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At Large
The Deadly Crusade Against E-Cigarettes
Experts meeting in Seoul this week want to ban a sure-fire way to prevent death from smoking.
Today is “The Great American Smokeout” — an appropriate day to take a moment to spare a thought for the 44 million Americans in the grip of a deadly addiction. Over half of all smokers tried to quit last year, and an estimated 443,000 died from cigarette-related illness.
Public health officials made great strides in reducing the prevalence of smoking, beginning with the groundbreaking Surgeon General’s report in 1964. Back in the 1970s, 2 out of every 5 adults puffed: now about 1 in 5 do — but what’s left seems to be a coterie of hardcore addicts for whom the officially approved methods of smoking cessation just don’t work. Figures released by the Centers for Disease Control and Prevention last week reveal the sad truth: The U.S. made no progress toward reducing smoking rates in 2011, and has made very little since 2005.
When it comes to smoking cessation, public health officials are out of ideas — and it shows. Delegates from more than 140 countries that are party to the World Health Organization’s anti-tobacco treaty, the Framework Convention on Tobacco Control (FCTC), are meeting in Seoul, South Korea, this week, and high on their agenda is banning or further restricting the best hope for slowing this catastrophe: harm reduction through electronic cigarettes and smokeless tobacco products.
As for the innovative new devices, known as e-cigarettes to their users, WHO director-general Dr. Margaret Chan told the delegates, “[I]ndustry is seeping through the cracks.” But it’s not that e-cigarettes are actually harmful, mind you — they’re not. It’s just that they resemble actual cigarettes, so public health officials fear that the use of e-cigarettes may impede their efforts to “de-normalize” smoking.”
It’s worth a moment to understand what we’re talking about here. Electronic cigarettes work by giving addicted smokers the nicotine they crave, without the toxic smoke. They supply “vapers” a variable amount of nicotine in a watery vapor and produce a red glow at the tip when puffed upon. That similarity — especially the nicotine, the highly addictive substance smokers crave — is what is best about e-cigarettes. The nicotine “hit” they supply matches, more or less, that of inhaling cigarette smoke, as do the behavioral mannerisms of holding the thing as though it was their familiar “friend,” and killer: the lethal cigarette.
But that’s where the similarity ends. There are no products of combustion to be inhaled hundreds of times a day, and hence no tobacco toxins. Nicotine is not a health threat, per se: its danger lies in its potent addictive power. “Vapers” get the satisfying drug but none of the tarry smoke. That’s why many smokers who switch to e-cigarettes succeed in staying smoke-free, while those who try to quit using the FDA-approved methods so often fail. (The little-known fact, rarely discussed by “public health” gurus, is that the patches, gums and drugs they recommend as “safe and effective” are all-too-often neither).
E-cigarettes and smokeless tobacco products should be seen as two variants of a method called harm reduction — providing smokers with nicotine but without the toxic smoke. The message to desperate addicted smokers from the neo-prohibitionists who are gathered in Korea to try to ban these reduced-harm products can roughly be translated as “quit, or die.”
Lethally addictive cigarettes remain available on every street corner in Seoul and Atlanta while authorities denounce e-cigarettes as though the harmless sticks were Satan’s emissaries. (In fact, the product is already banned in Canada, Australia, and New Zealand.) And while, as of today, e-cigarettes remain available in the hyper-precautionary European Union, a new Tobacco Products Directive is expected this year to call for a ban (while tightening the existing proscription on the nearly-harmless type of Swedish smokeless, snus). Such measures would leave addicted smokers with no effective means to help them quit.
The irrationality of these “public health” arguments puts into stark relief the blind-spot of the prohibitionist zealots: They fail to acknowledge the inconvenient fact that the millions of smokers in Europe and America (not to mention the billion or so worldwide) are not going to suddenly accept being regulated off their nicotine. The millions who have succeeded in quitting thanks to e-cigarettes and reduced risk tobacco products will not kick their habit and become nicotine-abstinent if these products are prohibited. No — they will revert to the widely available, deadliest source: cigarettes.
Prohibiting the safest form of nicotine delivery will increase, not stem, the calamity of cigarette-related death. Truly informing smokers about reduced-risk nicotine products, such as e-cigarettes and smokeless tobacco, and increasing access to these products is the best way we have to save millions of lives.
About the Author
Gilbert Ross, M.D., is executive and medical director of the American Council on Science and Health.
Letter to the Editor View all comments (24) | Leave a comment
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Joellen| 11.15.12 @ 8:06AM
It's simple, replace the cig with a doobie. It's legal now in 2 states, watch out for the next 48.
mike 3/505| 11.15.12 @ 8:13AM
This shows that it's not about public health...it's about the power to tell other folks what to do. I quit smoking over a year ago...except for one annual, ceremonial cigar with some of my combat buddies. I'm using an e-cig. I breath better, don't cough all the time and importantly, I don't irritate folks around me. The doc says they are pretty much harmless. So, what's not to love?
PolishKnight| 11.15.12 @ 10:13AM
I'm highly sensitive to cigarette smoke but if the smokeless products don't irritate me, I'm ok with them.
The reason why there are so many hardcore addicts out there is due to the industry's success in making the modern cigarettes more addictive via adding chemicals (I think mere sugar) which to my senses make them smell like meth and crack. Perhaps they are chemically related.
When I was in Eastern Europe, I saw street saleswomen handout out samples to _10_ year olds. I should have taken pictures. Breaking Bad makes the meth industry appear moral by comparison.
gr82cu2| 11.15.12 @ 4:23PM
I absolutely believe your comment about the tobacco companies making cigs more addictive through additives. When I first switched 100% to my ecig I kept feeling as if something was missing but I couldn't put my finger on it. That lasted about 3-4 weeks before it left me. I'm convinced that it was because there were other things in tobacco cigarettes I was addicted to other than nicotine.
PolishKnight| 11.15.12 @ 5:12PM
The scientists at the tobacco companies found that if they added sugar or some other chemical, it increased the addictiveness EXPONENTIALLY. They said 2+2 didn't equal 4, it equaled 16. Marlboro was the first they claimed. I noticed that Marlboro is one of the biggest selling brands in Eastern Europe in a market where the local brands are amazingly cheap. (Want to know how cheap? $3 a carton!!!) I was tempted to bring back our limit of 6 cartons to hand out to co-workers, but didn't want to feed their addiction.
Occam's Tool| 11.15.12 @ 7:50PM
Hey, I hate most foreigners, and love making money off them. I've got $20,000 in PMI. My favorite places to sell, of course, are Indonesia and Jordan and Egypt, for obvious reasons.
Ralphie| 11.15.12 @ 10:46AM
Doobies produce smoke, not a serious substitute for the issue at hand.
I know people that have tried all the FDA certified methods that have quit with the e cigarette. As stated the delivery of nicotine from these most closely resembles that from a tobacco cigarette. The hand/oral habit is also the same.
There was a time lawmakers wanted to reduce nicotine in cigarettes, but it isn't the nicotine, it is the smoke. Lower nicotine means more cigarettes smoked.
Perhaps if they started from the definition of what is the problem (inhaling smoke), they could see that e cigarettes are the most effective solution. I think someone tried to market nicotine water and it was denied. That also would provide a delivery system in the body like smoking, but the hand/oral connection and convience would not be similar.
I remember buying candy cigarettes as well as cigar gum years ago. Nicorette is about as successful as those placebo candy products in my opinion.
In a perfect world, people would smoke, overeat, etc. Then they would still die.
PhysicsBear| 11.15.12 @ 11:32AM
It's all about tax revenues and the tobacco lobby.
The Bruce| 11.15.12 @ 12:04PM
Lucky Strike Means Fine Tobacco.
mikemorgan | 11.15.12 @ 12:13PM
What a well written and thoughtful analysis here as electronic cigarettes let users eliminate tobacco while reducing or eliminating nicotine and second-hand smoke, so see E Cig Werks for more.
Stick| 11.15.12 @ 1:20PM
They really must hate us, why else do they lecture us to live longer while complaining of the cost?
Flatdog | 11.15.12 @ 2:12PM
Stick, when I used to smoke, but was thinking of quitting, I was delayed in my intention because British Rail, that I had to use daily to commute to and from work, banned smoking in any of the carriages on their trains.
We rebels made a stand in the restaurant car, and the steward used to lend us his spatulas to scrape the "No Smoking" signs off the windows!
Every now and then, a Born-Again-Non-Smoker would go and call the guard, but we all knew who these Quislings were, and as soon as they headed in the direction of the guard's van, we stubbed out our cigarettes, and nobody was smoking!
Flatdog | 11.15.12 @ 1:46PM
I'm Anglo/Irish and spent my formative years in Rhodesia, where they grew vast quantities of tobacco.
I had a 60-a-day habit from the age of 18 until my 35th birthday, when I quit with the use of regular sugar-free chewing gum. I first quit for a couple of years in Rhodesia, doing cold turkey. I crawled the walls for two weeks, and then I cracked the problem. I had avoided alcohol and all my friends for that fortnight, because with no peer pressure, and the fact you don't want a cigarette when you are sleeping. I took up the habit again when I returned to England. It was the culture shock!
Next, I gave up using nicotine chewing gum, which was not available then on the NHS, but only on private prescription from a doctor. £17 for a week's supply. I found no difficulty giving up the nicotine gum after I had lost the other habits, like sticking a cigarette in your mouth and setting light to it, taking a deep breath and feeling the smoke enter your lungs.
I concluded that for me, at least, nicotine is not addictive. It was all the other habits involved that were compulsive.
I proved this the last time I quit, 18 years ago, by chewing regular sugar-free gum and wadding it under my lower lip as I did before with the nicotine variety.
Jack London| 11.15.12 @ 2:25PM
I wonder how much the writer's organization is being paid by the e-cig industry. Even Forbes is citing latest research on their harm.
http://www.forbes.com/sites/ro.....r-smokers/
gr82cu2| 11.15.12 @ 4:21PM
Haha! A study with 32 people? Are you kidding me?
From your article: "Dr. Lessnau explained that there are no major studies to date, but he believed that the impact on lung cancer will be substantial. He explained that “regular tobacco products produce more than 1,000 toxic substances, many of them tar related–whereas, electronic cigarettes do not”.
Nicotine has been shown to improve mental acuity and cognition too! It does have benefits. I'm not advocating for someone who is not addicted to nicotine to do so but it isn't all bad. Depends on whose studies you'd rather believe. My daughter-in-law is allergic to almost everything a person can be allergic to and she also has asthma. I can use my ecig in an enclosed car with her in it and she has zero reaction.
Occam's Tool| 11.15.12 @ 7:42PM
Nicotine can produce problems with hypertension and accelerated heart rate, Jack. But Cigarette smoking is worse. Nicotine IS the most addictive drug known to man (Stahl's Essential Psychopharmacology 3rd edition), and cigarette smoke as a delivery source is vastly more lethal than nicotine alone.
The choice really isn't between abstinence and E-Cigarettes, Jack. It's between cigarettes and E-cigarettes. You see, the delivery area is across the lungs' surface blood exposure, which is vastly more addictive than the oral route or the patch route.
The best is the enemy of the good here, you see.
Drunken Sailor| 11.15.12 @ 2:44PM
Guess you missed the part about harm reduction. Author never said they were totally safe.
From your own link.
He went on to state that although “electronic cigarettes cannot be recommended to improve lung health, there is certainly some degree of harm reduction compared to regular cigarette use.”
gr82cu2| 11.15.12 @ 4:08PM
E-cigarettes are the ONLY thing that kicked my 2 pack a day, 35 year addiction to cigarettes. I know many others who are the same. If they outlaw these, you are right, many of us would go back to the killer: cigarettes. BTW, they don't all glow on the end when you puff on them. None of mine have ever been of that variety. I believe the real force behind this movement to ban ecigs is the tobacco companies. They want our money or they want us dead. Too bad RJR and the other big tobacco companies don't see this trend as a new opportunity.
Occam's Tool| 11.15.12 @ 7:47PM
@gr82cu2: actually, sir, they do. Lorillard especially is looking at e-cigarettes as a growth area.
firebottles2| 11.15.12 @ 4:45PM
I smoked like a fiend for 30 years. One day, my wife, my sister-in-law and I quit without any drugs hypnosis or E-cigs. Anyone can if they REALLY want to.
Occam's Tool| 11.15.12 @ 7:48PM
@fire: your N=1. Null study. Not generalizable. You are a man of uncommon will.
Butch| 11.15.12 @ 11:49PM
Face it. Smokers are the only outlet allowed for your ventilation of bigotry.
derfel cadarn| 11.16.12 @ 12:09PM
You have made the erroneous assumption that that this issue is about saving lives,it is not it is about control. As a large portion of those organizations looking to ban e-cigarettes also wish to lower the human population dramatically, saving people is the last item on their agenda. If people wish to smoke how is it our business to intervene? If government were not in the health care business, as they have no right to be then government would and should have no say in the matter.