CDC Official Condemns E-Cigarettes As an 'Egregious Experiment' on 'Our Children'


Senate HELP Committee

During a Senate hearing yesterday, Tim McAfee, director of the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention (CDC), described the marketing of electronic cigarettes as "a huge experiment" and argued that "it is not fair to our children to ask them to pay a potential price…for a hypothetical benefit to adult smokers." In fact, he said, "it is egregious to suggest that we need to have kids do this in order for adults to quit."

McAfee was referring to the fear that e-cigarettes will encourage teenagers to smoke, both by getting them hooked on nicotine and by "renormalizing tobacco use" through ads presenting a safer, less irksome, noncombustible alternative. Implicitly recognizing the weak empirical basis for that claim, McAfee said, "We're not saying it is a gateway."

But they are. Last fall McAfee's boss, CDC Director Tom Frieden, claimed "many kids are starting out with e-cigarettes and then going on to smoke conventional cigarettes." Frieden frequently raises the possibility that e-cigarettes will "get another generation of kids more hooked on nicotine and more likely to smoke cigarettes," as he put it in an interview with the Los Angeles Times last month. Yet as Boston University public health professor Michael Siegel notes, "there is no evidence that e-cigarette use leads to cigarette smoking among adolescents."  

McAfee, like Frieden, portrays that scientifically unsubstantiated worry as more believable than the "hypothetical benefit to adults smokers." But as Siegel points out, those benefits are in fact quite real, since we know that smoking is much more dangerous than vaping and that many people have switched from the former to the latter. A survey reported last month in the International Journal of Environmental Research and Public Health, for example, collected information from more than 19,000 e-cigarette consumers around the world, 81 percent of whom had completely stopped smoking. The former smokers reported significant improvements in overall health and in specific functions such as breathing, endurance, smell, and taste. The researchers, led by Greek cardiologist Konstantinos Farsalinos, concluded that e-cigarettes "can be effective even in highly dependent smokers," that "side effects are minor," and that "health benefits are substantial."

The sample used in that study was drawn mostly from people who participate in online e-cigarette forums, who may not be representative of vapers in general. You would expect e-cigarette enthusiasts to include a disproportionate number of people who have successfully substituted vaping for smoking. These are nevertheless actual people who have experienced actual benefits, in contrast with the entirely hypothetical group of teenagers who never would have smoked if they had not vaped first, none of whom has been identified so far. Notably, only 0.5 percent of the e-cigarette consumers in Farsalinos et al.'s survey said they were not smokers when they first tried vaping.

Mitch Zeller, director of the Center for Tobacco Products at the Food and Drug Administration (FDA), testified at the same hearing as McAfee, but his comments about e-cigarettes were more temperate and evenhanded. That is encouraging, since the FDA is charged with regulating e-cigarettes, which gives it the power to determine whether they stay on the market and, if so, in what form and on what terms. But Zeller's testimony also highlighted the extent to which the FDA plans to substitute its judgment for that of consumers.

E-cigarettes "have the potential to do good, and they have the potential to do harm," Zeller said. "It really depends on who is using them and how they're being used." For instance, he said, "If we look at a subset of smokers who are otherwise unable or unwilling to quit," and "we could get all of those people to completely switch all of their cigarettes for one of these noncombustible products, that would be good for public health." Then again, he said, some vapers might continue smoking and "start to become less interested in quitting," which "might not be good for public health."

Even that way of framing the issue is too categorical. In Farsalinos et al.'s survey, about a fifth of the respondents did not quit smoking completely, but they did cut back, on average from 20 to four cigarettes today. Like the former smokers, they reported health improvements, although the impact was not as big. Hence dual use could, on balance, reduce tobacco-related disease and death, even if some of those smokers might have quit completely had they never tried vaping.

More fundamentally, the FDA's approach makes sense only if you agree that the government should strive to minimize morbidity and mortality for the population as a whole, as opposed to letting individuals make their own choices. As Zeller explained, "our job as the regulator is to figure out what is going on at the population level." In other words, it's not enough to show that e-cigarettes are safer than the conventional kind, or that individual smokers can dramatically reduce the hazards they face by switching. You also have to show that the resulting reduction in morbidity and mortality is greater than any possible increase in morbidity and mortality among people who start or continue smoking because e-cigarettes are available. "I would absolutely concede that any of these products at an individual level can do good," Zeller said, but "the decisions that we have to make are not going to be made about what might be good for the theoretical individual." And that, in a nutshell, is what's wrong with the collectivist logic of "public health."

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  1. “I would absolutely concede that any of these products at an individual level can do good,” Zeller said, but “the decisions that we have to make are not going to be made about what might be good for the theoretical individual.” And that, in a nutshell, is what’s wrong with the collectivist logic of “public health.”

    These people serve the public. The public is everyone but you, and you, and you, and you… Everyone except any particular individual.

    1. Look sarcasmic, I will absolutely concede that owning a car can at an individual level do good. The decisions we have to make are not going to be made about what might be good for that theoretical individual who might need a car to get to work or the doctor or whatever.

      You can pretty much use that logic to ban anything.

      1. Yes, real anecdotes about individuals successfully improving their health are theoretical, but unproven models (or in this case hand waving) of population behavior are not.

        1. See, without something new to be hysterical about, Tim McAfee, director of the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention (CDC), will have no 6 figure job.

  2. Glenn Reynolds made a great analogy. The Victorians used to do things like insisting on long table cloths because a table leg was similar enough to a human leg that exposing it might create impure thoughts. The crusade against e-cigarettes is the same kind of thinking. They are no cigarettes and do not cause anything close to the harm to users cigarettes do. But they look like cigarettes and might cause children or others to have the impure thought that cigarettes are not bad. They, therefore must be banned just like table legs were required to be covered back when sexual thoughts were thought to be impure.

    We are close to the point in this country where marijuana will be legal but nicotine infused steam will be illegal. The country’s political class has gone insane.

    1. Victorian table porn was hair-raising.

      1. Ikea is nothing but a sin palace.

        1. “But, your Honor, that table was just flaunting its mahogany legs, it obviously wanted it!”

          1. “With that short red tablecloth, it was saying ‘take me now!'”

          2. I heard the Victorians are where we got Dark Meat/White Meat instead of thighs and breasts.

            1. Chickens? I ain’t going there.

    2. John, you just described animists. The e-cigs look enough like the supernaturally evil regular cigs that they are considered equally evil. They are totems for the animists. Supernaturally evil totems. They look the same, so they scare the shit out of them the same. It doesn’t matter if they do good for people; they look like something evil!

      I can’t stress how much these people are animists. Basically the same as a caveman hooting at the moon.

      1. They are. People think they are engaging in some evil conspiracy to create a totalitarian hell. That may end up being the result of their actions, but it won’t be because they planned it. They are too stupid to plan anything. They just know how to mumble words. They live in a fucking fantasy land.

  3. It’s about the children – none of whom have parents who could live longer thanks to replacing regular cigarettes with vaping!

    1. Those were sub-standard parents, anyway.

    2. These kids would be better off surrounded by second-hand smoke, obviously.

  4. Regulators. Can’t live with’m. Can’t shoot’m.

  5. Let me be cynical for a moment. The government is in bed with the tobacco companies. They depend on the sale of cigarettes for both tax money and to fund that giant slush fund known as the tobacco settlement. Could it be that the government hates e-cigarettes because they are not harmful and will get people stop stop smoking real ones and thus end the gravy train?

    1. That’s been my opinion for a long time. There’s never been a more clear-cut case, in fact. It’s IMPOSSIBLE to want to ban e-cigarretes unless somebody’s paying you to. The arguments on that side are just too stupid for a functioning human being to believe.

    2. Could it be that the government hates e-cigarettes because they are not harmful and will get people stop stop smoking real ones and thus end the gravy train?


    3. I wouldn’t be too surprised. Tobacco tax brings in a lot of money. You can’t have too many people quitting smoking.

    4. That may be part of it. The guys at the CDC are probably true believers.

      1. The CDC guys are definitely animists. There may be tobacco lobbyists and politicians who see it as a cash cow, but the CDC guys are just obsessive control freak animists.

    5. Let me be cynical for a moment.

      The inhalation of water vapor is legitimately being equated with the inhalation of combustion products. What’s not to be cynical about?

      My son has allergies and asthma, he regularly gets prescribed medication that has to be nebulized and inhaled. Not only is the elimination of combustion products beneficial, the inhalation of water vapor, without additives, is therapeutic as well.

      I’m of the mind that scientists and healthcare workers might be riding the gravy train as well.

      1. That is stretching the definition of “scientist”.

    6. Actually from what I understand the tobacco companies are all on board, but the pharmaceutical companies that make nicorette and the patch are the one’s who are pouring money to squash the threat ecigs pose to their business.

  6. God forbid that a once politically incorrect behavior become normal again.

    Before the Victorian era, society was relatively comfortable with discussions of sex. After the Victorian era, the rude and lascivious behavior became “re-normalized.”

    1. Sorry John. I didn’t see your post.

    2. Did it? Most people are still extremely skittish talking about sex.

  7. Regulate first.

    Nothing is safe until WE say it is.

    1. Well, duh! Businesses are the enemy! They profit off their workers while they rip off their customers! They can’t be trusted! They’d poison their customers if we weren’t there to regulate them! We’re saving lives!

  8. “the decisions that we have to make are not going to be made about what might be good for the theoretical individual.”

    Well. There it is, right out in the fucking open.

    I smoked Marlboros for 24 years straight since the age of 17. I switched to e-cigs 2 years ago, and have not smoked a real cigarette since. Not one. I really don’t care what they think about teens and children and smoking. If they make e-cigs as much as a hassle as real cigs, they kill what is so far the only alternative I’ve ever found (except for not smoking at all).

    1. I’m not a smoker. Question: is it like switching from Coke to Coke Zero. Would smoking a real cig be too potent for you now?

      1. Probably. But I’m sure I would get used to it.

      2. Vaping liquid comes in a variety of nicotine strengths. You can get stronger stuff or weaker stuff. Potency is totally controllable.

      3. I smoked reds for nearly 20 years, since I was 15. I switched to vapor two and a half years ago. When I started vaping, I was using the 24mg/ml dosage. I gradually stepped it down and am now at the 6mg/ml level.

        I will occasionally smoke real cigs, and the amount of nicotine in a regular cigarette is a noticeable change, to the point where a cigarette will make me sort of lightheaded if I have been vaping all day.

        1. Why did you decrease the dose instead of the vaping less?

          1. habit, i did the same. though i vape less now too

            1. Yes, same here. Tapering off of both the nicotine and the act.

      4. I smoke cigars intermittently and vape occasionally, I happen to be ‘nicotine-insensitive’.

        To me, they are two entirely different habits.

        Think about sitting in a steam room/sauna vs. sitting in a small closed room with a small fire lit in the corner. Alternatively, standing next to a humidifier vs. standing next to a grill.

        I can take a full drag off an e-cigarette without any hesitation. The sort of thing that would render a majority of smokers unconscious.

      5. “is it like switching from Coke to Coke Zero?”

        Coke Zero sewer water.

        But the difference is not great.

        1. The squirrels have eaten my “greater than” sign, which should have been between “Coke Zero” and “sewer water”.

      6. I like e-cigs more. As Epi said, potency isn’t an issue. The vapor is visible enough that you don’t miss the sight of smoke. The only thing to miss is smelling like an ashtray.

    2. Are you the Slammer married to Penn Jillette?

  9. They make me want to take up vaping just to spite them.

  10. Ahhhhh! So satisfying. The salty ham tears shed at the altar of statism.

    The free market solves smoking addiction, where billions upon billions spent by the government and thousands upon thousands of pages of regulation could not.

    Yummy, yummy, yummy. I haz a happy.

    1. It is better than that. People stop smoking and the government no longer gets its tax money. So now the government cries over the lost tax revenue after the tax accomplishes exactly what it was sold as doing. “But we didn’t mean it when we said we wanted people to stop smoking!!”

  11. Can I just take a moment and thank Sullum for bashing the public health crowd.

    I know some people who want to reform public health and make it more compatible with a free society.

    But for the most part, there’s a very obtuse mindset that regards any concern over individual freedom as a bad faith attempt at making people sicker and to profit from it.

    1. Public health is invested with leftists. The leftists did what they always do, corrupted the institution or field causing it to quit doing its original function and becoming another tool for promoting leftist politics.

      Public health “experts” no longer care or worry about actual public health issues like bed bugs and contagious diseases and sanitation. Instead they do nothing but promote leftist politics by turning unapproved activities like smoking and gun ownership into “public health problems”.

      The entire field is beyond hope and had its life sucked out of it by the prog vampire.

  12. Why are we acting as if this is an actual policy discussion by concerned politicians or bureaucrats? It’s purely concern-trolling by parties extorting a burgeoning industry for baksheesh. Once e-vape businesses begin greasing palms, congressmen will begin singing their praises. Worries about alleged smoking teens will disappear into the ether.

  13. What is someone invents an e-joint. Will that be illegal?

    1. There are already vaporizers for weed, John. And the answer is no, because it isn’t tobacco, so it’s not a supernatural evil like tobacco.

      1. And the answer is no, because it isn’t tobacco, so it’s not a supernatural evil like tobacco.

        Agreed. Yet another statist public health fuck up. Tobacco makers have their ads combed over with a Geiger Counter to make sure their not giving kids cancer and the peddlers have to keep the product right beside the safe, but every head shop on earth can be decked out in neon signs, fluorescent paint, and black lights with munchies available at the register.

      2. Considering how nasty pot tastes to smoke, I would think a vaporizer for weed would be awesome.

        1. It is awesome. It tastes like a fresh bowl every toke, and can get you pretty lit with only a few hits.

          And the better stuff now tastes much different when compared to the regular ass stuff.

  14. I think I saw that guy’s face last night.

    IIRC, it was just after I’d finished riding my horse. I was taking the tack off and brushing his coat. I’d done his back and reached his tail…

    Oh. Just a resemblance.

  15. Aside from the hidden push against ecigs by big pharma, we had a dozen or so of the most liberal democrats in congress putting a face to the push against ecigs, with the most absurd justifications.

    So, when will reporters start asking Republicans where they stand on this issue – will the supposed party of “less government in our lives” take a stand against these liberal democrat nanny state assholes or are we going to see another “Kelo v New London” situation (where Republicans, then controlling congress, in response to that outrageous supreme court decision that legitimized stealing peoples property by the state and giving it to other people, said and did absolutely nothing)?

  16. So how about restricting them to adults? Oh. You’re not enforcing that?

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