The California chapter of the American Medical Association (AMA) has introduced a resolution to the 2015 Annual Meeting of the AMA, to be held June 6-10 in Chicago, which recommends the taxation of electronic cigarettes and a complete ban on e-cigarette advertising.
The effect of such a policy would be to protect Big Tobacco cigarette sales from competition. It is widely recognized among financial analysts that the more e-cigarettes sold, the lower cigarette sales drop. In fact, the finance minister of Manitoba recently concluded that an increase in e-cigarette use in the province will result in a significant decline in cigarette consumption. E-cigarettes are clearly serving as a substitute for real cigarettes. A ban on e-cigarette advertising would undoubtedly decrease e-cigarette consumption at the expense of an increase in smoking. Levying a tax on e-cigarettes would have the same effect.
Thus, the California chapter of the AMA is essentially acting to protect cigarette sales. Its resolution might appropriately be called the "Cigarette Sales Protection Resolution" or the "Huge Favor for Big Tobacco Resolution."
Interestingly, while the resolution calls for taxation of e-cigarettes and a ban on e-cigarette advertising, it does not call for a similar increase in cigarette taxes or a complete ban on cigarette advertising. It's also interesting to note that the AMA is not calling for a ban on alcohol advertising.
A ban on electronic cigarette advertising would almost certainly not pass Constitutional muster as it would violate the First Amendment. Specifically, it would never satisfy the fourth prong in the Central Hudson criteria: that the restriction on speech be no broader than absolutely necessary to advance the government's interest. Since the government's interest in this case is to protect youth from advertising exposure, there are less drastic ways of regulating such exposure, such as simply prohibiting advertising that targets children or which reaches a disproportionate youth audience. Certainly, a complete ban on advertising interferes with the company's right and need to reach adult smokers and is much broader than is needed to protect youth from substantial advertising exposure.
The Rest of the Story
It is bad enough that the California section of the AMA is aiding Big Tobacco by helping to protect cigarette company profits. But what makes it even worse is that they are lying to physicians nationwide in order to support this misplaced agenda.
First, the California AMA claims that: "Among U.S. adolescents, use of e-cigarettes may in fact serve as a gateway to nicotine addiction in their future." There is absolutely no evidence to support this contention. In fact, the existing evidence suggests that the opposite is true: it appears that e-cigarette use is deterring youth from the use of combustible cigarettes, and thus away from a high likelihood of a lifelong addiction to nicotine.
Second, the California AMA claims that: "research indicates that real world application of e-cigarette use is associated with significantly lower odds of quitting smoking combustible (traditional) cigarettes among U.S. adults." This is just not the case. The research shows, instead, that e-cigarettes are at least as effective as the nicotine patch in promoting smoking cessation. These products are not for everyone, but they clearly do not inhibit quitting. They aid quitting among many smokers. There is no evidence that any smoker using e-cigarettes would have quit smoking if only he or she had not tried the e-cigarette.
Third, and worst of all, the California AMA claims that: "Toxicity testing of e-cigarette vapor has shown the presence of toxic and carcinogenic substances comparable to those found in combustible cigarettes." This is a blatant lie. The truth is exactly the opposite. E-cigarette vapor contains levels of toxic and carcinogenic substances that are orders of magnitude lower than in tobacco smoke. In fact, e-cigarettes eliminate most of the thousands of toxins present in tobacco smoke.
The California AMA certainly has the right to promote any public policies it wants to, even if they are directly opposed to the protection of the public's health. But the California AMA does not have right to lie to physicians nationwide in order to support their misguided policies.