Another Tobacco Control Professional Tells Public that Cigarette Smoking is No More Harmful than Using Non-Tobacco Electronic Cigarettes

While cigarette smoke contains more than 10,000 chemicals, including more than 60 known human carcinogens, and is known to kill more than 400,000 Americans each year, a professor of nursing who is a tobacco control practitioner at the University of Virginia is telling the public that smoking is no more dangerous than using electronic cigarettes, which contain no tobacco, involve no combustion, and deliver nicotine without the tens of thousands of chemicals in tobacco smoke.

In an op-ed published yesterday in the Daily Progress (Charlottesville, VA), a professor of nursing at the University of Virginia argued that: "What we don’t know is the science as to whether e-cigarettes are a safer alternative or just more of the same. As a professional nurse, I wager the latter."

The Rest of the Story

As a professional nurse, I don't think she should be wagering. Especially because this is a particularly bad bet.

If you want to put money down on which is safer, why would you choose a product that we know kills hundreds of thousands of Americans each year over a product which has not yet been shown to have any serious adverse health effects? Why would you choose a product which delivers nicotine plus tens of thousands of chemicals and more than 60 carcinogens over one which delivers nicotine with just a few chemicals and low levels of only a few of the carcinogens in tobacco smoke? Why would you pick the product which has been shown to cause acute endothelial dysfunction over the one which does not appear to have acute effects on the coronary circulation? Why would you wager on the one which is known to acutely impair lung function over the one which actually improves lung function among smokers who switch to it?

What is particularly disturbing to me is that this is a nurse providing medical advice to potentially thousands of readers and she misleads them into thinking that vaping is every bit as dangerous as smoking. This undermining of the public's appreciation of the serious hazards of cigarette smoking is, in my mind, public health malpractice. If the tobacco companies were to make the same argument, we would attack them for committing fraud.

Beyond this fraudulent statement, there are numerous other misrepresentations in the piece. First, she insinuates that electronic cigarettes cannot be used to help smokers quit:

"The American Lung Association is very concerned about the potential health consequences of electronic cigarettes, as well as claims that they can be used to help smokers quit."

There is no argument over whether electronic cigarettes can help smokers quit. They have been documented to have helped many smokers quit. Many testimonials as well as a number of surveys, focus groups, and at least two clinical trials have documented that electronic cigarettes can indeed help some smokers quit. We don't know the exact proportion of smokers who will quit after trying electronic cigarettes, but to claim that they cannot be used to help smokers quit is false.

Second, while she attacks electronic cigarettes because they contain tobacco-specific nitrosamines, she fails to tell readers the rest of the story: that nicotine patches and nicotine gum also contain tobacco-specific nitrosamines. In fact, there are only trace levels of tobacco-specific nitrosamines in electronic cigarettes and these levels are comparable to those in FDA-approved nicotine replacement products.

Third, while she tells readers that one brand of e-cigarettes was found to contain diethylene glycol in a test four years ago, she fails to inform readers that subsequent to that, there have been no reports of any electronic cigarette brands that tested positive for diethylene glycol. This hasn't stopped the Mayo Clinic from calling e-cigarettes a "cousin to anti-freeze" and it doesn't stop the author of the op-ed from trying to scare the public into thinking that using electronic cigarettes is like exposing oneself to anti-freeze.

Finally, she misleads readers into believing that electronic cigarettes deliver the same poisons as tobacco cigarettes, which is not true. She writes: "E-cigarettes might seem to tout a pathway to tobacco-less freedom, but they entangle individuals in the same poisons as their smoke-filled grandfathers."

It is getting to the point where not a day goes by without a tobacco control practitioner disseminating false information about electronic cigarettes. This troubles me for two reasons. First, it is damaging to the public's health. It discourages smokers from quitting (using electronic cigarettes) and it may even stimulate some former smokers (who already quit using electronic cigarettes) to resume smoking. In fact, what advantage is there to remaining an ex-smoker if electronic cigarettes contain the same poisons as cigarettes. You might as well go back to smoking.

Second, I think that these repeated and sustained fraudulent statements are damaging the credibility of the tobacco control movement. If we in public health cannot be trusted to provide accurate information about health risks, then who can?