be much point to vaping products. 

I realise mine will not be a popular view. But the popular view isn't getting vaping anywhere. They tried the same failed argument in both the EU and US, and got shot down both times. It would be optimistic to expect the same argument to suddenly succeed in SA. I'm not sure what alternative argument could be pitched, though.

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## Raindance (16/5/18)

RichJB said:


> That is the vaping industry's view, that the only risk from smoking is a physical risk. Public health has a different view, that addiction to anything entails not just physical harms but a lifestyle hit, social stigma and financial harms too. This is referenced in the Bill. From the Preamble:
> 
> 
> 
> ...


Some good points there @RichJB, for now I will need review my position and see if i hwve a case left.

Regards

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