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More E-Cig News Coverage

Electronic cigarettes are in the news again, this time with a New York Times article, by Sabrina Tavernise, on the "hot debate" over harm reduction versus "caution".

The article highlights the positions of Boston's Michael Siegel and his former professor, San Francisco's Stanton Glantz. The article is balanced and thoughtful, covering the major controversial points, and giving a say to virtually all of the major voices in the debate.

Siegel is highlighted, with a photo and the epithet "hard-charging" in the article's opening paragraph, which quotes him to the effect that e-cigs are "disruptive" (in the positive sense of "game-changing"), comparing their relationship to smoking with the way computers replaced typewriters.

Glantz is given the floor next, putting forward the notion that e-cigs will "erase the hard-won progress" in smoking reduction, and will keep smokers "hooked" longer, since they "can get a nicotine fix at their desks."

Michael Steinberg of Rutgers is quoted next, pointing out that a few more years of research will give us better information about the safety issues, but wondering, "will the horse be out of the barn by then," and pretending not to notice the horse galloping past his office window.

The article acknowledges the danger of giving the industry over to Big Tobacco with tight regulation, and nods to the concern that lax rules could lead to "devices that do not work properly or even harm people" (an argument that gives tacit approval to continued interim use of products that are already proven to certifiably kill people).

The regulations must be carefully crafted in such a way that smokers will be coaxed away from cigarettes to e-cigarettes, say some scientists, according to Tavernise. David Abrams, of the antismoking research group at the Legacy Foundation's Schroeder Institute, says " need a little help to eclipse cigarettes, which are still the most satisfying and deadly product ever made."

Bonnie Herzog, the Wells Fargo securities specialist who has done much to encourage and shape e-cig investment, thinks e-cig sales may surpass sales of conventional ones in 10 years or so, and the FDA's tobacco czar Mitch Zeller agrees that vapers are "speaking with their pocketbooks".

Next the anti-vaping side is up again, and Glantz is given air time to express his horror of "dual use", as usual not saying why it is not better to smoke less, even if it is not as good as quitting totally. It becomes clear that a visual aversion to the appearance of smoking behavior lies at the root of much opposition. Glantz feels like he has "gotten into a time machine" and he doesn't like it.

Gateway fears are mentioned at this point, and the CDC study on the rise in e-cig use by youth is cited. Unfortunately, there is no mention of the Michigan study showing a dramatic decline in youth cigarette smoking during the same period, a study which, in combination with the data on increased vaping, effectively demolishes the gateway argument.

The article notes that 7% of youth trying e-cigs have never smoked, and says this prompts concern that they might start, without stating any basis for the fear that they might do such a thing. CDC director Thomas Frieden is quoted to the effect that "the precautionary principle, better safe than sorry, rules here". It's an odd definition of "safe" for a major health watchdog to use, given that we're talking about a policy that will cost the lives of smokers in the interim, in the interest of protecting against a totally unsubstantiated fear.

Nicotine wonk Neal Benowitz, a UCSF colleague of Glantz, is quoted to the effect that the drug, in and of itself, is relatively benign, and worries more about the long term effects of inhaling propylene glycol (an FDA approved additive in many foods and cosmetics, not used as anti-freeze in automotive radiators).

Everyone expects the long-term negatives to be slight, once fully researched. The only question is how slight will they be: 1.) small, 2.) tiny, 3.) miniscule, 4.) negligible, or 5.) nano-level. One wonders how useful this information will be, in proportion to the lives that will be sacrificed in waiting for it.

The recent New Zealand study, showing e-cigs to be marginally better than the nicotine patch for smoking cessation, is mentioned, and for once, the writer notes that, although not large enough for statistical significance (it was 1.5%), the difference was consistently in favor of e-cigs. Most reporters simply said they were "about the same". Thomas Glynn of the American Cancer Society is quoted as saying it was "nothing to write home about". I don't know. I wrote home.

The article notes the complications introduced by the entry of Big Tobacco into the market, since everyone seems to agree that they are the enemy, yet acknowledges that they stand to be the foremost supplier. Abrams is quoted: "We need a ju-jitsu move to take their own weight and use it against them." Benowitz wants to lower permissible nicotine levels in smokes, in order to drive nicotine addicts to e-cigs that will have more of the benign drug. Siegel and Glantz are given the last words, with Glantz concluding, as usual without evidence, that "the evidence will show their true colors."

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