Opinion: We Should All Be Mad About What’s Happening To E-Cigs

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mad-kidElectronic cigarettes are shaping up to be nothing short of a miracle.  There exists a legally obtainable product in our free market that eventually kills around half its users.  Despite decades of anti-smoking legislation, tax hikes, counter-marketing programs, and scare tactics, smoking is still alive and well killing around 443,000 individuals (the population of Atlanta, Georgia) a year.  E-cig may be the one thing to finally stop this.

Anti-smoking efforts have not gone without any success.  The adult smoking rate in the United States has dropped from more than 40% in 1965 to around 18-19% now.  How much of that decline is a result of anti-smoking efforts and how much of it is a natural byproduct of people seeing what smoking does to friends and family is a topic very much up for debate.

One thing does seem clear, the lower the smoking rate gets, the harder it is to continue the decline.  Internationally, almost all countries that are actively fighting smoking rates have stalled at just under 20%.  Even before electronic cigarettes blazed into the scene, many smoking and public health experts agreed that the war on smoking needed a new weapon.  Most options — graphic warnings, further limiting access and use, and even higher taxes and age restrictions — tread very close to infringing on individual (and even commercial) liberty.

electronic-cigarette-vaporThen enters electronic cigarettes.  The wonder of a device appears capable of assisting smokers (with some reliable level of success) in their efforts to quit.  But more importantly, the device offers all the comforts of smoking with 99% less harm, effectively making traditional cigarettes as we know them OBSOLETE!

Some experts have theorized that if every smoker in the US were using electronic cigarettes instead of tobacco cigarettes, the number of deaths per year correlated to smoking would be less than 4,000 (less than 1% of the current 443,000 deaths a year).

But this news has been met with a very mixed reception — almost all of it extreme.  Smokers — particularly those that have been trying to quit for years using every “approved” method on the books — tend to view the devices as a godsend.  Sale of electronic cigarettes have already surpassed that of approved nicotine replacement therapies (like the patch) across the EU.  Some smokers remain skeptical — and why wouldn’t they when “approved” quit methods offer 10-12% success rate in the best of circumstances and long-term research suggests most ex-smokers will return to smoking eventually.

vapetravelAnti-smoking groups, public health officials, and anyone truly hurt or bothered by smoking tend to have a negative reaction to e-cigs right off the bat.  We can’t fault them for this.  Tobacco companies made a killing with shady business practices, overt kid-friendly marketing, bending the truth about smoking and good old-fashioned corruption.  Anyone would have a hard time trusting anything that might look like it’s part of that industry.  We can’t really be mad about that.  We can think they’re terrible for not learning the facts before making outrageous guesses about possible drawbacks of the devices.  But we can’t be mad at them for distrusting something they are preconditioned to distrust — just like no one can blame you for finding it hard to trust a guy named Hitler McMurderface.

What we can and should be mad about is the blatant politics at play now that there’s plenty of evidence to at least make some educated guesses about the devices and the industry (namely, that they aren’t as bad as smoking).

There are three sides at play here, and none of them are playing fair.

hardcore-smokers-quitTobacco prohibitionists have been fighting for decades to destroy smoking at it’s very root.  Many of them have made careers out of demonizing tobacco and smoking (with good reason).  However, tobacco prohibitionists entirely ignore the “reduced harm” option in the fight against smoking.  If the choices are to let someone continue smoking or offer the person a way to smoke with reduced harm done to them, tobacco prohibitionists prefer to keep the reduced harm option off the table.  They fail to recognize that decreasing overall harm is better than forcing an individual to stick with their total harm option.  These are also the kind of people that seem more than willing to bend the facts about smoking for the greater good (see: secondhand smoke) or that argue smoking half a pack of cigarettes a day is no less dangerous than smoking three.

Prohibitionists see electronic cigarettes as a loophole design
ed to help people continue smoking.  According to them, e-cigs only exist to allow smokers to be smokers outside the confines of anti-smoker legislation.  As such, the prohibitionists are pushing for hefty smoking bans, taxes, sales restrictions and more on the products despite their promise.

Us: Does it matter that these could save lives?  Them: Not if it means a single person who might one day quit will keep smoking.

Meanwhile, the biggest three tobacco companies (R.J. Reynolds, Philip Morris, and Lorillard) are moving into the electronic cigarette industry and making almost everything the prohibitionists say seem more and more true.  And why wouldn’t they?  It’s a win-win situation.  Electronic cigarettes are quickly cutting into their profits.  Why not snatch up the biggest companies or launch massive distribution networks to take advantage of the growth?  Meanwhile, if politicians and regulators kill the industry because they fear it’s Big Tobacco in disguise (which it now looks like), tobacco gets its lost smokers back.  If they don’t, Big Tobacco has a new reliable revenue stream.

So what is Big Tobacco doing?  Exactly all that and (it appears) advocating for pretty harsh tobacco-focused regulation.  They’re stepping into the ring and becoming enough of the electronic cigarette industry that any regulations against the industry will be designed with Big Tobacco in mind.  This is likely to leave small companies incapable of compliance.  Big Tobacco has been working with regulators for decades.  They know the dance: give some here, take some there, make everyone happy.  By “admitting” that electronic cigarettes are dangerous and offering to give up flavors, Big Tobacco makes competition with them almost impossible and gives politicians an opportunity to pat themselves on the back for a tobacco control effort well done.  Even if smart and appropriate legislation is handed down for electronic cigarettes, big tobacco has the money, the experience, and the leverage to dominate the market, hedge out the businesses that made the industry happen, and make e-cigs just another Big Tobacco endeavor.

Us: What if the consumer wants more choices?  Them: We offer tobacco and menthol.

nicotine-patchLast, but certainly not least is the pharmaceuticals companies — namely those that sell smoking cessation products.  These companies have long been farming the pockets of smokers that are hoping to kick the habit.  The problem is that the best “approved” cessation products fail 99% of the time (the likelihood a former smoker will eventually return to smoking).  Companies like GlaxoSmithKline (which produces nicotine gum, patches, and lozenges) are getting involved in discussions about electronic cigarettes — despite not being the source of information on them or the buyers, sellers, or distributors of them.  Often highlighted in e-cig advocate Michael Siegel’s blog, many public health professionals weighing in on the debate are undeclared consultants of major pharmaceuticals companies.  These individuals don’t declare these potential conflicts of interest because they can reasonably argue that the pharmaceuticals industry has no direct stake in e-cigs.

And what are smoking cessation sellers hoping to do with e-cig industry?  Just about anything the can to get in its way.  In the US, the ship has pretty much sailed for e-cigs being regulated and sold as barred up, walled off smoking cessation products — that’s not happening.  If they had been, the industry would have been handed over to Big Pharma in much the same way we hope it isn’t handed over to Big Tobacco.  But, and this is a huge but, people are using the devices for cessation regardless of how they’re marketed — and they are rapidly appearing to be more successful than the approved stuff.  So these companies appear to be slamming the new devices any way that they can — deliberately reiterating outdated fears and debunked statistics.  It all appears to be part of a campaign of deliberate misinformation to keep the public guessing about electronic cigarettes.  Almost always the final word in any talk about e-cigs is if you are thinking about quitting, we suggest that you use approved cessation methods (I.E. use our stuff because that’s how we make money.)

Us: Aren’t you just being a sore loser because your stuff doesn’t work and e-cigs appear no more harmful, far cheaper, and much more successful?  Them: If you are thinking about quitting, we suggest that you use approved cessation methods.

photo1Much of this is deliberate political positioning and lobbying based on emotion.  The future of electronic cigarettes should be determined by science and reason.  Appropriate regulation would be based on the damage which science has proven the product actually does — not what we fear it might do (which is exactly what the New York City Council admitted to basing it decision on).  That something being called a public health miracle can so easily be obstructed by frustration, greed, and spite should make everyone mad.

This world has a disease — a curable disease.  Smoking is not the kind of boogie monster that goes away if you scare it back.  We should all be looking for every possible solution and giving each its due consideration regardless of the emotions we feel for the way it looks.  That we aren’t, shows that our understanding of public health is still lacking.

Freedom of choice and innovative solutions to complex problems should trump political posturing and corporate greed.  That there’s even a chance that this isn’t the case should have us all a little fuming.

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