Boston Siegel’s 2010 E-Cig Report

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Electronic cigarettes got their start in the Chinese market back in 2004.  By 2009, they had made their way into several international markets and launched a veritable storm of controversy.   Mostly, anti-smoking groups and regulatory agencies had a hard time distinguishing between e-cigs and the cigarettes they had grown to distrust over decades.

As of 2010, electronic cigarettes were still very new to the US market and the poor quality of many imports from China had not made a good impression on much of the fledgling market.  Still, a number of companies, groups, and institutions worldwide had started their own research efforts into figuring out what the deal was with e-cigs.  One Boston University School of Public Health professor–assisted by a Berkeley political science grad student–drew conclusions from the results of a pile of e-cig studies.

That professor would ultimately become one of the electronic cigarette industry’s strongest (and often loudest) advocates, Michael Siegel. “It was largely after doing this research that I came to the conclusion that e-cigarettes are much safer than tobacco cigarettes and that they at least hold promise for smoking cessation,” says Siegel.

The report (which you can read here) covers many of the more significant aspects of electronic cigarettes. Perhaps the two most exciting and profound tidbits in the article at the time were that electronic cigarettes did appear to be far safer than conventional cigarettes and they exhibited a capacity to suppress smoking cravings. This is the sweet spot for smoking cessation — providing the benefits of nicotine without the substantial health problems associate with smoking and still making users feel like their need to smoke had been satisfied.

The Results

The report drew on the results and commentary of studies looking at electronic cigarettes.  It then discussed four primary topic areas: the safety of e-cig use, their effectiveness in smoking cessation, common arguments against harm reduction, and common arguments to arise about e-cigs in particular.

In the realm of safety, 16 studies had extensively categorized the compounds that existed in electronic cigarette liquid and vapor.  According to the report, just from those studies, our knowledge of the chemical constituents of electronic cigarettes far surpassed that of tobacco smoke (which is known to contain somewhere around 10,000 to 100,000 chemicals).  The chemicals that were found in e-cig vapor were either non-toxic, non-carcinogenics or occurred at several magnitudes below that of cigarette smoke.  Even the amount of tobacco-specific nitrosamines (TSNAs) found in e-cigs compared roughly to the amount found in a nicotine patch (again, several orders of magnitude below conventional cigarettes).

At the time of the report, there was little on the topic of e-cig use for smoking cessation.  There were 2 studies however that suggested e-cigs could be used to this end and be successful.  The first found that electronic cigarettes managed to deliver nicotine more rapidly than a nicotine inhaler and produced fewer minor side effects.  The other found that cigarette cravings could be reduced significantly by the use of an electronic cigarette.  So, according to these studies, smokers could nip the craving and still get the nicotine their body wanted.

Harm reduction is still a controversial territory for smoking cessation.  It basically means offering a less harmful alternative to an otherwise destructive behavior.  The problem is that many abstinence-only groups feel harm reduction is just another way to make said behavior more acceptable and prominent.  Much of this formed from long-cultivated mistrust in the tobacco industry.  When electronic cigarettes came along, the harm reduction landscape was shaken with a product that didn’t fit previous arguments.

The report ultimately makes an argument for a reassessment of harm reduction as an answer to the national smoking problem. “In light of this evidence, it is unfortunate that in the United States, [a whole bunch of anti-smoking organizations] have all issued statements supporting FDA efforts to take [electronic cigarettes] off the US market.”

This line from close to the end of the report so well outlines that issue that this writer won’t attempt to paraphrase: “With entrenched skepticism toward harm reduction now manifested as deep cynicism about electronic cigarettes – a distinct product that actually does reduce risk and threatens cigarette makers – the tobacco industry is ironically benefiting from its own past duplicity.”

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