A war im anti war we meet with global news makers and talk about the stories that matter on the edges their own. Ok. One of the real dangers of a ping today we ask a team of experts about the safety of cigarettes and other babying devices and you can be part of our conversation you can tweet your questions. Or leave a comment in a live chat and in this stream. According to the centers for Disease Control and prevention the happening nearly 1600. 00 lung injury cases in United States including 34. 00 deaths linked to pay so saw 1. 00 of the cases happening to a specific brand substance all put out but for many people fighting is seen as a healthy alternative to smoking but how does that work have a look even though there are a ton of different devices out there ranging from baby pens to box mogs all beeper risers have these few basic components in common a battery coil awake and even with the e. Liquid is drawn onto the coil by the way from there the battery pushes electricity through the coil heating feel liquid until it vaporizes creating a vapor thats vanished pale everything beyond that is basically customisations of these components some devices have batteries some have more foils some use different kinds of breaks but all paper as yours essential leave work in this same basic way. Joining the conversation in california dr cedric jamie hes a public mary and Critical Care physician and host of the you tube shadow medicine deconstructed in North Carolina robert terrine hes a professor of biology and physiology at the university of North CarolinaChapel Hill School of medicine and in colorado Amanda Wheeler executive director of the arizona smokefree Business Alliance an organization that represents the states industry welcome everyone. Good to have. You had a patient who came to you and they will. Be the vice that you would give them knowing what you know today. Knowing what i know about babying the honest the bias i would give my patient not that i give patients is simply to stop making we dont know exactly the cause of it but we know that it does induce lung injury and ive seen and had multiple patients in the hospital in the i. C. U. With this injury so my best advice for any and everyone who braved the stop doing to want tax im enjoying all i could what are you saying. Thats a good question so again when we look at patients clinically right so we look at them and the way that we define and evaluate or an e cig are raping induced acute lung injury because we rule out infection we rule out all other causes of lung injury we get a history of a ping from the patient and then we look at their imaging and we can see on an x. Ray even on a cap that the lungs are going to appear to look more white whenever you have long looking more white on an x. Ray or cat scan on the lungs apostle of black you know that this represents fluid or inflammation of some kind now there have been multiple cases where people have actually been biopsied as a result of a ping and what we see under the microscope and im sure rob can go over this as well and you can see lung injury caused within the epic illegal cells of the lung and the lung once it gets injured one so that the filial cells are communicating with other cells to recruit them to that area it tends to look like in organizing type of material that can actually lead to fibrosis and scarring and then somebody cant breathe and. Now before we get too much further into this conversation weve got a comment from someone live on you tube who says this is what we should all know so this is see because he says 1st of all a distinction needs to be made in the questioning of even our show the title what are the real dangers of a thing as the word of a thing as a verb. We must 1st ask what are we so i mean to actually give out one to you of course because you are the executive director of the smoke free Business Alliance smokefree meaning they ping what is it about your alliance and your organization advocates for what kind of a pens are we talking about sure absolutely so our the businesses in our organization manufacture and sell nicotine beeping products designed for adults markers who are trying to quit smoking when you. Talk about the race to people if they say did you hear that in a way that made you concerned in any way amanda well much like your commenter from you tube i think we need to be careful when we discuss these things. They thing is a delivery method nicotine theyve been has been around in this country for over 10 years without incident what were seeing right now as an issue with people they being black market marijuana products and marijuana oils in over 80 percent of the cases that is the common denominator were not seeing these injuries show up in the kinds of commercially available Nicotine Products that have been widely used in the United States for the last decade and altering the research is what amanda believes to be the case train. I would say i totally disagree with that so weve done research from costco bees on healthy baby has even 2 or 3 days early so rabbit i think on some some of my Science Education just full of the purpose of me going back to school we explain exactly what that means and i was going to do that. So i was like nothing changes so i always talk to santa but its go ahead of it alone its a london thing right yes. I will keep quiet now so this we finish a study about 2 years ago and what we did is recruit healthy baby those who didnt have any obvious disease and then we stated them and then we put a tube down into their airways which is the bronchoscopy and then we had a camera that you could look around the airways and even these healthy body pose it was just smoking regularly cigarettes we could see their ways of really red and inflamed damaged. We also took biopsies from those vapors we studied them and we found a lot of changes quite often more changes than smokers always. And roberts right you know when you when you look at the literature impatient to do vate this is what you see you see some evidence of inflammation within the airway and in fact there has been a study published in which winnies people are reaping what it allows it allows for bacteria to actually if youre to the airway a little bit longer than it usually would so the airways arent normal and so i think we have to be careful when we say things like healthy alternative yes its an alternative but im not quite sure about alternative is healthy so its interesting you say that i want to bring in this tweet in from Charles Gardner ph d. Who writes that the reason that were talking about this is because this conversation coincides with the unique u. S. Explosion of illegal unregulated bootleg t. H. C. Bay poil cartridges that have been shown repeatedly to be contaminated with by timothy acetate oil pesticides and fungus sides isa carets he writes have been used safely for 12 years so were not talking about be sick so dr jamie talk to us about your thoughts on this tweet from your expertise specially that last line where he says he cigarettes have been used safely for the past 12 years have been yes thats a good thats a good point and he makes a very good point however this is how i will agree with his point add to his point and maybe even disagree just a little bit when you think about baby yes bates were discovered and really really started to begin to use in 2003 by a chinese pharmacist but the nicotine industry has been using aerosolized type of products since 1963 however if you were going to say that because of the introduction of oil within the delivery devices of t. H. C. Leads to injury you also have to assume when you look at these patients and you look at the data 60 percent of these pace. Its use both east cigs and t. H. C. Products i agree with amanda i agree with the gentleman who left that tweet that most of these patients do use t. H. C. Products but again these patients also use Nicotine Products so once the t. H. C. Product maybe begins the injury you have to assume that vaporing is still healthy even though the injury has begun the injuries begun so even if you say t. H. C. Is the issue right sure but once the lung is injured it nor longer has that protective mechanism any longer and its ok and erin pfizer is a very Amanda Amanda was an excellent because i know you have just got to Say Something and then what you come back is if i say a t. H. C. Product is the part of the time of this plant that actually that surprise that shorthand is that sad to say that. I believe that the case im sure im i am no expert on cannabis or t. H. C. But yeah i believe that is correct that t. H. C. Is the psychoactive component of marijuana and you know theres overwhelming evidence with the types of pesticides the types of additives like vitamin e. That are being put into those black market cannabis they its that people really are playing with their lives you know our products that we sell Nicotine Products we have been manufacturing those the same way for over a decade these long and injuries are a phenomenon that has come up in the last year so obviously something in the marketplace has changed you know though the way that we manufacture commercially available Nicotine Products has not changed what has changed are the additives that are being introduced into the black market and the pesticides theyre being used on that black market marijuana and so you know it really isnt an issue that is coming from the legitimate nicotine manufacturers all of our ingredients are fairly registered with the food and Drug Administration our manufacturing facilities are regularly inspected by the food and Drug Administration what we put into our parks and what we are doing is the same thing that weve been doing to help smokers for over 10 years and that is you want to explain how you will actually go missing sigal balti and what do you do so everybody compared to not sure absolutely so in a nicotine liquid there are 4 main components Propylene Glycol the nicotine and flavor additives. And like i said those are the same things that weve been putting in there for over a decade the same ingredients that are used in nicotine you liquid in the United Kingdom where their Health Officials have defended them and i want to i want to finish that i think experience if you want to. Discuss that experience its water vapor and nicotine and labor and then what you get out of that how do you like how does that feel. I mean you know i use a very low nicotine liquid i i its been a long time since i smoked my nicotine levels very low so its just a very mild satisfies a very mild craving for nicotine overall you know a very pleasant experience you know breathing in vapor and exhaling add getting a little bit of nicotine that satisfying that urge without turning into a deadly product like a combustible cigarette so thats overall you know a very helpful experience were for myself as well as thousands of other smokers i think of i think its important to remember that i remember earlier saying that weve been doing this for a decade without incident again theres incident and then theres reporting i can quite frankly tell you that over the course of the last couple of years in terms of history taking more doctors are asking if somebody uses an isa direct product so you cant really say that there were no incidents before 10 years a billboard 10 years ago within the last 10 years because i can say that positions werent probably asking specifically if people use products or east cigarettes now we ask and because of this epidemic people are now telling us oh my gosh yes i do use this children really important to kind of squeeze that out and not just say that well it didnt take place at all and now its all taking place and asked to be just t. H. C. Im glad that you mentioned and i just im glad that you mentioned that robert ill go to you with this but i want to link something that dr jamie said which is that now doctors are asking and it could be because of something that amanda said earlier which was something in the market has changed i want to share just an anecdote robert activity for your thoughts after barry read here on twitter says in the high street of the town car can to lock in scotland it now has 8 shops as many Charity Shops and twice as many hairdressers and barber shops one year ago there was one shot. And he goes on to say he thinks the reason is that its another trinket to display and used to show how modern one is devices are popular with both sexes and the tao is predominantly working class so robert i wanted your thoughts on the idea of this being a modern way to smoke and whether or not the public thinks this is a good thing thats replaced a bad thing you know 1st of all commercial just go back to amandas comment that people have been very pink for 10 years or into the so its generally acknowledged tobacco smoking kills about 50 percent of its users however after 10 years those people are actually fairly healthy so if you get someone to start smoking with their 1819 when theyre 29 they look fine buy it takes 203040 years to actually develop lung disease but it will catch up with you and we will get it right so saying that people be bracing for 10 years which are instances enough time and i think this is could be a major problem there is the current epidemic which may or may not be due to a t. H. C. Or not but theres also the potential long term effects and everything we see in suggests that very thing is setting you up for a long term lung disease exactly the same way as tobacco smoke however if people wait this is a huge experiment which people run which could be taking part of it and we wont know for another 2030 years. What they do want to just remove that 2nd point that little to put which is about it was about taking a lifestyle i guess but for a man to pick up on an idea is that its a lifestyle i would say those are you doing it then smoke like most of it now say i think younger people its were going to say were going to smoke thats what a lot of people say but innovate. Well i would actually say you know for the businesses that are in my organization the median age of our customers is you know in the early fortys so we primarily cater to people who have been lifelong smokers who have been unable to quit with other products like the patch or gum i understand that for the young people that it may be more of a status thing that theyre picking up on and they also use radically different types of devices than the types of devices that i sell in my business and the business is in r. Soucy ish and so so for those people that are looking at this as some kind of you know cultural trend or some kind of status symbol those really are the people that my businesses and businesses like mine are serving were really here for people who want to stop smoking who have tried Everything Else who are looking for a Harm Reduction tool because thats truly what this is you know it is a norm of Harm Reduction you know and for those smokers who have been able to quit with they think its a different sort of lifestyle its a its a sort of thing that were very passionate about that we advocate very vocally for something that we care about its not something to be trendy or look cool its something thats changed our lives radically and we have a passion for fighting for that for advocating for that and for sharing that with others who may also need similar kind of help i think its so that there isnt that Much Research i just hope tight for one second there isnt that Much Research in that were going to have to wait a while to see maybe what the damage is thats jamies told his perspective his perspective. As a vapor amandas talking about what the benefits that she gets from Public Health of england let me let me just hold tight for my woman we just showed you this because this may be evidence or it may be one of the many studies as we go forward about Public Health in. And is a Government Organization in the us looking at Peoples Health and they did a study looking at smoking versus vapor they filled a bell would draw with cotton balls and 2 bell giles one they allowed to smoke 16 packs over a month of cigarettes the other one vate for the same amount of time and then this is where we pick up the experiment have a look. Here is the belgian cigarette smoke i mean it just is so revolting thats just the inside of the joke here a lot of tall service whats going on inside your lungs and now were going to cut this to. The rule. But theres loads of it and this is only after one month. So now lets have a look at the cigarette lets just see a little bit of a car thats the only one thats really got much in the car just 1st what. So but i misspoke Public Health england is a u. K. Organization of course but it looked like that demonstration proved the point of people who like to vacate the smoking is much worse for you than say ping is you would look at that demonstration and say what so when i look at that demonstration what i do see is 1st of all cotton balls cant go to the i. C. U. They cant tell you if they feel bad or if theyre coughing i think bit earlier somebody about at the point that its Harm Reduction. When people Smoke Cigarettes and i think cigarettes are bad and i dont think anybody should smoke a cigarette i havent you dont really hear of people for ending up in the i. C. U. After the 1st time they smoked a cigarette ok and im not saying they should and they should not Smoke Cigarettes but kids kids if amanda 14 year old came home and out of a pen and her and she would be upset all im saying is here smoking these kids are less than 35 years old 80 percent of them theyre getting sick of her