Will People 'Mistakenly Perceive' Health Benefits From Not Smoking?

In an NPR story about electronic cigarettes (the subject of my column last week), American Cancer Society scientist Thomas Glynn calls the product, which delivers nicotine vapor without burning tobacco, "intriguing" and says it has "a lot of possibilities." But he quickly adds that "it needs to go through some rigorous testing before the public health community would be comfortable with it." If that testing is anything like what the Food and Drug Administration traditionally demands for new drugs, the requirement probably would be prohibitive. Even if one or more e-cigarette companies decided it was worth jumping through the FDA's regulatory hoops, the product would be taken off the market in the meantime. In essence, then, Glynn's position is that e-cigarettes, which eliminate almost all the hazards associated with smoking, look very promising, could save a lot of lives, but should be banned for the forseeable future, even while far more hazardous conventional cigarettes remain on the market with the FDA's blessing (assuming the Senate approves a bill favored by Glynn's organization that would authorize the agency to regulate tobacco products). 

The FDA is still mulling what to do about e-cigarettes, but the clueless comments of an official quoted by NPR are not encouraging:

"We're concerned about the potential for addiction to and abuse of these products," said FDA spokeswoman Rita Chappelle. "Some people may mistakenly perceive these products to be safer alternatives to conventional tobacco use."

Mistakenly? There are legitimate questions about the long-term health effects of nicotine consumption and the success rate for people who use e-cigarettes to quit smoking; the same questions also apply to FDA-approved nicotine products. But it is beyond serious dispute that inhaling water vapor containing nicotine and propylene glycol is much less hazardous than inhaling smoke containing nicotine along with myriad toxins and carcinogens. It makes no sense to worry about "the potential for addiction" in the abstract, without regard to the harm it causes. 

"If there is anyone who believes cigarettes are no more hazardous than e-cigarettes," says harm reduction advocate David Sweanor, "I'd recommend a remedial course in basic sciences." In a letter to Sen. Frank Lautenberg (D-N.J.), who wants the FDA to ban e-cigarettes, Joel Nitzkin, who chairs the American Association of Public Health Physicians' Tobacco Task Force, says that, in terms of health hazards, e-cigarettes "should be seen as generic equivalents of the pharmaceutical nicotine products," promising "a risk of illness and death less than 1% of the risk posed by cigarettes."