Tuesday, October 15, 2013

Tobacco Control Practitioners Continue to Deceive the Public About Electronic Cigarettes

In a campaign of deception, tobacco control practitioners throughout the country continue to spread both misleading and outright false information about the health issues regarding electronic cigarettes.

Here are just a few examples from recent days:

1. A tobacco control practitioner in Indiana claimed that we don't know what is in electronic cigarette vapor. Another tobacco control practitioner, from Illinois, claimed that there's no evidence that electronic cigarettes can help people stop smoking.

According to an article in the Princeton Daily Clarion: "E-cigarette supporters claim it can help smokers on the road to becoming smoke free, but Gwen Siekman, the Coordinator for a Tobacco Free Gibson County, says that e-cigarette smokers are just trading one addiction for another." ...

"“They are totally unregulated and they are very scary,” Siekman said. Supporters of the e-cig say there’s no secondhand smoke that will affect non-smokers around them, but Siekman said, “They don’t know what that vapor has in it.”"

"Ronda Hockgeiger, Wabash County Health Department’s prevention coordinator, said that there’s no new evidence that e-cigarettes help people stop smoking." ...

"Siekman is adamant that people should not use e-cigarette to quit smoking."

2. A tobacco control practitioner in Florida was quoted as stating that "we don't know the long-term effects of inhaling that nicotine solution, all day, every day, for years. So we don't know if they're safer than tobacco. The research hasn't been done."

3. A Utah tobacco control practitioner claimed that smokers who use cigarettes and electronic cigarettes increase their nicotine consumption: "smoking cigarettes and e-cigarettes leads to increased nicotine consumption."

4. A Florida physician and tobacco control advocate published an op-ed piece, in which he argued that the idea of using electronic cigarettes for harm reduction is not a public health approach, but simply a marketing strategy: "My first concern is over the concept of Tobacco Harm Reduction, or THR as those promoting e-cigarettes like to call it. They frequently question why physicians would be against a product that might reduce the risks posed by traditional tobacco products. I am against THR because it is a marketing strategy, not a public health policy."

The Rest of the Story

All of these tobacco control practitioners are spreading misleading and/or false information about electronic cigarettes. And this is just from the past several days. The amount of inaccurate information being disseminated by tobacco control groups throughout the country is alarming. It is also very damaging because it misleads the public and hides the truth. The net effect is to undermine the public's appreciation of the hazards of cigarette smoking.

Let's take the lies one by one.

First, it is not true that we have no idea what is in electronic cigarette vapor. These products have been extensively studied and we have a fairly good idea what is in there. The difficulty is not that we are unaware of the vapor constituents; the problem is that it is difficult to project the long-term risks of inhalation of small levels of a chemical like formaldehyde or acrolein. But we actually have a much better idea what is in electronic cigarette vapor than what is in tobacco smoke.

Second, it is not true that we don't know whether vaping is safer than smoking. Even tobacco companies would not argue that smoking is no more dangerous than vaping. It doesn't take rocket toxicology to figure out that inhaling nicotine plus tens of thousands of chemicals including more than 60 known carcinogens is going to be more dangerous than inhaling nicotine plus low levels of a few chemicals. It doesn't take rocket epidemiology to figure out that burning tobacco is going to result in a more dangerous product than heating nicotine dissolved in propylene glycol and glycerin. tobacco companies don't argue that smoking may be no more dangerous than vaping. Why would a public health advocate advance such an argument?

Third, it is not true that dual users of electronic cigarettes and regular cigarettes increase their nicotine consumption. Actually, smokers who substitute electronic cigarettes for regular ones decrease their nicotine consumption because the electronic cigarette is nowhere close to a tobacco cigarette in its ability to deliver nicotine. The overwhelming majority of electronic cigarette users are lowering their nicotine consumption, even if they maintain dual use of both products.

Fourth, it is not true that the idea of using electronic cigarettes for harm reduction is simply a marketing strategy. Vaping is much safer than smoking, and smokers who have been able to quit using electronic cigarettes have likely saved their lives. This is a bona fide public health strategy that could literally transform the tobacco epidemic. Other examples of harm reduction strategies in public health are needle exchange programs, methadone programs, and comprehensive sex education. Are those also merely marketing strategies?

In addition to spreading lies and misinformation, these tobacco control practitioners (and hundreds like them throughout the country - these are just a few recent examples of what I am reading literally every day in newspapers nationwide) are providing damaging and inappropriate advice: telling smokers not to quit smoking using electronic cigarettes. This is terrible advice. If a smoker is able to quit, we should be congratulating that person, not attacking them or telling them that they did something wrong and are endangering their health. It's quite the opposite.

To my mind, publicly advising smokers who are or may be able to quit using electronic cigarettes not to quit using these products is tantamount to committing public health malpractice on a grand scale.

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