Thursday, November 19, 2009

Physicians Group Supports Electronic Cigarettes for Smoking Cessation and Challenges Opponents to Justify their Condemnation of the Product

The American Association of Public Health Physicians (AAPHP) has challenged opponents of electronic cigarettes to justify their condemnation of this product given that the FDA's study of these devices found that they contain only miniscule levels of carcinogens, compared to the high levels present in traditional cigarettes.

According to a press release issued earlier this week: "In July of this year, the Food and Drug Administration released a study that condemned electronic cigarettes as an unsafe alternative for smokers, but not all physicians are convinced that the study was accurate or even completely transparent to the tax payers that fund them. "We urge FDA to make public the laboratory data behind the July 22 condemnation of electronic cigarettes, along with comparable data on pharmaceutical nicotine products and conventional cigarettes. Then, on the basis of these data, either fully justify or retract the July 22 condemnation of electronic cigarettes," says Joel L. Nitzkin, Chair of the American Association of Public Health Physicians Tobacco Control Task Force in a letter to the FDA."

"The letter specifically targets the new tobacco legislation that passed through Congress this summer which gives the FDA power to regulate tobacco products in the United States and notes that the success rate of current smokers who attempt to quit by using pharmaceutical aids is as low as 5%. Making smokers more aware of less harmful alternatives, snus and e-cigarettes included, could significantly reduce the amount of smokers who die due to tobacco-related illnesses."

"The message the AAPHP is sending to the FDA is a clear one and that is that electronic cigarettes are not the wildly dangerous alternatives that they have been portrayed as in news publications and on television, but perhaps one of the best products available for current smokers to switch to. Only time will tell if the FDA will retract their July study in favor of a more complete one or if smokers will continue to be limited to only products offered by big tobacco or big pharma with no explanation."

The Rest of the Story

I applaud the AAPHP for taking this strong and science-based stand, which contrasts with the ideology-driven positions that have been taken by a number of anti-smoking groups that have called for the removal of electronic cigarettes from the market, despite clear evidence of their utility in helping smokers quit and their relative safety compared to cigarettes. As I have mentioned previously, every one of these anti-smoking groups, it turns out, has received funding from pharmaceutical companies and thus have a conflict of interest -- none have disclosed this conflict.

In contrast, the AAPHP position is based not on pure ideology, but on the science, which clearly indicates that electronic cigarettes are a far safer alternative to regular cigarettes and that they appear to be effective in helping highly resistant smokers to quit successfully.

The anti-smoking groups' condemnation of electronic cigarettes is based largely on the FDA's laboratory findings, which actually indicated that e-cigarettes are much safer than regular ones because they contain miniscule levels of carcinogens, while cigarettes contain very high levels of a large number of carcinogens. The level of tobacco-specific nitrosamines is reduced by a factor of up to 1400, indicating a substantial degree of relative safety compared to smoking.

Taking electronic cigarettes off the market is the worst single thing we could do to harm the public's health. Hundreds of thousands of vapers would be forced to return to cigarette smoking and they would therefore suffer a deterioration in their health. How is that a good thing for the public's health? So far, none of the anti-smoking groups have answered this question.

Another thing that none of the anti-smoking groups have done is to disclose their conflicts of interest with Big Pharma, a failure which I believe is unethical. Financial interests in pharmaceutical companies which rely upon smoking cessation drugs for substantial profits are quite relevant to policy regarding e-cigarettes because these products represent a huge threat to the financial well-being of these companies. E-cigarettes represent a huge potential threat to Big Pharma, because they appear to be much more effective than pharmaceutical smoking cessation products.

A final thing that none of the anti-smoking groups has done is to meet my challenge of naming even one specific hazard that e-cigarettes likely pose to vapers. While the damage that would be done to the health of huge numbers of vapers if e-cigs are taken off the market is definite, the health damage that is supposedly being done to vapers from using e-cigarettes is purely speculative and completely hypothetical.

The anti-smoking groups don't appear to want to address the specific scientific issues, probably because they have little ground upon which to stand. Instead, they insist on diverting the issue to talk about anti-freeze, children shelling out $90 to buy e-cigarette kits, and dangerous carcinogens present in e-cigarette cartridges (without mentioning that the levels of these carcinogens are trace levels, and orders of magnitude lower than in cigarettes, confirming their relative safety).

When groups make national policy recommendations without a willingness to actually address the science, you know we've got a problem. Never is that more apparent than with the issue of electronic cigarettes.

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