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Welcome to Drinking Bros, presented by Ghostbed.com.Sit back, relax, and grab a fucking drink.
Welcome to a very special episode.I guess it's a crossover of Drinkin' Bros and Citizen.Really, it's about you guys.It's about the people that watch our show, veterans, first responders.There's a lot of people out there.
You've heard us talk about over the past couple of months this organization called Smoke Less Vets. Just as a problem statement.
There are over a million veterans right now who receive care at the VA and Report that they smoke and 52% of them have expressed to the VA in some capacity that they would like to quit now the VA for whatever reason
Refuses to educate the public on the reality of the options available to them and their efficacy They won't authorize the use of some of these alternatives and have even spread a lot of misinformation, right?
So for example, I'll just I'll just give this one out of the gate E-cigarettes are 95% less harmful than cigarettes.
That's a fact verifiable fact The VA ignores the study and even suggests that East e-cigarettes and vapes cause cancer Now this is a problem.
Obviously, it's it's something that we see a lot in society right now that that these so-called experts or people in charge and in whatever capacity
You know have an axe to grind or they're just resistant to change or something It doesn't really matter what it is.
But what it does is stops progress now joining me today are Mac Matthew Kenny and Dr. Timothy Vermillion people that have both been on Citizen before you've seen them before and they are deeply involved in this.Thank you gentlemen for coming.
Welcome to the show First, I want to go to you, Matt.Tell us about Smokeless Vets, what it is, how it started, and what the aim of this organization is.
Thanks, Dan.Yeah, I'm really excited about this initiative. is a dedicated initiative created by a bunch of veterans like ourselves.
We're on a mission to try to help one million veterans quit smoking by promoting harm reduction and modern cessation methods.I think we recognize as veterans that they face unique challenges in trying to quit.
And we want to emphasize the importance of some of these innovative tools and other reduced risk alternatives to help veterans quit smoking.
I think through an educational campaign like what we're trying to do, some strong partnerships with awesome organizations and media companies like yourselves, partnerships and grassroots advocacy, I think that we can make a lasting impact on veterans' health and hope with force readiness and other things like that.
Sure.Yeah.I mean, obviously force readiness is important.Taking care of people after the fact is important.Um, and taking care of your own is important.Nobody's coming to save us.We figured that out over the last 25 years.
So it's imperative for us to, to do that work ourselves, obviously.Um, Dr. Vermillion, um,
obviously a doctor, give us a little bit, just for the audience, give us a little bit of your background and how you got involved in this, and then how you see this issue from the, let's call it the 30, because we're going to get a little granular today, but from the 30,000 foot level.
Sure.So my doctorate is in social work.I'm mostly a therapist, mostly veterans and first responders.So I got into this because I've been working with demand reduction with, um,
organizations like Partnership for a Drug-Free New Jersey over time, over a long period of time.And most recently it was last March that I did something with harm reduction and related to opiates.
And with that conversation came people asking about tobacco and kind of giving me some more information because I wasn't fully informed at that point.
And I was surprised to learn that it's almost the biggest thing that we could do for the public in general is to get people off cigarettes because it kills so many people a year, almost 450,000 plus at this point.
So I started to kind of look into it a little bit more and started to look in my niche towards veterans, which is really the population that I work most with.
and started to recognize that there was a lot of things going on with the veteran population in terms of smoking.They smoke more than the average population and they also end up with the same types of issues.
And even more so sometimes because they're also involved in toxic environments like the burn pits and stuff like that which further aggravate their lung tissue and their physical health.
So right now, I wanted everybody to understand this piece too, is right now this month is Lung Cancer Awareness Month.I posted this on my Facebook, I think, but there's almost 8,000 cases of lung cancer in the VA with veterans every year.
And then there's also, they say, 900,000 veterans at risk of getting lung cancer right now.And it's not just about quitting cigarettes and you're good.
It's noticing that within the last 15 years, if you smoked in the last 15 years, this could have had an impact on you.So it's really about doing this now, right?Getting people off of cigarettes now.And that'll help you as you start to move forward.
Well, before we get into audience questions, I'm curious about a couple things.The first one is you, you're suggesting that, and I think this is obvious, but I just want to make it clear that Smoking can be a compounding factor.
There's not a whole lot you're going to be able to do about avoiding burn pits and explosions when you're in combat, right?Or even sometimes on military bases.
And smoking certainly is just going to add more fuel to that fire, for lack of a better phrase.But the question is, you said if you smoke within the last 15 years, what's the relevance of that number?
Yeah, so in terms of the screenings that the, by the way, if you are age 50 or older and have smoked within the last 15 years, the VA is saying go get a screening for lung cancer, right?
So that's where the issue is, is that if you smoked even within the last 15 years, you're now more at risk of having lung cancer, especially depending on your age.
Interesting, I've not heard that before, so thank you for that one.Okay, now we're going to get to, we'll start, we've got a pretty good list of questions from the audience here, and then we'll talk about some anecdotes later.
We also have people in the chat who are going to chime in.First question is, Uh, why do veterans and active duty military personnel have higher smoking rates compared to the general population?
And I'm asking, well, the person asked why, uh, presumptively, but that it is true that the rates of smoking are higher and these jobs in higher stress jobs, uh, EMT fire, things like that also quite a bit higher than the general population.
Um, Matt, do you have any thoughts on that?
Sure, and I think maybe some of the listeners would enjoy a personal anecdote, too, or example.I didn't smoke, but I chewed tobacco for 15, 20 years.And the peak of, I think, my dipping was on deployment when we were in Iraq.
We were at a combat outpost.I was about three hours from the forward operating base in Mosul that we would
reload at, and we would go out and we would stay for four to five day missions out at the combat outpost and then we would come back, but you know, those missions would be exhausting, right?You're at high tempo the entire time that you're out there.
And when you're traveling back, you know, a three hour drive in a Humvee, especially when you're not driving or being the gunner, you know, you could be exhausted.
That doesn't make it any less dangerous when you're driving through these different villages in which we were regularly attacked.And so, you know, one of the ways that I coped was was to throw in a dip the entire three hour ride back.
I know that all of my soldiers did too.So you could see the high tempo, the high stress, the last thing that you want to do is become complacent or tired or fall asleep when you're supposed to be checking out your sector.
So I think that that's a good example.It becomes a necessity.It also becomes the one way in which you can kind of relax with your buddies, throw a dip in or a cigarette at post mission, kind of talk about what's going on.
So I think that there's a lot of reasons why it... why it becomes a part of your habits and the things that you do every single day.But I do think that we've got some good solutions to provide, too.
Sure, yeah.You're talking about staying alert, really, in a lot of ways.And really, it's an interesting idea.And it's why cold turkey smoking cessation, one, is usually ineffective.Some people can pull it off.
But also, there are nootropic benefits to nicotine.There's a lot of them, as a matter of fact.And we've gotten ourselves into a situation where we're kind of throwing the baby out with the bathwater.
But it does feel like it's making a comeback, thanks to a couple of people, including you guys, who are talking about this stuff.I think this is a really good question.
This is my favorite question out of all of these that are asked, because it just leads down so many different threads.
Certainly, high stress job where you got to be alert, nicotine is going to play a factor, no matter what form it comes in, in my opinion.Then, of course, there's cultural acceptance.
You know, over the last, let's call it 25, 30 years, the cultural acceptance of smoking in the workplace, for example, has gone downhill dramatically.
Taking a smoke break for 15 minutes a couple of times a day isn't really something that happens in most modern offices.
But in the military, that's not a thing right we do a lot of sitting around for as much work as we actually do There's a lot of hurry up and yeah And we call it smoking and joking right you're hanging out with your buddies After either board or in combat or after some high-stress event getting back for a patrol Just sipping sitting around ripping a heater is not it's kind of a ritualistic thing, right?
And then in addition to that and this is something That that doc I'd like to you to talk about one thing people don't know That's also a factor in tobacco with military people is that it's quite a bit cheaper on military bases and there's some pretty good data to back this up actually, so
There are no state and local taxes applied, which means if you're in a state like New York that has a really high sin tax, as they call it, that doesn't exist on a military base, right?So it's not $16 a pack for a pack of cigarettes.
It's $4, just like it is in every other state, right? Then there's just the way the DOD handles putting products on a military base.
Typically what they do is they take the lowest competitive price in the country, and then they reduce it by 5%, so it's even cheaper than you can get it anywhere, no matter, regardless of the tax, right?
One study that I read earlier this week found that Marlboro Red and Newport Menthol packs were about 80 cents to 87 cents cheaper on base than anywhere else in the country, which would translate into like 300 to 350 bucks savings a year.
Now that might not sound like much, but when you're a private in the military and you're making $24,000 a year before taxes, then that's actually quite a bit. Before we move on from this question, Doc, do you have any thoughts on that?
And then can you comment just briefly, because we'll talk about this more later, on the nootropic effects of nicotine and why it might be attractive to people, as Matt suggested, in high-stress environments but need to stay alert even when they're exhausted.
Sure, so having more access to cigarettes definitely make it easier to get and more people to have it.There's a social component with smoking, so if it's cheap and people can easily get it,
and they do it together, then it develops this feeling state, the camaraderie, right?
So if you are away from your family for the first time, if you are now in a place where you have to be a part of a group, then smoking is going to be something that you might take up if the rest of the group is doing that.
And this does another thing, it also increases this feeling state, this idea of smoking equals I feel accepted, I feel like I belong.So even when you're not with those people, the smoking can actually bring up some of that feeling state for you.
So I'm smoking and therefore I feel like I belong, you know, that I'm with somebody. So, there's a psychological effect, and then there's the neurotropic effect, which, as we were saying, can definitely increase attention.
The idea, when we talk about nicotine itself, there's really, by itself, there's really not much that is harmful in the nicotine itself.So, a lot of people do use it for trying to stay up, try to concentrate.
Just the first thing in the morning, sometimes they get up, right, because it makes them feel good.Just like a cup of coffee might, you know, you can compare nicotine to caffeine and it has a lot of the same benefits.
So, as far as the neurotrophic effects, in terms of attention and everything, It is definitely something that is worth investigating more in terms of different ways of getting it into the system without the power and toxins of combustible cigarettes.
Yeah, sure.I like what you said.Smoking with your buddies is a social feature. And having a sense of belonging that look that's a big issue.
We found over the last 15 or 20 years studying The the G what the post 9-11 vet and the Vietnam vet suicide epidemics we've had You know that that's that feeling that you are disconnected now from
The people and I to me you can you can follow that thread down.It's not very far You get disconnected from the people that you depended on and that depended on you and your sense of purpose goes along with it Typically, right?That's it.
That's a very common thing All right, great.Let's go on to the next question doc.This is mostly for you Can you explain why traditional methods like patches and gums which by the way was is?
So far as I know was the only thing available at the VA when I asked back in 2011, that's the only thing they had available was gum.I don't think they even had patches back then.But why are they not as effective as some of the more modern methods?
Look, the VA has a lot of resources now, right?If you wanted to call right now and say, I want some coaching in terms of quitting, they have the 1-855-QUIT-VET, and they will put you into coaching.
If you didn't want to call somebody, I don't like talking on the phone too much, you might want to text, you can type, text VET 247-848, and there's some resources there. So they have the resources in that way.They are doing stuff.
They just might not be able to get that information out to the people that need it.
As far as the medications and stuff go, they have the nicotine replacement therapy, which doesn't work per se because it doesn't have the mouth feel, I guess, the throat hit.It doesn't have the physical actions that are tied up into it.
that come with smoking or come with dipping.And again, when we think about the psychology of it, the psychology doesn't say that necessarily that the nicotine is going to make you feel like you belong.
But smoking that cigarette, you know, that e-cigarette, doing the same motion, that might also encourage that feeling state that they're looking for.So by doing something that is closely related
to combustible cigarettes, to dipping, that will help with people sticking with a replacement-type therapy, which again, the nasal spray I think they have now, the lozenges, the gum, they don't have that. They also have the medications, right?
Interesting thing that I like to think about the bupropion and the, I can't even say this word, I've got to write it down somewhere, the Chantix, I'm not going to say the big word, is that when you look at the dangers of Chantix, you know, you have possible, you know, rarely maybe, but possible seizures, possible hallucinations, possible increase in ideation of suicide.
And the same thing with bupropion, you know, there's some increase in chances of these types of things.So in terms of possible harm, we're also looking at that possibility in terms of the medication.And then last part is the counseling, right?
So if you're going to benefit from really trying to come off of cigarettes, sometimes you'll need that, not just coaching from that phone call, but also sitting there and doing like cognitive therapy for smoking.
Sure, yeah.Matt, talk about the ritual part of it, what it meant for you to just hang out.I mean, we talked about it before, hanging out with the guys, ripping a heater, man.I mean, that was kind of a thing.Yeah.
And it sticks with you after the fact, too, because that becomes, let's call it a comfort zone in times of stress, not just the chemical itself, but the ritual.
Yeah, I look back and some of my favorite times or favorite memories were with a dip in and grabbing a beer with some of my battle buddies, too.I still do it.Now it just happens to be with pouches.
And part of it is after a really stressful day, too, I've changed a little bit.I usually just throw one pouch in or something like that at the end of the day. And I still enjoy it.It's still kind of a good mental break for me.
I think it really is that I've been doing it for so long, throwing in a lipper, right?And so that same sensation of being able to put a pouch in instead of the lipper.And as a side note, too, my wife is a whole lot happier, right?
I'm not like, oh, I have spitters all over the place. knocking over onto the carpet.But no, I mean, I still, that's still something that we do.
And what's interesting is I run into like buddies, and one of the first things like, you know, military and veteran buddies, and one of the first things that they do is, you know, pull out their tin of pouches now.
And we were like, yeah, you want one?And like, you know, you'll share.And it's still part of the culture to like, and I don't know how to explain it outside of that, except that it is a kind of a part of our military culture.
And it's a way for us to kind of quickly you know restart that bond and and And just have that that communal feeling again.
Yeah, that's always been interesting to me You you meet up with one of your buddies you haven't seen in a while Shake hands hug whatever and then everybody reaches into their pocket and pulls a dip out like well.Yeah, that's what I mean What is that?
I don't know what that is, but it happened.I've seen I mean, I've done it myself It's it's happened so many times It's very interesting now doc What does we talk about what doesn't work?
Let's talk about what does work and then we'll talk about some of the other stuff later But what does the research now say about the effectiveness of things like e-cigarettes and nicotine pouches companies like Lucy's and etc who As Smoking cessation tools only forget about the health part for now.
We'll talk about that later, but just for smoking cessation
Yeah, so there's been a lot of research over the last couple of years.The UK has really been pushing vapes, unlike the US, which is more of a quit at all costs type country.The UK is more of a, let's look at
embracing harm reduction whole hog, right?So in that effect, they did a lot of research.The Royal College of Physicians have been doing research since at least 2019.
And each time they do the research, they find that e-cigarettes are far superior to other nicotine replacement therapies, again, for some of the same reasons that I've already mentioned.
And then we have the Cochrane Review, which was just updated, I think, this year, and that's over 71 studies that they looked at, all pointing to the benefit of moving towards e-cigarettes and other harm reduction methods like that.
There's other systematic reviews as well, but as far as e-cigarettes go, those are the big ones.Pouches don't have as much information out there right now, as many studies right now.
I know that Cleveland Clinic said that there's definitely less toxins if you're going to use pouches, but they haven't been studied as much.
But I do know, I know that we're going to probably touch on this a little bit later as well, but Sweden, they're down in the single digits as far as their country, the whole country, smoking rate, which is really like crazy in comparison to the rest of Europe, which is in like 20, 25% of smokers still, even higher than that, I think.
now they're in their single digits, and that's because they pushed snuff and they pushed the pouches.So we know it works, it's just not as much study on them at the moment.
Yeah, interesting, Sweden especially, because you'll see on social media, you'll see extremely attractive women with a top lipper, Zen or Lucienne.
It's like, all right, cool, I guess we're doing that now, which is quite a bit better than smoking, obviously, so no shade there. The next question is, what harm reduction strategies are being successfully adopted in other countries?
One, you just alluded to one in Sweden there and mentioned the UK as well.And why is the US lagging behind in adopting these methods for veterans?Now, you mentioned the UK.The US has Always lagged behind in these situations.
No for for whatever reason.I don't understand it.
Maybe it's bureaucracy Maybe it's something else who knows but the Israeli government for example has been researching CBD since the 1950s they've been researching psychotropic drugs to treat things like
stroke victims and autism and post-traumatic stress and is a therapeutic since the 1950s as well.Doc, why is that?Why are other governments so far ahead of us on some of this stuff, even though we have all the resources you could ever want?
Yeah, it could be over-regulation.I know the FDA, with the psychedelics, with the psilocybin, those mushrooms, they were just pushing back against that.
And the VA, in their rebellious phase, I guess, decided that they're going to push forward, despite what the FDA said, in terms of their research.So that was interesting to see.But as far as the US goes, it mostly has to do with our regulations.
Still, there's this culture, and I think that we might have actually spoken about it a little bit in previous discussions, but there's the culture of people should quit, right?And harm reduction is not a healthy way of quitting.
You know, it's just do what you need to do to quit.And I think that's a larger perspective that we have in the U.S.than other countries might.So I think it is a cultural shift that we have to kind of look at, and I think that would be helpful.
Um, I think one of the, yeah, Matt, I was going to ask you what you thought about that.Go ahead.Sorry.
Uh, yeah, no, one of the things that I was thinking about is, and one of the things that we identified was that a lot of our veterans don't know about these alternatives and that the positive benefits.
And I think that that's a big part of what we're doing at smokeless.That's just trying to get that education out there because. You know, the products are there.
I think obviously what we want to see is responsible organizations like the VA to include more of that education.But I think that that's a pivotal point and what we need to do is educate our veterans about these different alternatives.
Yeah, I mean, that's a good point.Not knowing that something exists, like people know that pouches and vape exists, obviously, they know that exists.What they haven't heard is the connection right between those products and cessation of smoking.
And I think part of it is that there's, there's not very many people talking about the actual benefits of nicotine.It is,
Doc, as you mentioned, it is kind of in our culture to, you know, to, I don't know, clutch our pearls about some of this stuff for one reason or another.
And on the psilocybin thing, you can think a couple of organizations, Heroic Hearts, Marcus and Amber Capone, a couple of organizations to push that narrative about the benefits of psilocybin to the VA.So that's very good.
Next question, and this is gonna, we're gonna start getting a little granular here.How can switching to, To less harmful alternatives like e-cigarettes or pouches or whatever potentially save veterans lives.What does that look like?
Like if from a from a medical standpoint doc, what's that look like?
Yeah, so this goes back to the harm reduction piece.And when people come in and have tried to quit, it's a very difficult thing to quit cigarettes.And some people don't want to quit.
When they talk about how many people want to quit and they say it's like 60, 70, all the way up to 90%, there's 10% to 40% that don't want to quit. So one of the things that we have to kind of, again, educate them on is the dangers of smoking.
And we can also let them know that just smoking or using a vape or another product is 95% safer.And one thing that we can do in terms of making a healthier choice is to make that decision.It's like, okay, you know, this is where you are now.
What's the first step that you can take, right?And that first step might be moving to a healthier alternative. which again could be a vape, could be a pouch.
Once you make that first step, you can choose to make other steps, but it's really making that first step that's going to have the most impact because that's a success.
When somebody says, I've been trying to do this for years and I'm still smoking a cigarette, then we say, okay, let's take this first step.Let's try to move you off of the cigarettes, and maintain your nicotine intake in a safer way, right?
And then if they do that in success, if they want to make another step, they could possibly do that and have more success in the background that could help them, encourage them to continue moving forward.
Yeah, just almost like getting the ball rolling.You know what I mean?
I think consider it a barrier to entry almost like one not knowing that the option exists or to not understanding the correlation between that option and smoking cessation specifically can really be a hindrance.
I mean, a lot of people I think I think of it like diet and exercise, people look at the options to improve themselves through diet and exercise, and they don't see things that fit into their daily life.
So it's like, Oh, well, that's not an option for me.It's like, Alright, well, You want to dig a little deeper, but part of that is certainly the education being out there, the information being out there.
Now, Matt, since you've worked in public affairs and politics before, I want to ask you, what is it that the VA, the Veterans Administration should be doing differently right now?
This is a big one because, you know, one of the highest touch points for people once they leave the military is the VA.It might be the highest touch point.And right now it's not getting done.Right.
So from your experience, what do you think they should be doing?
Yeah, and I think the VA should be prioritizing harm reduction strategies and actively educating us veterans on the benefits of safer nicotine alternatives.
I can tell you my personal experience, I tried quitting using different methods, using the pouch and the gum, and they didn't work for me.But when I used the pouches, it was like a natural transition.Now, it did take me a few weeks, but I ended up
preferring the pouches over, you know, what was Copenhagen long cut for me for a number of different reasons.But I'm saying like my point is it just it's a it's an easier transition.So I really think if we could get the VA
to start prioritizing harm reduction strategies and educating veterans, especially as they transition out, but also when they come looking for those, that it should be provided to them as an option.
Maybe updating their cessation toolkit to include some of those other alternatives would be helpful too.
Now, we talked about psilocybin.It's making a little bit of a move into the VA now.Are you familiar with any other success stories about strategies we as a community have used to course correct the VA?
Because there's been problems over the years, right?
But certainly I think anybody that looks at it the VA look it's an organization They're gonna make mistakes obviously still because it's an organization of people and people make mistakes But it's quite a bit better than it was when you and I got out of the military frankly, right?
I mean quite a bit better.Yes So are you familiar with any specific success stories on on new forms of treatment?I mean, I knew that In the military, the military, the U.S.
Army especially, kind of led the way in normalizing LASIK and PRK surgeries in America, which are very useful, right?And they did it for obvious reasons.I was in the infantry.They wanted me to be able to see better.
So they, you know, polished my eyeballs.That makes sense. They can and should be leaders on some of this stuff, right?Like we should be taking all of advanced medical science and applying it to our warfighters.Certainly, you would think, right?
To make sure that they're operating at the highest possible level because this is the ultimate meritocracy.It is literal life and death.And then it continues to be that afterwards.Just curious if you've got any off the top of your head.
We didn't really discuss this, but... No.
Well, no, I mean, honestly, it's interesting to talk about.I have been involved in a lot of different efforts.I think the VA has done a good job of improving on the access and accountability side.
That's really what kind of brought me into veteran advocacy.I got out in 2013 and 2014, we had the VA scandal.
So, my point is that I do think that the right level of advocacy from veterans especially, you know, can move the needle with the VA and we've seen it happen with the choice card, with changes to accountability after the wait time debacle and things like that.
So, we know that the military and the VA can implement these processes if they have the right motivation.
You know, you had asked about other success stories too, and I kind of just remember how quickly they were able to introduce that quick-clop bandage.
You remember that wasn't there when we first started, but towards the end it was like, I think it was called like rapidly equipping force.Almost everybody had it so quickly.And so we know that they can move quickly if they want to.
And I think that this is an area that that is a win-win for everybody like I said in the beginning Look, this is a force readiness thing for for active duty I was an officer and I just remember how many soldiers had Dental issues or medical issues and were non-deployable because of that and so, you know knowing that this is significant and healthier I think that you know on the active duty side.
There's a There's a lot of incentive for it.But also, like we pointed out, we could get a million veterans to quit smoking.And that's part of our goal.
And I think there's a lot of opportunity there and for the VA to do something really great for the veteran population.
Yeah, absolutely.Dr. Vermillion, your thoughts on what the VA should be doing differently?
Yeah, so, I mean, they are pretty good at thinking outside the box or letting people in.They have transcranial magnetic stimulation.They have the, what's that, the compression sickness container, right?They use that.
So, they have things that are out there, again, the psilocybin, right?They have things that they're trying, they're out there, you know, looking at.And I think that as far as what we're talking about today, we know that this kills people.
you know, this is a serious issue.This is 480,000 people across the nation, and then it's, you know, as we were saying before, almost 8,000 people a year having some issues with lung cancer that are veterans.So, we know this is an issue.
We know how many people that it's affecting.It's probably far more than the transcranial magnetic stimulation or the compression sickness thing is going to help, right?
So it makes little sense as why we would want to sit back and just kind of, you know, see what happens, right?We should get out on the front of this movement knowing full well, based on what's happening in the world, that this works, right?
This harm reduction strategy moving towards less something that's 95% less harmful.We know this works more so than these other things that we're just trying.So let's move into doing that.
Let's move into changing our stance on, again, vaping and pouches. So that's that doesn't matter.
Sure.Yeah.I mean, I 100% agree.We got to be leaders on any issue because that's what the military is supposed to be.And Matt, I know you'll agree with this.Your service doesn't end when you take the uniform off.
In a lot of ways, it's just beginning because you go back into the general public. and you take that experience with you, right?And it's meant to make our country better.
And to that point, one of the ways we make our country better is by not wasting people's time and money.And explain to me, if you can, how adopting these harm reduction strategies for veterans saves taxpayers money in the long run.
Well, I think treating smoking-related illnesses probably costs the federal government billions of dollars every single year.
So promoting harm reduction tools and getting veterans to be able to quit smoking faster, we've highlighted a number of times that vaping is 95% healthier than your traditional combustible smoking.
So I think all of that leads to a reduction in costly preventable health issues.
Doc, what do you gotta say about that?I'm just looking up some data here, but I'd like to hear your thoughts on that as well.
Yeah, and besides the cost of, the health issues is the cost of lost work days.If you are smoking, you have, your immune system isn't as primed as it could be.
So if you're still in the military, that means if you get injured, it takes you longer to recuperate, and so you're not getting back out to the front lines to be with your, your unit, do what you came to do.
And of course, you know, the healing issue is also an issue with the veterans and the VA as well.
So on either side, it's not just the cost of how much it costs doing the medical stuff, but it's the cost of lost work days and even the cost of lost missions on the inside while you're still working.
Sure.Yeah.And I'll add to that, uh, just the, you know, the old adage and ounce of prevention is worth a pound of cure.And we can, we can quantify that in actual numbers.If there are 8,000 people showing up to the VA each year,
with cancer and they're being treated by the VA.Cancer drugs on average, drugs and treatment on average is about $285,000 to $290,000 a year.That doesn't include, as you mentioned, the loss of time and all this other stuff.
It also doesn't account for the personnel at the VA are working, so this is a lowball estimate.That's $2.3 to $2.5 billion a year. that the US government is having to spend just trying to keep these people alive.
I'm gonna guess, I don't know for sure, but I'm gonna guess that some vapes and pouches will cost considerably less than $2.5 billion a year.Yeah, so on that note, we're here talking about all this stuff.
What role do you think that influencers and public figures play in spreading awareness about better smoking cessation options for veterans?
Well, first, you know, yeah, no, uh, individuals like yourselves reach large audiences.
And I think, you know, maybe helping us to, uh, normalize these alternative, uh, methods for quitting smoking, helping us increase awareness of the newer and effective tools, uh, would be, would make a huge impact on the initiative.
Sure.And, uh, I'll add, you know,
Friends of ours, Omar Villacrispy, some of you know him as, Jared Taylor, obviously one of our business partners here, the Hodge twins, a lot of people have jumped on board with this because most of them have used tobacco products and stopped using one of these methods.
And they all have a personal anecdote of struggle going through the whole thing.I'll add this, that Every one of you is an influencer to some degree, right?
If the problem is a lack of information and education, then it's kind of incumbent upon you, if you care about your community, and I assume you do, to learn about this stuff and pass that on to everybody else.Now, the problem, obviously, is that
You're not going to get this information from the VA, which again, is the highest touch point.So people have to find good reasons why we're doing the show today.People have to find good resources of information for this.
Doc, where do people go to find out about this stuff?Do you, are there, and when I say that, there's some people that want to look at actual research.You know what I mean?Is that something you can find on the Smokeless Vets website?
Yeah, there's definitely research on the Smokeless Vests website.If you just scroll down to the bottom, you'll see a bunch of research in there as well.But there's just tons of research out there.
I was talking about the Royal College of Physicians, but there's also, if you just go to the Nicotine and Tobacco Research Journal. They'll talk about both the cigarettes, and they have a systematic study of 62 studies on the pouches.
And again, they found that less toxic than cigarettes, right?So there's a lot of research out there.You can find it right at the bottom of Smokeless Bets for ease, and then you could also search your local library or, you know,
You did mention to that, you know, one of the, and we've, we've found this as one of the, the fastest, uh, using demographics of some of these alternative methods are, uh, are, are younger women too.
So hopefully they could help us, uh, educate our younger men on, uh, on the, on the positive alternatives too.
Yeah, for sure.Yeah.Funny.Yeah.Matt, again, having worked in public policy, then we know we know what's effective.We have research to back up that claim.Right.So we're arming people with the truth.
Now, I want to ask you, what can veterans and their families do to advocate for better resources and support for the VA?And I'll say this.
Since you you've worked in public policy I'd like to explain this in simplest terms for the average Joe because sending emails and social media posts and stuff like that Kind of feels like shouting into the void It's like you write something you put a letter in a bottle and throw it out in the ocean Hope somebody reads it the VA is a very large organization.
I think they've got 350,000 employees or something like that that that's a monolith.That's a very difficult apparatus to communicate with and So what strategies can people use to get some actual work done here?
Yeah, I wouldn't, um, I don't want to discount maybe, uh, sending correspondence into the VA.
I do think in, in, at certain times that could be incredibly effective, but I think, uh, you know, uh, maybe, uh, an easier and more impactful way is to talk to your local politicians, both down at the legislature, because they're gonna, you know, be able to influence your in state in, in Arizona.
It's called the department of veteran services that itself, uh, could include educational materials and do updates as well.
But I think talking to your new member of Congress, in Arizona we have especially a number of members who are now in swing districts, and I think
If we're going to make a real impact on the VA, it's got to be done at the federal level, and there's no, I think, greater champion than getting your member of Congress to get on board with what we're trying to do with smokeless vets, and to reiterate those during their committees that oversee the VA.
So just a reminder that the VA is a federal agency, and so if we want to make those changes, doing it through the federal government and through your members of Congress and your senators would be the fastest way to make some of those reforms.
Yeah, just real quick, for those of you who are curious, the Veterans Affairs Committee in the House, Mike Bost from Illinois is the chairman, and there's quite a few members on both sides of the aisle there that you can reach out to.
You can find that at veterans.house.gov, that information.So certainly a good idea to reach out to your legislators.I would say that it's an even better idea to not do it by yourself.Strength in numbers is a real thing.These people work for you.
And when they hear a bunch of their constituents upset about something, they typically respond in some way. Now, next, Dr. Vermillion, can you share, because we've talked about the efficacy, I want to hear some anecdotes.
Can you share some success stories of veterans who have actually quit smoking using these innovative products like pouches, vapes, whatever?
Yeah, really it comes down to, I wouldn't share information on my own clients per se, because a lot of them I'm still seeing.
But I have been receiving lots of stories online in terms of people talking about their success in terms of moving from cigarettes into vaping, and then feeling a ton amount of better.
are able to actually specifically tell me these specific things that have changed for them, whether it's energy, whether it's breathing.
So they can actually tell me specific things that cutting out the smoking and moving towards vaping has helped them.
And they're still vaping, the two that I'm thinking about right now, but they're feeling much, much better having changed from cigarettes, a combustible cigarette, to an e-cigarette.
Don't want to get too far into the weeds here, but can you if you're if you're able?Because I don't know much about this, but what's the the difference between?
Your o2 levels your blood o2 levels and how it's affected by having just gunk in your lungs and poisoning yourself and look it's affected by when I came back from I
Sodder City, mine was down to like 90, 95 or 96 or something, which, and I'm in pretty good cardio shape, right?So it should be 98 to 99.It was very effective and I couldn't figure out why it was.
It was like, oh, I'm smoking a pack and a half of cigarettes a day.That's probably, like it just kind of dawned on me, like it wasn't obvious what the hell was going on there.But can you talk about how that affects you physiologically?
Yeah, and I can touch on it because it's not my scope of practice, I'm not a medical doctor.But when you're smoking, and I think you could actually go online and see the, you still there?Oh yeah.
Okay, I just wasn't sure if my sound just sounded like it would cut out.You can go online and you can look at comparisons between what a smoker's lungs look like versus a vapor's lungs look like.And so when you have the smoker,
pull in that smoke, it's pulling in all that tar, and that tar starts to coat the tissues.And what that does is it impacts the ability for the tissues to have oxygen exchange.
And so the more you smoke, the more tar that you have built up, the less ability to have that oxygen exchange happen.And so you have a buildup in carbon dioxide and less oxygen available.
So you'll see a lot of people actually get fatigued from smoking too much and having that be an issue.And that doesn't happen with vaping.
So when people move from tobacco to vape, that's why they start to feel better, or one of the reasons why they start to feel better, is that they don't have this sludge covering their lung tissue and inhibiting the ability for oxygen exchange.
Yeah, I mean, just, I'm sure everybody knows this, but the way your body absorbs oxygen is through membranes in the lungs, and if they're coated with something, it's gonna be less efficient.And yeah, I mean, chronic, I think the thing that,
That improved with me most rapidly was The I didn't have chronic muscle fatigue anymore I mean it started to become very obvious that I wasn't in as good a shape as I thought I was now On this note.We're talking about it What do you think or not?
What do you think?but what are the biggest misconceptions about e cigarettes and nicotine pouches as a smoking cessation tool and one and then two The the second part of the question is how do we debunk them?
But and let's just stick with the first part of the question first What are the misconceptions because you know, there's a lot I mean even the VA as I mentioned in the intro here Will sometimes say that vapes cause cancer and I don't think there's any evidence of that effect.
So can you speak to that doc?
Yeah, sure.There's a lot of mights, right?Oh, might do this and might do that.But really, there's no evidence that factually says that vapes cause cancer.
So, you know, that's one of the biggest things is trying to combat this misinformation that's out there. And a lot of people are under the impression that vapes are as bad as or worse than smoking cigarettes.
And that's because of the media campaigns that have been going on.And a lot of these campaigns are geared towards what's happening with kids and stuff like that.On the plus side, teen smoking's down, teen vaping's down.So it's not a threat, right?
So that's not as much of a threat.So let's not look at that.Let's not focus on that.Let's focus on the fact that people are actually dying of smoking cigarettes.
and we can have them have a huge improvement in their health and their longevity if we can move them off of the cigarette.So that's, again, combating that misinformation, right?Recognizing that vaping is not killing people.
It's not causing popcorn lung, right, in general.That's, you know, it wasn't a vaping, a vape cigarette that did that.You know, that was something else completely.But everybody, everything gets compounded
which isn't unhealthy in terms of having good information.So yeah, that's what I would think.
Matt, do you have any thoughts on that?
Dr. Vermillion touched on this a little bit, but just to expand, I think there's this misconception out there that you're just replacing one addiction with another, and that has been created around this idea that vaping is terrible or that pouches are terrible, when in reality, these alternatives reduce harm significantly, allow veterans to quit in a more gradual and sustainable approach.
So, yeah, I think that's one of them.
Sure, yeah. I don't know.I'm addicted to water.I drink water every day because it makes me feel better and keeps me alive.I guess you could say I'm addicted to caffeine because I want the nootropic effect for it, but it's a choice I make.
I understand that there are physical addictions to things.But if it's something that's making me feel better and I feel less good when I don't do it and there's no harm in doing it, it seems like a difference without a distinction, to be frank.
Maybe it's just me.So on that note, I kind of want to talk about some of the We've talked about we all know the dangers of smoking.
There's the biggest litigation in the history of this country has been because of the smoking industry and you know, we're getting we're getting beyond all that so now we're starting to You know get it's that we're drinking through a fire hose.
There's a lot of information out there that popcorn look I think I remember that somebody actually said that to me two months ago and because I was I was Smoking a jewel or something like that.Somebody said that to me.
I'm like, yeah, you know, that's not real, right?
That's like that's not that's not a thing That's not something you need to be concerned about now I will say For the sake of argument get your products from reputable sources and not don't buy them out of somebody's trunk of their car or anything like that Don't buy like a milk jug full of liquid and make it yourself.
Okay, let's just let's be reasonable here but I do want to know about some of the
The positive benefits of nicotine as a chemical because I think that's something that really gets over it's demonized because of Smoking and the dangers of smoking and smokeless tobacco and the dangers from that but nicotine itself doc You mentioned it earlier isn't intrinsically a negative thing.
So could you speak to that a little bit?I
Yeah, so I think even if you go into the VA toolbox and they have workbooks for veterans in order to kind of help them through tobacco and smoking cessation, they even say that nicotine isn't that bad for you.
And I saw something recently kind of pointing to when they talk about nicotine being harmful to people that are under 25.
I think we all know somebody that smoked, our parents, our grandparents that smoked when they were young and they had the nicotine in their system and they seemed to not have that much damage from it.At the same time,
When we talk about the positive effects of nicotine, it's just like any other stimulant.Granted, any stimulant can cause a cardiovascular issue, right?It's a vasorestrictor.It's a vasorestrictor.So, any stimulant can cause an issue.
I guess the big fear is that it's addictive, right?And we hear that word addictive and that in itself sounds bad. And, you know, if we lose control, that would be an issue, right?If we lose control of our ability to do anything, it would be an issue.
But as far as anything else, other than being addictive, there doesn't seem to be any issue with the nicotine itself, other than it being something that helps people feel better depending on how they use it.
Sure, yeah, and there's quite a bit of research on this now.I'm sure we've been talking about it for years on this show because Onnit, the organization here in Austin run by Aubrey Marcus, they've been into the nicotine use a lot.
Rogan's talked about it a lot.
There's certainly, you mentioned it being a stimulant, there's certain release of neurotransmitters like dopamine and norepinephrine that increase alertness and things like that, which is probably Matt, why you used it and why a lot of us use it just to kind of stay alert back in the day.
There's also neuroprotective effects.There's good research.
There's a chemical called acetylcholine that's a neurotransmitter involved in memory and learning, and we found that nicotine releases a lot of it and that the release of it is protective against degenerative brain diseases like Parkinson's and Alzheimer's, right?
So look, I'm not telling you to treat your Alzheimer's with nicotine or anything, but this is, you know, This is just the data.Do with it what you want.We have to get past this idea that it's intrinsically evil.
And if you shake hands with somebody who just smoked or dipped, that you're going to get cancer immediately.We tend to go a little wild with our assumptions just because it's such a fear-based approach that we've been using so long.
But that's not science, right?
I didn't share this.I think we talked about it on the podcast before, but I went from active duty into law school.I mean, I was still on active duty when I started law school, and I still use nicotine.
hugely helpful throughout all that with the memory and learning.I thought that it, you know, it helped improve my focus and alertness too.
So just from personal experience, I mean, I, like I said, while I quit dipping, I never stopped using nicotine and I, I don't know.I mean, I enjoy it.It's a, it's something that, uh, that I find value in.
Uh, doc, what were you going to say?
Yeah, I was just going to touch on the idea that you said, you know, we can't touch people's hands or something like that with beer smoking.
When we talk about vaping and the pouches, especially with vaping and talking about secondhand smoke and secondhand threats and stuff like that, there's really none of that involved in vaping.
So just another benefit in terms of moving from cigarettes, which kill 41,000 people a year from secondhand smoke. to moving towards vaping, which has not done anything to another person.Good lord.
Yeah, I mean, the numbers are staggering.We're talking about 41,000 people dying a year, 8,000 veterans who are going in for cancer treatments a year related to this stuff.You know, the practical effects are people dying too young.
The practical effects include the government having to spend a ton of money to deal with this stuff. What additional resources or innovation should veterans be aware of right now when trying to quit smoking?Let's go through the process.
Matt's your patient.He's been smoked for 10 years.He wants to quit.What do you tell him?
Yeah, you know, there's a lot of resources, you know, we could start with talking about the ones that we do have in terms of knowing the 1-800-QUIT-LINES, there's ones in the VA as well as outside of the VA.
So we could talk about all those resources.
But really, when people are not ready to quit smoking or have some resistance, because in order for these things to work, in order for the NRTs to work, the medications to work successfully, you have to want to quit.
People that have just a little bit of that desire to quit, they drop out.You know, there's a 50% dropout rate within the first couple of weeks of doing any type of nicotine or smoking cessation, rather.
It's crazy, right, a dropout rate of actually getting treatment. So, people are trying and they're failing and they're trying and they're failing.
So, we have to kind of understand where they are and be like, okay, listen, you know, these are the benefits or these are the options that are available to you and these are the benefits.
Again, we talked about Chantix and, you know, it has its risks just like vaping does.But Chantix is one of the things that has been shown to work.Vaping goes along with that, right?
Vaping, Chantix, and there's another medication that we don't have in this country. I think it is, but that's a plant-based tobacco cessation method, right?
We don't have that here, but again, that's another thing that we might be able to bring in at some point.So there's a bunch of different things that are out there that we could kind of push.
So there's three things that I know that work, and that's the Chantix, the e-cigarettes, and this other thing that we don't have here yet.So again, we move them. in terms of harm reduction to the step that they're ready to take.
Like, okay, you know, and move on with that.
That's the, again, I'll mention it, you know, if it's, if it doesn't fit into your lifestyle, you're not going to do it.And I think it's a really important thing to mention that you have to want to quit for the drugs to work properly.
But why would you, and this is, I'm playing, you know, devil's advocate here thinking from my own perspective, you know, 15 years ago when I stopped this stuff, why would I want to lose the benefits, right?
So I think it's, one is educating people on what the treatment options are out there.
If you don't get much out of the nicotine and you want it out of your life, then fair enough, you know, maybe the drug's right for you and you better be motivated to do it.
But if it's, you know, if you want to maintain some of the benefits without the risks, then, you know, you've got a couple of pretty decent choices out there now.
Now, I'm reading down this list of testimonials that our audience sent in, and it's the same thing over and over.I've been trying for years, over and over.I'm okay for a little while, and then I stop.
It's like, look, I tell people this all the time with their diet and fitness journeys, and I just mentioned it a second ago.
If you don't actually want to do it, one, and two, if you don't tailor this thing to your lifestyle, you know, you wake up at this time and go to sleep at this time, your day is this busy.
If you try to create a diet plan or an exercise plan that doesn't fall within those parameters, you will fail, right?So you have to be smart about this stuff and use the things that work for you.
Before we get out of here, because we're getting close to the end of the show here,
I really want to give people a specific call to action about what they can do, where they can find information, and then if they see the information, okay, now I can follow up with this or whatever.Matt, I'll start with you.
Tell us about how people can engage with smokelessvets.org, get the information, and maybe even get support.
Yeah, look, don't give up.If you're dealing with this issue on your own, know that you have more options today than ever before.I think that quitting is possible.Let's explore some of those harm reduction tools.
If the traditional methods aren't working for you, as a veteran myself, I found that these alternatives can work.
Then you go to smokelessvets.org, you can follow me on Matt Kenney USA on X, and we'll try to continue to share more information through those two mediums, but also if you have an opportunity, share the information you learned today on the podcast with some of your friends who might be struggling with those same issues, and let's help a million veterans quit smoking.
Absolutely, just like you When you go vote you grab somebody and take them to the polls with you.
This is this is important It's about our communities about keeping people healthy and and and you know, making sure people aren't dying too young It really is doc.
Yeah, you know Obviously smokeless vets org some people Might need a little bit of extra support.Do you have any recommendation for them on that?I
Yeah, again, you know, you could do the VA stuff, the quit line, that's good.
But one of the biggest pieces in maintaining your abstinence from cigarettes, right, when we're talking about just cigarettes at the moment, is to get constant help over time.
So try to make sure that you have good support structure, your family, friends, people that know that you're trying to do this.
And then make that, just today, make that decision to take the safer, the healthier option, and go and move from cigarettes to vaping, or if you're a person that dips, move to the pouches.
That's what you can do right now, today, as soon as we're done this, is to throw away the cigarettes and go pick up something that's 95% safer and healthier for you and your family.
Sure.I mean, that's a pretty easy sell for me, right?On two fronts.One, I tell people this all the time.If you don't want to eat junk food, if you don't want to be tempted to eat junk food at 10 p.m.or midnight, don't buy it.
If it's not in your house, you're not going out somewhere to go get it at 10 p.m.If it's not in your home, if it's not convenient, you're not going to use it.So resist the urge to have it around.And two, obviously, is if anybody
came to you with a verified sales pitch that here's the same thing you're doing, but 95% safer, you'd have to be crazy not to take that, right?That's the best deal you're ever gonna get anywhere.So thank you guys for coming today.
I really appreciate all the information.I'm really hoping that people will share this.Share smokelessvets.org.It is really important.This poison has taken too many of us.
And I've seen buddies, family members for years, we've been dealing with this stuff.Now there are real options.Now there are real options where you can, you know, avoid the negative stuff and even benefit from the positive stuff, right?
We're in the best possible time to deal with this situation.Before we get out of here, any closing thoughts from you, Doc?
Just, again, make that first choice today.Move off of something that is going to hurt you and move to something that's 95% safer.
It can take a while to move off of cigarettes, but if you take that first step today, then it'll be one step towards that goal.
And Matt, anything from you?Anything about smokeless bets?
Look, I just want to share that if I could do it, I think that you can.Obviously, it's hugely beneficial to your health.You got to take care of yourself, got to take care of your family.
So let's get these veterans and service members off of cigarettes and onto healthier alternatives.
That's right.Remember, folks, it's not always about you life and especially if you're a service member, you know, this or a veteran being strong and being healthy is about what you can do with that, protecting your family, providing for your family.
So, you know. Get out there and work on it.Don't give up, like Matt said.Never give up on that stuff.It's too important.And finally, go to smokelessvets.org.Check out all the information.
If you've got any other questions, you can find all of us on social media.You know where to find us.And you can reach out to us directly.Thank you again, gentlemen, for coming.Really appreciate your time today.And thank you all for listening.
Please share this.And please stop smoking.
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