Tuesday, November 22, 2011

Anti-Smoking Community Still Being Guided by Ideology Rather than Science on Electronic Cigarettes

In a letter to the editor published last week in the New York Times, the director of smoking cessation services at Columbia University Medical Center urges smokers not to quit using electronic cigarettes because it involves "directly inhaling heated nicotine into the delicate tissue of smokers’ lungs." He praises nicotine replacement therapy as a "proven" aid to smoking cessation.

The Rest of the Story

I have news for you. Smoking cigarettes involves "directly inhaling heated nicotine into the delicate tissue of smokers’ lungs." Would we rather that smokers directly inhale heated nicotine plus 10,000 other chemicals or that they just inhale the nicotine?

For literally thousands of ex-smokers, electronic cigarettes have helped them to stop or greatly cut down on their cigarette smoking. Many of these are smokers who tried to quit with NRT but failed. Telling them that they should not use electronic cigarettes is tantamount to recommending that they return to cigarette smoking instead of continuing to stay smoke-free with the help of electronic cigarettes.

Moreover, to call NRT a "proven" strategy for smoking cessation is misleading. What NRT has been "proven" to do is to fail in about 92% of quit attempts.

For a while, I was baffled by why a physician would offer this strange advice to smokers, and based on such flawed reasoning. I reasoned that like many other opponents of electronic cigarettes, he must have a financial tie to pharmaceutical companies. This was not the case. However, I did discover that the author appears to have an interest in opposing e-cigarettes, as he has written a book on quitting smoking that relies heavily upon the use of traditional pharmacotherapy and his web site solicits speaking engagements for the presentation of his smoking cessation method. He even has his own publicist and literary agent.

While I am not claiming that there is a financial interest involved (I believe that the author should have disclosed whether or not he receives any money from the sale of his book and/or from speaking engagements), there does appear to be a major conflict of interest.

The rest of the story is that this is yet another example of an anti-smoking professional who is publicly opposing electronic cigarettes, but without revealing that he has a conflict of interest. The public deserves unbiased and unconflicted, science-based recommendations on strategies to improve their health, especially when the advice may potentially lead to harm for thousands of individuals.

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