Monday, August 03, 2009

Oregon Attorney General Bans Electronic Cigarettes Because They Threaten the Health and Safety of Oregonians

Action on Smoking and Health Urges 49 Other Attorneys General to Follow Suit

The Oregon Department of Justice moved Thursday to ban the sale of electronic cigarettes in Oregon. The Department filed two settlements which prevent two travel store chains from selling electronic cigarettes.

According to an article on the KTVZ web site: "The Oregon Department of Justice filed two settlements Thursday that prevent two national travel store chains from selling "electronic cigarettes" in Oregon. The action is the first of its kind in the country and prevents Oregonians from buying potentially dangerous products that the U.S. Food and Drug Administration has yet to approve. "When products threaten the health and safety of Oregonians, we will take action," said Mary Williams, deputy attorney general. "If companies want to sell electronic cigarettes to consumers, they have to be able to prove they are safe." The affected travel store chains, Pilot Travel Centers, which has seven centers in Oregon, and TA Operating, which has four centers in Oregon, both sell "NJOY" brand electronic cigarettes. ... The settlement announced Thursday prohibits the sale of electronic cigarettes in Oregon until they are approved by FDA, or until a court rules the FDA does not have the authority to regulate electronic cigarettes."

The national anti-smoking group Action on Smoking and Health (ASH) issued a press release urging all 49 other Attorneys General to follow suit by also banning the sale of electronic cigarettes in their states. ASH warned the public about "the known dangers of electronic cigarettes."

According to the press release: "ASH, which in the past successfully urged state attorney generals to crack down on the illegal sale of cigarettes over the Internet, and to take action against the use of cartoon characters in cigarette ads, is providing the attorneys general with background information about the known dangers of e-cigarettes...".

ASH put forward a scientific argument that any reduced health risks resulting from the elimination of the toxins in tobacco smoke would only apply to cancer, not heart disease.

Specifically, ASH wrote: "Current smokers at elevated risk for cardiovascular problems may switch to e-cigarettes, thinking that they are far safer. But actually any decrease in health risk relates to cancer (since e-cigarettes reportedly contain far fewer carcinogens), and not to cardiovascular problems (as to which nicotine is the main culprit)."

The Rest of the Story

The rest of the story is that the Oregon Department of Justice is full of crap. They boasted to the public that "When products threaten the health and safety of Oregonians, we will take action." However, they announced no action last Thursday to protect the health and safety of Oregonians from the threat posed by tobacco cigarettes.

If the Oregon Department of Justice were honest in stating that whenever products threaten the health of Oregonians, they will take action, then they would certainly have taken action against the leading cause of preventable death in Oregon: tobacco cigarettes, which have been documented to kill more than 5,000 Oregonians each year.

Instead of having the courage, integrity, and honesty to tackle a proven health threat in the state of Oregon, the Department of Justice has chosen to ban a product which has not been documented to pose any substantial health risk to Oregonians, and which most likely is helping to avert significant disease and mortality in the state by keeping many of its residents off of cigarettes.

What the Oregon Department of Justice is saying is that they would rather have Oregonians smoke cigarettes -- with their more than 10,000 chemicals and 57 carcinogens -- than inhale electronic cigarette vapor, which has not been shown to deliver any of those 10,000 chemicals or 57 carcinogens in anything more than trace quantities.

From a public health perspective, this is the most absurd, non-science-based, and potentially damaging policy decision by a state government that I have witnessed in a long time.

ASH's petition to the other 49 states is equally absurd and non-science-based. However, what makes ASH's action even worse is that they are being dishonest in their presentation of the scientific facts. It is one thing to state its policy preference. But to present the Attorneys General with a serious misrepresentation of scientific facts - a severe factual inaccuracy in its assertion of the science - is unacceptable.

Specifically, ASH is being dishonest in its assertion that removing the tobacco-related chemicals from electronic cigarettes will only reduce cancer risk, not the risk of cardiovascular disease.

ASH asserts that nicotine is the main culprit of cardiovascular disease and that inhaling the nicotine without the 10,000 or more other chemicals will not reduce the risk of cardiovascular disease. This is demonstrably false. While nicotine is one chemical in tobacco smoke that is thought to contribute to the atherogenic properties of cigarette smoking, it is not the only one. Carbon monoxide, for example, is thought to contribute to cardiovascular disease. In addition, the particulate components of tobacco smoke almost certainly lead to an increase in cardiovascular disease risk. Moreover, smoking causes changes in cholesterol which increase heart disease risk but are almost certainly not attributable to the presence of nicotine.

This is not to say that removing the 10,000 or more chemicals in tobacco smoke - other than the nicotine - makes electronic cigarettes risk-free in terms of cardiovascular disease. But it does mean that electronic cigarettes do reduce the risk of heart disease compared with conventional ones. ASH's scientific claim in this case is baseless.

The fact that a baseless scientific claim is being used to support a policy action is much more problematic than if ASH were simply supporting a policy based on a strong theoretical argument that could be true. In this case, the argument is demonstrably untrue.

ASH's other major claim - that electronic cigarettes represent a known danger - is unsupported by scientific evidence. The only two pieces of information that have been put forward to support the claim that electronic cigarettes are a known hazard are: (1) the presence of carcinogens in e-cigarette cartridges; and (2) the presence of diethylene glycol in one cartridge.

However, the carcinogens are present in trace levels, lower than those allowed by the FDA in nicotine replacement products and 1400 times lower than the level in a Marlboro cigarette. There is no known danger of cancer at this low level of exposure.

The diethylene glycol has not been shown to actually be inhaled by the vaper. Thus, it remains to be seen whether this represents a known danger or not. More importantly, this contaminant was only found in one cartridge and there is no evidence that it is present in potentially dangerous quantities in the majority of cigarette brands. Diethylene glycol was not present in the cartridges of the e-cigarette brand which the Oregon Department of Justice removed from the market.

If ASH wants to talk about the potential dangers of electronic cigarette use, that's fair game; but to talk about the "known" dangers is disingenuous, if not an outright false representation of the science.

The only "known" danger of electronic cigarettes would be the possible risk of heart disease with long-term use. However, ASH and the Oregon Attorney General seem to have forgotten that these products are being marketed to cigarette smokers. So "known" dangers need to be interpreted in comparison to the "known" dangers of cigarette smoking. It simply cannot be contested that e-cigarettes are a much, much safer alternative compared to tobacco cigarettes. Even from the perspective of nicotine itself, which is delivered in much more potent doses in the conventional cigarette.

In President Obama’s inauguration speech, he promised to “restore science to its rightful place.” He was clearly making a promise that policy would be science-based, not driven by purely ideological tenets or political concerns. Through its action of banning electronic cigarettes but allowing the real ones to remain unscathed on the market, the Oregon Department of Justice is institutionalizing, rather than ending, the triumph of politics over science in policy making. This is not the way to restore science to its rightful place.

I'll close with the words of an electronic cigarette user in Oregon who summarizes the rest of the story better than I possibly can: "I live in Oregon. I use e-cigarettes, personal vaporizers. After smoking tobacco for over 35 years, I haven't had more than 10 tobacco cigarettes in the last 4 months. Now 'my' Attorney General wants to protect me by preventing me from using a device that allows me to use nicotine and nicotine only. He would rather I use tobacco and all its 4000+ carcinogens. I could do without that kind of protection."

To which I would respond: It's not health protection. It's politics.

No comments: