Wednesday, November 09, 2011

New York Times Article Highlights Absurdity of Anti-Smoking Groups' Opposition to Smoking Cessation Via Electronic Cigarettes

An article by John Tierney in yesterday's New York Times highlights the absurdity of anti-smoking groups' opposition to smoking cessation via the use of electronic cigarettes.

Tierney first notes the results of a clinical trial on the use of electronic cigarettes as a smoking alternative. In that trial, which involved smokers who had little interest in quitting: "After six months, more than half the subjects in Dr. Polosa’s experiment had cut their regular cigarette consumption by at least 50 percent. Nearly a quarter had stopped altogether."

Tierney then notes that: "Though this was just a small pilot study, the results fit with other encouraging evidence and bolster hopes that these e-cigarettes could be the most effective tool yet for reducing the global death toll from smoking."

However, as Tierney reveals: "there’s a powerful group working against this innovation — and it’s not Big Tobacco. It’s a coalition of government officials and antismoking groups who have been warning about the dangers of e-cigarettes and trying to ban their sale. The controversy is part of a long-running philosophical debate about public health policy, but with an odd role reversal. In the past, conservatives have leaned toward “abstinence only” policies for dealing with problems like teenage pregnancy and heroin addiction, while liberals have been open to “harm reduction” strategies like encouraging birth control and dispensing methadone. When it comes to nicotine, though, the abstinence forces tend to be more liberal, including Democratic officials at the state and national level who have been trying to stop the sale of e-cigarettes and ban their use in smoke-free places. They’ve argued that smokers who want an alternative source of nicotine should use only thoroughly tested products like Nicorette gum and prescription patches — and use them only briefly, as a way to get off nicotine altogether."

"The Food and Drug Administration tried to stop the sale of e-cigarettes by treating them as a “drug delivery device” that could not be marketed until its safety and efficacy could be demonstrated in clinical trials. The agency was backed by the American Cancer Society, the American Heart Association, Action on Smoking and Health, and the Center for Tobacco-Free Kids. ... they cite an F.D.A. warning that several chemicals in the vapor of e-cigarettes may be “harmful” and “toxic.” But the agency has never presented evidence that the trace amounts actually cause any harm, and it has neglected to mention that similar traces of these chemicals have been found in other F.D.A.-approved products, including nicotine patches and gum."

The article cites me as stating: "It boggles my mind why there is a bias against e-cigarettes among antismoking groups."

The Rest of the Story

While it does continue to boggle my mind, I have come upon two potential influences that may at least explain the anti-smoking groups' positions.

First, they appear to share an ideology by which it is impossible to acknowledge that anything good could come out of the use of something called a "cigarette" or by an action that looks just like "smoking." Even when abundant evidence suggests that such a product is helping thousands of ex-smokers to stay off of cigarettes and that the product is much safer than smoking, the ideology of these groups appears to blind them to the overall public health benefits of these products.

Second, nearly every one of the anti-smoking groups which opposes e-cigarettes and which called for their removal from the market has received money from pharmaceutical companies that manufacture competing smoking cessation drugs. This bias is, I think, acting subconsciously to cloud these groups' perspectives on the data, the science, and the policy issues. Electronic cigarettes represent a substantial potential threat to the profitability of existing smoking cessation medications and could have implications for sales of these existing products on the order of billions of dollars.

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