Senator Frank Lautenberg (D-NJ) has announced that he wants the FDA to immediately take electronic cigarettes -- which deliver essentially pure nicotine (with no tar or other tobacco constituents) -- off the market. At the same time, he is a supporter of legislation that would provide special protection to actual tobacco-containing cigarettes and ensure that this most toxic variety of cigarettes always remains on the market and continues to kill hundreds of thousands of Americans each year.
The electronic cigarette is a battery-powered device that contains a nicotine/propylene glycol solution and vaporizes the nicotine, producing a vapor of nicotine that is inhaled by the smoker. Because there is no tobacco, there is no tar and so while the vapor contains nicotine, it does not contain any of the thousands of other constituents of tobacco smoke. Also, because the cigarette produces a vapor, and not smoke, there is no secondhand smoke that could affect others. Moreover, the amount of nicotine delivered can be controlled by the user, allowing the smoker to gradually reduce the level to wean himself off of cigarettes entirely if he so desires.
Senator Lautenberg's call for removing the electronic cigarette from the market, as well as for providing special protection - and government approval - for the much more toxic actual tobacco-containing cigarettes - was endorsed by the American Heart Association, American Lung Association, American Cancer Society, and the Campaign for Tobacco-Free Kids.
Representative Cliff Stearns (R-FL) countered Lautenberg's call for the removal of electronic cigarettes from the marketplace, arguing that these products are designed to help smokers quit, that they have succeeded in doing so for many smokers, that they are safer than tobacco-containing cigarettes, and that they are safer for nonsmokers because they do not produce secondhand smoke.
According to an article in The Hill: "Stearns shot back at Lautenberg on Monday, saying that there is no evidence that the device is harmful. 'Before the FDA takes any immediate action, it should put forward scientific evidence that these products are harmful or unsafe,' he said in a statement. 'These e-cigarettes are smokeless and do not produce carcinogens. The nicotine in e-cigarettes is controlled in a capsule that can help in smoking cessation by allowing the user to reduce gradually the nicotine level, hopefully to zero.' Stearns has sent electronic cigarettes to House Minority Leader John Boehner (R-Ohio) and President Obama to help them quit smoking."
The Rest of the Story
How special that a public policy maker who touts himself as being a champion of the public's health as well as some of the leading national health advocacy organizations are demanding that we ban what is clearly a much safer cigarette than those on the market, but that we allow, protect, approve, and institutionalize the really toxic ones.
This is about as idiotic and irrational an approach as I have ever seen in my 22 years in tobacco control and public health.
One company has a product on the market which delivers only nicotine. There are potentially serious health effects of this nicotine, especially with regards to heart disease. However, there are no other toxic chemicals and no carcinogens, so there is no risk of cancer or chronic obstructive lung disease.
Another company has a product on the market which delivers nicotine plus more than 4000 other chemicals and toxins, including over 60 proven carcinogens, and which we know kills over 400,000 people a year.
Our health groups' response: prohibit the first company from marketing its product, but officially provide government approval of the products manufactured by the second company.
What Senator Lautenberg and the health groups are trying to do is ban a much less harmful type of cigarette but to give an official government seal of approval to the much more toxic one that we know is killing hundreds of thousands of Americans each year.
The logic of these actions completely escapes me.
Or at least the logic did escape me until The Ashtray Blog pointed out that Senator Lautenberg is the recipient of more than $128,000 from pharmaceutical companies (in 2008 alone).
The only real threat that electronic cigarettes pose is not to the public's health, but to the profits of the pharmaceutical companies, which manufacture competing products (nicotine replacement therapy). If lots of smokers turn to electronic cigarettes, rather than pharmaceuticals, in order to try to quit smoking, then the pharmaceutical companies stand to lose lots of money. So perhaps it is not surprising that Senator Lautenberg is standing up to protect the financial interests of the pharmaceutical companies over the interests of the public's health.
The behavior of the health groups is equally mystifying. But perhaps not so mystifying when you consider that the Clearing the Air blog points out that these groups received millions of dollars from a foundation which is largely underwritten by a pharmaceutical company. Might a financial interest explain why these health groups are sacrificing a huge potential benefit to the public's health for the protection of pharmaceutical company profits?
Electronic cigarettes pose a threat to pharmaceutical smoking cessation aids precisely because the pharmaceutical aids are so dismally ineffective. The rates of successful smoking cessation with these pharmaceuticals is less than 10%. Thus, the overwhelming majority of smokers who try to quit using pharmaceutical aids are unsuccessful.
Accordingly, there is a huge potential market for a nicotine delivery system (such as an electronic cigarette) that will be more popular with smokers. The fact that the e-cigarette system is similar to a cigarette may make it much more effective and popular for use among smokers who are trying to quit smoking.
To be sure, this is a potentially life-saving intervention. There is initial evidence that many smokers have found the e-cigarette to be an effective method for smoking cessation. Moreover, it makes sense that smokers would find it more attractive to use an e-cigarette than a nicotine patch.
Furthermore, we know that smokers almost never continue using nicotine replacement to stay off cigarettes. A very small percentage quit, but the overwhelming majority return to cigarette smoking.
In contrast, it is quite plausible that many smokers would find the e-cigarette to be an alternative to smoking and it may actually be more successful in keeping them off cigarettes. If true, this would literally save "countless lives."
But the anti-smoking movement is too much in bed with the pharmaceutical industry to allow this natural experiment to actually take place. The movement is so heavily funded by Big Pharma that it cannot risk the loss of pharmaceutical profits, even if disallowing the experiment comes at the expense of a substantial number of human lives.
While there must be oversight of the claims that e-cigarette manufacturers are making regarding the safety of the product, the attention should be focused on these claims, rather than on an outright ban on this type of cigarette.
Moreover, since the product is clearly being marketed primarily as an alternative cigarette, rather than as a smoking cessation aid, it should not fall under the regulatory jurisdiction of the FDA.
Once again, we see that the scientific evidence base and common sense reasoning are not guiding the tobacco control movement. It is, instead, being guided largely by money. The profits of both tobacco and pharmaceutical companies are being protected at the expense of the protection of the public's health.
It is truly a tragedy.