American Lung Association's Lies About E-Cigarettes are Dangerous and Irresponsible

Earlier this week, I revealed that, ironically, in a campaign attacking e-cigarette companies for lying to the public, the American Heart Association was itself lying to the public by asserting that e-cigarettes cannot help smokers quit.

Today I reveal that, not to be outdone, the American Lung Association is lying even more blatantly to the public and in a way that is not only irresponsible but dangerous for the public's health.

In a press release issued yesterday, the American Lung Association made the following claims:

• Cigarette smoking is no more hazardous than using e-cigarettes.
• E-cigarettes cannot help smokers quit.
• If you have switched completely from smoking to using e-cigarettes, you have not quit smoking.
• The use of e-cigarettes has caused recent hospitalizations and deaths.

Specifically, the American Lung Association stated:

1. "While the e-cigarette industry tells smokers falsely that switching to their products is safer and can help them quit, the American Lung Association is urging the FDA to reject these false quit smoking claims, and is also urging smokers to "Quit, Don't Switch." 
2. "Switching to e-cigarettes does not mean quitting."
3. "One of the biggest problems with e-cigarettes is that many people have switched to e-cigarettes believing it will help them quit tobacco products, which it doesn't."
4. "E-cigarettes are tobacco products. No tobacco product is safe, and that includes e-cigarettes. Recent hospitalizations and deaths related to vaping underscore the fact that vaping is in fact harmful."  

In a separate fact sheet, the American Lung Association reiterates its assertion that if someone quits smoking by switching to e-cigarettes, they have not quit smoking: "Despite what Juul and e-cigarette companies want you to believe, switching to vaping (e-cigarettes) is not quitting smoking."

In the same fact sheet, the American Lung Association reiterates its claim that e-cigarette use is causing irreversible lung damage, as seen in the vaping-associated respiratory illness outbreak: "E-cigarettes still produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. As we’ve recently seen on the news, the inhalation of harmful chemicals can cause irreversible lung damage, lung diseases—and even death."

On another web page, the American Lung Association asserts even more definitively that e-cigarettes can cause irreversible lung damage, as has been seen in the recent EVALI outbreak: "While much remains to be determined about the lasting health consequences of e-cigarettes, there’s evolving evidence about the health risks of e-cigarettes on the lungs—including irreversible lung damage and lung disease."

The Rest of the Story

Ironically, all four of the assertions made by the American Lung Association are false, even though they are made in the context of criticizing the e-cigarette industry for lying to the public.

1. Cigarette smoking is no more hazardous than using e-cigarettes.

There is abundant evidence that smoking is much more hazardous than using e-cigarettes. Smoking kills more than 400,000 people each year, while the use of e-cigarettes has not been confirmed to have caused any deaths to date. Tobacco smoke contains more than 10,000 chemicals, including at least 60 known human carcinogens, while e-cigarette aerosol has been shown to contain only a few chemicals of concern and biological monitoring has demonstrated that smokers who switch to e-cigarettes have lower levels of toxins in their body and experience improvement in both cardiovascular and respiratory health.

2. E-cigarettes cannot help smokers quit.

A randomized clinical trial published in the New England Journal of Medicine demonstrated not only that e-cigarettes can help smokers quit, but that e-cigarettes were actually more effective than nicotine replacement therapy, which is typically viewed as the gold standard.

3. If you have switched completely from smoking to using e-cigarettes, you have not quit smoking. 

This is such an absurd statement that it hardly requires refutation. It is essentially stating that: "If you have quit smoking (using e-cigarettes), you have not quit smoking." A person who switches completely from smoking to e-cigarettes has quit smoking. They are no longer smoking. It's not clear what is so difficult to understand about that fact. If you have completely stopped smoking, then you have quit smoking.

4. The use of e-cigarettes has caused recent hospitalizations and deaths.

There is no solid evidence that e-cigarettes are responsible for any cases of the EVALI outbreak. The predominant cause is the vaping of THC and CBD cartridges that contain vitamin E acetate oil as a thickening agent. There is no evidence to support the assertion that traditional e-cigarettes, sold legally in retail stores, are responsible for the outbreak.

These lies are so egregious that it is difficult for me to explain why the American Lung Association is going to such lengths to deceive the public. The only explanation that seems plausible to me is that the American Lung Association simply cannot tolerate the concept that a device which is used similar to a cigarette and which delivers nicotine could possibly be helping people to quit smoking. This is apparently such a difficult concept for the American Lung Association to accept that they have gone to the extreme and nonsensical assertion that if you quit smoking using e-cigarettes, you have not actually quit smoking.

It appears that the American Lung Association is only prepared to acknowledge that a person has quit smoking if that person quits the way the ALA wants them to quit: using FDA-approved medications produced by Big Pharma companies with which the ALA has a financial relationship (and has had a long-term financial relationship, receiving hundreds of thousands of dollars). In the first two quarters of 2019 alone, the American Lung Association received $182,000 from Pfizer, the maker of Chantix, a smoking cessation drug that the American Lung Association is recommending that smokers use rather than e-cigarettes.

The American Lung Association simply cannot tolerate the thought that someone could use a product in a way that "looks like" smoking to quit smoking, even though it is much safer than smoking and has been shown to be a much more effective of quitting smoking than using a nicotine patch or other nicotine replacement products. E-cigarettes are currently the most effective strategy for quitting smoking for anyone who is unable to quit cold turkey (which is the overwhelming majority of smokers).

It's fascinating to me that the American Lung Association, whose goal is supposed to be to prevent lung disease, would be condemning vapers rather than congratulating them. This is rubbing vapers' noses in the ground and is extremely disrespectful to them. These are the very people whose stories the American Lung Association should be celebrating! These are the kind of successes that the American Lung Association should treasure.

The rest of the story is that the American Lung Association is acting in a way suggesting that protecting the public's health is not their most critical value. Their primary value seems to be purity: that is, freedom from any tobacco product. This suggests that they are viewing tobacco use on moral terms, not health ones. If you use tobacco products, you are a bad person. It is a character flaw. It is a vice that cannot be tolerated or accepted. You have to cleanse yourself completely or you remain tainted. Even if switching to vaping has saved your life!

This is not public health. It is some form of puritanism. But more importantly, it is a type of public health malpractice. Recommending that ex-smokers who are relying on vaping to keep them smoke-free stop vaping is tantamount to telling them to return to smoking, since that would be the practical effect if they actually took such advice. If a physician instructed a vaping patient to return to smoking, that would essentially be malpractice.

Whatever the biases or political views that are motivating the American Lung Association, it is clear that this organization is not in any position to be giving medical advice. And it certainly not in any position to be criticizing the e-cigarette companies for lying to the public.