Alaska Health Department Airs First Pro-Smoking Television Ad Since 1970

Since 1970, the television airwaves have been clear of pro-smoking advertisements. That is, until recently, when the Alaska Department of Health and Social Services began running a television spot that undoubtedly promotes smoking by strongly discouraging smokers who might otherwise quit from using electronic cigarettes. The commercial will likely also cause ex-smokers who have quit via electronic cigarettes to return to cigarette smoking. Worst of all, the commercial lies to the public by attributing to electronic cigarette diseases for which there is no evidence of an association with vaping.

The text of the commercial reads as follows:

"What's in an e-cig cloud? ... Nicotine, just like the other cigarettes. Ultrafine particles that can lead to asthma. Embalming fluid. Ugh. Lead. Doesn't that cause brain damage? Nail polish remover. ... Don't let Big Tobacco cloud your judgment."

The Alaska state health department also provides a fact sheet which implies that electronic cigarettes are no safer than real cigarettes. The health department justifies this conclusion based on a single study, which tested the effect of electronic cigarette vapor on bronchial cells in cell culture.

The Rest of the Story

There is no doubt that this commercial is extremely misleading and that it contains false information. It is designed to scare people so much about the health effects of vaping that they essentially view these products as no different from tobacco cigarettes in terms of health risk. The ultimate effect of this campaign is that many smokers in Alaska who might otherwise have quit smoking or cut down substantially by switching to electronic cigarettes will be dissuaded from doing so. Moreover, many ex-smokers who successfully quit via the use of electronic cigarettes may well return to smoking, since it appears from the commercial that e-cigarettes are not better for your health than tobacco cigarettes.

Let's start with the information that is outright false. The commercial implies that electronic cigarettes can cause "asthma" and "brain damage." This is an outright lie. There is absolutely no evidence that electronic cigarettes cause asthma or brain damage. In fact, Dr. Riccardo Polosa and colleagues have shown that electronic cigarettes actually improve symptoms of asthma in smokers who either completely or even partially switch to these products. No study has ever shown that electronic cigarettes cause brain damage. What we do know is that switching to electronic cigarettes can substantially improve the health of smokers.

Now let's move to the information that is downright misleading. Telling the public that electronic cigarettes contain embalming fluid and nail polish remover is misleading because it belies the fact that e-cigarettes merely contain small amounts of the main components of those products. Someone who uses an electronic cigarette is not inhaling embalming fluid any more than someone who purchases a new sofa is inhaling embalming fluid.

To demonstrate how misleading and damaging this commercial is, consider the very same commercial applied to nicotine gum:

"What's in nicotine gum? ... Nicotine, just like cigarettes. And 4-(methylnitro-samino)-1-(3-pyridyl)-1-butanone, a powerful carcinogen that causes lung cancer. N-Nitrosonornicotine. Doesn't that cause esophageal cancer? Don't let Big Pharma cloud your judgment."

The above commercial text is just as scientifically valid as that provided by the Alaska health department. However, if the Department aired such a commercial, it is very clear that such a campaign would be terribly misleading. It would also be terribly damaging, because it would likely scare people who might otherwise quit using nicotine gum not to proceed with their quit attempt. And it might dissuade people who have already quit using nicotine gum from continuing the gum use, which could likely lead to their returning to smoking.

If the tobacco industry put out such an advertisement, there is no question that we in public health would be condemning the campaign and arguing that it is a pro-smoking campaign. Anti-smoking groups would likely try to have the commercial pulled off television on the grounds that it is pro-smoking and thus violates the intent of the 1970 ban on television advertising of cigarettes.

Now consider the very same commercial applied to the nicotine inhaler:

"What's in a nicotine inhaler? ... Nicotine, just like cigarettes. Nickel, a metal which has been shown to cause cancer, respiratory failure, and heart disorders. Lead. Doesn't that cause brain damage? Don't let Big Pharma cloud your judgment."

Once again, the commercial text is just as scientifically valid as that provided by the Alaska health department. However, if the Department aired such a commercial, it is very clear that such a campaign would be terribly misleading. It would also be terribly damaging, because it would likely scare people who might otherwise quit using a nicotine inhaler not to proceed with their quit attempt. And it might dissuade people who have already quit using the nicotine inhaler from continuing the inhaler use, which could likely lead to their returning to smoking.

And once again, if the tobacco industry put out such an advertisement, there is no question that we in public health would be condemning the campaign and arguing that it is a pro-smoking campaign. Anti-smoking groups would likely try to have the commercial pulled off television on the grounds that it is pro-smoking and thus violates the intent of the 1970 ban on television advertising of cigarettes.

We could even run a similar commercial about the nicotine patch:

"What's in a nicotine patch? ... Nicotine, just like cigarettes. 4-(methylnitro-samino)-1-(3-pyridyl)-1-butanone, a powerful carcinogen that causes lung cancer. And doesn't that also cause lung immunosuppression? Don't let Big Pharma cloud your judgment."

Another untruthful aspect of the campaign is its denial that smoking is any more hazardous than vaping. Can you imagine if the tobacco industry made such a claim on a web site? The anti-smoking movement would be up in arms. How dare the tobacco industry undermine years of education about the hazards of cigarette smoking by telling the public that smoking may be no more hazardous than using an electronic cigarette. But this is exactly what the Alaska health department is doing.

My colleague Stan Glantz has praised the campaign, urging all other states to air the same commercial. However, I can't possibly condone a campaign that lies to the public, significantly misleads its audience, undermines years of public education about the health hazards of smoking, and has the effect of promoting smoking by discouraging smokers who would otherwise have quit using e-cigarettes not to do so.