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To fight the expanding outbreak, the country is relying on a medical system that is overburdened even in normal times.

After suffering from a fever and breathing problems for more than 15 days, Xiao Shibing, a 51-year-old resident of Wuhan, China, finally sought help at a hospital. Despite the symptoms, he was not tested for the new coronavirus -- a lapse suggesting that there may be far more cases of the virus than are being officially reported.

Instead, Mr. Xiao was told that he had a viral chest infection, so he went back home. As he grew sicker, he went to three other hospitals. But they told him they did not have enough beds.

Like many of the thousands of Chinese patients who are concerned about the new coronavirus, Mr. Xiao is scrambling to get help from a health care system straining to serve even the basic needs of patients.

''It is like kicking a ball from here to there,'' said his wife, Feng Xiu.

Mr. Xiao, who was eventually hospitalized on Sunday -- about a week after his initial attempt -- still hasn't been tested for the pneumonialike virus.

As it struggles to combat a coronavirus outbreak that has sickened more than 4,500 people and killed 106, the Chinese government is relying on a medical system that is overburdened and overwhelmed even in normal times. While other parts of everyday life in China have significantly improved in the past decade, the quality of health care has stagnated.

In major cities like Beijing and Shanghai, many people have to stand in line in the wee hours of the morning to secure appointments with doctors. When they do get an appointment, patients get only a couple of minutes with a doctor. During flu season, residents set up camp overnight with blankets in hospital corridors.

China does not have a functioning primary care system, so most people flock to hospitals. On an ordinary day, doctors are frustrated and exhausted as they see as many as 200 patients.

Those weaknesses are most pronounced in the poorer areas of China -- like Wuhan, the epicenter of the coronavirus. Panicked residents of the city are heading to the hospitals if they have any sign of a cold or cough. Videos circulating on Chinese social media show doctors straining to handle the enormous workload and hospital corridors loaded with patients, some of whom appear to be dead.

Despite having dealt with the SARS coronavirus nearly two decades ago, many Chinese hospitals in smaller cities are not fully prepared to deal with a major outbreak like the current virus. Wuhan hospitals have posted messages online urgently appealing for medical equipment. The situation is even more desperate in poorer, rural areas nearby.

Last week, eight hospitals in Hubei Province -- where Wuhan is situated and where most of the cases have appeared -- put out a call for N95 masks, goggles, surgical masks and surgical gowns. In the absence of proper equipment, some medical workers have resorted to cutting plastic folders to jury-rig goggles.

Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, said that China had invested a lot in building a robust public health infrastructure in the wake of SARS and that many of them were mostly well equipped to deal with infectious diseases.

''But they apparently didn't anticipate something so sudden, so acute and so tremendous,'' he said.

The government's response to the crisis could exacerbate the problems. Across China, the authorities are sealing off cities, closing down schools and checking on residents. But the lockdown -- affecting 56 million people -- could make it difficult to get medical supplies to hospitals that desperately need them.

Chinese officials have acknowledged that they are struggling to deal with the outbreak. At a news conference last week, the Wuhan health commission said there were long lines and a shortage of beds. In response, it said it had designated hospitals as ''fever clinics'' for people to go to for treatment.

With medical facilities in short supply, the local government has also pledged to build a new 1,000-bed hospital in 10 days, and vowed that another new 1,300-bed hospital would be ready by the middle of next month. It is taking a page out of the government's playbook during SARS, when it built a new hospital in Beijing in just a week.

Yet it is still not clear that there will be sufficient beds to deal with the virus, which remains highly contagious.

Chen Xi, an assistant professor of health policy and economics at the Yale School of Public Health, said it was more important to have a working system of family doctors who can act as gatekeepers for the hospitals.

''Without an efficient screening process,'' he said, ''these two hospitals would not be very effective.''

The central government is under increasing pressure to show that it is adequately coping with the crisis. On Monday, Premier Li Keqiang, who has been assigned to oversee the national response to the outbreak, visited Wuhan to inspect efforts to contain the disease. He pledged to provide local health centers with 20,000 pairs of safety goggles.

As the government scrambles to contain the outbreak, the sick are just trying to get medical attention.

Cai Pei, 41, of Wuhan, said his wife had begun coughing and developed a fever three days ago. He wrote on Weibo, a popular social media platform, that hospitals would not admit her, and that he had difficulty finding masks and cold medicine in pharmacies.

Making matters worse, three Chinese medical companies have said that they do not have the capacity to make enough test kits for the new coronavirus, according to local news media reports.

Mr. Cai and his wife still do not know whether she is infected with the coronavirus or another more common ailment.

''Sometimes I can only hide and cry, but I couldn't tell her and had to reassure her that it is not the virus,'' Mr. Cai said by telephone. ''It is very scary. If it's real, we have a child and elderly parents at home. What if we all get sick?''

With no proven drugs to treat the new virus, the health authorities have told doctors to prescribe a combination of treatments -- anti-viral H.I.V. drugs as well as traditional Chinese medicine -- to patients. Some of the medicines being prescribed are a mixture of ingredients like buffalo horn, jasmine and honeysuckle as well as anti-viral H.I.V. drugs like Lopinavir and Ritonavir.

As happened with SARS, traditional Chinese medicine -- an industry that the government has pledged to develop -- is prominently being touted as a way to treat this new coronavirus. But there is no clinical evidence that the gallstones of cattle, the roots of plants and licorice could work in combating it.

Journals have published studies by Chinese scientists saying that traditional Chinese medicine helped alleviate symptoms of SARS. China's ministry of science and technology said in 2003 that it had found banlangen, the root of the woad plant, as well as a liquid made up of ingredients like cholic acid, jasmine, buffalo horn and honeysuckle to be effective in curing an acute inflammation of the lungs.

''There has never been a good antiviral agent, so that means that people would try things that have some effect,'' said Dominic Dwyer, a medical virologist at the University of Sydney. ''But there's no evidence of significant benefits with any antiviral drugs or traditional Chinese medicine.''

The problem with finding a drug that can effectively fight an infectious disease like this coronavirus, SARS or Middle East Respiratory Syndrome is that it needs to be tested in sufficient numbers in a randomized way in proper clinical trials. Patients must also give informed consent.

''That is very difficult in an outbreak situation,'' said Kanta Subbarao, a senior researcher on respiratory illnesses at the Doherty Institute in Melbourne, Australia.

In Wuhan, Mr. Xiao's daughter, Xiao Hongxia, said her father had been diagnosed with severe pneumonia and was now labeled a ''highly suspicious case.'' He is relying on ordinary fever medicines and anti-inflammatory drugs, she said.

''There is no special medicine for the coronavirus so far,'' Ms. Xiao said, ''so we can only rely on the patient's own immunity.''

Amber Wang, Yiwei Wang and Elsie Chen contributed research.

Amber Wang, Yiwei Wang and Elsie Chen contributed research.

PHOTOS: A medical mask factory in Nantong. A shortage of equipment in China has hampered the response to the outbreak of coronavirus. (PHOTOGRAPH BY AGENCE FRANCE-PRESSE -- GETTY IMAGES) (A1); Patients have overwhelmed medical facilities in Wuhan, like Red Cross Hospital, above. To meet the demand for medical care, officials pledged to rush construction of a new hospital, left. (PHOTOGRAPHS BY HECTOR RETAMAL/AGENCE FRANCE-PRESSE -- GETTY IMAGES) (A9)

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Feeble Health System in China Strains to Combat Deadly Virus.

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To fight the expanding outbreak, the country is relying on a medical system that is overburdened even in normal times. After suffering from a fever and breathing problems for more than 15 days, Xiao Shibing, a 51-year-old resident of Wuhan, China, finally sought help at a hospital.

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Essential oils have become big business-but are they medicine or marketing?

Twenty years ago, Carla Cohen fell mysteriously ill. She couldn't put her finger on what was wrong; it felt as though some conspiracy between her mind and her body were eroding her capacity to work. Cohen, who was an entertainment executive in Los Angeles, woke up every morning feeling weak and foggy-brained, with a low-grade fever. Her doctors couldn't make a diagnosis, and suggested antidepressants. "I said, 'I'm not depressed!' They just told me to go home and rest."

Disillusioned by Western medicine, Cohen began exploring other options. She studied with multiple healers and shamans; she read books with titles like "The Body Toxic" and pursued a massage-therapy license. As part of her training, she took a class on a massage technique called "raindrop therapy," which incorporates essential oils-aromatic compounds made from plant material. At the time, essential oils were not well known, but Cohen was drawn to them right away. "From the very first moment with those oils, I noticed something was firing that hadn't been firing," she said. "I was deeply moved."

Today, Cohen puts frankincense oil on her scalp every morning; when she feels a cold coming on, she downs an immune-system-boosting oil blend that includes clove, eucalyptus, and rosemary. On days when she has to negotiate a contract on behalf of an organization that she volunteers for, she uses nutmeg and spearmint to sharpen her focus. She earns the majority of her income working as a distributor for Young Living, a leading vender of essential oils.

Cohen is middle-aged, with a friendly, open face framed by graying curls. Though her house, in Long Beach, is full of New Age trappings-a statue of Ganesh, huge hunks of crystal-she speaks with the quick clip of someone who once gave a lot of corporate presentations. As we sat at her kitchen table, a glass globe puffed out clouds of tangerine-scented vapor.

Cohen offered me a glass of water enhanced with a few drops of an essential-oil blend called Citrus Fresh. "It helps the body detox," she said. "Not that you're toxic." The water was subtly tangy, like a La Croix without the fizz.

Cohen went into her treatment room and came back with a small vial labelled "Clarity." She put a few drops in my left palm. "This is good for getting your mind clear," she said. "Rub it clockwise three times. That activates the electrical properties in the oil, and aligns your DNA." Following Cohen's instructions, I cupped my hands around my nose and inhaled deeply. The smell was heavier than that of perfume, so minty that it was almost medicinal. Cohen looked at me expectantly. "I feel perkier," I ventured.

At first, Cohen sold oils to friends and family; she also drummed up business at local yoga studios, and taught classes at a vintage-clothing store. Most of the people she met were unfamiliar with the product. "Oils were not on the radar," she said. But, around seven years ago, when she signed up for a booth at a holistic health fair, she arrived to find someone else selling oils, too. She started seeing them mentioned in mainstream women's magazines. Marie Claire advised rubbing a lavender-oil blend on your pulse points for sounder sleep; Elle suggested slathering your face with a frankincense-oil blend to keep your skin young.

More people seemed open to hearing about the medicinal applications of oils as well. "My parents were very much believers in the idea that the doctors were God and the government protects you," Cohen said. Now, it seemed, people were realizing that typical sources of care weren't infallible. "We have amazing answers here," Cohen told me. "Why not try it? What do you have to lose?"

Essential oils have long been used to scent products and to flavor foods; Coca-Cola and Pepsi are among their major consumers. But these days, when people talk about essential oils, they're likely referring to the little vials of liquid essence of lemon or tea tree that you can buy at grocery stores or yoga studios, or from a distributor like Carla Cohen.

Oils are touted as something between a perfume and a potion, a substance that can keep you smelling nice while also providing physical and psychological benefits. They are often stocked on the same shelves as herbal remedies such as echinacea and St.-John's-wort; big-box stores sell aromatherapy diffusers as an alternative to synthetic-smelling products like Febreze. The model Miranda Kerr used oils to help her get over her breakup with Orlando Bloom. The pop star Kesha tweeted that she starts off every day by sniffing essential oils: "They make me feel so peaceful." Gwyneth Paltrow is a fan, unsurprisingly, but so are RuPaul, Alanis Morissette, and a trainer for the New York Knicks.

Oils' rising popularity is part of the contemporary appetite for wellness, an embrace of holistic healthy-living practices ranging from the low key (meditation) to the wacky (Brain Dust, a forty-dollar jar of adaptogenic herbs and mushrooms that promises to "align you with the cosmic flow for great achievement"). Wellness is often dismissed as frivolity, another way for wealthy white women to spend money and obsess about their bodies. But you're just as likely to find essential oils in a small-town drugstore in the Midwest as in an organic market in L.A., and their appeal is often less about indulgence than about anxiety. "I am concerned about antibiotic resistance, emerging viruses, and the risks posed by chronic disease," the herbalist Cat Ellis writes in her book "Prepper's Natural Medicine: Life-Saving Herbs, Essential Oils and Natural Remedies for When There Is No Doctor." For many consumers, essential oils represent a purer and more ancient form of medicine, one with Biblical overtones-all those scriptural references to anointing-and none of the baggage of the contemporary health-care system. (Wellness-focussed Web sites are more likely to cite oils' centuries of use in Ayurvedic medicine.) Like homeschooling, beekeeping, and canning, the use of essential oils crosses the political spectrum and speaks to a common desire for increased self-sufficiency-or, more darkly, a fear of imminent institutional collapse. Many of the products available from Goop, Paltrow's posh wellness emporium, are also for sale on Infowars, Alex Jones's alt-right conspiracy-theory Web site.

Much of the oil sold in the United States comes from two companies based in Utah, Young Living and doTerra, both of which have claimed to be the largest seller of essential oils in the world. The two companies have more than three million customers apiece, and a billion dollars in annual sales. While there are cheaper oils-Walmart sells a kit of sixteen "therapeutic grade" essential oils for thirty dollars-Young Living and doTerra have built their brands on claims that they sell completely pure, naturally derived oils. "They have Skittles," Kirk Jowers, a vice-president at doTerra, said. "We have the real fruit."

In June, I attended Young Living's "Fulfill Your Destiny" convention for distributors, held at Salt Lake City's Salt Palace event center. The company, which was founded in 1994, has grown tenfold in the past decade, and the hallways were packed with good-natured, heavily fragrant people heading to workshops with names such as "Yoga: A Business Tool" and "Essential Care for Animals." They wore T-shirts that said "Essential Oils. Heck yeah" and "There's an oil for that" and "I'm silently assessing your oil needs." Never have I sneezed so much; never have I been blessed so enthusiastically when I sneezed.

Young Living sells more than a hundred and fifty oils, and a section of the convention center featured samples of them. Some were familiar-oregano, eucalyptus-while others were proprietary blends meant to evoke different physical or spiritual states. Christmas Spirit "taps into the happiness, joy, and comfort associated with the holiday season"; Dragon Time promotes "feelings of stability and calm during cycles of moodiness." It was early in the day, so I dabbed on a drop of Acceptance, and then some Highest Potential, for good measure.

In between sessions, Laura Warford, a stay-at-home mom with a drawl and a shimmer of silver eyeshadow, told me that she had become involved in oils after her daughter, Emmy Grace, died from a heart defect when she was three days old. Warford came home from the hospital, her breasts still leaking milk, and tried to manage her grief while also taking care of her toddler son. Nights were the worst-she had a hard time falling asleep, and when she did she would wake up again minutes later with her mind racing. A friend recommended diffusing lavender oil. The effect was immediate: she felt calmer and was able to sleep through the night. Soon Warford began selling oils. She found a community of supportive friends through Young Living Facebook groups and shared her story with them. She got up every day by reminding herself that she was helping other people. "You can lose yourself outside of being Mommy," she said. "I can be creative now. I can use my gifts that I didn't even know I had before this. I can have adult conversations with people. I went from making zero dollars a month to over zero dollars a month. I got to come here because of Young Living's paycheck. I bought my plane ticket and my convention pass with my money. That's empowering. That feels good."

Both Young Living and doTerra follow a multilevel-marketing model. Distributors often buy products at wholesale prices and sell them at a retail markup, but the real money comes from recruiting other distributors into your "downline," and getting a commission on their sales. Young Living divides its sales force into a complex hierarchy stratified partly by sales volume, ranging from Distributor (the lowest level, comprising ninety-four per cent of members) to Royal Crown Diamond (less than one-tenth of one per cent).

"Young Living is freedom-spiritual freedom, relationship freedom, incredible financial freedom," a Diamond-level distributor said at a Young Living panel. (Diamond-level distributors earn a median monthly income of thirty-two thousand dollars.) She told the audience that she had built her oils business while working up to sixty hours a week as a television anchor and homeschooling her special-needs child. "There is nothing holding you back but yourself. We all have the same oils, we all have the same twenty-four hours in the day. The only ones that don't make it to Diamond are the ones that give up. Anybody in this room can do it," she said, to huge cheers. On another panel, the featured speaker was a tan woman in a white dress and strappy gold sandals. "As a Royal Crown Diamond, I work only four hours a day. I have a personal chef-my chef is right here," she said, pointing into the audience. "And I am so blessed. That's what happens when you get to this level. You get blessed with these things. When I wake up, I don't look at the Internet. I go outside. I swim every day. I didn't always have that luxury. But as you advance you get to treat yourself."

Multilevel-marketing companies such as Amway and Mary Kay have long sold people-primarily women-the idea of building a business by working their social connections. A decade ago, that happened through hosting parties or classes; these days, the chatty, relationship-based sales pressure favored by the companies takes place largely on social media, and the industry is attracting a greater share of young people. In recent years, a number of multilevel-marketing companies that target millennials have cropped up, selling everything from leggings (LuLaRoe) to jewelry (Stella & Dot). Marketing pros advise newcomers to "friend" strangers, reach out to acquaintances from high school, and post daily selfies of themselves enjoying the products they sell. (The onslaught of relentlessly sunny product-pushing posts has also led to a backlash, including memes on Facebook and Pinterest: "Someone needs to create a new essential oil called 'Leave Me the Hell Alone.' ") Though the medium may have changed, the sell remains the same-becoming a distributor is a path to independence, flexibility, and "abundance," the industry's favorite euphemism for money.

The reality for most recruits is quite different. Multilevel-marketing companies are structured in such a way that a large base of distributors generally spend more than they make, while a small number on top reap most of the benefits. It is often expensive to invest in an initial stock of products, as well as to make required minimum monthly purchases-around a hundred dollars for Young Living members who want to receive a commission check. According to a public income statement, more than ninety-four per cent of Young Living's two million active members made less than a dollar in 2016, while less than one-tenth of one per cent-that is, about a thousand Royal Crown Diamonds-earned more than a million dollars. Everyone in the industry studiously avoids any comparison to pyramid schemes, which are illegal, but the structural similarities are hard to ignore. "You have the two legs of your pyramid," a doTerra employee told me, as she explained the company's compensation structure. "I mean, not a pyramid, but, you know, it has a triangular shape."

Despite the workshops on marketing and business-building at the Young Living conference, the subject of money felt vaguely taboo. "I don't feel like I'm selling, I feel like I'm sharing," a Canadian distributor told me, a sentiment I heard over and over again. "What's different with this company is the heart motive."

Turnover is notoriously high in the multilevel-marketing world, but many distributors who don't make a substantial income nonetheless stick with it, in part because the benefits are more than just monetary. Distributors, many of whom are stay-at-home mothers, find social connections and creative outlets through their oil business. "Some months, I think she spends more than she makes," the daughter of a Young Living distributor told me. "We moved around a lot, that was hard for her. She's made a lot of friends through it. She's happy."

In 2000, Michael Pratt, a professor of management at Boston College, conducted an ethnographic study of Amway distributors. He concluded that the company offered few of the benefits that traditionally inspired loyalty. Its workforce was geographically diffuse; workers had inconsistent income, no benefits, and little job security. What held Amway together was its ability to foster strong feelings of identification, and to get its members to see the company as the embodiment of an idealized life. Young Living's affection for abstract nouns-purity, abundance, wellness, vitality-helps to define a shared culture that prizes freedom, family, and self-sufficiency, and is suspicious of regulation and Big Pharma. All the ancillary swag for sale at the conference-the T-shirts and bumper stickers and magnets-helped to transmit the message that Young Living's distributors were not just people who sold oils; they were oil people.

Gary Young, the founder of Young Living, made his first appearance at the convention by riding into the arena on a sled pulled by a team of huskies. (Last year, he flew in on a zip line.) An annual highlight is the announcement of a new oil blend. This year's concoction, Fulfill Your Destiny, was available to distributors for thirty-four dollars for five millilitres and included black pepper, blue spruce, and frankincense, "which opens up your pineal gland," Young said from the stage.

Young is a tall, lean man in his late sixties with a handsome lined face and a penchant for cowboy hats. His origin story is a key part of Young Living lore: how he grew up in Idaho in a cabin with a dirt roof and no running water; how, in his early twenties, he was working as a logger when a tree fell on him, fracturing his skull, rupturing his spinal cord, and breaking nineteen of his bones; how, once he woke up from the coma, doctors told him that he would never walk again. After two suicide attempts, he decided to drink nothing but water and lemon juice. After two hundred and fifty-three days, he regained feeling in his toes. "That he walks today is a miracle that defies his medical prognosis," according to his biography, "D. Gary Young: The World Leader in Essential Oils," which was written by his wife and published by Young Living.

Young's recovery spurred his immersion in alternative medicine. In 1982, he opened a health center in Spokane, Washington, that included birthing services. One of the babies he attempted to deliver, his own daughter, died after spending an hour underwater in a whirlpool bath. The death was ruled an accident, but the county coroner said that the baby would likely have lived if she had been delivered under conventional conditions. The following year, Young said in the presence of undercover detectives that he could detect cancer with a blood test; he was arrested for practicing medicine without a license and, according to the Spokane Spokesman-Review, pleaded guilty to a misdemeanor charge. Around the same time, Young opened a clinic in Tijuana. John Hurst, a reporter for the Los Angeles Times, submitted a blood sample, posing as a patient, and was told that it showed signs of aggressive cancer and liver dysfunction. A "health educator" suggested that Hurst undergo the clinic's two-thousand-dollar-a-week detox program. When Hurst revealed that the blood sample had come from a cat-"a healthy 7-year-old, 20-pound tabby cat named Boomer"-she replied that the cat was "not healthy" and "probably has leukemia." (It did not.)

After meeting a French lavender distiller and grower at a Whole Life expo in California, Young became fascinated by the medicinal properties of essential oils. In the early nineties, he travelled to France to study distillation methods. He bought a hundred and sixty acres of farmland in Idaho and planted peppermint, tansy, and lavender. In 1994, he married his third wife, Mary, a trained opera singer and a driven businesswoman. The couple renovated a run-down building in Riverton, Utah, to use as the headquarters of Young Living Essential Oils; Young mixed his Abundance oil blend into the paint he used on the walls.

In 2000, Young opened the Young Life Research Clinic, in Springville, Utah, which administered essential oils and other alternative therapies to patients with heart disease, depression, and cancer, among other conditions. The clinic employed a pediatrician named Sherman Johnson, who had recently had his medical license reinstated. About a decade earlier, Johnson had been investigated by the state medical board after a woman had died while he was treating her for cancer. According to the Salt Lake Tribune, after a nurse raised questions about the woman's death, the body was exhumed. In a subsequent probe, it was determined that she had had multiple-personality disorder but not cancer; that Johnson had believed her story that she had been injected with cancer by a group of witches and gay doctors; and that she had died from an overdose of Demerol, administered by Johnson. Johnson pleaded guilty to manslaughter.

In 2005, the Young Life clinic settled a lawsuit with a patient who claimed that infusions of Vitamin C had caused renal failure, almost killing her. Young closed the Utah clinic and opened one in Ecuador.

As Young Living grew, former employees told me, reining in Young's spending became an issue. At the company's showcase farm, in Mona, Utah, Young built replicas of a Wild West town and a medieval castle. As "Sir Gary," he hosted tournaments, in which he donned a suit of armor and competed in jousting events. He had plans drawn up for a two-hundred-and-fifty-million-dollar theme park, Mount Youngmore, which would feature jousting, a five-star hotel, and a mountain with Young's face etched on it. (Young has denied this.) "It was just crazy what they were trying to build out there," David Stirling, then Young Living's chief operating officer, told me. Stirling said he was also alarmed by a video he saw of Young, whose only medical degree is a doctorate in naturopathy from an unaccredited school, performing gallbladder surgery and giving essential oils intravenously at the clinic in Ecuador. Stirling attempted to shift Young Living's focus away from Young to the oils, but he met with resistance from Young-and also from many distributors, who felt a deep loyalty to Gary and Mary.

Young eventually fired Stirling, citing, among other reasons, the fact that Stirling kept Young out of the company magazine. (A spokesperson said he was let go for "performance reasons.") "Satan exercised dominion over you to the point where you started thinking that you had knowledge and ability greater than anyone else, including me, the creator of the company," Young wrote in an e-mail. Young declined to speak to me, but the spokesperson said, "Successful company founders are often cut from a different cloth than the rest of us, which is true of Gary Young and his pioneering cowboy spirit."

In April, 2008, Stirling and several other former Young Living executives founded doTerra. Their goal was to make essential oils more appealing to a general audience. "At Young Living, we sold to a lot of Reiki masters," Emily Wright, one of doTerra's co-founders and Mary Young's former personal assistant, said. "When we started doTerra, we really wanted to focus on mothers, to teach them to be empowered to take care of their families. We took essential oils out of this weird healers' niche and into the mainstream."

At first, doTerra's distributors, whom it refers to as Wellness Advocates, were largely concentrated in Utah. Several doTerra executives are Mormons, and the company's connection to the Church was an advantage, because distributors could rely on its large number of stay-at-home mothers and its naturally networked communities. Utah has more multilevel-marketing companies per capita than any other state; direct sales are Utah's second-biggest source of revenue, after tourism. The Mormon Church also has a long-standing mistrust of federal oversight, which has made Utah a friendly home for businesses that operate outside medical norms. Attempts to regulate these industries are often portrayed as threats to individual freedom. In the nineties, during a battle over the regulation of dietary supplements, vitamin advocates paid for a TV ad starring a bewildered, bathrobed Mel Gibson, accosted in his kitchen by a SWAT team for having a bottle of vitamins. More recently, parents have begun refusing in large numbers to vaccinate their children; in Utah County, the hub of the state's alternative-health industry, forty-three per cent of kindergartners have not received their full suite of vaccinations.

DoTerra positions itself as friendly and transparent, selling oils as something between a home remedy and a craft project. The company's social-media posts encourage a D.I.Y. approach to health: "Rosemary supports healthy digestion and internal organ function. Next time you're creating a pizza masterpiece, add a drop of Rosemary to gain these benefits!" One of its best-sellers is a kit called Family Essentials, which includes lavender ("take internally to reduce anxious feelings") and lemon ("to clean tables, countertops, and other surfaces"). Where Young Living had emphasized oils' mystic qualities, with talk of energy fields and harmonic frequencies, doTerra's marketing made oils seem like a normal part of any family's medicine cabinet. The company's friendly tone and Pinterest-ready suggestions were soon the dominant mode for spreading the message about oils. Today, Young Living's and doTerra's social-media posts are virtually indistinguishable; both feature empowering slogans ("You are beautiful, inside and out"; "You're like really pretty"), flower petals, and smiling babies.

By 2012, doTerra had pulled even with Young Living in terms of total revenue and number of distributors; a market-research group called doTerra "singularly responsible" for the industry's rapid expansion. That year, Young Living sued doTerra for three hundred and fifty million dollars, alleging, among other things, that the company's founders had stolen trade secrets and poached Young Living distributors. At the end of 2015, doTerra claimed that it had surpassed a billion dollars in sales; the following February, Young Living said that it had, too. The court case dragged on for five years, concluding with a civil jury trial this spring. On the second day of the trial, the smells of oils in the courtroom "gave me a bit of a headache and even a stomach ache," the judge said. "I hope we can keep down on the aromatherapy." In June, a jury dismissed all charges against doTerra and its executives.

During the final week of the trial, I toured doTerra's headquarters, in Pleasant Grove, Utah. An employee led me through an air-conditioned warehouse full of fifty-gallon barrels of oils with labels identifying their origins: frankincense from Oman; lavender from Bulgaria. Essential oils, which are made by steam-distilling or cold-pressing plant material, are incredibly resource-intensive to produce. It takes more than a million rose petals to make an ounce of rose oil, which doTerra says is good for the complexion. A single barrel of frankincense oil is worth hundreds of thousands of dollars. The rose oil is so valuable that it was locked in a separate area. As oils have become more popular, sourcing has become contentious. Frankincense, coveted both for its alleged ability to regenerate cells and for its Biblical prominence, is derived from the resin of trees that grow only in the Horn of Africa and the Middle East. Anjanette DeCarlo, an environmental scientist who specializes in frankincense, told me, "If the demand keeps up without proper controls, we risk causing an ecological crash of a rare and endangered ecosystem." Young Living recently pleaded guilty to illegally trafficking in rosewood oil from Peru, which considers rosewood trees a threatened species.

Companies in the fragrance and food industries regularly supplement naturally derived oils with synthetic molecules, yielding cheaper products and greater consistency. "An oil that is synthetic in its chemistry won't work the same way," David Hill, an avuncular chiropractor who was formerly the director of Gary Young's Utah clinic and is now doTerra's chief medical officer, told me. Last year, a former Young Living distributor named Miles Jordens crowdsourced the funds to have several companies' oils analyzed by an independent lab. He found that two of Young Living's oils contained synthetic adulterants. "When you start to see the amount of plant material required to produce oils, and when you have millions of people ordering-I just question how the demand can be met without possibly cutting corners," Jordens told me. A Young Living spokesperson said that the company tested its oils in independent labs and found no evidence of adulteration.

Representatives of both doTerra and Young Living like to highlight the medical benefits of their products. "There are literally thousands of studies on the benefits of essential oils," Hill said. In fact, there have been very few large-scale, peer-reviewed studies of essential oils' use on humans, and their conclusions have been relatively modest. It appears that lavender may improve sleep quality and duration, and that peppermint may reduce symptoms of headache and irritable-bowel syndrome. Many more studies have looked at oils' impact on cell cultures in a lab, sometimes with encouraging results. Some oils have been shown to have antimicrobial effects, and to work synergistically with antibiotics. But the conclusions reached by scientists are beside the point for many consumers. "I'll use my wife as an example," Hill said. "She's not going to be able to tell you the first thing about chemistry. Put a research paper in front of her-zero interest. And that's probably how most people are. What's real to them is the experience they're having."

The Food and Drug Administration is charged with preventing sellers of alternative-health products from making unfounded medical claims. Without ample independent testing, companies can't assert that their products prevent, diagnose, treat, or cure disease. They get around this by relying on abstract words like "vitality" and "balance," and by talking in vague terms about general body systems or mild issues that don't rise to the level of disease. Young Living and doTerra have attorneys on staff to insure that product descriptions are within legal bounds.

It's much harder to police the millions of independent distributors. In September, 2014, the F.D.A. sent a sternly worded letter to doTerra, scolding the company for distributors' claims about oils and conditions including cancer, brain injury, autism, Alzheimer's disease, and A.D.H.D. The agency cited a tweet by a doTerra consultant using the handle Mrs. Skinny Medic that listed "oils that could help prevent your contracting the Ebola virus," and a Pinterest post by Wellness Empress that recommended peppermint oil for asthma, autism, bacterial infections, and brain injury. (Young Living received a similar letter.)

A few weeks later, federal agents appeared at doTerra's Utah headquarters, and began examining the company's files. "It's always fun when the F.D.A. shows up on your doorstep," Hill said. "And they walk into your office and say things like 'Dr. Hill, you are personally culpable for every single person using these oils.' These were scary moments." DoTerra instituted a fifty-person compliance team to scour social-media posts, looking for noncompliant language, and hosted weekly conference calls, helping distributors translate their stories into acceptable language. "We have a whole team using very sophisticated software, whose whole job is to systematically go through and look for potential claims, like 'frankincense and cancer,' or 'doTerra lavender Ambien,' " Kirk Jowers, the doTerra vice-president, told me. "Anything suspect that goes up, we try to get it down within twenty-four hours, and we're very effective."

But although doTerra supplies educational materials to its Wellness Advocates, there are no requirements that they review or distribute them. "The multilevels have the whole aromatherapy community worried," Peter Holmes, the author of the textbook "Aromatica," told me. Both doTerra and Young Living encourage consumers to drink certain oils, a position that's controversial even among alternative-health practitioners. Holmes said that, while he is unaware of the practices of specific companies, "You hear about completely untrained housewives telling people to ingest up to fifty drops. That is sheer insanity. That is medically dangerous. It's a crazy situation."

This May, a doTerra representative named Lara held an Essential Oils 101 class at a barbecue restaurant in Waco, Texas. The wood-panelled room had paintings of trains on one wall and of hunting dogs on another. Lara, a bright-eyed woman in chunky jewelry, introduced herself as "the crazy oil lady." She was in the midst of a doTerra leadership-training program that brought her to a handful of states to lecture about oils. She told the dozen people assembled that she had become interested in oils a few years ago, when her three-year-old son started showing symptoms of autism after receiving the measles-mumps-rubella vaccine. "My pediatrician had no help for me," she said. But diffusing oils made her son as "calm as a kitten." After a few years of treatment with oils, she said, he is on track developmentally.

Lara distributed a handout that listed various ailments and their oil treatments: eucalyptus for bronchitis, lavender for third-degree burns, cypress for mononucleosis, rosemary for respiratory syncytial virus. Diffusion "kills microorganisms in the air which helps stop the spread of sickness," the pamphlet read. Oils "repair our bodies at a cellular level so when you are not sure which oils to use, don't be afraid to use several oils and the body will gain a myriad of benefits." Lara told the people in the room that doTerra had oils that were "very antiviral" and could knock out bronchitis in twenty-four hours. She shared essential-oil success stories-her migraines gone, her friend's rheumatoid arthritis reversing, a colleague's mother's cancer in remission. A blond woman at the back of the room raised her hand. "Cancer?" she said, sounding both skeptical and hopeful. She explained that her sister-in-law had recently been treated for breast cancer, and was taking a pill to prevent its recurrence, but the side effects were terrible. The blond woman was hoping for a more natural solution.

"There is an oil for that," Lara said cautiously. "There is some research. It is an option. It would not have those side effects."

A young man in an orange shirt identified himself as having autism and Tourette's syndrome. Lara passed him a vial of vetiver. He held the bottle up to his nose and inhaled deeply. "Am I supposed to get chills?" he said. "I'm getting chills."

I thought of a book I'd recently read, "The Chemistry of Essential Oils Made Simple: God's Love Manifest in Molecules." In it, David Stewart, an aromatherapist affiliated with Young Living, writes that essential oils have a divine intelligence and discernment that allows them to heal without harming, to provide our cells with exactly what we need and nothing we don't. "The molecules of a therapeutic grade essential oil form a harmonious, coherent, functional family designed and intended to serve us and heal us according to the highest will of their creator and our creator who is one and the same-God," Stewart writes. The idea could give anyone chills: a better kind of medicine, one that's pure and uncompromised, derived from nature, sold to you by a friend. A small bottle full of all the good things and none of the bad.

Source Citation

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Essential oils have become big business-but are they medicine or marketing? Twenty years ago, Carla Cohen fell mysteriously ill. She couldn't put her finger on what was wrong; it felt as though some conspiracy between her mind and her body were eroding her capacity to work.

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When we fret about the deterioration of the American diet, we tend to focus on the excessive amounts of sugar, salt, and calories we're now eating.

What we don't talk about: an important ingredient that's gone missing as we've been filling our plates with more chicken and cheese.

Fiber. Only 5 percent of people in the US meet the Institute of Medicine's recommended daily target of 25 grams for women and 38 grams for men. That amounts to a population-wide deficiency - what nutritionists call the " fiber gap."

"People are so busy avoiding carbs, they forget that these foods give [them] important dietary components," said nutritionist Julie Jones, of St. Catherine University.

Fiber is the closest thing we have to a true superfood - or super-nutrient since it's a part of so many different foods. Eating a fiber-rich diet is associated with better gastrointestinal health and a reduced risk of heart attacks, strokes, high cholesterol, obesity, type 2 diabetes, even some cancers. That's because fiber is amazingly helpful in many ways: It slows the absorption of glucose - which evens out our blood sugar levels - and also lowers cholesterol and inflammation.

These benefits grow the more fiber people eat. In a recent Lancet review of 185 studies and 58 clinical trials, researchers found that if 1,000 people transitioned from a low-fiber diet (under 15 grams per day) to a high-fiber diet (25 to 29 grams per day), they'd prevent 13 deaths and six cases of heart disease. ( Some researchers have described not eating high-fiber carbohydrates as "the opportunity cost" of the ultra low-carb ketogenic diet.)

If fiber were a drug, we'd be all over it. But the average American gets just 16 grams per day - half of what we should be eating.

A big reason for that has to do with what we now eat. Instead of munching on fruits, vegetables, beans, nuts, and seeds, more than half of the calories Americans consume come from ultra-processed foods. On any given day, nearly 40 percent of Americans eat fast food. These prepared and processed meals tend to be low in fiber, or even fiber free. (A cup of cooked oatmeal has 4 grams of fiber and a pear has 6 grams, while a McDonald's hamburger has one gram and soda has none.)

This pattern of eating is not just leading to weight gain and obesity-related health issues; it's hurting our gastrointestinal health in ways researchers are only beginning to understand. That's because fiber's benefits are a lot more complicated than our prune-peddling moms and grandmothers appreciated.

Fiber doesn't just help us poop better - it also nourishes our gut microbiome. The science, while still pretty nascent, is fascinating and it points to the fact that the fiber gap may be even more damaging than we've realized.

There are many different types of fiber - and they do different things in our guts

To think of fiber as just Metamucil and bran cereal is to do its complexity a disservice.

Fiber (or "fibers," as the researchers who study it say) is a group of different kinds of plant-based carbohydrates that affect our gastrointestinal tract in myriad ways. The big difference between fiber and other carbs, like starches and sugar, is that we can't directly digest or absorb it. And some fiber types can only be broken down by the gut microbiome, the ecology of trillions of diverse bacteria lining our intestines and colon.

Scientists have learned over the years that fiber can be soluble (meaning it dissolves in water), viscose (gel-forming), or fermentable (bacteria can metabolize it) - and they're just beginning to understand how these different fiber types interact with our gastrointestinal tract and affect our health.

Take cellulose, a type of fiber in fruits and vegetables: it's insoluble and it's not fermentable. Hemicellulose, found in bran, can't be dissolved in water and it's not gel-forming (viscous) but it is fermentable. Psyllium, in Metamucil, is water soluble, gel-forming and less fermentable than other fibers. There's also another class, known as "functional fiber": industrially processed but natural fibers (such as inulin or fructan) and synthetic fibers (such as polycarbophil), all of which can be added to foods and supplements.

Understanding this variety is relevant to our health because different fibers have different health effects on our gastrointestinal tract, said William Chey, a professor of gastroenterology and nutrition at the University of Michigan. Gel-forming fibers like psyllium, for example, hold on to water. So if your stool is hard, they can help soften it, Chey said. "If your stool is too loose, the water-absorbing capacity can add form."

Fermentability is also important, he explained, because it reflects whether the gut microbiome views fiber as a food source or not. Fermentable fibers can exacerbate gas and bloating, so people who experience those symptoms might want to adjust their intake.Researchers have demonstrated that a low FODMAP diet - which limits fermentable foods, including fibers such as fructan - can alleviate irritable bowel syndrome.

"Most doctors and people think all fiber is created equal," Chey added. "But different types of fiber have different properties in the gut, especially as it pertains to the microbiome."

Most humans have evolved to eat lots of fiber

The second thing to know about fiber is that humans evolved to eat it - a lot of it. Long before we learned to cook, domesticate animals, and put McDonald's on every corner, our evolutionary cousins - such as chimps and bonobos - followed frugivore diets, subsisting mainly on fiber-heavy fruits, roots, shoots, nuts, and seeds. There's also ample evidence that early humans went to great lengths to eat fiber-rich carbohydrates, such as oats and acorns.

Today, studies of Tanzania's Hadza people, one of the few remaining hunter-gatherer groups on the planet, are a useful model for understanding just how much fiber early humans probably ate. Tribe members consume 100 to 150 fiber grams per day - enough to fill some 50 bowls of Cheerios, and 10 times what Americans take in, as NPR reported. Their daily diet is rich in roughage - tubers, berries, baobab fruits - and the Hadza people don't eat any ultra-processed foods.

Researchers who study the health effects of fiber, including Jens Walter at the University of Alberta, say the Hadza's enthusiasm for roughage should remind us of how much the human diet has shifted away from fiber.

"It's really just within the last 5,000 years, and definitely within the last 100 years, that we basically took all the fiber away," he said. "The average amount of fiber consumed by now is a small fraction to what we evolved with." (Caveat: There are human communities - like the Inuit in Greenland - who've adapted to survive on meat-heavy diets without many plants, but they're outliers.)

This change isn't just attributable to the advent of fiber-free processed and fast foods in advanced economies. More than 10,000 years ago, before agriculture and selective plant breeding, early fruits and vegetables were almost unrecognizable by today's standards.

Generation after generation of farmers have since bred them to be bigger and tastier - in many cases increasing their sugar content and stripping them of fiber. Milling, meanwhile, cleared the whole-grain fractions out of our bread and bakery products, which were a major fiber source, Walter said. And meat replaced fibrous beans and lentils as the main source of protein in many parts of the world. Researchers are now documenting the health impacts of that change.

Why fiber is good for our gut

Because our intestines can't directly digest fiber, we've long seen fiber as beneficial for relieving constipation by adding bulk to stool and promoting regular bowel movements.

Another commonly touted fiber benefit: It can help us feel full, so we eat less and maybe even lose weight. (There's some debate about fiber's effect on satiety and appetite. The most recent systematic reviews of the research suggest fiber's impact here is surprisingly modest, though others note that many studies have focused on supplements instead of whole foods, which are probably more satiating.)

Still, all this "was before people [realized] how much the non-digestible things we eat impact our gut bacteria," said University of Michigan microbiologist Eric Martens.

Researchers now consider fiber's role in nourishing our gut microbiome - the ecosystem of microbes in our intestines - to be one of its main health benefits. They don't yet fully understand why fiber is so good for our gut, but they have some ideas.

Fermentable fibers - which include all soluble fibers and some insoluble fibers - are metabolized or fermented by bacteria in the gastrointestinal tract. That process produces chemicals, including short-chain fatty acids, which are important food sources for our gut bacteria.

They also carry health benefits, Martens said. Short-chain fatty acids have been shown to promote insulin production, so we can better manage the spikes of sugar (or glucose) in our blood, for example, helping to manage type 2 diabetes. In addition, they seem to have anti-inflammatory properties.

"When we don't consume enough fiber, we are essentially starving our gut microbiome," said Alberta's Jens Walter, "which is likely detrimentalfor a variety of reasons. We also probably lose [microbiome] diversity."

Andrew Gewirtz of Georgia State University was among the researchers who noticed that mice develop metabolic syndrome - obesity and its associated disorders, such as diabetes and high cholesterol - when they are fed a high-fat diet. But when fiber was added to the high-fat diet, most of that metabolic syndrome went away.

"We realized the fiber is very important for our metabolic parameters," Gewirtz told Vox. So he decided to compare the microbiomes of mice on a fiber-enriched high-fat diet with mice on a low-fiber high-fat diet, to figure out what they might reveal about why extra fiber seemed to offset the health harms of dietary fat. And he found the two sets of mice wound up having really different microbiomes: Rodents on the low-fiber diet had a marked reduction in the total numbers of bacteria in their gut and a less diverse microbiome compared to the mice on the high-fiber diet.

That lack of diversity might have negative health effects - one of them to do with the mucus layer in the gut.Mucus acts as a protective barrier between us and the outside world. It's constantly being replenished by secretions from the cells that make up our intestines, and it's covered with a layer of bacteria, part of our microbiome. Fiber feeds the bacteria on top of the mucus layer as it passes through, helping to keep our microbiomes robust, Gewirtz said.

Another fiber study - again in mice - showed what happens when the bacteria in the digestive tract don't get any fiber. Researchers, including Martens, found the bacteria begin to eat away at the mucus layer, bringing them into closer contact with the intestinal tissue.

"The hypothesis is if we stop feeding the microbiome [fiber], the bacteria will resort more frequently to digesting that mucus barrier as a source of nutrients."

If bacteria eating up the mucus layer sounds bad, well, it is. The mucus layer keeps pathogens out, and the researchers were able to show that if they introduced a pathogen in the context of a low-fiber diet, it had an easier time getting into the intestine and causing an infection. "The lack of a mucus barrier made the disease get much worse much quicker," Martens added. "It may irritate the [intestinal] tissue or provoke immune responses," leaving the mice more vulnerable to disease.

While it's not yet clear how or whether these findings will translate to people, researchers know that altering the fiber in one's diet creates changes in the human microbiome.

And for now, this science shows us that we should start thinking about fiber differently, Gewirtz said. The exclusive focus on fiber's constipation-fighting properties misses the big picture: "It's just one thing that fiber does" and maybe not as important as fiber's impact on our microbiome.

Only five percent of Americans meet the recommended fiber target - and that means most miss out on fiber's benefits. So how can you eat more fiber? Every researcher I spoke to suggested aiming to get a diversity of fiber from a varied menu of whole foods, instead of relying only on supplements or fiber-enriched processed foods, especially the sugary bars and brownies now being marketed as fiber-delivery tools.

To do that, consider snacking on whole fruits, replacing white bread with whole-grain alternatives, eating potatoes with the skins on, and tossing berries, nuts, and seeds on your yogurt, cereals, or salads, Hannah Holscher, an assistant professor of nutrition at the University of Illinois, suggested. "Lots of small changes can add up."

If you like smoothies, throw your fruits, veggies, and nuts in a blender. Contrary to the hype about smoothies degrading fiber, some of the researchers I spoke to actually encouraged this approach. "Even baking does not destroy most fibers," Walter said.

"[The] natural sources are probably better for both your digestive health and your microbiome. They're more diverse from the chemical level," Martens added. "If you can get 25 to 30 grams per day from beans, nuts, vegetables and fruits, and whole grains - that's a good place to start."

Andrew Reynolds, a diabetes and obesity researcher at New Zealand's University of Otago (and the lead author on that recent Lancet review of fiber's benefits), laid out what meeting one's fiber target might look like in a meal plan. He tracked what he ate on a recent day.

Morning
Two slices chunky wholegrain toast with apricot jam: 5 grams fiber
Two cups of black coffee: 0 fiber
1 small apple: 2 grams fiber

Lunch
Red beans and brown rice with salsa verde and hot sauce: 7 grams fiber
Large handful of unsalted peanuts: 2 grams fiber
2 cups tea with low fat milk: 0 fiber
1 carrot, raw: 2 grams fiber
2 small prunes:​ 1.5 grams fiber
Two cups of black coffee: 0 fiber

Evening
1 wholemeal Turkish pide bread: 2.5 grams fiber
2 cups of kale and white bean salad with tahini dressing: 8 grams fiber
1/3 eggplant with yoghurt dressing and pomegranate: 2 grams fiber
1 cob of corn: 2 grams fiber
2 lamb meatballs in 1 cup fennel/tomato sauce: 4 grams fiber
1 glass white wine: 0 fiber

Reynolds consumed 38 grams of fiber, the recommended target for adult men. But he also advised that people shouldn't obsess about meeting fiber targets. "Any increase in fiber is good for you, especially for those on a low-fiber diet."

For many Americans, upping the fiber intake may be easier said than done. The reasons people aren't eating fiber look a like like the reasons they're not following a healthy diet generally. "[It's] a perceived lack of time to prepare meals at home, eating out more, [a lack of] knowledge about how to prepare different high-fiber foods ... in a way that tastes good," Holscher explained.

Some high-fiber foods - like fresh produce and nuts - also cost more than lower-fiber alternatives, such as sweets or soda. And even though grains, beans and lentils come cheap, they're not always convenient to prepare. So maybe the solution to the fiber gap is making fiber cool, and as cheap and easy to eat as hamburger.

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Nearly all Americans fail to eat enough of this actual superfood

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When we fret about the deterioration of the American diet, we tend to focus on the excessive amounts of sugar, salt, and calories we're now eating. What we don't talk about: an important ingredient that's gone missing as we've been filling our plates with more chicken and cheese. Fiber.

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It seems like a simple question, right? Is vaping bad for you? But behind that curtain are a lot of moving parts and pieces. We can start with the most simple premise. A comparison of smoking vs. vaping. That breaks down like this.

Smoking involves setting chemically treated tobacco on fire and inhaling smoke. The tiny particulates in smoke are incredibly invasive and will deeply burrow themselves into living tissues. Vaping involves vaporizing a liquid solution containing nicotine and food grade ingredients. There is no combustion with vaping.

There is no scientific consensus in the United States regarding whether or not vaping is bad for you. There is, however, a lot of information from both sides of the argument that can be presented to you so you can make your own decision. But here's where we must start off this discussion. If you don't smoke, don't vape!

Non-Smokers Aren't Vaping

The good news is that the overwhelming majority of vapers are smokers or former smokers. In fact, the 2014 Health Survey for England, where vaping is promoted as a tobacco alternative, it was found that only 1% of the people that had tried e-cigarettes were never smokers. It is very rare for a non-smoker to take up vaping. E-cigs are an alternative tobacco product for adult tobacco consumers. That is the intent of vaping. We do not recommend or promote vaping to people who have never smoked.

If you are a smoker trying to quit, we encourage you to explore every option available to you to help you kick cigarettes. If you are an adult tobacco consumer wondering if you can use e-cigs to quit smoking, we can't answer that. There is no official American scientific position to confirm or deny vaping as a viable smoking cessation method.

A 2016 European study published in in the journal Addiction found that 15 million smokers in Europe have either quit or reduced smoking with e-cigs. There is a recent study based on the National Health Review Survey that shows that 52% of vapers in the United States have given up smoking. That is promising, and we look forward to more research.

Is Vaping Safer Than Smoking?

This is where this debate really needs to be. ' Is vaping safer than smoking' is the real world question smokers are asking not "is vaping bad for you?". Let's start with smoking. Tobacco smoke contains thousands of chemicals, and many of them are proven carcinogens, which are chemicals linked to cancer.

Contrast the known dangers of tobacco with e-cig vapor. E-cig vapor is the product of vaporizing a nicotine e-liquid solution made up of VG and or PG , both food grade substances.

Although US researchers have not reached an official conclusion, researchers in other countries have been more assertive. In the UK, both Public Health England and the Royal College of Physicians agrees that vaping is at least 95% safer than smoking. With such a strong consensus in the UK, why are US researchers reluctant to make any official declaration?

Tests of e-cigarette vapor have produced very different results. Some research has found formaldehyde in vapor and some, such as this 2017 San Diego State University vapor study , have found that e-cig vapor does not generate toxic particulates. Why are there different results from different e-cigarette vapor studies?

It is only very recently that electronic cigarette researchers have realized that the type of vapor device used is an important consideration. No one can answer "is vaping bad" without considering the technology being tested. Many of the early studies never stipulated what type of e-cigarette was used nor what style of vaping was tested. In fact, researchers would test the devices in ways that no one would use when vaping. The best example of this are the claims of formaldehyde in e-cig vapor.

Is There Formaldehyde In E-Cig Vapor?

Researchers have been known to use e-cigarettes in unrealistic ways to cause a specific result. For example, a 2015 New England Journal of Medicine article declared that electronic cigarette vapor contains dangerous formaldehyde. The formaldehyde was generated when the vapor product was vaped at high voltage. But a closer look at the same study also showed that when the same vapor device was used at 3.3 volts, no formaldehyde indicators were detected. Here's the problem. Vapers do not enjoy inhaling burnt vapor. Burnt vapor tastes terrible! It is not reasonable to assume that vapers will be vaping at extreme power settings unsuitable for the device and atomizer that they are using.

Studies have shown that if coils are stressed and overheated, some toxins can be generated.

The same studies show that no formaldehyde indicators are detected when e-cigs are used within reasonable voltage/wattage ranges.

Greg Gutfeld from Fox News humorously weighed in on the New England Journal of Medicine report with a comparison. Gutfeld said that "This e-cig study's assertion is like saying driving a car is deadly if you floor it in reverse on a narrow cliff while doing Jell-O shots in your underwear.

The bottom line is this. Any product can be misused in ways that compromise safety. There is no doubt that the type of device being used and how it is used play a major role in e-cigarette safety. If you are using an electronic cigarette product, use it within the manufacturer's recommended guidelines. Learn how to vape and how the devices work . Choose only good quality products. If you are dripping or using a sub ohm mod, make sure you are aware of the relationship between wattage or voltage and the resistance of the atomizer that you are using.

Pros and Cons of Vaping

Let's take an honest look at the pros and cons of vaping. At Vaping Daily, we are advocates for vapers and vaping. The FDA is currently exploring possibilities that vaping may be an asset in the effort to reduce tobacco harm and, we support that position. The real end game here is to stop smoking and save lives. This world loses millions of moms, dads, grandpas, aunts, and friends every year because of smoking. That must change, and it is way past time.

No combustion eliminating dangerous byproducts of combustion

Eliminates the odor of smoke

No second-hand smoke

Avoid the chemicals, such as ammonia, used to treat tobacco

Variety of nicotine levels enabling more control of nicotine intake

Saves money, vaping can be cheaper than smoking

Range of products and technologies available for every level of user

More variety of enjoyable flavors for adult tobacco consumers

Is Vaping Without Nicotine Bad For You?

The FDA has identified nicotine as the factor most responsible for addiction to tobacco products. In response, the FDA is considering regulations that will require the reduction of nicotine in tobacco products. But is vaping without nicotine bad for you? If nicotine is the problem, is vaping without nicotine safe? Hold on! It's not that simple.

Nicotine is the most well known addictive chemical associated with tobacco use. How bad is nicotine ? Nicotine in and of itself is a stimulant and not a known carcinogen. It is not the nicotine that causes cancer from smoking. The more dangerous chemicals from smoking are the byproducts of combustion. Avoiding combustion is the driving force behind the popularity of vapor products.

Vaping without nicotine is typically a result of a progression of reducing nicotine over time. If you are thinking about trying vaping because it looks cool and you think non-nicotine vaping will not be harmful, don't do it. Is vaping without nicotine bad for you? American researchers do not have an official position yet. But here is what we do know. Your lungs perform best with clean, oxygen-rich air.

Popcorn Lung And Diacetyl

Popcorn lung is the name for a condition called bronchiolitis obliterans, a serious lung disease. Diacetyl is a butter flavoring often used as the butter flavor for products like microwave popcorn. Workers in microwave popcorn production facilities exposed to inhaled diacetyl fumes are reported to have contracted bronchiolitis obliterans. Hence the name popcorn lung.

Diacetyl is used in some e-liquid flavors. As a result, concerns have been raised about vapers potentially being at risk for popcorn lung. It is recommended that vapers avoid e-liquids with diacetyl or acetoin. Many of the leading vape juice company's never use diacetyl in any of their products.

Is vaping bad for you if there is diacetyl in your e-liquid? There is no evidence of that, but as a precaution, many vapers chose diacetyl free products. By the way, there is also diacetyl in tobacco smoke. Even with e-liquids that contain diacetyl, there is much less diacetyl in vapor than there is in tobacco smoke. To date, there are no known cases of any vaper contracting respiratory disease from vaping.

Is Vaping Addictive?

Well if nicotine is addictive, is vaping addictive? Researchers assume that nicotine is addictive. There has been some research indicating that nicotine is not as addictive as once thought but there is no consensus on that at this time. There are, however, studies that might indicate that vaping is less addictive than smoking.

A 2 017 PATH study analysis at Penn State University found that vaping does not appear to be as addictive as smoking cigarettes. PATH stands for the Population Assessment of Tobacco and Health. PATH is a long-term study that is tracking 30,000 people. A massive sample size.

Researchers discovered that vapers are less likely to have strong cravings, to need nicotine after waking up, and more able to resist in restricted areas. The PATH study did not find that vaping was not addictive, just that it appeared to be less addictive than smoking.

Another interesting side note is that PATH data once again shows that non-smokers are not taking up vaping in in large numbers as some critics claim. In fact, 93% of respondents that have tried e-cigarettes are smokers or former smokers.

An Update On Smoking Addiction

The interesting twist to all of this has been the recent discoveries that there are more chemicals in cigarette smoke that may be psychoactive and addictive. Not just nicotine. But, scientists are not sure what it is. Today's neuroimaging technology has shown that when someone smokes a cigarette, they see a decrease in MAO. MAO is monoamine oxidase, which the body uses to break down dopamine. With lower MAO, the dopamine level remains higher contributing to addiction.

Scientists do not know what it is in tobacco smoke that suppresses MAO but they do know that it is not nicotine. The conclusion is that there is an unknown chemical in tobacco smoke causing this phenomenon.

You would think that by now we would have all the answers but here's the thing. Just a few years ago we used to report to people that there were 4,000 chemicals in cigarette smoke. Then, as technology improved, we came to find out there were 5,000 detectable chemicals. In the last few years, that changed again as we now understand that scientists have detected 7,000 chemicals in cigarette smoke. The more we learn about cigarettes and effects of smoking , the more ominous the picture gets.

Of course, this unknown addictive element in cigarette smoke does not get nicotine off the hook! Nicotine is a stimulant. Any stimulant can have addictive properties and increase heart rate and blood pressure. Children, pregnant women, and people with heart conditions should avoid nicotine and vaping.

Is Vaping Bad For You? Conclusions.

Here we are back to your original question. Is vaping bad for you? Now, this is where you come in to weigh what you have read and make a determination based on the best information available at this time. We have established that the device you use and how you use it makes a difference. Avoid low-quality vapor and e-liquid products. Make sure to choose the best el e ctronic cigarettes to suit you specifically.

If you don't smoke, don't vape. If you are an adult tobacco consumer, then vaping is an option. Ultimately, it boils down to relative risk. Even vaping's harshest critics admit that vaping is likely less harmful than smoking. We do not know if there are long-term health risks associated with vaping because there is no evidence either way at this point. Vaping is still a new phenomenon. We certainly know the dangers of smoking and the terrible health consequences.

The research will continue. Vaping Daily will keep you updated on the latest studies from around the world. The mounting body of scientific evidence is growing toward vaping being a legitimate risk reduction method. Electronic cigarettes still have naysayers, but fewer of them all the time.

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Is Vaping Bad For You? What's the truth?

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It seems like a simple question, right? Is vaping bad for you? But behind that curtain are a lot of moving parts and pieces. We can start with the most simple premise. A comparison of smoking vs. vaping. That breaks down like this. Smoking involves setting chemically treated tobacco on fire and inhaling smoke.

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And why they don't make any sense at all

Being an argumentative sort of person, every once in a while* I find myself getting into a spot of witty repartee. It usually happens on twitter, the land of the 140-character he-said/she-said/THE-GOVERNMENT-IS-OUT-TO-GET-YOU banter, but occasionally I find myself getting into arguments in other places online, or even in real life.

Often these arguments are over the subject of vaccines. Because whilst vaccines have been accepted by public health organisations the world over as the most important medical innovation of the 20th century, and one of the most lifesaving interventions that we've ever come up with, there is a small minority of people who are convinced that vaccines are bad for their child's health.

A small, very vocal, minority.

Now, I'm not here to criticize parents. It's very important to note that most parents want the best for their kids. They are trying to look out for their children, and occasionally in this pursuit they get misled. And make no mistake, the people who sell vaccine fear are professionals in the art of deception. They know exactly how to convince a worried parent that the most dangerous thing in the world for their child is the vaccine, rather than, say, the measles.

It's not the parents who are spreading vaccine denial. They are victims of professionals. If you are a parent who is worried about vaccination: don't stress. You are a good parent. You have just been lied to. Have a read of this article, and maybe go have a chat with your doctor about why immunization is important and why it's a good thing for your kids.

Whenever you talk vaccines, the anti-vax professionals come up with the same arguments time and again. Here are my top 8, and why they make no sense whatsoever:

8 Vaccines Cause Autism. I'm not really going to go into this, because it has been refuted time and again. Virtually every study involving a) humans, b) more than 10 participants, and c) researchers who haven't been convicted of fraud, has shown that there is no link between vaccines and autism. It was a valid concern in the early 90s, but we have 30 years of evidence showing that autism is in no way linked to vaccines.

VACCINES DO NOT CAUSE AUTISM ALL REPUTABLE STUDIES HAVE SHOWN THIS FOR DECADES

7 There Hasn't Been Much Research. This is always a bit of a weird one, because people are usually claiming that on the one hand there hasn't been enough research done on vaccines to prove them safe, but on the other they know the truth because they've done their research and it shows vaccines to be basically poison.

It's a strange argument to make, but it comes up all the time.

This is simply a lie told by vaccine-deniers to make parents scared. Vaccines are one of the most well-researched interventions of all time. We have data from literally millions of children across the world demonstrating their safety. There has been more research on vaccines than almost any other medical intervention.

The research has been done. Time and again. Vaccines are safe and effective.

6 Vaccines Are Enormously Profitable. This is also a weird one, because...so what? So are any number of things. The international flour market is gigantic, but that doesn't make every bread advert a missive from the devil. Flour millers have actually been influential in protecting babies worldwide by fortifying their products with macronutrients and preventing neural tube defects.

It's also untrue. Pharma companies make far more money from so-called 'blockbuster' drugs than vaccines - for example, Astrazeneca's Nexium, despite being no more effective than cheaper options for gastrointestinal problems, has made them more than $50 billion. The yearly earnings have been somewhere between 2 and 5 times as much as the flu vaccine. In fact, if you look at the top 20 earners for pharma companies, not one of them is a vaccine.

5 Vaccines Cost Loads. Perhaps more importantly than this, however: vaccines don't cost much at all. Take the whooping cough vaccine. A full 3 doses costs around 100 USD. That seems like quite a bit, until you remember that a single case of whooping cough can easily top $10,000 if it requires significant treatment.

Vaccines are actually cost-saving. What this means is that for every dollar you spend on vaccines, you get about seven dollars back because you stop people from getting sick and dying from their illnesses. Generally speaking, it would be much more profitable for the medical industry to not vaccinate, because disease tends to be really expensive.

4 The CDC Is Lying. This is one of my favourite red herrings, because it is just so easy to disprove. Whenever someone brings up the CDC, my response is...so what? Let's say the CDC is evil, awful, in the pocket of Big Pharma. It's not - the people who work at the CDC are dedicated, honest, and usually incredibly good at public health - but for the sake of argument, let's say the CDC is corrupt.

Who cares?

People who focus on the CDC ignore one glaring truth: the US isn't the only country in the world. If the CDC is corrupt, what about every other public health organisation in the world that recommends vaccines. Australia. France. The UK. Japan. China. The list goes on. Forget about the CDC. Have a look at the Australian Department of Health on vaccines. Or the Japanese immunization schedule. Or one of hundreds of other countries that all choose to vaccinate. Either there's a global conspiracy including countries that are literally at war with one another - a bit unlikely - or immunization is a good thing no matter what you think of the CDC.

3 The US Is Special. This is another one that I love, because it's so easily disprovable. No, the US doesn't give a uniquely high number of immunizations. Much of the OECD has a virtually identical vaccine schedule to the US, bar a few minor differences. The US also has significantly less punitive laws in terms of vaccination than other countries - for example, in France you can go to jail for failing to vaccinate your kids.

So no. The US isn't special. It's just another country, trying to stop nasty diseases like polio, diptheria and measles from killing children.

2 Vaccine Manufacturers Can't Be Sued For Making Kids Sick. This is actually a very simple lie. You can sue whoever you want, even in the US. What the 1986 National Childhood Vaccine Injury Act actually does is make it much easier to get compensation for children who have suffered vaccine injuries. If you can demonstrate that you had a vaccine and suffered a recognized issue - let's say anaphylaxis - there is a reasonably simple method of gaining access to compensation in the US.

Elsewhere in the world, for example Australia, often all you can do is sue in civil courts. And even if you've suffered genuine harm from vaccination, proving this in a court of law is next to impossible, meaning that people who do suffer injuries are almost never compensated.

It's also worth noting that saying "vaccine manufacturers can't be sued" is again a uniquely American piece of nonsense. There are hundreds of other countries. Most of them allow anyone to try and sue anyone. And yet, the UK court system isn't flooded with cases of vaccine manufacturers being successfully sued.

I wonder why?

1 Vaccine Injury Is Common/People Are Getting Sicker. Last but not least, the most common one of the bunch. Forget the CDC, forget the pharmaceutical companies, this is the real evil.

Every year, people are getting sicker. And it's all down to vaccines.

There are two parts to this story. Firstly, we aren't getting sicker. Not even a little bit. Life expectancy is marching steadily upward, with some people predicting that we will be living past 100 in this century. Not only that, but infant and child mortality is at record lows, and is only heading swiftly down. This isn't just true for wealthy countries mind you - the entire world is getting stubbornly healthier.

Secondly, vaccine injury is an amazingly well-researched field. We know the rate of injuries associated with vaccines all too well. It's roughly 1 serious problem for every million vaccinations given. This is a number that has been replicated worldwide, from Japan to Thailand to Australia to Finland and yes, to the US.

Vaccines Rock

There's not really much more to say. These are common arguments, mostly just based on simple lies. Vaccines are safe and effective, not because pharmaceutical companies say it's so or because the CDC has proclaimed it, but because thousands of dedicated researchers the world over have spent decades checking to make sure that they are.

So go and get your kids vaccinated. It's good for society, it will save us all money, but most of all it might save their life.

Vaccines rock.

It's as simple as that.
If you enjoyed and/or like vaccines, send some claps my way with the button below! You can also follow me or on , or read one of my other articles about why herd immunity is pretty cool, how we stop babies dying from whooping cough (hint: it's vaccines), or what you can do to keep kids safe from disease.
* For 'while', read 'hour'

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8 Common Arguments Against Vaccines - The Method - Medium

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And why they don't make any sense at all Being an argumentative sort of person, every once in a while* I find myself getting into a spot of witty repartee. It usually happens on twitter, the land of the 140-character he-said/she-said/THE-GOVERNMENT-IS-OUT-TO-GET-YOU banter, but occasionally I find myself getting into arguments in other places online, or even in real life.