In a column published yesterday on the Bottom Line's Daily Health News, Dr. Steven Marcus, executive director of the New Jersey Poison Information & Education System, apparently accuses the tobacco companies of producing and marketing electronic cigarettes as a ploy to hook kids and deceive smokers into thinking that these devices are a safe alternative to smoking.
Dr. Marcus either writes or is attributed as arguing that: "In their ever-diabolical efforts to sell their dangerous wares, cigarette manufacturers and marketers have created a new smoke screen... electronic cigarettes, which are touted as a safe alternative to smoking. These are small, battery-powered, refillable devices that resemble traditional cigarettes but don’t actually burn tobacco. While the product is said to contain "only" pure nicotine (which is unsafe), a recent FDA analysis indicates nicotine is not the only danger they present ... The new "fake cigarettes" supposedly contain just liquid nicotine -- but a recent FDA report found nitrosamines in half the samples from the two leading brands tested. Dr. Marcus made it a point to say that "you should not get nitrosamines unless you burn something" and that "these things are not supposed to burn." Nitrosamines are the key carcinogens in tobacco. So the question is, if there is nothing burning in e-cigarettes, then where do the nitrosamines come from?"
The Rest of the Story
There's just one problem with this health column.
E-cigarettes are not produced and marketed by tobacco companies. Big Tobacco has nothing to do with them. In fact, these products are a great threat to Big Tobacco, because they are the first products on the market which actually pose a serious threat in terms of getting people to quit smoking.
Nicotine replacement products pose very little threat to tobacco companies because only about 8% of smokers who use these products are successful in quitting. But anecdotal reports suggest that electronic cigarettes are far more effective in achieving smoking cessation. So Dr. Marcus couldn't be further from the truth.
As far as where the nitrosamines come from, it's quite simple. The nicotine is extracted from tobacco, and trace levels of nitrosamines are present in the extracted nicotine. The same thing is true of nicotine gum and nicotine patches, which also contain trace levels of nitrosamines.
So while Dr. Marcus appears to challenge the assertion by e-cigarette distributors that these smoking alternatives do not contain tobacco, are not tobacco products, and do not involve the combustion of any material, the truth is that they contain no tobacco and they deliver nicotine through a vaporization, not a combustion process.
What Dr. Marcus doesn't reveal, in discouraging Garden State smokers to stay away from these dangerous and toxic e-cigarettes, is that traditional cigarettes contain up to 1400 times higher concentrations of nitrosamines (not to mention the other 40+ carcinogens) than e-cigarettes. He also doesn't mention the fact that nicotine replacement products also contain nitrosamines.
Shouldn't he, then, also be discouraging smokers from using NRT products? Shouldn't he also be warning smokers about the toxic and dangerous nature of nicotine gum, nicotine patches, and nicotine inhalers?
It's one thing to give out inappropriate health advice (suggesting that ex-smokers who have successfully quit using e-cigarettes discontinue using these devices is inappropriate, as most of them will return to cigarette smoking which will likely severely harm their health). But to give out inappropriate health advice based on completely untruthful information seems irresponsible as well.
Unfortunately, Dr. Marcus is not necessarily to blame. The FDA has given out misleading information to the public which likely led to Dr. Marcus' confusion. The FDA alarmed e-cigarette users by warning them about the carcinogens present in the product. But the FDA failed to provide the context for its pronouncement: it failed to mentiont that the levels of carcinogens were trace levels, that the same trace levels are found in nicotine replacement products, and that conventional cigarettes contain levels of these carcinogens that are orders of magnitude higher.
It's hard to blame physicians like Dr. Marcus when a reputable source of information like the FDA is disseminating misleading and deceptive information.
Or perhaps Dr. Marcus got his information from an anti-smoking group, like Smoke Free Wisconsin, which has still failed to correct its own false accusation against the tobacco companies: Smoke Free Wisconsin also claimed that Big Tobacco was marketing e-cigarettes as a ploy to hook kids, and continues to do so to this day, even though I have informed the group that it is wrong.
You will also see that numerous commenters have made it clear to Smoke Free Wisconsin that its claim is untruthful. But that has not stopped Smoke Free Wisconsin from continuing to advance its false claim. Apparently, the truth is threatening to this anti-smoking group because it ruins what would otherwise have been a juicy story. But since this is anti-tobacco, the truth doesn't matter anyway. It's all for a good cause.
Except that in this case, it's not for a good cause. The move to ban e-cigarettes from the market is a bad cause, because doing so would significantly harm the health of hundreds of thousands of ex-smokers who would be forced to return to cigarette smoking.
So in this case, we can't even claim that the lies are acceptable because they are for a good cause - helping improve the public's health. This is one case where we're lying and we're working to harm the public's health all at the same time.
One or the other would have been hard to take - but both together is hard for me to accept.