Journalists Almost Get It Right
It's time to deconstruct some of the half-truths coming out in journalistic treatments of the e-cigarette issue.
Let's look at this pretty-good piece that came out in the LA Times last week: Jury is out on health effects of e-cigarettes.
LAT: "The answer is probably years away."
Large parts of the answer are in now. The only questions remaining are those of long term effects, because of course they require long term studies. Banning the product pending those answers will result in many more deaths, since potential quit attempts will be frustrated. And since the only uncertainty is about whether those effects are: 1. very much lower than cigarettes, or 2. completely negligible, the policy of banning pending results is a death-dealing strategy.
LAT: " 'There are a few studies out there right now, but scientists like to have a gazillion,' said Stanton Glantz, a professor of medicine and director of the Center for Tobacco Control at UC San Francisco."
The first quote from an expert is from one noted for an extreme anti-vaping stance. And of course waiting for "a gazillion" will consign many smokers to death in the interim, people who might have been able to quit with a harm reduction device.
LAT: " 'My big question with e-cigarettes is whether it puts youth on a pathway to smoking,' said acting Surgeon General Boris Lushniak."
The second expert quote is from another anti-vaping zealot. And indeed, we have the data to answer Lushniak's question in the negative (see below), but it is not mentioned here. LAT: "But without a renewed focus on the campaign against tobacco, the U.S. will miss its goal of reducing the national smoking rate to 12% by the end of the decade."
The prediction "the US will miss its goal" is assumed, not proven. The two contending strategies for meeting that goal: 1. more preachments from government nannies and 2. encouragement of harm reduction devices like e-cigarettes, are at the crux of the debate. The article is using one of the possible conclusions (the hoped-for one, it would seem) as a premise.
LAT: "E-cigarettes are uniquely positioned to undo recent public health gains, Lushniak and others fear." There is no attempt to specify which gains are undone, or how.
LAT: "The FDA's Center for Tobacco Products has begun collecting reports of adverse effects from e-cigarettes, and those complaints include claims of eye irritation, headaches and coughing."
Perhaps it would be good to compare these banes, "eye irritation, headaches, and coughing" (presumably among a percentage) with the banes of continued smoking without benefit of harm reduction devices: thousands of deaths from cancer, heart disease, enphysema, and more. What's to compare?
LAT: " 'It's not the nicotine that's the real enemy; it's the way it's burned and delivered in cigarettes,' said psychologist David Abrams, executive director of the American Legacy Foundation's Schroeder Institute for Tobacco Research and Policy Studies in Washington." Finally a quote from a pro-vaping source! LAT: "Nicotine exposure during adolescence 'may have lasting adverse consequences for brain development'."
True, but it ignores the fact that the entire e-cig industry favors a ban on sale to minors for this very reason, and has favored such bans at state levels where they have been inexplicably opposed by groups like the Lung Association, the Cancer Society, and the Heart Association, as well as the Campaign for Smoke-Free Kids.
LAT: "And then there are the potential health effects on bystanders, who are also exposed to nicotine and propylene glycol emitted by the e-cigarette and its user."
Fails to mention, until later, that the recent Burstyn study at Drexel University (by far the most definitive study so far) found no effect on bystanders.
LAT: "Studies performed on e-cigarette vapor have detected heavy metals and volatile compounds such as formaldehyde, but the concentration and threat they pose has been hotly debated."
Fails to mention that these substances have been found only at trace levels, not unlike the insignificant levels of harmful substances allowed by the FDA in virtually everything. This is the heart of the debate over "concentrations".
LAT: In a review of studies that examined e-cigarette mist, Drexel University environmental and occupational health expert Igor Burstyn concluded that "while these compounds are present, they have been detected at problematic levels only in a few studies that apparently were based on unrealistic levels of heating."
Finally a reference to the most definitive study so far, one that vindicates e-cigarettes completely except for uncertainties about long term effects, which of course can't be answered until the long term. Stanton Glantz wants "a gazillion" of studies like this one, which would require a wait that will kill thousands, maybe millions.
LAT: "Abrams took heart in that assessment, though he acknowledged that the vapor was not benign. Even so, the bystander effects are 'almost immeasurable compared to the toxins in secondhand cigarette smoke', he said."
Oops: we think "unmeasureable" or "non-measurable" was meant. ("Immeasurable" means 'so big you can't measure it; "unmeasurable" means 'so small you can't measure it'.)
LAT: " 'That assessment may change when several studies examining fine particulate matter from e-cigarette vapor and their effects on the cardiovascular system are completed', Glantz said." Why does it seem like he's saying that in gleeful anticipation?
LAT: "Some results suggest e-cigarette users are continuing to smoke conventional cigarettes and relying on the electronic substitutes to satisfy nicotine cravings in . . . places where cigarettes are forbidden." The anti-vaping experts have never explained sensibly why this is bad. Why is less smoking, with occasional e-cig use, not better than smoking all the time, even if it isn't as good as quitting altogether. "Dual use" is a whipping boy for vaping opponents, but they have not backed up the charges against it with any evidence.
LAT: "Another study published in the journal Lancet compared the effectiveness of e-cigarettes to nicotine patches and gum. Researchers said they expected e-cigarettes to be the clear winner, but it was a tie."
Almost true. It was a photo finish, with e-cigs winning by a nose. The percentages were too low to be "significant" in the scientific sense, but e-cigs consistently performed ever-so-slightly better. And nobody explains why performance as good as the most effective things around so far isn't a positive for e-cigs.
LAT: "Now experts are looking toward long-term behavioral studies that will reveal how smokers actually use e-cigarettes . . . for two years."
How many smokers, who might have quit, will die in those two years? That would be an interesting study.
LAT: " 'It should tell us if people are using them for cessation, or as a gateway to traditional tobacco use'," said Brian King, an epidemiologist at the Centers for Disease Control and Prevention."
We have the data to answer this "gateway effect" question, but everyone is ignoring it. If you juxtapose the results of the CDA study brought out with horror last Fall, indicating that e-cig use has doubled among youth in the last year, with the results of a University of Michigan study brought out last month, indicating that cigarette smoking among youth has gone down dramatically during the past three years, the clear indication is that e-cigs are not a gateway to cigarette smoking. Quite the contrary. The text of the Michigan report, with typical prohibitionist logic, attributes the reduction to finger-wagging by anti-smoking groups and increased taxes. But there is no proof that this is the cause. Once again the wished-for conclusion is used as a premise. The temporal factors do not support this conclusion, since the same finger-wagging and tax hikes were going on from 1998-2010, during which time smoking among youth remained on a plateau. The temporal evidence suggests that some new factor appeared in the past 5 years or so to produce a reduction. The best candidate is e-cigs. In any case it is impossible, given the juxtaposed data of these two studies, to suppose that e-cigs are a gateway to smoking. Yet anti vaping zealots continue to state this fear, often stating it as a proven fact instead of an unsubstantiated fear, as a primary reason for banning e-cigarettes.