E-cigarettes

More Vaping, More Smoking: The Implausible Case Against E-Cigarettes

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FIN e-cigarette ad

A front-page story in yesterday's New York Times notes the divide within the anti-smoking movement on the merits of electronic cigarettes, as exemplified by the split between Boston University public health professor Michael Siegel and his former mentor, Stanton Glantz, director of the University of California at San Francisco's Center for Tobacco Control Research and Education. The Siegel camp sees e-cigarettes, which deliver nicotine without tobacco or smoke, as a promising harm reduction tool, while the Glantz camp sees them as a public health menace. Because health reporter Sabrina Tavernise accurately summarizes the arguments of both sides, it is hard to see how a fair-minded reader could end up agreeing with Glantz. Here are the two main arguments against e-cigarettes:

E-cigarettes will lure teenagers into smoking. Since avoiding that smelly, dirty, and dangerous habit is the main motivation for vaping, this fear seems implausible. Furthermore, there is no evidence that e-cigarettes are serving as a gateway to the conventional kind. In fact, the recent increase in vaping among teenagers has been accompanied by a continued decline in smoking.

Vaping will discourage smokers from quitting by giving them a way to get their nicotine fix when they can't light up. Again, there is no evidence that is actually happening, and the same objection could be raised against nicotine gum, lozenges, or patches.

As Tavernise notes, the "public health" debate about e-cigarettes "comes down to a simple question: Will e-cigarettes cause more or fewer people to smoke?" The testimonials of vapers tell us that e-cigarettes are a viable alternative for many people who would otherwise continue sucking smoke into their lungs. We know those people actually exist. The same cannot be said of smokers who never would have started or who would have quit but for e-cigarettes. Those vaping-enabled smokers may exist only in the imaginations of Glantz and his allies. So if your concern is the net impact on tobacco-related morbidity and mortality, the existing evidence strongly favors e-cigarettes.

Regardless of how that collectivist calculus comes out, the indisputable safety advantages of e-cigarettes would be enough to recommend them as an option for individual smokers. Unlike some of her colleagues, who in the past have implied that the relative hazards of smoking and vaping are a matter of scientific dispute, Tavernise understands the significance of eliminating tobacco and its combustion products: 

Public health experts like to say that people smoke for the nicotine but die from the tar. And the reason e-cigarettes have caused such a stir is that they take the deadly tar out of the equation while offering the nicotine fix and the sensation of smoking. For all that is unknown about the new devices—they have been on the American market for only seven years—most researchers agree that puffing on one is far less harmful than smoking a traditional cigarette.

None of the e-cigarette critics quoted by Tavernise disputes that point, and it is hard to imagine how anyone reasonably could (although that does not stop some activists from trying). But the huge difference in risk between vaping and smoking is not enough for Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention. "I think the precautionary principle—better safe than sorry—rules here," he tells the Times. In what sense is it "safe" to prevent smokers from buying a product that could literally save their lives? If the Food and Drug Administration, which is supposed to start regulating e-cigarettes soon, takes its cue from Frieden, the result could be more smoking-related disease and death instead of less. "If we make it too hard for this experiment to continue," says Siegel, "we've wasted an opportunity that could eventually save millions of lives."

Frieden has been known to simply make stuff up in his campaign against vaping, claiming without any evidence that "many kids are starting out with e-cigarettes and then going on to smoke conventional cigarettes." That he is now resorting to the precautionary principle—which my colleague Ron Bailey aptly sums up as "never do anything for the first time"—says a lot about the weakness of the case against e-cigarettes, which is essentially an emotional reaction against a product that looks too much like a long-reviled symbol of evil. "Part of the furniture for us is that the tobacco industry is evil and everything they do has to be opposed," University of Nottingham epidemiologist John Britton tells the Times. "But one doesn't want that to get in the way of public health."

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  1. Wild wild west.

  2. Obviously the solution is to ban nicotine.

    1. That’s what the FDA has planned. This will leave just the tar & smoke that kills cells deader than a door nail. Nicotine does not kill cells, cells actually thrive and multiply. By omitting the nicotine, they’ll finally hit their goal of no more smoking.

      1. “BWAHAHAA!!”

  3. I would also like to point out (loathe though I am because this is usually some brainless liberal’s argument) that the Commonwealth countries already have an e-cigarette that’s made to help people quit:

    http://www.nicorette.ca/products/inhaler

    1. Yep, big Pharma product that is an eCig wannabe. Who do you think is behind most of the lobbying against eCigs!

  4. I think blu and now the niche vaping stores did it right by not making the things look like cigarettes. I was at a wedding this weekend where about three or four people had those contraptions you get from the boutique vaping stores and they looked much closer to spacecraft than they did to cigarettes.

    1. I thought the niche stores were around before blu? Anyway,you’re right. The good ecigs don’t look a thing like real cigarettes.

      1. I’m a little uncertain on the timeline. I first tried vaping as a quitting mechanism from 2009-2010, and the only thing I could find was an e-cig that was pretty much designed to look like a cigarette. All I remember is that they were hard to find and cost like 50 bucks. I saw “blu” come out after that and I hadn’t seen the contraption ones until recently, but that may just be me.

        1. In 2009 most of the e cigs were cigalikes. My first was a Blu which I quickly abandoned for a manual button cigalike that worked much better.

          Even back in that period, Mods began to show up with larger batteries. The last three years the technology has expanded with Variable Voltage and Variable Wattage devices giving more consistent draws over the live of the larger rechargeable batteries.

    2. But can we get exploding e-cigs like cigar loads for those of us that like practical jokes?

  5. The Times article makes much of the fact that 7 percent of teen e-cig smokers had never tried regular cigarettes before. But nicotine by itself isn’t that bad for you (the article says it’s probably not any worse than caffeine.) If those 7 percent never go on to regular cigarettes, even public health types shouldn’t care.

    1. Public health types will always care.

  6. Excellent article!!!

  7. Vaping will discourage smokers from quitting by giving them a way to get their nicotine fix when they can’t light up. Again, there is no evidence that is actually happening,

    That is a bad refutation. All nicotine delivery systems allow a temporary alternative to smoking and it would be easy to find evidence they are so used.

    1. Yes, that is exactly how I use my e-cig. It still leads to a reduction in the number of total cigarettes I smoke.

      I still smoke real ones too because I want to, but I definitely would say that decision is influenced by the fact that I can keep my smoking to a manageable level (from a health perspective) because of vaping.

      1. The biggest advantage for addicted smokers who switch to vaping is that, unlike a traditional smoker who quits and can never have another cig again for fear of getting right back into it, vaping allows a smoker to quit but have the flexibility to have an occassional cig with a cocktail and not be concerned about becoming addicted all over again.

        That is what they PH advocates really hate.

        1. Yes, though it is definitely more than with the occasional cocktail. I go all day without having one and I don’t feel bad at all having one when I get home from work. That after work cig isn’t going to kill me.

        2. The funny thing is, as a 43 year 2-3 PAD smoker, I started using an e cig almost 5 years ago. I was a dual user for about 7 months, dropping my cigarette count almost instantly to a half dozen a day. Now it’s been over 4 years since my last drag on a real smoke.

          I have absolutely no desire for even a single drag on one. The flavors involved with e cigs, even the ability to have a flavored tobacco liquid, is so much more enjoyable.

      2. I use snus. I’m a bit leery of vaping while still smoking because I wouldn’t want to increase my nicotine tolerance and then have it banned or heavily taxed.

        1. Yeah, nobody wants to tax snus.

          http://publichealthlawcenter.o…..s-2013.pdf

    2. That is a bad refutation. All nicotine delivery systems allow a temporary alternative to smoking and it would be easy to find evidence they are so used.

      But does having the temporary alternative discourage them from quitting? People who want to smoke generally find a way to do it, even if it means standing outside in the sleet.

      Balance that against the number of people who want to quit, where the alternative offers a way.

      1. Those vaping-enabled smokers may exist only in the imaginations of Glantz and his allies.

        I’ve described how I myself disprove this. And not I wouldn’t find a way to smoke at work. I can’t/don’t want to smell like smoke and I wouldn’t. If I couldn’t vape I’d probably have quit entirely because if I’m going the whole day without smoking I might as well go cold turkey.

        It shouldn’t matter, the issue here is that I should be free to do as I please.

  8. It doesn’t matter what the truth is. The media’s purpose is drum up hysteria over whatever new, semi-plausible scare comes down the pike.

    1. But this one has zero plausibility.

  9. Not to hijack the discussion but if they really want to decrease smoking among teens and early 20’s then they should legalize pot.

    I’ve seen several teens in my circle turn to cigarettes because their families convinced them that they could get a lot of trouble smoking dope.

    Most of them were smoking just a couple joints a week but when they turn to cigarettes the nicotine addiction leads to a huge increase in smoking volume.

    Sure, smoking dope is still inhaling smoke into your lungs and that’s not healthy. However, if my kid is going to smoke anything, I’d prefer a few a week over half a pack a day.

  10. Market opportunity: make an e-cig that looks like an asthma inhaler. No anti-smoking nanny is going to hassle you about taking a hit from one of those.

  11. Tendentious invocation of the Precautionary Principle should be banned as a perniciously addictive form of ideological vaping

  12. We must stop the children from drinking water because they’ll think it’s OK to drink vodka!

  13. All these specious arguments against vaping are just a smoke screen for their real objection, namely, the puritan disgust of people enjoying drugs, shamelessly, in public. Why waste pixels knocking down straw men?

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