If It's Not Regulated, How Can It Be Safer Than Sucking Smoke?


In a front-page story about electronic cigarettes, The New York Times predictably misses the crucial point that they are far less dangerous than conventional cigarettes, since they produce nicotine vapor without tobacco or smoke. The story opens with an anecdote about a woman who cuts her cigarette consumption in half with the help of an e-cigarette that delivers "an odorless dose of nicotine and flavoring without cigarette tar or additives," a description that suggests all these features are of equal salience. Yet almost all of the hazards of smoking are due to smoking, so eliminating combustion products makes a huge difference. E-cigarettes also eliminate the tobacco (which contains some carcinogens even when it's not burned), so the remaining health concerns have to do mainly with the nicotine, which the Food and Drug Administration has approved for over-the-counter sale in smoking cessation products it deems safe and effective, and the propylene glycol in the vapor, which the FDA considers "generally recognized as safe" when used in food. Depending on the brand and type of cartridge, the vapor may also contain flavoring agents, also generally recognized as safe in food. While inhaling these chemicals might raise additional health concerns (a point the Times emphasizes), no one has seriously suggested they are in the same league as the myriad toxins and carcinogens smokers routinely suck into their lungs.

Instead of noting these indisputable facts, the Times presents, on the one hand, medical experts who profess to be completely in the dark about the relative hazards of e-cigarettes and, on the other hand, self-interested laymen representing e-cigarette distributors. One of the former claims, "We basically don't know anything about [e-cigarettes]," because "they've never been tested for safety or efficacy." This is nonsense; we know enough about e-cigarettes to say they are much less hazardous than regular cigarettes. The Times reports that a spokesman for the Electronic Cigarette Association "said e-cigarettes delivered nothing more than a mixture of nicotine and water vapor and emitted 'no carcinogens.'" Why put "no carcinogens" in quotation marks? Is anyone alleging that e-cigarette vapor contains carcinogens? Is there any evidence to suggest that it does? Nicotine is not a known carcinogen, and neither is propylene glycol.

In a 2008 report (PDF) on an industry-commissioned analysis of vapor from the Ruyan e-cigarette, Murray Laugesen of the consulting company Health New Zealand (which calls him "New Zealand's most experienced researcher on smoking policy and cigarettes") concludes:

Ruyan® e-cigarette is designed to be a safe alternative to smoking. The various test results confirm this is the case. It is very safe relative to cigarettes, and also safe in absolute terms on all measurements we have applied. Using micro-electronics it vaporizes, separately for each puff, very small quantities of nicotine dissolved in propylene glycol, two small well-known molecules with excellent safety profiles, into a fine aerosol. Each puff contains one third to one half the nicotine in a tobacco cigarette's puff. The cartridge liquid is tobacco-free and no combustion occurs.

Does anyone dispute Laugeson's findings—by which I mean, offer actual reasons to think he is wrong, as opposed to presuming that no risk can be acceptable until it has been explicitly blessed by a government agency? The Times doesn't say, because it doesn't even mention the study.

The Electronic Cigarette Association says:

Multiple studies by different laboratories around the globe have been conducted identifying that the vapor that is ingested when using an electronic cigarette, depending on the manufacturer,  contains approximately 20 ingredients including nicotine, all regarded as generally safe for human consumption when ingested prudently and in accordance with proper labeling. By contrast tobacco smoke contains 4,000 ingredients including arsenic and carbon monoxide, and dozens of cancer-causing ingredients.

True? Not true? The Times does not bother to ask the health experts it consults. Furthermore, it misrepresents "the reaction of medical authorities and antismoking groups" to e-cigarettes, saying "it has ranged from calls for testing to skepticism to outright hostility." That range does not include harm reduction advocates such as Canadian anti-smoking activist David Sweanor, Boston University public health professor Michael Siegel, Bill Godshall of Smokfree Pennsylvania, or Joel Nitzin, chairman the American Association of Public Health Physicians' Tobacco Task Force, all of whom have vocally opposed taking e-cigarettes off the market because their safety advantages are so obvious.

The blinkered attitude of the Times is captured in the headline: "Cigarettes Without Smoke, or Regulation," as if the latter lack is just as important as the former. Not to put too fine a point on it, but conventional cigarettes are not regulated by the FDA either. The article notes that a bill (under consideration by the Senate this week) is "making its way through Congress that would give the F.D.A. the authority to regulate tobacco." The e-cigarette's unregulated status tells us nothing about how its hazards compare to those of conventional cigarettes.

More on e-cigarettes here. In a Los Angeles Times op-ed piece, Michael Siegel argues that the tobacco regulation bill is bad for public health.