Thursday, May 24, 2012

In Embarrassing Ironic Twist, Lorillard Promotes Smoking Cessation While Anti-Smoking Groups Do Not

In an irony of epic proportions that is an embarrassment to the anti-smoking movement, the Lorillard Tobacco Company is now promoting smoking cessation among thousands of consumers using electronic cigarettes, while most anti-smoking groups are not.

Believe it or not, here is the actual advice that Lorillard and anti-smoking groups are giving - publicly - to current smokers who are thinking of quitting smoking using electronic cigarettes:

Lorillard: Do.
Anti-Smoking Groups: Don't.

And here is the advice that Lorillard and anti-smoking groups are giving - publicly - to ex-smokers who have successfully quit using electronic cigarettes:

Lorillard: Continue to stay off tobacco cigarettes by using the electronic ones.
Anti-Smoking Groups: Do not use the electronic cigarettes.

This advice from the anti-smoking groups is tantamount to saying: "Return to cigarette smoking rather than use a product whose risk profile is not 100% documented."

The Rest of the Story

Through its acquisition of blu ecigs®, Lorillard is now officially in the business of harm reduction and it is devoting a substantial amount of resources to promoting smoking cessation via the use of electronic cigarettes. On the other hand, anti-smoking groups are largely opposed to the use of electronic cigarettes and have called for their removal from the market. They, along with the FDA, are actively discouraging smokers from trying to quit using these products and are scaring smokers who have quit using electronic cigarettes into discontinuing the use of these devices and instead, returning to smoking.

In addition to being a strange but true ironic twist, I view this as being a major embarrassment for the anti-smoking movement.

Is it not unfortunate that we in tobacco control are the last to adopt the idea of harm reduction to help protect the health of millions of smokers who - let's face it - are not going to quit smoking? Is it not a disgrace that Big Tobacco is now promoting a form of smoking cessation that we in tobacco control are discouraging?

I had the opportunity to meet Lorillard CEO Murray Kessler earlier this week at the TMA Annual Meeting and to hear him discuss the acquisition of blu. Ecig Advanced has also published an interview with Kessler in which he explains the company's commitment to promoting the electronic cigarette industry. While some might be skeptical about the motivation behind a tobacco company purchasing an electronic cigarette company and might assume that the purpose is to sabotage the e-cigarette industry, it is clear to me after speaking with and listening to both Jason Healy at blu (who I have known for several years) and Murray Kessler that this is not the case at all. Lorillard is committed to developing a thriving business for its blu product, and that means a willingness to promote smoking cessation via blu cigs.

Knowing Jason, I can assure my readers that if Lorillard was even in the slightest way not committed to supporting blu fully, he would not have agreed to the acquisition. Moreover, the choice of blu shows that Lorillard is committed to building an industry segment that can compete successfully in a difficult regulatory environment. Blu ecigs has been a leader in the industry in terms of quality control:
  • Blu was one of the first companies to move to in-house (domestic) production of its juice, ensuring tighter quality control over the contents of its cartridges;
  • Blu was one of the first companies to document the levels of nicotine in its products through analytic testing;
  • Blu wisely made a decision to rely upon glycerin as an excipient, rather than propylene glycol, thus avoiding health concerns related to the long-term inhalation of propylene glycol and eliminating any worries about the respiratory irritant effects of propylene glycol (even though these are obviously minor compared to tobacco cigarettes).
While I have to admit that initially I thought the entrance of a tobacco company into the electronic cigarette market might undermine the development of this industry, I now believe it is the opposite. There are three reasons for this:

1. The entrance of Lorillard into the electronic cigarette space now means that a substantial amount of resources - not previously available - can be devoted to marketing the product and making the public aware of electronic cigarettes, something which has previously been quite slow to develop. It is unfavorable for the e-cigarette industry that even four years after introduction of this product, consumers are still largely unaware of the very existence of the product. Even tobacco control experts are confused about the differences between a cigarette and an electronic cigarette.

2. The entrance of Lorillard into the electronic cigarette space now means that the industry has the resources to conduct the types of studies that may be required in order to obtain FDA approval for various important marketing claims that will ultimately be pivotal for the industry. While it is unclear whether the FDA will apply section 911 to electronic cigarettes (I have urged the agency not to do so), if it does there is no chance that any of the smaller electronic cigarette companies could possibly produce the research required to meet the heavy burdens of that statute. At least there is now a chance. But more importantly:

3. The entrance of Lorillard into the electronic cigarette space creates a formidable force that the FDA must now deal with and which has the resources to apply pressure to the agency to promote a reasonable approach to electronic cigarette regulation. It is not clear to me that the smaller e-cigarette companies, on their own, have the experience or political power to interact with the FDA in a way that would influence the agency's decisions. That is no longer the case.

4. Finally, the entrance of Lorillard into the electronic cigarette space helps the entire industry by establishing an entity that can introduce the most stringent and appropriate quality control measures and help address concerns such as:
  • the presence of diethylene glycol in some cartridges;
  • unpredictable delivery of nicotine;
  • inaccurate nicotine levels on cartridges;
  • exploding batteries;
  • leaky cartridges, etc.
I hate to steal Jacob Sullum's analogy again, but it is the best expression of the rest of the story. The anti-smoking groups are essentially telling survivors of a shipwreck who are submerged in the ocean not to use the ship's lifeboats because they have not been FDA tested and approved. Instead, they are telling the drowning passengers to stick to the "tried and true" method: treading water.

The difference, of course, is that in the case of electronic cigarettes, these "lifeboats" have actually been tested quite extensively and we know that for literally thousands of ex-smokers, they work. Even among unmotivated smokers, these products allow more than 50% of smokers to either cut down substantially (by more than half) on the amount they smoke or to quit altogether.

For the better part of two years, I have been struggling to figure out why anti-smoking groups are so hesitant to embrace even the possibility that electronic cigarettes may be helping many smokers to improve their health. It is now clear to me that the primary reason for their hesitance is this:

It is simply not in the anti-smoking mindset, given the dogma of the movement, to condone a behavior that looks like smoking. Ironically, the very factor that makes electronic cigarettes so effective for cessation - the fact that they simulate smoking - is precisely the factor that prevents anti-smoking advocates from embracing the strategy, despite its obvious public health advantages.

The rest of the story is that the anti-smoking groups are going to be the last on board in the recognition that, as Murray Kessler himself said, non-tobacco-containing, nicotine-delivering devices of some sort are going to be the wave of the future. I find it to be an embarrassment that a major tobacco company is now promoting smoking cessation using this new technology while most anti-smoking groups are still discouraging smokers from trying to quit using what may be the single most effective method available to them.

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