American Heart Association Claims that Vaping Causes Severe Strokes and is More Risky than Smoking

In a press release issued last Thursday, the American Heart Association claimed that vaping causes severe strokes and poses a higher risk of severe strokes than smoking.

According to the press release: “E-cigarettes may pose the same or higher risk of stroke severity as tobacco smoke. … Electronic cigarette (e-cigarettes) vaping may pose just as much or even higher risk as smoking tobacco for worsening a stroke, according to a preliminary study in mice presented at the American Heart Association’s International Stroke Conference 2017. … From a brain health perspective, researchers said, electronic-cigarette vaping is not safer than tobacco smoking, and may pose a similar, if not higher risk for stroke severity.”

The American Heart Association’s statement was spread widely through the media. For example, here’s just one headline that appeared: “E-cigs could raise the risk of suffering a stroke more than smoking.”

The Rest of the Story

The American Heart Association’s conclusion that vaping poses an equal or higher risk of suffering a severe stroke is based on a single mouse study. In this study, which has not been published or peer reviewed, but was presented last week at the American Stroke Association’s International Stroke Conference, the investigators found that mice exposed to e-cigarette aerosol for 10 days or 30 days had more severe strokes than those exposed to tobacco smoke.

To extrapolate from this single pre-clinical, animal study to population-based human health effects is ludicrous. There are many reasons why stroke-related findings from rodent studies do not translate well to humans. For example, as Braeuninger and Kleinschnitz point out:

There are, of course, significant physiological, neuroanatomical and metabolic differences between humans and small rodents, which are the most widely used experimental animals in preclinical stroke research. For example, small rodents usually require higher drug doses on a mg/kg body weight basis for a similar effect than larger mammals. Thus, effective doses derived from preclinical stroke studies in small rodents cannot simply be transferred to the situation in humans, even if adjusted for body weight.”

There is no scientific justification for the American Heart Association spreading the conclusion that vaping causes strokes. Nor is there any scientific justification for spreading the message that vaping poses a higher risk of suffering a stroke than smoking.

This blatant disregard for the truth, which I would term “public health malpractice,” is not only unscientific but it is also damaging to public health. There are literally millions of smokers who have considered, or are currently considering, the question of whether or not to switch from smoking to vaping. Thanks to the American Heart Association, we can expect that huge numbers of smokers will choose to stick with smoking and that many ex-smokers – who quit via e-cigarettes – will decide to return to smoking.

After all, if vaping poses a greater risk of stroke than smoking, then there is absolutely no reason to quit smoking using e-cigarettes. You’d be better off smoking. And if you already quit smoking by switching to e-cigarettes, then you’d be better off returning to smoking than continuing to vape. Why take a chance of increasing your risk of suffering a stroke?

You can see why I call this an example of public health malpractice. The American Heart Association is essentially advising smokers that they are better off continuing to smoke than quitting smoking and switching completely to vaping. This is perhaps the most absurd medical advice I have ever heard in my entire career in medicine and public health. Even the tobacco companies – in the worst of their behavior – never told smokers that they would be at greater risk of disease if they quit smoking. But that is precisely what the American Heart Association is essentially telling smokers.

If the American Heart Association has any regard for scientific accuracy and professional responsibility in communication, it will offer an immediate retraction, correction, and apology for this action.

If that happens, I will report it here as soon as I become aware of it.

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Sen. Ron Johnson Continues to be a Champion for Vapers in the US Senate

On Tuesday, February 21st, Senator Ron Johnson (R-WI) sent a letter to incoming Health and Human Services (HHS) Secretary Tom Price congratulating him on his confirmation and urging Secretary Price to “consider suspending the FDA’s e-cigarette rule.” In addition to citing the obvious damage to the economy that will result from full implementation of the FDA’s deeming rule, Senator Johnson highlights the harm to public health that removing nearly all vapor products will cause.

CASAA is grateful for Senator Johnson’s leadership and we are hopeful that other members of congress will be receptive to the facts about vapor products and tobacco harm reduction as a whole.

Senator Johnson’s letter to HHS Secretary Tom Price is available here.

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EP18: HR1136 ~ GoonLP ~ Rabox ~ Omni RTA ~ Purge ModsHey…

EP18: HR1136 ~ GoonLP ~ Rabox ~ Omni RTA ~ Purge Mods

Hey everyone! Welcome to Tuesday Bro Tuesday Episode: 18





Got a very rad program planned this week.  Of course there are some reviews. The Smoant box goes though some torture testing and we welcome the Goon LP as well as the PURGE mod to the review queue. Of course we have some viewer mails and some random juice tasting at the end so tuck in, Grab your best vape, and enjoy the program


–This week in the queue are the following vapes–

Goon LP

Smoant RABOX

Omni RTA

Purge Mod


Timestamps and links are below!

Top of the program is news and updates

Reviews part one is at 9:10

Getting to know GrimmGreen is at 29:16

Reviews part two is at 35:58

Viewer mail is at 53:44

Juice is at 01:06:47


new Cole Bishop

Fire the General


Purge Mods

Omni RTA

Smoant RABOX




Bro Trip

Jam Monster

Faerie Wings

Vlog Day

Double Helix Recoil Caps

Crispy Caps Recoil Caps

((Other links))

My Juice ►
Subscribe ►
Instagram ►
Facebook ►
Twitter ►

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HR 1136 – Modernizing the predicate date for vapor products is a vital first step

The FDA Deeming Clarification Act of 2017 (HR 1136) was introduced on Thursday, February 16th. Republican Tom Cole of Oklahoma (4th district) and Democrat Sanford Bishop of Georgia (2nd district) have built on previous legislative attempts from 2015 and 2016. HR 1136 is an updated version of HR 2058 and the Cole/Bishop amendment.

Last June, CASAA’s legislative coordinator, Alex Clark, along with representatives from vapor trade associations met with Representative Cole to discuss threats to vapor products if the predicate date was not modernized. An additional point discussed was the battery standards language contained in the Cole/Bishop Amendment (an amendment that could potentially still be added in through the appropriations process for 2017). We are pleased that HR 1136 addresses the most pressing of those concerns; specifically, Section 3(c) which states that manufacturers who make changes to devices in order to bring them into compliance with a battery standard created by the FDA would not be subject to submitting to the PMTA process in order to keep those devices on the market.

HR 1136 is the product of years of effort from all stakeholders. Modernizing the predicate date is a necessary first step to developing appropriate regulation for this life-saving product category while we continue to work towards long-term solutions. No one legislative, judicial, scientific, or public relations effort will accomplish our ultimate goal; different efforts and strategies are required to keep moving the ball forward. Looking to the future, fair regulatory treatment of vapor products is part of the larger campaign to change the tobacco control culture in the United States. Ultimately, policy makers, regulators, and public health advocates must change their abstinence-only approach to one of comprehensive harm reduction in order to humanely reduce the morbidity and mortality associated with smoking cigarettes.

In the coming weeks and months, CASAA will continue working cooperatively with other vapor organizations to develop campaigns in support of passing HR 1136. However, for those who are chomping at the bit to get started, this week is an excellent time to engage in face-to-face engagement with lawmakers.

Your representative will likely be back in their district from February 20th through 24th. This is a great time to make contact through their district offices and set up meetings. In some cases, your reps will be holding town hall meetings. Although there are other issues that have grabbed national attention, in lieu of being able to set up a personal meeting, addressing your representative at a town hall meeting can be just as effective.

How to speak at a town hall meeting:

Town halls are a time for your lawmakers to answer questions about policies and legislation that affects you. So you’ll want to frame your brief presentation in the form of a question.


  • Briefly, tell your story.
  • The FDA deeming regulations will limit or, in some cases, completely prohibit your access to life-saving vapor products.

What is the solution:

  • HR 1136, introduced by representatives Cole [R-OK] and Bishop [D-GA], would modernize the 2007 predicate date in the Tobacco Control Act (TCA) for vapor products. This would allow most vapor products to remain on the market without being required to undergo the prohibitive PMTA process. Cigarette makers were given similar consideration when the TCA was passed in 2009. We are asking for equal treatment.
  • The FDA will still have the authority to regulate vapor products. In fact, this bill would explicitly grant FDA more authority than is already given to them by the TCA.

What is “the ask”:

  • Can we count on your support of HR 1136 and will you sign on as a co-sponsor?


As we move forward, we will have more opportunities to engage with lawmakers to urge support for HR 1136.

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Tobacco Control Journal: There Can Be No Legitimate Discussion of Our Articles Without Our Permission

In a revelation of the religious-like character of the modern-day tobacco control movement, the journal Tobacco Control has suggested that there can be no legitimate discussion about articles it publishes without its permission; that is, on the Rapid Response forum at the journal’s own web site. All other discussion of the scientific validity of journal articles is apparently illegitimate and inappropriate.

In an unprecedented editorial (I’ve never before seen a journal argue that the only legitimate forum for discussion of its articles is in the journal itself), the journal writes:

“the growing use of personal blogs to criticise published articles has led us to reflect on appropriate ways of engaging in such debate … the proper place to pose questions and debate conclusions from research published in Tobacco Control is directly to the authors, in the form of a Rapid Response. … placing personal blog posts or social media messages complaining about a study … do not advance the field or allow an appropriate scientific dialogue and debate. … As a result of discussion about these issues, the Tobacco Control editorial team has now established a policy that editors will not respond to external blog posts or social media messages about specific studies. … We will always welcome legitimate criticism of methods, results and interpretation of published research. But we will discourage engagement with and dissemination of polemics that contribute to public misunderstandings and create conflict. As journal editors, we encourage constructive criticism and debate in ways that strengthen the evidence base for effective tobacco control policy rather than amplifying individual voices.”

The Rest of the Story

I have never seen a scientific journal make such a bold statement. Do you mean to tell me that the only legitimate scientific discussion of an article published in a journal is that which takes place in the journal itself, in a forum that is managed and controlled by the journal? Do you mean to tell me that any other discussion or criticism of research articles is not constructive and serves only to “amplify individual voices?”

Moreover, what is wrong with creating “conflict” if it is warranted because the conclusions of an article are not supported by its findings? In fact, a blogger who is criticizing the conclusions of a study because they are warranted is not “creating” conflict. What is creating conflict is the fact that the paper disseminated those unwarranted conclusions and that the journal chose to publish this shoddy science in the first place.

The editorial does not specify exactly what irked the journal so much that it boldly went where no journal has gone before and declared that any discussion of its articles outside of its own purview is illegitimate. However, I think it’s quite clear that what irked the journal was criticism on several blogs – including my own – of an article that concluded vaping is a gateway to youth smoking based on a sample of 4 nonsmoking youth who experimented with e-cigarettes and then went on to try one or two cigarettes.

In this study, the sample size of youth who were nonsmoking, recent vapers at baseline was only 13 and the number of youth in this category who “initiated” smoking was only 4. Thus, the sweeping conclusion of the paper, which has been publicized internationally, was based on only 4 kids! Moreover, despite having a sample size of 347 high school seniors, the study could not find a single student who became an actual new smoker after having experimented with e-cigarettes. The few students (a grand total of 4) who did try a cigarette or two did not progress beyond having one or two cigarettes.

Rather than simply admit that it made a mistake and this unwarranted conclusion slipped through the cracks, the journal instead tried to divert attention from its mistake by attacking the messengers: those like myself who pointed out the error.

It’s unfortunate that the journal chose to respond in an ad hominem manner rather than to actually address the substantive scientific question, which is whether or not the conclusion that vaping is a “one-way bridge” to smoking among youth can be justified based on the finding that 4 youth who were nonsmokers at baseline and who had experimented with e-cigarettes went on to smoke one or two cigarettes in the next year (and did not become smokers).

The issue is whether that is the kind of scientific evidence that legitimately supports the paper’s conclusion that vaping is a gateway to smoking, rather than the method by which a blogger who notes this study weakness should attempt to correct the public health damage done by the publication of the article.

I don’t whether the editorial was directed at me or at other bloggers, or both, but I can assure my readers that I will not stop providing discussion of the scientific research regarding electronic cigarettes just because one journal wants to control the entire discourse on the subject.

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Striking Balance | Health Canada On Vaping | Part 1  When you…

Striking Balance | Health Canada On Vaping | Part 1  

When you want answers the best person to ask is always the one in charge. For vaping in Canada that person is Suzy McDonald, the Director General of the Tobacco Control Directorate‎ at Health Canada.

At this critical moment for vaping, on the cusp of federal regulation, what are the driving priorities at Health Canada on the vaping file? What are the deliberations around flavours, nicotine and the evolving science of vaping? And, what does ‘legal’ truly mean for vapers in Canada?

Find out in part one of this exclusive two-part series—the first television interview granted by the top policy-maker—only on – February 14, 2017.

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New video resource for THR advocates and policy makers – Facts about Vaping!

Millions of long-term smokers have developed diseases that have caused them to die early. It is well understood that these diseases are caused almost exclusively by inhaling smoke. Vapor products, commonly referred to as electronic cigarettes, or e-cigarettes, do not burn tobacco or any other material, and so do not produce the smoke that causes smoking related diseases.

  • How an e-cigarette works.
  • Vapor products are an alternative, low-risk product.
  • Many people use vapor products exclusively and others smoke far fewer cigarettes.
  • Vapor products can be effective in helping people stop smoking completely.
  • Best estimates suggest that e-cigarettes are at least 95% less harmful than regular cigarettes.
  • Vaping is a clean source of nicotine absent most of the toxic chemicals found in smoke.
  • No known harms to bystanders from inhaling secondhand vapor.
  • There is zero evidence that nicotine causes cancer.
  • Isn’t nicotine addictive?
  • Vapor products are a less-risky alternative to the death and disease caused by combusted cigarettes.


Public Health England 2015 – E-cigarettes: an evidence update

Addiction 2014 – Real-world effectiveness of e-cigarettes when used to aid smoking cessation

Royal College of Physicians 2016 – Nicotine without smoke: Tobacco harm reduction

International Journal of Environmental Research and Public Health 2014 – Comparison of Selected Analytes in Exhaled Aerosol from E-Cigarettes with Exhaled Smoke from a Conventional Cigarette and Exhaled Breaths

International Journal of Drug Policy 2015 – A pilot study on nicotine residues in houses of electronic cigarette users, tobacco smokers, and non-users of nicotine-containing products

International Journal of Environmental Research and Public Health 2014 – A Simple Approach to Modeling Potential Bystander Exposures to Nicotine

Office for National Statistics 2016 – Adult smoking habits in Great Britain

Addiction 2016 – Electronic cigarette use in the European Union


Brian L. Carter, PHD
Director of Scientific Communications
Consumer Advocates for Smoke-Free Alternatives (

Christopher Russell, PHD
Centre for Substance Use Research, Scotland (

Cynthia Cabrera
The Cating Group (

Hometown Hero (

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Kentucky Health Group is Deceiving Public About Risks of Smoking … and It's Working

A Kentucky health group has orchestrated a campaign to deceive the public about the terrible health hazards associated with smoking by downplaying those risks. Sadly, a recent public opinion poll commissioned by the group demonstrated that its campaign of deceit is working. Adults in Kentucky have been completely fooled about the serious health risks of smoking.

According to the Foundation for a Healthy Kentucky: “Research suggests that e-cigs may be a gateway to using other forms of tobacco, and they can be just as harmful.”

The Rest of the Story

There is abundant evidence that vaping is much safer than smoking. In stating that vaping is just as harmful as smoking, the Foundation for a Healthy Kentucky is lying to the public. Moreover, this campaign of deceit is undermining the public’s appreciation of the severe health hazards associated with smoking. If smoking is no more hazardous than vaping – which doesn’t involve the burning of tobacco – then it must not be as harmful as previously thought.

I can assure you that if the tobacco industry were making the same claims, we would be attacking them and taking them to court for public fraud. But the Foundation for a Healthy Kentucky is making precisely that claim which would have us dragging Big Tobacco into the courtroom. Why is it OK for us to lie, but not the tobacco companies?

A recent public opinion poll commissioned by the Foundation for a Healthy Kentucky showed how successful its campaign of deceit has been. According to this poll, 64% of Kentucky adults believe that smoking is no more hazardous than vaping. And nearly one in five (19%) actually believe that vaping is more hazardous than smoking!

Interestingly, nowhere in its report or press release does the Foundation point out that these 64% of Kentuckians are wrong in thinking that smoking is no more hazardous than vaping. If anything, the report appears to lament the fact that 29% of adults in Kentucky think that vaping is safer than smoking.

What a tremendous disservice the Foundation for a Health Kentucky is doing by misleading the people of Kentucky into thinking that smoking is no worse for your health than using a product which doesn’t even contain any tobacco and doesn’t involve any combustion.

It is also contrary to public health to bemoan the fact that a segment of the public has a correct understanding of relative health risks. Our goal should be to aim for 100% of the public to have a correct understanding of relative health risks, not to try to deceive the public so that they don’t have correct information.

I’ll be watching to see if the Foundation for a Healthy Kentucky corrects this misinformation. Until that happens, they are harming the public’s health by decreasing the likelihood that smokers will quit and increasing the likelihood that vapers will return to smoking.

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