Why I Am Doing This: A Message from an Electronic Cigarette Smoker

Dear Dr. Siegel:

Last Feb 2011 my lung function was measured at 60% and blood/oxygen was dangerously low. I then tried E-Cigs and have not had a tobacco cigarette since. I now have normal lung function and high normal oxygen levels despite the fact that I had smoked for more than 45 years and never could quit. I was killing myself and nothing but e-cigs had ever helped. I admit to being addicted to the e-cig but I believe that they saved my life and want to help as many as possible learn the truth about E-Cigs. If E-Cigs were outlawed, I have no doubt that I would once again take up smoking and start down that dark path again.

The Rest of the Story

Let me first note that this is not the only letter I have received from an electronic cigarette user who has successfully quit smoking and written to express thanks for my willingness to disseminate the truth about the relative health risks of these products compared to regular tobacco cigarettes. In fact I have probably received nearly one hundred similar letters, of which this one is typical.

Let me also note that not once in my career have I ever received a letter from a nicotine patch user, expressing his or her relief and gratitude that nicotine replacement therapy helped to quit smoking and resulted in immediate, measurable improvement in their lung function.

Of course, these anecdotes - in and of themselves - do not constitute valid evidence for making public policy decisions regarding these products. However, the letters are important because they do demonstrate the kind of public health benefits which electronic cigarettes are providing to literally thousands of ex-smokers. This is a critical piece of information which I believe has not adequately been considered by those anti-smoking groups and researchers which have called for the removal of electronic cigarettes from the market, and/or for a stringent regulatory procedure to be put in place before electronic cigarettes are approved for sale.

This truly is the rest of the story, because it's not something that you're going to hear about on anti-smoking web sites, or read about in newsletters sent out by the major national, state, or local anti-smoking organizations. You're only going to hear about stories like this if you seek them out and/or if you are willing to entertain this type of evidence.

Sadly, many tobacco researchers and anti-smoking groups do not consider smokers to be a valid source of information (not worthy of providing useful information, not worthy of holding a job, you get the picture). So this type of anecdotal information has almost completely escaped the radar screen of the official anti-tobacco movement.

I can assure readers that I am always ready to listen to personal accounts, and that this type of anecdotal evidence plays a critical role in informing me about important scientific and policy issues. In the case of electronic cigarettes, the anecdotal information is abundant enough to make it clear that removing electronic cigarettes from the market, as recommended by a number of anti-smoking groups, would be a grave public health mistake, causing many vapers to return to smoking and to suffer substantial and immediate health effects.

While the clinical trial is the "gold standard" of scientific knowledge, it is only one of many ways of knowing. Case studies, case series, and clinical anecdotes play (and have always played) a major role in medical knowledge. They occupy an important place in the overall development of medical knowledge, and can no longer be ignored by the anti-tobacco movement.