Public Health

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

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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.

NEXT: Little Buddha, Big City

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  1. The most infuriating part is that all of the elements of e-cigarettes are safe, and the only reason they are opposed is because they look like cigarettes.

    This just shows the antirational nannyism of prohibitionists – it’s the addiction and the enjoyment that are bad things; they aren’t actually concerned about health.

    I’m going to purchase an e-cigarette and light it up in a bar and see what happens.

  2. Sorry for the double-post, but if Ohio’s definition of “smoking” is the common one:

    “Smoking” means inhaling, exhaling, burning, or carrying any lighted cigar, cigarette, pipe, or other
    lighted smoking device for burning tobacco or any other plant.

    then e-cigarettes in bars are totally legal indoors.

  3. One thing I have learned about prohibitionists over the years. They are not interested in facts or reason, only in a single direction: incremental prohibition. Once they take ground, they will never, ever give it back. They will practice willful ignorance to make this happen.

  4. The most infuriating part is that all of the elements of e-cigarettes are safe, and the only reason they are opposed is because they look like cigarettes.

    It’s also the FDA, and the regulatory impulse and the legislation controlling the FDA.

    Truth is not a defense against the FDA; you can be found guilty merely for making a claim that they have not evaluated. Particularly if numbers are involved, as Cheerios found out. In the Cheerios case as well, the FDA did not dispute the claim on a factual basis, it merely said that General Mills could not make a claim about Cheerios without going through the FDA.

    It’s possible to imagine a regulatory world where FDA approval is optional, but, e.g., insurance companies would be reluctant to pay for non-approved drugs and manufacturers would face a much tougher time in court. It’s also possible to imagine a world where a company that goes through the FDA process (truthfully, with no hiding of evidence) gets a safe harbor against lawsuits.

    We have none of that, though. The FDA process is completely mandatory, but following all the rules doesn’t protect the company at all from lawsuits, even if the company demonstrated safety to the FDA’s satisfaction.

  5. In fact, it’s the very beneficial claims of e-cigarettes that get them in trouble with the FDA, like Cheerios. You can sell something generically, or with generic good for you claims (that don’t make reference to numbers or science), but once you try to quantify how beneficial you are, you fall under the FDA’s most harsh purview of drugs.

  6. I wonder if NYT journalists masturbate to the thought of regulation. They sure seem to have a fetish for it.

  7. Shorter Sullum:

    NYT article on e-cigarettes adheres to all the Nanny State proprieties. Women and children hardest hit.

  8. I’m just thinking about all of the lulz I could have with an e-cigarette. I would just print off the statute, carry it and the e-cigarette around with me, and “smoke” it in places like a courthouse, public schools, bars, the grocery store…

    Although I don’t want to antagonize people to the point where they call their legislator and ban these devices indoors.

  9. “the reaction of medical authorities and antismoking groups … has ranged from calls for testing to skepticism to outright hostility.”

    Glad you noticed this quote, too, which immediately jumped out at me. Quite a range, indeed: e-cigs, threat or menace? Are they terrible, or only just really bad?

  10. The New York Times is a shitty newspaper.

    I look forward to its demise.

  11. I wonder if NYT journalists masturbate to the thought of regulation.

    No, they think about Obama.

  12. Angry Optimist: just go for the gold and try it on a domestic airline flight.

  13. No, they think about Obama.

    …on a unicorn.

  14. victory – that’s fucking beautiful. Maybe I should go for platinum and do it in the cancer ward.

  15. Is nothing sacred anymore? First we get E-Ink so you can read e-books without as much eye strain and now they give us E-Cigaretts so you can get nicotine without all the rsks of regular cigaretts. What next? E-Mail? Oh – wait . . . .

  16. maybe I should do like those Ron Paul dudes and start a blog about my IRL trolling with an e-cigarette.

  17. can e-cigarrettes be taken apart and re-packed with other, uh, “stuff” – and used a vaporizor for, certain medicine?

  18. Meh. NYT long ago shed whatever credibility it might once have enjoyed.

  19. This story should have been given to Cathy Young. Then it would have been, you know, longer.

  20. Do E-Cigarettes have a Buddha nature?

  21. When I see this story I can’t help but wonder what horrifically confounding logic and methods the FDA would use on legalized marijuana or cocaine. People I’ve met actually believe the pot “laced with PCP” bogeyman. With such strange beliefs being so common those legalization fighter are probably opening a huge can of worms.

    If you’ve already decided that you want to ingest a psychoactive substance shouldn’t it be your responsibilty to see that it doesn;t kill yah?

  22. In a June 2, 2009 editorial the New York Times describes the procedure of putting surgical instruments in the human body with the express interest in ending the life of a fetus:

    [P]rincipled devotion to women’s health and constitutionally protected rights…[T]he combination of anti-choice restrictions and ongoing harassment?must be stopped.

    But when an individual chooses to put a variety of compounds in their body with the express interest of both enjoying nicotine and mitigating the risks of smoking the New York Times thinks this warrants front page coverage and more government harrassment. I wonder if anyone there notices the chasm of hypocrisy in their use of the terms principles, rights and choice?

  23. This story should have been given to Cathy Young.

    No one smokes with two hands.

  24. I wonder if NYT journalists masturbate to the thought of regulation. They sure seem to have a fetish for it.

    I’ve been naughty. Beat me, fuck me, regulate me.

  25. can e-cigarrettes be taken apart and re-packed with other, uh, “stuff” – and used a vaporizor for, certain medicine?

    No. They cannot reach the necessary temperatures.

  26. Will they fit in my cigarette holder?

  27. The worst thing about e-cigarettes is that you can’t burn your kids with them when the little bastards misbehave.

  28. The worst thing about e-cigarettes is that you can’t burn your kids with them when the little bastards misbehave.

    Burns can leave scars. With these you might be able to give them a little shock or something.

  29. This article is a great counter-point to all those bemoaning the loss of newspapers. If this kind of garbage is what passes for “professional journalism” these days, then good riddance.

  30. “We basically don’t know anything about [e-cigarettes],” because “they’ve never been tested for safety or efficacy.”

    Here’s a thought experiment for you, Chuckles: why don’t you prove that they’re harmful and then we can talk about what to do about it.

    It’s truly infuriating that if you want to put something into your own body, you need to ask the permission of the Health Nazis Nannies if it’s OK first. God help you if you have an independent thought and think that you’re free to do so with a substance that hasn’t been ordained “safe” by them beforehand.

    It’s my body, not yours; I choose what goes or doesn’t go into it. KEEP YOUR LAWS OFF MY BODY!

  31. swillfredo pareto, damn good point.

  32. phalkor,

    Shocks? I guess I’ll just stick with the oranges.

  33. What is the technical feasibility of making an e-cigarette that emits smoke, but doesn’t have you inhale any? I live in a state that thankfully still allows me to light up at my local watering hole, so I don’t really need the “no smoke at all feature”. I don’t really need the e-cigarette at all because I’m not addicted and only smoke socially. But I have friends who smoke chronically who might be interested in the product but for the fact it takes away the coolest part of smoking- the smoke.

  34. It’s my body, not yours; I choose what goes or doesn’t go into it. KEEP YOUR LAWS OFF MY BODY!

    Yes but no. We all pay for everones health care so in the interest of public health we need regulation.

  35. Yes Fred, that’s item (i) above, assuming that you’re serious.

  36. Do E-Cigarettes have a Buddha nature?

    MUUUUUUUUUUUUUUUUUUU

  37. I prefer to make my own choices with my body rather than be dictated to by government, but as long as you continue to use nicotine, a chemical is calling the shots on your choices.

    Better off to not be enslaved by either.

  38. So, to extend the cliche, those who can’t teach gym, regulate. Those who can’t regulate, write for the NYT (or similar rag).

  39. Why does the New York Times let cigarettes off so easy– suggesting they may not be as bad as E-Cigs??

  40. Ah, we should deny choice (don’t use X) so as to provide one with a choice (use X or not), but the only correct answer is to leave one without a choice (don’t use X or you have no choice).

    Prohibition logic. It’s awesomes.

  41. Yet almost all of the hazards of smoking are due to smoking, so eliminating combustion products makes a huge difference.

    Shh, don’t tell the weed smokers. The future of marijuana leglization: Grind it up, put it in a pill, demand a prescription for it.

  42. We’ve got this problem of people beating themselves on the head with steel claw hammers causing concussions.

    I have a neat idea, let’s market foam rubber claw hammers so those who chose to beat themselves with claw hammers have the option of not doing as much damage.

    Since nobody has proven that foam rubber claw hammers are completely safe, they should be prohibited.

    Goddam, sometimes I just want to jap slap some people.

  43. I prefer to make my own choices with my body rather than be dictated to by government, but as long as you continue to use nicotine, a chemical is calling the shots on your choices.

    All drug use is abuse, too. Just like my once yearly cigar. I’m addicted to it, because it contains nicotine.

  44. “Since nobody has proven that foam rubber claw hammers are completely safe, they should be prohibited.”

    You mean like this?
    https://perfectimprints.com/images/products/FHAMR_im.jpg

  45. “Since nobody has proven that foam rubber claw hammers are completely safe, they should be prohibited.”

    You mean like this?
    https://perfectimprints.com/images/products/FHAMR_im.jpg

    You could choke on that thing.

  46. You could choke on that thing.

    And it might contain phthalates!

  47. Thanks for this valuable article. Yes, we know a lot about tobacco cigarettes: they are not good for your health and contain thousands of toxins. Kids are attracted to tobacco cigarettes for various reasons. Electronic cigarettes do not add any new reasons. Furthermore, an electronic cigarette starter kit costs between $60 and $150 which makes it unaffordable for most kids.
    Why have we not taken all tobacco cigarettes off the market?
    Electronic cigarettes are certainly a better alternative with many great benefits ranging from cost savings, to odor less, to no butts littering our country!

  48. > Nicotine is not a known carcinogen

    That’s not true, at least not in the sense that you mean here. See Heeschen et al (2001, “Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis”, Nature Medicine 7:833-9 doi:10.1038/89961, http://www.nature.com/nm/journal/v7/n7/full/nm0701_833.html)

    This does not invalidate the point of your article, which is that these devices are clearly safer than *smoking*, but it does call into question the logic of “if nicotine patches are okay shouldn’t inhaled nicotine be okay?” Maybe inhaled nicotine causes more cancer because there is more exposure in the lungs, which seem particularly susceptible to its cancer-amplifying effects.

  49. It’s great to see so much discussion about the electric cigarette and as an X-smoker of tobacco and a present e smoker, I want to hear these things are a safe alternative to smoking but I cannot help have doubts about it. If by design we inhale no water vapor does this mean that inhaling water vapor (laced with nicotine and other chemicals) is not safe? Do we know what happens to this water vapor once in the lungs? Do we know if the nicotine is fully absorbed or if there are particles that remain that can cause long term damage? I dont think we do.
    talk to others
    http://akovor.com

  50. And we all know how careful Chinese manufacturers have been about the safety of their exports.

  51. I will make this as short as possible.

    we have big pharma and big tobacco vs some small mostly online stores that sell e cigarettes in the US.

    basically Money talks here, and there is lots of lobbying etc etc.

    with that said… most of these stuff is made in China…. so…. they might have some sort of a point.

    here is the bottom line…. I will take my chances with a Chinese made e cig vs a USA made cancer stick. If thats a problem… LETS bring production to the US… maybe big pharma and tobacco can even fund it. we make it here.. sell it here.. and collect taxes here… everyone WINS… and we move on. NO pun intended here.. but that would be thinking with a lot of REASON… and that will never happen…. so I will wait and see…..

  52. Please feel free to stop by my website for more information on the electronic cigarettes and product comparisons if you like. It always helps to be informed, before taking a stand on an issue.

    Regards

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