The Last Straw: Anti-Tobacco Groups are Actively Promoting Smoking

Readers of the Rest of the Story may have noticed that I have not posted for a few days. This is not for lack of material. Lots is happening that deserves comment, and in the days to follow I will catch readers up on some important developments, including two more lawsuits filed against the FDA in an attempt to overturn its electronic cigarette deeming regulations.

I have not been able to write because I have been too distraught. I have come to the realization that the anti-smoking movement - which I have been a part of for the past 31 years, is essentially dead. And even worse, the anti-smoking movement is now actively promoting smoking. This is extremely difficult for me to understand and to reconcile. And it is especially difficult to stomach given the irony that while the anti-smoking movement is promoting smoking, hundreds of for-profit companies are the ones who are actually fighting to make smoking obsolete. In contrast, anti-smoking groups are fighting to preserve smoking and make sure that it does not become obsolete.

The last straw - the straw that broke the camel's back - is the anti-smoking movement's support of a complete ban on flavored e-liquids for use in vaping products, which follows its earlier vigorous opposition to a complete ban on flavors in toxic tobacco cigarettes.

To be clear, the major anti-smoking groups - including the Campaign for Tobacco-Free Kids, American Cancer Society, American Heart Association, and American Lung Association - opposed a complete ban on flavored tobacco cigarettes, but are now supporting a complete ban on flavored tobacco-free cigarettes. In other words, these groups have lobbied to retain the tobacco companies' ability to attract kids to smoking using a tasty, smooth, and attractive flavoring, while lobbying to remove non-tobacco companies' ability to attract smokers away from cigarettes and toward a much safer tobacco-free, smoke-free alternative.

Last week, it was revealed that the Office of Management and Budget (OMB) had made one critical change in the deeming regulations sent to it for review by the FDA. Specifically, the OMB removed from the regulations a ban on the use of all flavors except tobacco in e-liquids. This action is in accordance with the recommendation that I made to OMB in my meeting with OIRA staff last year.

After this revelation, the major anti-smoking groups and advocates criticized OMB, indicating that these groups support a complete ban on flavored e-cigarettes. For example, the American Lung Association stated: "We are deeply troubled that these important safeguards were stripped in this way when FDA repeatedly demonstrated that the science shows flavored products appeal to youth and young adults." 

The Campaign for Tobacco-Free Kids stated: "It is deeply disappointing that the White House missed this opportunity to protect our nation’s children by deleting this provision to remove candy- and fruit-flavored e-cigarettes and cigars from the market."

Dr. Stan Glantz argued that the FDA should issue a rule that bans all flavored e-cigarettes immediately.

The Rest of the Story

There is no greater action that the FDA could take to promote cigarette smoking than to ban the use of flavors in e-cigarettes. And by supporting such a ban, the anti-smoking groups are essentially promoting cigarette smoking in the population.

Flavored e-cigarettes have helped literally hundreds of thousands of smokers to quit smoking and millions more to cut down substantially on the amount that they smoke. A ban on flavored e-cigarettes would have resulted in countless former smokers being forced to return to smoking and countless current smokers being unable to quit smoking due to their lack of interest in switching to a non-flavored or tobacco-flavored alternative product.

Without question, the most critical feature that makes electronic cigarettes attractive to adult smokers and allows them to compete with deadly tobacco cigarettes is that they offer a broad array of flavors, providing ample choice so that every smoker can find a flavor that is particularly attractive. Without flavors in e-liquids, vaping would lose most of its appeal for most of its users and would largely wither away. Jacob Sullum has pointed out that 77% of vapers prefer flavored products. To be sure, a ban on flavored e-cigarettes would have amounted to a de facto ban on all e-cigarettes and would have caused tens of thousands of former smokers to return to cigarette smoking.

That supposedly anti-smoking groups are supporting a policy that is the single most effective step that the FDA could take to promote cigarette smoking in the United States is unfortunate, sad, and disillusioning. Clearly, the anti-smoking groups care more about kids (most of whom are already tobacco users) experimenting with flavored vaping products than with smokers dying of cancer, lung disease, heart disease, stroke, and peripheral vascular disease.

After pain-staking analysis, I have come to several conclusions about why anti-smoking groups are now ironically promoting smoking:

1. Electronic cigarettes represent a huge threat to their ideology. There is simply no room for a nicotine-containing product that could actually help improve people's health.

2. E-cigarettes are also a threat because it destroys the anti-smoking ideology to think that a person might actually derive some enjoyment from nicotine without it killing them.

3. It is unacceptable for people to be using a nicotine product that does not kill them because it doesn't allow for punishment of what is seen as this bad moral choice. In contrast, continued high levels of smoking are tolerable because these nicotine addicts are being punished for their poor behavior.

4. The "save the smoker" argument does not bring in donations, while the "save our children" appeal allows anti-smoking groups to continue to produce effective financial appeals to their constituents.

5. E-cigarettes not only threaten to make smoking obsolete, but to greatly reduce the use of pharmaceutical products, harming companies with which numerous anti-smoking groups have significant financial relationships.

6. Actually making smoking obsolete would essentially put anti-smoking groups out of business. Ensuring that vaping remains at the margins of society helps ensure that anti-smoking professionals continue to have jobs. Vaping products would actually make a cigarette "end-game" possible because they provide an alternative to smokers, easing concerns about the development of a cigarette black market. Thus, vaping actually does pose a threat to a continued high availability of jobs in tobacco control.

Fortunately, the OMB listened to my advice (and similar advice from thousands of vapers, harm reduction scientists and advocates, e-cigarette distributors, retailers, manufacturers, and consumer advocacy groups, and even the tobacco companies) and decided that promoting cigarette smoking is not an appropriate action for a public health agency like the FDA to take.

The former anti-smoking groups will continue to push for a ban on flavored e-cigarettes, and I will continue to everything in my power to oppose and prevent such a regulation from being promulgated and approved.