Now imagine that an alternative comes to the market, an innovative device that can help people wean themselves from the deadly product. It has the same look and feel as the lethal product indeed, that s a large part of its appeal. It, too, is addictive. But the ingredients that kill people are absent.
This, of course, is no imaginary scenario. The lethal product is cigarettes, which use nicotine to addict and combustible tobacco to kill. And the alternative is electronic cigarettes, which deliver nicotine without the tobacco, and emit a vapor that almost instantly evaporates. Yes, users can be hooked on nicotine, which is a stimulant. But people who vape are not going to die, at least not from inhaling their cigarette.
You d think that the public health community would be cheering at the introduction of electronic cigarettes. We all know how hard it is to quit smoking. We also know that nicotine replacement therapies, like the patch, haven t worked especially well. The electronic cigarette is the first harm reduction product to gain serious traction among American smokers.
Yet the public health community is not cheering. Far from it groups like the American Lung Association, the American Heart Association and the Campaign for Tobacco Free Kids are united in their opposition to e cigarettes. They want to see them stigmatized like tobacco cigarettes. They want to see them regulated like cigarettes, too, which essentially means limited marketing and a ban on their use wherever tobacco cigarettes are banned.
Thomas Farley, New York City s health commissioner, trotted out most of the rationales against e cigarettes the other day at a City Council hearing. (The City Council is considering a bill, strongly supported by the Bloomberg administration, that would forbid the use of an e cigarette anywhere that cigarettes are banned.) E cigarettes, he said, are so new we know very little about them. Thanks to e cigarettes, smoking is becoming glamorous again, and could become socially acceptable. The number of high school students who have tried electronic cigarettes doubled from 2011 to 2012. He made a particular point of showing how closely e cigarettes resembled old fashioned tobacco cigarettes.
The reason to fear this resemblance, say opponents of electronic cigarettes, is that vaping could wind up acting as a gateway to smoking. Yet, so far, the evidence suggests just the opposite. Several recent studies have strongly suggested that the majority of e cigarette users are people who are trying to quit their tobacco habit. The number of people who have done the opposite gone from e cigarettes to cigarettes is minuscule. What the data is showing is that virtually all the experimentation with e cigarettes is happening among people who are already smokers, says Michael Siegel, a professor at the Boston University School of Health.
Siegel is a fierce critic of tobacco companies, but he s also not afraid to criticize the anti tobacco advocates when they stretch the truth. When we got to talking about the opposition to e cigarettes in the public health community, he said, The antismoking movement is so opposed to the idea of smoking it has transcended the science, and become a moral crusade. I think there is an ideological mind set in which anything that looks like smoking is bad. That mind set has trounced the science.
Another person who considers e cigarettes promising is David Abrams, the executive director of the Schroeder Institute for Tobacco Research and Policy Studies. It s a disruptive technology, he said, that might give cigarettes a run for their money. In his view, the anti tobacco advocates had spent so many years arguing from a total abstinence framework, that they haven t been able to move from that position. Yet, he noted, the country has long tolerated many similar harm reduction strategies, including needle exchanges and methadone maintenance.
None of this is to say that electronic cigarettes should be free of regulation. But they should be regulated for what they are a pharmaceutical product that delivers nicotine, not a conduit for tobacco poison. Let them make health claims which they can t now do so long as they are backed up with real science. And, most of all, use e cigarettes to help make real cigarettes obsolete.
At that recent New York City Council meeting, one of the fiercest critics to testify was Kevin O Flaherty of the Campaign for Tobacco Free Kids. If it walks like a duck and it talks like a duck and it sounds like a duck and it looks like a duck, it is a duck, he said.
Is this what passes for science when you oppose electronic cigarettes?
Los angeles panel wants same rules for e-cigarettes, tobacco
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With pressure from public health officials and clean air advocates, a city panel on Monday embraced a plan that would apply regulations in place for tobacco products to e cigarettes.
After hearing from a number of health professionals that it is better to be overly cautious in dealing with the e cigarettes, the Arts, Parks, Health, Aging and River Committee urged the full City Council to limit where they can be used in public or sold in the city.
“ We have made such progress over the years, where smoking is down to about 13 percent, and it would be a shame to reverse that,” said Dr. Jonathan Fielding, health director for the county of Los Angeles. “ We recognize that some say (e cigarettes) help them quit smoking, but the strength of scientific evidence to get smokers to quit is not there.”
Fielding said public health officials believe the e cigarettes, which are generally produced and sold by major tobacco companies, are seen as a way to make smoking acceptable once again.
He added that the vapors produced by the cigarettes contain many of the same toxic materials as in regular tobacco and create a secondhand smoke situation for nonsmokers.
Several owners of rapidly proliferating vapor bars and restaurants asked that they be exempted from the ordinance, and Councilman Mitch O’ Farrell is seeking revisions to make that happen.
Jason Healy, president of blu e Cigs, questioned the goal of the city action. “ I think they are going to end up selling more cigarettes,” Healy said. “ If you have to get up and go outside to smoke an e cigarette, and they are joining others who are smoking regular cigarettes, they might as well join with them.
“ This is a recipe for relapse for smokers. We aren’ t sure the ban has worked that well, so why support something like this?”
Los Angeles Unified school board member Steve Zimmer feels the city ban is needed to help keep young people off of cigarettes. “ We are concerned this is a remarketing and a repackaging of tobacco (products), and it is very, very dangerous,” he said. “ This is marketing and targeting of youth who are already extremely vulnerable and in extreme peril.”
City Attorney Mike Feuer noted his office is prepared to defend the city in its law. “ I know you are wondering how much harm this device could pose,” he said. “ The answer is plenty. We cannot allow a return to a path of renormalization of behavior.”
The committee also heard from officials from the American Cancer Society and several anti tobacco organizations.
Councilman Paul Koretz, one of the authors of the proposal, said it is critical for the city to pass the regulations. “ This is nothing but an effort to market cigarettes to kids, when they have flavors like cotton candy or chocolate,” Koretz said. “ They are using this as a gateway to tobacco.”