In an op-ed piece published last Sunday in the Augusta Chronicle, the director of the Georgia Regents University Cancer Center warns of many potential public health hazards of electronic cigarettes, focusing most directly on what he argues is the likelihood that many youth who try these devices will progress to traditional tobacco cigarette smoking.
The author writes:
"The electronic cigarette has been designed with the same primary purpose
as a cigarette: to introduce nicotine into the human bloodstream. What
happens, however, to the vaper who determines that the controlled doses
offered by an e-cigarette no longer are satisfying that craving? Chances
are, many of them will look toward a more efficient delivery system –
the traditional cigarette. The CDC survey found that 76.3 percent of
students who had tried e-cigarettes in the past 30 days also had smoked
The Rest of the Story
First of all, the truth is that electronic cigarettes were not designed with the same primary purpose as a cigarette. Yes, the cigarette was designed to deliver nicotine into the human bloodstream as quickly and consistently as possible. However, in contrast, the primary purpose for which the electronic cigarette was designed was to get smokers off of cigarettes. The primary purpose of these products is clearly not to deliver nicotine most effectively to the bloodstream. To do that, one would design a product that burns tobacco at a high temperature. Instead, the primary purpose of an electronic cigarette is to simulate as much as possible the behavior of smoking, but without delivering the tar, which is the component that actually causes tobacco-related disease and death.
In fact, electronic cigarettes are a rather poor method for delivering nicotine to the bloodstream. Real cigarettes have already cornered the market on that goal. Moreover, most electronic cigarettes do not deliver controlled doses of nicotine. To get that, you need to buy a real cigarette!
This article, however, is not merely misleading about the purpose of electronic cigarettes. It actually distorts and misrepresents the science.
Specifically, the article argues that nonsmokers (presumably youth) who use e-cigarettes are likely to progress to cigarette smoking. After making this assertion, the article cites as supporting evidence a CDC survey which found that the vast majority of students who had tried electronic cigarettes in the past 30 days had also smoked conventional cigarettes. In other words, the article is trying to use the CDC survey as evidence that indeed, youth nonsmokers who try electronic cigarettes are indeed progressing to smoking.
The problem is that the survey was a cross-sectional one. You cannot determine from this survey whether youth who tried electronic cigarettes later transitioned to real cigarettes or whether it just so happens that the overwhelming majority of youths who have experimented with e-cigarettes are youth who were already smokers.
However, by citing the survey in this manner, the article deceives the reader by making it sound like the CDC survey supports the writer's contention that youth e-cigarette experimenters who never smoked are progressing to established smoking. The reader who is not intimately familiar with the CDC survey will assume that the survey showed that youth e-cigarette experimenters are going on to smoke in high numbers. But the survey didn't identify a single youth who progressed from nonsmoking to smoking due to electronic cigarettes. It simply didn't measure that phenomenon.
By misrepresenting the results of the science, the article is able to provide seeming scientific support for its unfounded assertion that e-cigarettes are serving as a gateway to youth smoking.
Of course, this misrepresentation of the scientific evidence by electronic cigarette opponents is nothing new. I have documented numerous examples of this sleight of hand over the past few months on this blog. In fact, the greatest magician has been the CDC itself, which used its cross-sectional survey to conclude, and to disseminate widely the conclusion that e-cigarettes are a gateway to a lifetime of addiction to cigarette smoking.
Why is it that electronic cigarette opponents are consistently misrepresenting the science to support their positions? The answer is simple: because the actual science just doesn't support their position. When the truth doesn't support your position, you have to fudge things if you want to retain that position. And that's the rest of the story.