Are vapor cigs safer than smokes? Regular smokes might be worse, but e-cigs no panacea
Clearing up hazy fallacies regarding vapor products
They come in many shapes and sizes: a “cig-alike” device with a glowing light at the tip, a stylish pen or a thick cylinder with a small tank for liquid. An estimated 5 million smokers have turned to vapor products like e-cigarettes, often as an alternative to tobacco. The reasons are understandable: vaping can mimic smoking, without the 4,000 toxic chemicals contained in cigarette smoke.
If you think smoking in the U.S. has been stamped out, think again. In Florida alone, the Centers for Disease Control and Prevention estimates that more than 28,000 adults die from smoking-related illnesses each year, leading to more than $6.3 billion in health-care costs annually. In fact, while there are 5 million “vapers” across the country, 40 million people still smoke.
Yet some communities, including Orlando, have banned vaping in public areas. There are anti-smoking activists who actually oppose vaping, or who believe the products should be classified, taxed and regulated as tobacco. Some people believe vapor products actually contain tobacco, although they don’t. Others are concerned that they have the tar that burning tobacco does, although, again, they don’t. There’s also confusion about the nicotine levels in e-liquid, which can range from zero to 3 percent, but are rarely higher.
With the Florida Department of Health and other governing bodies awaiting federal regulation, it’s important to “clear the haze” around vaping.
Vapor products are noncombustible electronic devices that contain no tobacco and do not emit smoke. Instead, they use an internal battery that heats liquid into vapor that that can be inhaled, or “vaped.” The e-liquid may contain nicotine, which is what smokers are addicted to, and why many persist in smoking even when they say they find the taste and smell of cigarettes distasteful.
But unlike smoking, vaping lets users choose from among products with various nicotine levels, or, in the case of the “tank systems,” adjust the levels according to their needs. This is important, because many vapers see a chance to wean themselves off nicotine by selecting eliquid with ever-lower nicotine percentages, down to none at all. The “harm reduction” achieved as vapers move away from smoking combustibles is vaping’s greatest potential benefit.
There are also benefits for the friends and family members of vapers. (Ask anyone married to a former smoker who now vapes.) Air-quality studies like those done at the Center for Air Resources Engineering and Science at Clarkson University confirm that there is no so-called secondhand vapor and no discernible risk to the public health from it. Many health experts think vapor products can help us wipe out smoking. In a letter to the World Health Organization, 53 specialists in nicotine science and public-health policy called vapor products “among the most significant health innovations of the 21st century — perhaps saving hundreds of millions of lives.”
But the industry, which is populated by more than 100 independent businesses in Orlando alone, faces onerous regulation that grows out of fear rather than facts. Overregulation threatens to snuff out the innovation that has driven the category and put many independent vape shops out of business — ironically, handing over the category to Big Tobacco. As an industry, we know that an appropriate degree of government oversight is needed, like a federal ban on purchase by anyone under 18. It’s equally important that the category is regulated to ensure product safety and quality as it expands. But legislators should act in a way that allows this multi-billion dollar industry to continue to grow, innovate and change the lives of smokers.
As it speeds toward $10 billion in revenue by 2017, it’s clear that the vapor industry is contributing to our economy. But its benefits go beyond new jobs. Vapor just might be the breakthrough we’ve been looking for in the fight against tobacco.
There are benefits for the friends and family members of vapers. Many health experts think vapor products can help us wipe out smoking.
Today’s moderator
For many public-health professionals, e-cigarettes were the longawaited solution to the tobacco epidemic. Finally, we have a product that looks like cigarettes, works like cigarettes and is popular among smokers, but without much of the harm of cigarettes. What more would we need to deliver the final blow to the “real” cigarette industry?
Indeed, it looks from what we already know that e-cigarettes are not as harmful to individuals as combustible tobacco and can potentially help some smokers quit or at least decrease their smoking risks. If only things were that simple. While public-health experts want e-cigarettes to be used as a quitting or “harm reduction” tool for hard-core smokers who could not quit otherwise, they also do not want e-cigarettes to induce nicotine addiction and provide a gateway to cigarettes among nonsmokers. As noble as this agenda can be, it means nothing in reality, since those who control the e-cigarette market have not and will not sign on it.
The manufacture and marketing of a highly addictive product such as e-cigarettes has one primary goal: to hook as many people as possible on it. This is now what we see with the use of colors, flavors and celebrities to market e-cigarettes to youth. It is working: National data show that experimentation with e-cigarettes has more than doubled among high-school students in the U.S. between 2011-12. Many of those have not used tobacco products before and are thus potential recruits to the nicotine business.
The usual response of harmreduction proponents is that this is a price to pay to rid the society of the biggest scourge of combusted tobacco. They also argue that this “side effect” can be limited by applying proper policy measures. The problem with this argument is that we do not know that e-cigarettes will deliver us from tobacco, since evidence does not show their clear margin as a quitting tool; often they are used in conjunction with cigarettes. And the ability of policy to protect youth is expected to be limited for such a “cool” product.
Let’s remind ourselves that the conventional tobacco industry has claimed for years that it doesn’t market cigarettes to youth, despite its own documents showing that the industry did everything possible to target youth and women with its marketing practices. This same industry is now getting into the e-cigarette market, which leaves little doubt about its intentions to saturate the market with different addictive products to suit its different sectors.
Some may argue still that nicotine is relatively benign, and that what kills in cigarettes are the carcinogens and combustion products — not nicotine. This is true if one considers that what is harmful is only what kills, and that what affects the quality of life does not matter much. I say that because nicotine is one of the most addictive substances in nature — it produces stronger dependence than heroin or cocaine — and nicotine addiction has lifelong psychological, social, economic and health consequences. Let me quote the words of a tobacco-industry insider, Helmut Wakeman, in his 1969 address to the Philip Morris board of directors: People “will take cigarettes ahead of food if starved of nicotine.”
Introducing this disease to millions who otherwise would not have smoked tobacco is not a sensible harm-reduction strategy. So unless we have a clear idea about the value of e-cigarettes as a quitting tool, as well as their full potential of hooking new people on nicotine, ecigarettes should be subject to strict regulations to limit their marketing and advertisement to youth, their use in indoor areas, and their flavoring. Also, there should be taxation measures to curb the demand for them.
As for public-health advocates of e-cigarettes, they need to move from wishful thinking to protecting the health of people based on clear and comprehensive evidence.
The marketing of a highly addictive product such as e-cigarettes has one primary goal: to hook as many people as possible on it.