The California Department of Health Services (CDHS), under a grant funded by the Centers for Disease Control and Prevention (CDC), has produced a brochure entitled "Protect Your Family from E-Cigarettes: The Facts You Need to Know."
Here are some of the "facts" being disseminated by the CDHS:
1. "The aerosol is a mixture of chemicals and small particles that can hurt the lungs just like cigarette smoke."
2. "E-cigarettes are just as addictive as regular cigarettes."
3. "People can become addicted to nicotine from e-cigarettes and they may start using regular cigarettes."
4. "Studies show that e-cigarettes do not help people quit smoking cigarettes."
The Rest of the Story
The California Department of Health Services is lying to the public. Here is a brief analysis of each statement and an evaluation of its validity:
1. "The aerosol is a mixture of chemicals and small particles that can hurt the lungs just like cigarette smoke."
EVALUATION: Unsupported by scientific evidence
While it is true that there are a small number of chemicals in the aerosol of many electronic cigarette brands and there are certainly small particles, at present there is no evidence that these small particles can hurt the lungs just like cigarette smoke. In fact, there is strong evidence that electronic cigarette use does not produce the kinds of decrements in lung function observed with cigarette smoking.
2. "E-cigarettes are just as addictive as regular cigarettes."
EVALUATION: A lie
It has been quite convincingly shown that electronic cigarettes are not nearly as addictive as regular cigarettes. The nicotine delivery from e-cigarettes is quite poor and inconsistent in most brands. The delivery of nicotine from e-cigarettes is much lower than in regular cigarettes. Patterns of use of the product, especially among youth, demonstrate that the addictive power of e-cigarettes is much lower than that of tobacco cigarettes.
3. "People can become addicted to nicotine from e-cigarettes and they may start using regular cigarettes."
EVALUATION: Unsupported by scientific evidence
It has not yet been demonstrated that people can become addicted to nicotine from e-cigarettes. Certainly, people who are already addicted to nicotine from smoking may remain addicted to nicotine when they switch to electronic cigarettes. But there is as yet no evidence that nonsmokers who try e-cigarettes are at significant risk of becoming addicted to nicotine. More importantly, there is no evidence that people who start out with e-cigarettes are progressing to cigarette smoking. In fact, existing studies have failed to find more than a couple of youths who have started smoking after having been introduced to nicotine for the first time through e-cigarettes.
4. "Studies show that e-cigarettes do not help people quit smoking cigarettes."
EVALUATION: A lie
In fact, the opposite is true. Studies show that e-cigarettes do help people quit smoking. The existing studies suggest that e-cigarettes are about as effective as nicotine replacement therapy. It is possible that newer products are more effective for smoking cessation, but at very least, we can say that these products do help many people quit smoking.
While I commend the California Department of Health Services for putting out a pamphlet that warns parents that e-liquids are poisonous and urges them to keep these products away from young children, I condemn the Department for blatantly lying to the public. In their apparent zeal to demonize electronic cigarettes, the California Department of Health Services has crossed the line into unethical public health conduct, breaking one of the key principles: communicate honestly with the public.
That federal revenue is being used to support the dissemination of these lies makes this conduct even more egregious. I urge the CDC to cancel this contract with CDHS on the grounds that the Department is violating basic public health ethics by lying to the public.
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