Any clear-thinking health professional would agree that cigarette
smoking is without question the most devastating and preventable public
health risk that we need to address in this country. And now, four-plus
years after the Food and Drug Administration (FDA) was given legal
authority over tobacco products, the regulatory agency faces arguably
its most important public health decision in its history. The time has
come to confront their responsibility to smokers trying to quit and
their families.
The worldwide death-toll of cigarette smoking is reliably predicted
to hit one billion this century. Despite this depressing fact, the
measures implemented by the FDA thus far, ostensibly to reduce the toll
of smoking, have been almost entirely lip service, without making any
real impact. A relatively new method of helping addicted smokers quit
has been adopted by millions of smokers – many of whom are now
ex-smokers — over the past few years. I refer of course to electronic
cigarettes (e-cigarettes). Concurrent with the dramatic spike in sales
of this device comes word of historic declines in the sale of real
cigarettes.
E-cigarettes work by delivering a potent “hit” of nicotine in water
vapor, with flavorings and propellants of no significant health concerns
— neither to the “vaper” (as they call themselves), nor to bystanders.
Most of them resemble cigarettes — which is both their blessing, and
their curse.
Astoundingly, this nascent public-health miracle has been met with
something between derision and hysteria by anti-tobacco groups
worldwide: globally, the WHO, health-oriented NGOs, the British
regulator MHRA, and many nations are sparing no effort to discourage
smokers from trying them, employing misleading (even false) alerts and
dire website warnings, phony surveys, and exaggerated concerns about
youth being led astray. Unfortunately, and embarrassingly for
science-based public health policy, our FDA and CDC have been willingly
complicit in this widespread disinformation campaign. Meanwhile they
purposely ignore studies that indicate the benefit of e-cigarettes for
helping smokers quit. I ask, “How could this be?”
The possible explanations are not pretty: willful ignorance, dogma based on experiences garnered in the 20th century, or greed.
I accuse those responsible for impeding truthful communication about
the real risks of e-cigarettes of collaborating in a
“cigarette-protection campaign,” whose effects will be to discourage
smokers from quitting, leading to more dead smokers. Consider this:
those who stand in the way of acceptance of e-cigarettes are acting from
motivations that are far removed from public health. The nonprofit
groups in the forefront of anti-e-cigarette activism are also heavily
funded by pharmaceutical companies in the business of selling
near-useless cessation drugs — a fact which they conveniently neglect to
disclose. If tobacco companies carried on the same way, they would be
hauled into court by the FDA in a heartbeat. Meanwhile, the net result
of the official campaigns: cigarette markets protected, worthless
cessation aids promoted. Who profits? Not addicted smokers.
Despite the pervasive anti-smoking campaigns, a handful of marginally
successful cessation drugs and the “denormalization” measures, the
addictive drumbeat goes on. In our country alone, cigarettes exact an
annual sacrifice of about 450,000 prematurely dead. Another 8 1/2
million people and their families suffer lingering ills thanks to
smoking. And still, near twenty percent of our population continues to
smoke, with little change over the century’s first decade.
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