Friday, September 18, 2009

American Legacy Foundation Policy Would Result in Hundreds of Thousands of Ex-Smokers Returning to Cigarette Smoking, Aiding Big Tobacco

The American Legacy Foundation has joined the list of anti-smoking organizations which are pushing for the prohibition of the sale and marketing of electronic cigarettes. The Foundation has released a policy statement, which calls for the FDA to pull e-cigarettes off the market because Legacy claims that these products are not known to be "safe and effective."

According to the policy statement: "The FDA should take electronic cigarettes off the market until it is satisfied that they are safe and effective." Given that the average time it takes for drug companies to conduct clinical trials and demonstrate the safety and efficacy of their products is about 8 years, this would mean the removal of electronic cigarettes from the market for about 8 years.

The American Legacy Foundation expressed concern that "the FDA detected carcinogens, including nitrosamines. In other words, these analyses showed that the tested products contained detectable levels of known carcinogens and toxic chemicals."

The Rest of the Story

The rest of the story is that what the American Legacy Foundation is calling for is the return of hundreds of thousands of ex-smokers to cigarette smoking, and the return of a huge amount of lost profits to Big Tobacco.

Given that a major goal of the American Legacy Foundation is to encourage smokers to quit and keep them off cigarettes, it is quite ironic that Legacy would support a policy that would do exactly the opposite: force hundreds of thousands of vapers to return to analog cigarettes.

Legacy has long had a problem with hypocrisy: as I reported on this blog, it partnered with organizations that were the chief causes of youth exposure to smoking in movies at the same time as it decried the problem of smoking in movies. It gave an award to the very company that was responsible for delivering cigarette ads to millions of children at the same time as it bemoaned the problem of youth exposure to cigarette ads in magazines.

Now, the hypocrisy is more serious, because if the policy is adopted, it will actually result in the loss of lives. On the one hand, Legacy wants smokers to quit and stay off of cigarettes. On the other hand, Legacy is telling hundreds of thousands of ex-smokers who have done exactly as they were told and gotten off cigarettes that they are going to have to return to cigarette smoking because there are traces of carcinogens in e-cigarette cartridges.

Am I getting this right? Legacy wants ex-smokers to return to cigarette smoking because the organization is worried about the fact that there are traces of carcinogens in electronic cigarettes. But the truth is that the regular cigarettes don't merely have traces of carcinogens, they are loaded with them, to the order of 1400 times higher a concentration of the very same carcinogens that were detected in e-cigarettes.

Given the known hazards of cigarette smoking and the disease and death that it causes, why is Legacy worrying about the merely hypothetical risk associated with a product that delivers nicotine but without the 10,000 plus other chemicals? Electronic cigarettes have been on the market for more than three years, and there are no known adverse effects. You would think that if there was some deep, dark secret about the product that was causing serious risk to users, we would have heard about it by now. We've certainly heard about the serious risk caused by Chantix, which is associated with death as an adverse side effect, yet the same organizations calling for a ban on e-cigarettes have no problem with Chantix remaining on the market.

Legacy has expressed concern that electronic cigarette cartridges were found to contain nitrosamines. But the levels of nitrosamines in e-cigarettes are miniscule, much lower than what is present in tobacco cigarettes, and on the order of what is present in approved products such as nicotine gum and nicotine patches. Studies have documented that there are detectable levels of nitrosamines in nicotine gum and patches, but I don't see Legacy calling for the removal of those products from the market.

If Legacy is truly concerned about exposure to nitrosamines, then the last thing in the world it should do is call for a ban on electronic cigarettes. The level of nitrosamines in Marlboros is 1400 times higher than in electronic cigarettes.

So what Legacy is saying to vapers makes no sense: "We are concerned about your exposure to nitrosamines. So we'd like you to return to a product that has 1400 times higher the level of nitrosamines for the next 8 years, while we do studies to determine whether the product that has only traces of nitrosamines is better for you than smoking your Marlboros. So keep puffing away on your Marlboros for the next 8 years, and if you're still alive after that, we'll let you know that it's OK to go back to the electronic cigarette."

There seems to be a lack of understanding of basic principles of toxicology, epidemiology, and biological science. There is simply no way that a product which contains traces of carcinogens - and no other known toxic chemicals - could be more dangerous than a product which contains high levels of more than 40 known carcinogens and delivers more than 10,000 chemicals in addition to the nicotine.

What about the diethylene glycol? The same diethylene glycol is present in regular cigarettes, so what sense does it make to tell vapers: "We're worried about diethylene glycol exposure, so return to your regular cigarettes, which contain diethylene glycol, even though your brand of e-cigarettes may not actually expose you to diethylene glycol."

If the real concern is over diethylene glycol, then why not simply ask the FDA to take off the market those brands of e-cigarettes that contain diethylene glycol? That would pretty much solve that problem, no? Why force all vapers to return to cigarette smoking when there is only one brand of e-cigarettes that has been found to have this problem? Why not simply test all the brands and then force the companies selling brands with diethylene glycol to stop selling their products until they get rid of it?

And by the way, it is troubling that Legacy is making a big fuss over diethylene glycol detected in one cartridge of electronic cigarettes (without any evidence that the diethylene glycol makes its way into the vapor that is actually inhaled), yet Legacy has issued no concern about, and no warning to smokers about the diethylene glycol that we know smokers are inhaling and which is actually known to be present in the inhaled smoke.

If Legacy wants to do something that may actually improve the public's health, rather than increase disease and death by forcing ex-smokers to return to cigarette smoking, how about putting out a public relations campaign telling smokers that they are breathing in an ingredient found in anti-freeze?

Why is the diethylene glycol only a concern to Legacy when present in the non-tobacco cigarette, but not when present in the tobacco cigarette? Shouldn't we be sounding the alarm to smokers that they are inhaling a component of anti-freeze? Why only spread this alarm among people who have already succeeded in quitting smoking? And if we're trying to protect people from inhaling diethylene glycol, what point is there in telling vapers to return to cigarette smoking, where we know that they will be exposed to diethylene glycol?

And lest anyone argue that removing e-cigarettes from the market will result in vapers deciding to give up nicotine products completely, the vapers themselves have made it very clear that this is not the case. Anyone who believes that pulling e-cigarettes from the market will result in hundreds of thousands of vapers successfully becoming completely abstinent from nicotine may be interseted in purchasing a bridge down in lower Manhattan.

What is so disturbing to me about this policy statement from Legacy is not that it takes the position of calling on the removal of e-cigarettes from the market, but that it is based on such a complete misunderstanding of science, such an ignorance about the reality of what is going on in the world out there, and such a misrepresentation of the demonstrable facts about what FDA's lab testing - and other lab testing of e-cigarettes - has actually revealed.

By calling on the removal of e-cigarettes from the market, the American Legacy Foundation is greatly undermining its own goal of promoting smoking cessation and it is providing tremendous assistance to Big Tobacco in getting hundreds of thousands of former customers to return to their smoking addiction, and to return to padding Big Tobacco's pockets. The tobacco companies could not possibly be happier with their supporters at the American Legacy Foundation.

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