Tuesday, August 25, 2009

Action on Smoking and Health Warns Public of the Dangers of "Secondhand Electronic Cigarette Smoke"

In a press release issued last week, the national anti-smoking group Action on Smoking and Health (ASH) warned the public of the dangers not only of electronic cigarette use but also of "secondhand electronic cigarette smoke."

The press release warns the public of the dangers of exposure to carcinogens it alleges are present in the exhaled vapor of electronic cigarette "smoke."

According to the press release: "The FDA recently reported that it found in samples of e-cigarettes a variety Of "toxic and carcinogenic chemicals" including diethylene glycol, "an ingredient used in antifreeze, which is toxic to humans"; "certain tobacco-specific nitrosamines which are human carcinogens"; and that "tobacco-specific impurities suspected of being harmful to humans - anabasine, myosmine, and nicotyrine - were detected in a majority of the samples tested."

"There is every reason to believe that many of these cancer-causing chemicals are also found in the "vapor" given off by e-cigarettes, says Banzhaf, which nonsmokers in the vicinity are then forced to inhale. These secondhand "smokers" may include infants and toddlers, the elderly, and those with pre-existing medical conditions which may make them especially susceptible to exposure to these chemicals." ...

"People seated on airplanes, or in restaurants and other public places where tobacco smoking has been banned, should not be forced to inhale a potentially dangerous mixture of nicotine, propylene glycol, anabasine, myosmine, nicotyrine, certain tobacco-specific nitrosamines which are human carcinogens, and who knows what else, he says. As the Surgeon General has noted, there is no safe lower level of exposure to any known human carcinogen so, as with asbestos, even fleeting exposures should be guarded against. "

The Rest of the Story

Let's set a few things straight right away.

First of all, if we are going to guard against fleeting exposure to any known human carcinogen, then we would have to immediately ban nicotine replacement products, such as nicotine patches, nicotine gum, and nicotine inhalers, as these products have been shown to contain the same carcinogens as have been detected in electronic cigarettes. However, ASH does not appear to be calling for a ban on NRT products, despite the fact that "as the Surgeon General has noted, there is no safe lower level of exposure to any known human carcinogen so, as with asbestos, even fleeting exposures should be guarded against."

Second of all, ASH seems to be completely oblivious to the notion that the dose of a chemical exposure is an important factor in its toxicity. Peanut butter contains the potent carcinogen - aflatoxin - but I don't hear ASH calling for peanut butter to be pulled from the market to guard against exposures to this carcinogen, to which the Surgeon General has noted there is no safe level of exposure.

In fact, many foods contain trace levels of carcinogens. The FDA has set maximum levels for these carcinogens. For aflatoxin, the FDA requires that there be no more than 20 parts per trillion present in foods (other than milk, for which the maximum allowable level is 0.5 parts per trillion.

What is laughable about ASH's alarmist claim that the carcinogens in electronic cigarette cartridges pose a hazard to bystanders is that the level of carcinogens detected in the cartridges was miniscule. It was comparable to the levels of the same carcinogens present in nicotine replacement products. If ASH is worried about carcinogenic exposure of bystanders who are in the vicinity of electronic cigarette users, it should also be worried about carcinogenic exposure of bystanders in the vicinity of nicotine inhaler users.

But I don't hear ASH warning the public about the potential hazards of nicotine inhaler use to the public. That makes me think that there is something more than objective scientific analysis going on here.

To make ASH's science even more shabby, there is no evidence that the carcinogens in the cartridges make their way into the inhaled vapor. And there is no evidence that they make it into the exhaled vapor of the e-cigarette user. Nor is there evidence that the exhaled vapor of the e-cigarette user causes any significant exposure for bystanders. There is, in fact, very little reason to believe that exhaled electronic cigarette vapor poses any significant threat to nonusers, and there certainly is no significant risk of cancer.

What is so troubling to me about these absurd and unsubstantiated statements by ASH is that they undermine the entire credibility of anti-smoking groups' claims about the hazards of secondhand smoke. If anti-smoking groups are making ridiculous claims about the dangers of "secondhand" exhaled electronic cigarette vapor, what reason is there for the public to believe that they are not also making ridiculous claims about the hazards of secondhand smoke?

ASH is truly undermining the credibility of the entire anti-smoking movement in terms of its claims about the hazards of the real secondhand smoke. The public is going to start to dismiss all of the movement's claims, even those which are scientifically sound.

Perhaps even more concerning to me is why ASH - and other anti-smoking groups - have completely abandoned science to become extremist activist groups that are merely spewing propaganda and hysteria. What exactly is it that is so threatening about e-cigarettes that has led these groups to discard any degree of scientific integrity?

I can only hypothesize here, but my perception is that e-cigarettes are threatening precisely because they are potentially much safer than conventional cigarettes. What this means is that to have any conscience, anti-smoking groups must abandon their abstinence-only philosophy and accept that the best course of action might actually be to encourage smokers to use a product which looks like and acts like a cigarette.

The anti-smoking groups are showing their true colors here. It is apparently not the health effects of cigarettes that are the real problem; it is the cigarette itself. Take away the overwhelming majority of the toxic and carcinogenic chemicals from the cigarette and what do you have? In my view, a much safer alternative to cigarettes. In the anti-smoking groups' view, you still have a cigarette. And that is unacceptable.

Not only does this threaten the abstinence-only philosophy, but it also threatens the status quo: that is, the continued survival and normal business of the anti-smoking groups themselves. Can these groups thrive in an environment in which a cigarette-like product is the life-saving answer to effective smoking cessation for hundreds of thousands or perhaps millions of smokers? Apparently not. They would rather stick with the status quo, where pharmaceutical products are used unsuccessfully by 90% of smokers and continued high rates of smoking justify the expenditure of more money to fund anti-smoking activities and programs.

Remember that ASH is funded heavily by Big Pharma (specifically, by Pfizer - the maker of Chantix). If e-cigarettes really take off, they represent a huge threat to the profits of pharmaceutical companies, and in turn, they represent a threat to future funding of ASH. This conflict of interest is significant, but ASH has failed to disclose it in any of its statements about the dangers of electronic cigarettes. Each of the other anti-smoking groups which have warned the public about the dangers of e-cigarettes is also heavily funded by Big Pharma. Is this merely a coincidence? I think not.

The rest of the story is that ASH has completely lost sight of any semblance of science, and its propaganda has deteriorated to the level of pure hysteria. This undermines the anti-smoking movement's ability to convince people of the very real threats of the real secondhand smoke and it gives the public reason to doubt that anything the movement says about tobacco smoke is accurate. It is not only unethical because it is dishonest, but it is destroying the scientific integrity of the anti-smoking movement.

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