On his blog, Professor Stan Glantz, a highly respected researcher in the anti-tobacco field (and a former mentor, role model, and hero of mine), has posted a set of slides with the title "E-cigarettes Increase Harm to Smokers, So Should Not Be Promoted as a Harm Reduction Strategy."
In the presentation, Dr. Glantz claims that: "There is now a large scientific literature that, in fact, e-cigarettes increase rather than reduce harm, which moots industry arguments that they should be promoted as a part of modern tobacco control."
He goes on to argue that: "The tobacco industry and its allies continue to use claims of reduced harm to argue against applying strong tobacco control policies to e-cigarettes and other noncombusted tobacco products. For example, there is an aggressive lobbying effort to convince delegates to the 11th Conference of the Parties for The WHO Framework Convention on Tobacco Control to embrace e-cigarettes and other so-called smoke free tobacco products as part of tobacco control."
The Rest of the Story
There are three disturbing things about Dr. Glantz's presentation.
First, it misrepresents the scientific evidence. There is a large body of scientific and clinical evidence that switching from smoking to vaping substantially improves health. Clinical studies have demonstrated that there is an almost immediate improvement in respiratory symptoms and in objective lung function, measured by spirometry. Any vaper who has switched from smoking to vaping can tell you this. It has been experienced by literally millions of people. To suggest that e-cigarettes increase harm is not only false but I think irresponsible. There is abundant evidence that quitting smoking brings substantial health benefits - both in the short-term and long-term - and despite the statements of anti-tobacco organizations, switching from smoking to vaping is quitting.
While it is true that smokers who only partially substitute e-cigarettes for real cigarettes do not reap the health benefits of those who are able to quit smoking, there is no convincing evidence that dual use increases the harms from smoking. The idea that any benefits from people quitting by switching to e-cigarettes is more than offset by increased harms of dual use is not grounded in rigorous science.
Moreover, the presentation denies that even if one only considers smokers who completely switch to vaping, there is an improvement in health. It does, however, provide a well-grounded, evidence-based and scientifically confirmed explanation for why quitting smoking by using e-cigarettes does substantially improve health: "They [e-cigarettes] generate the nicotine aerosol that users inhale by heating a liquid rather than burning tobacco, so users are not exposed to many toxic combustion products so people who switch completely from cigarettes to e-cigarettes would be better off." Yes, exactly.
Second, the presentation is disturbing because by arguing that vaping increases harms for smokers, it discourages smokers from quitting and is likely to have the effect of actually advising smokers not to quit. After all, if vaping is more harmful than smoking, as Dr Glantz claims, then a smoker is better off continuing to smoke than quitting and switching to e-cigarettes. Whether intended or not, this presentation is essentially providing medical advice to smokers that they are better off continuing to smoke if they are unsuccessful using NRT or other pharmaceutical methods and should not quit by switching to vapes even if they are interested in doing so.
Third, and perhaps most disturbing, is that the presentation portrays anyone who argues that smoking is more hazardous than vaping as "the tobacco industry and its allies." In other words, you can't possibly be an independent scientist who happens to believe the evidence showing that smoking is more hazardous than vaping. If that's what you believe, then you are either part of the tobacco industry or an ally of the tobacco industry.
This is exactly the kind of attitude that is leading to the polarization that we see in America today. You're either in the in-group or the out-group and your policy attitudes automatically put you in one group or the other. There's no nuance. There's no middle ground.
I can state unequivocally that I am neither part of the tobacco industry nor am I a tobacco industry ally. Yet I believe, as a scientist with 40 years of experience in studying smoking, that cigarette smoking is more dangerous than using a vape that contains no tobacco and involves no combustion and has only a few chemicals as opposed to the more than 10,000 present in tobacco smoke. Because of that belief, I am apparently now an ally of the tobacco industry - an industry against which I testified in numerous lawsuits that resulted in punitive damage awards of more than $150 billion!
Not only is this attack on scientists who support harm reduction divisive and polarizing (and untrue) but it is also disrespectful. It is an insult to the many researchers and distinguished professors throughout the country and the world who have concluded, based on a multitude of evidence, that cigarette smoking is more hazardous than vaping. It is dangerous to define someone's identity and industry affiliation based solely on their scientific opinions. There's no need for this divisiveness, polarization, and disrespect. One can offer their opinion without disparaging an entire group of academics who are dedicating their careers to trying to save people's lives and who have no affiliation whatsoever with the tobacco industry.
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