National Study of Adults Can Find Only Six Nonsmokers Who Have Ever Tried Electronic Cigarettes

Anti-smoking groups continue to oppose electronic cigarettes, in part because they claim these products will increase smoking by inducing nonsmokers to become addicted to nicotine. A number of anti-smoking advocates expressed these concerns at an FDA-sponsored press conference in July 2009. At that press conference, anti-smoking advocates warned that "these products could encourage smoking" and alarmed the public about "the risk that electronic cigarettes may increase nicotine addiction among young people." The American Lung Association went so far as to "urge[s] the FDA to act immediately to halt the sale and distribution of all e-cigarettes...".

At the press conference, Dr. Jonathan Winickoff, chairman of the American Academy of Pediatrics' tobacco consortium, warned that electronic cigarettes are likely to appeal to young people and will encourage nicotine addiction, ultimately leading to the initiation of cigarette smoking. The FDA continues to this day to warn the public that electronic cigarettes may appeal to young people and lead them to become addicted to nicotine and then to start smoking.

The Rest of the Story

In an article published in the Journal of Environmental and Public Health and co-authored by Dr. Winickoff himself, the authors examined the use of electronic cigarettes and other "emerging" tobacco products among a national sample of 3,240 adults.

Despite all of the anti-smoking groups' dire warnings about the appeal of electronic cigarettes to nonsmokers, the study was able to find only 6 (six) nonsmokers who had ever used these products. This is 6 out of a total of approximately 2000 nonsmokers and 3240 total adults in the sample. It is unclear if any of these 6 reported continued use of electronic cigarettes.

(See: McMillen R, Maduka J, Winickoff J. Use of emerging tobacco products in the United States. Journal of Environmental and Public Health. Volume 2012 (2012), Article ID 989474, doi:10.1155/2012/989474.)

So much for electronic cigarettes being appealing to young adults and other nonsmokers. These findings seem to confirm what I have argued for months: that electronic cigarettes are marketed towards smokers, not towards youth and/or nonsmokers. These products are intended to help smokers quit or cut down in order to improve their health. They are an alternative to tobacco cigarettes. There is little if any appeal to nonsmokers to use these products.

It is a good thing that the FDA was prevented by the courts from following the American Lung Association's advice (and that of numerous other anti-smoking groups) and removing electronic cigarettes from the market. Such an action would certainly have led to the initiation of tobacco use among literally thousands of ex-smokers who had successfully quit using e-cigarettes but would have been essentially forced to return to tobacco cigarettes.

It is also a good thing that many vapers are ignoring the dire warnings from anti-smoking groups and that they have taken their chances on this product, which for many of them, has likely saved their lives.

It is worth mentioning that in addition to electronic cigarettes, the article examined the use of dissolvable tobacco products, snus, and waterpipes. Importantly, while very few nonsmokers reported using electronic cigarettes (0.3%) or dissolvable tobacco products (0.2%), a substantial proportion did report using snus (2.7%) or waterpipes (5.4%).

These data dispel any serious concern that electronic cigarettes or dissolvable tobacco products are appealing to nonsmokers and will lead eventually to nicotine addiction and the initiation of cigarette smoking. On the other hand, these data are consistent with the hypothesis that the same is not the case with snus and waterpipe tobacco use. 

Unfortunately, however, the authors do not make this distinction in their article. They lump all these forms of "tobacco use" together.

The article concludes by recommending that clinicians "offer counseling about the risks of these products as another form of tobacco use."

But that is a false statement, as electronic cigarettes are not a form of tobacco use. They contain no tobacco, as these authors should well know and should have pointed out. Why the need to lie to the public about the facts? It appears as if there is a pre-ordained agenda against electronic cigarettes.

But apparently, the arguments against electronic cigarettes are so weak that opponents need to lie to the public and claim that vaping is a form of "tobacco use" which they should know is simply not the case.

The rest of the story is that: (1) there is strong evidence that electronic cigarettes do not appeal to nonsmokers and that there is little reason to believe that they will lead to any substantial increase in cigarette smoking; and (2) opponents of electronic cigarettes continue to resort to lying to the public; in this case, misrepresenting electronic cigarettes as a form of tobacco use when in fact the product contains no tobacco.