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.
