Tuesday, September 27, 2016

FDA and CDC are Lying About the Most Basic of Facts; How Can We Trust Them on More Complex Issues?

Donald Trump is not the only one who needs some fact-checking. My analysis of the September 22 article by the CDC's Office on Smoking and Health and the FDA's Center for Tobacco Products reveals that these agencies are misleading the public by lying to them about the most basic of facts: namely, whether or not electronic cigarettes contain tobacco.

According to the article: "e-cigarettes were the most commonly used tobacco product by middle (3.9%) and high (13.4%) school students. Use of tobacco in any form, whether it be combusted, noncombusted, or electronic, is unsafe."

Clearly, the CDC and FDA are telling the public that e-cigarettes represent the "use of tobacco" in electronic form. But this is untrue. Electronic cigarettes do not contain any tobacco. In fact, that is what distinguishes them from conventional cigarettes and from all tobacco products. In contrast to tobacco products, which contain tobacco, electronic cigarettes do not contain tobacco.

If you can't get past that most basic point, then there is no point continuing the discussion any further.

The FDA and CDC go on to state that: "Regardless of mode of exposure to nicotine (inhaling, chewing, or electronic), such exposure during adolescence (a critical time for brain development) may have lasting adverse consequences for brain development. Nicotine exposure during adolescence also causes addiction and may lead to sustained use of tobacco products." While there is evidence that this is true for cigarettes, I'm aware of no evidence that the use of e-cigarettes causes abnormal brain development. Further, I'm aware of no evidence that e-cigarettes cause nicotine addiction or that they lead to sustained use of tobacco products.

The study reiterates that it is examining "curiosity about tobacco." But curiosity about e-cigarettes is not curiosity about tobacco. In fact, it is the exact opposite. It is curiosity about a non-tobacco product. It is curiosity about a tobacco-free product. If the FDA and CDC can't be trusted to make that critical distinction and to communicate it accurately to the public, then how can they be trusted to address more complex issues such as developing policies on cigarettes and e-cigarettes that are going to maximize the protection of the public's health?

The Rest of the Story

A number of my colleagues have suggested to me that although the FDA and CDC are not telling the truth, the end goal of scaring kids into thinking that e-cigarettes are just as bad as cigarettes is a good one and will have a beneficial outcome, because it may help turn the tide of increasing experimentation with these products. I don't agree for three reasons:

1. Dishonesty is never justified in public health communication: The public health code of ethics requires that we be honest in our communications to the public. This is not simply an option that we have to consider among other possible options. This is an underlying principle that should not be discarded, even if we perceive that being dishonest may yield short-term public health gains.

2. Being dishonest risks losing public credibility and trust: Even if lying to the public - such as telling them that e-cigarettes are a form of tobacco use - were to produce short-term gains, these gains are far outweighed by the risk of doing long-term damage to the credibility and trust of public health. Once that credibility and trust are lost, it is not going to come back for a long time. And then, even when we do tell the truth, the public will not believe us.

3. The FDA and CDC's misleading the public about the fact that e-cigarettes contain no tobacco is actually having adverse public health consequences: Even if one were to throw concerns about honesty out the window, I don't believe that misleading the public by making them think that e-cigarettes are just another form of tobacco use has even short-term benefits. Conversely, by obscuring this critical difference between cigarettes and vaping products, this deception is leading many smokers to give up on attempts to quit smoking and it is causing many ex-smokers to consider returning to smoking because they don't see any benefit to vaping over smoking if they are simply alternative ways of using tobacco. Why continue vaping if it doesn't offer clear health benefits over smoking?

Would it kill the CDC or the FDA to once, just once, acknowledge that electronic cigarettes are tobacco-free products? I don't believe I have ever seen even a single communication, public statement, or article from either agency which acknowledges that e-cigarettes do not contain tobacco. This is absurd when you think about it because it is doing the greatest favor to cigarette profits that one could imagine: hiding the fact that there is a tobacco-free alternative which people can use by which they can avoid the use of tobacco as well as the combustion of tobacco.

The cigarette companies couldn't pay for a more effective marketing campaign to protect cigarette sales against competition.

1 comment:

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