Big Government, Public Health, and E-Cigarettes, Part I

 

Since the US Surgeon General’s report on smoking and health in 1964, governments (local, state, federal) and tobacco control groups have waged a comprehensive campaign to encourage smokers to quit and discourage non-smokers from starting. They have used every tool available with cost being of little concern.

They’ve educated about the harms associated with smoking. When that didn’t do the trick, they attempted to shock and scare smokers away from the habit with graphic images. They’re in a half-century cycle to fight for increased taxes. They’ve banned smoking anywhere people congregate. They’ve filed individual lawsuits, class action lawsuits, and lawsuits from state attorneys general (resulting in the tobacco master settlement agreement that forced tobacco companies to pay billions to the states, all costs passed on to consumers via increased prices).

They’ve restricted the ability of companies to sell and market products, restricted use of brand-name advertising and eventually they decided scaring children might discourage them from becoming smokers. They also thought sending terrified kids home to shame their smoking parents could only benefit their cause.

Years ago, they decided that their noble ends justified any means and they deliberately misrepresented the health risks associated with smokeless tobacco, just as they are doing with e-cigarettes now.

Finally, after 45 years, Congress passed and President Obama signed the Family Smoking Prevention and Tobacco Control Act of 2009, which created FDA regulation of tobacco products. The Tobacco Control Act effectively allowed all current tobacco products to continue to be sold and made it nearly impossible to introduce new products to market, even if the products were safer and might save smokers’ lives and reduce the toll of lung cancer, COPD, heart disease, and stroke rightly attributed to smoking.

About three years before the FDA started regulating tobacco, e-cigarettes started to trickle into the US market. The products were invented by a smoker. Hon Lik was a pharmacist in China who lost his father to lung cancer and struggled to kick the smoking habit himself. Hon Lik recognized what tobacco researcher Michael Russell concluded years earlier and widely understood by scientists – that “people smoke for the nicotine, but die from the tar.”

That’s a critically important point. Surveys of Americans, smokers, tobacco users and even people with a medical background in the US demonstrate that most people do not understand the critical distinction between smoke and nicotine. The CDC, FDA, various Surgeons General, and tobacco control groups like the Campaign for Tobacco Free Kids, the American Cancer Society, and state, county, and city health departments have misled the public and the media and perpetuated ignorance by deliberately conflating harms associated with smoking, tobacco, and nicotine.

Pharmaceutical companies understood it, however. The recognition that people smoke for the nicotine but die from the tar provided the foundation for the development of nicotine replacement therapies like gums and patches. If nicotine itself is largely innocuous, but if delivered via a combustible cigarette causes death and disease, why not give smokers the nicotine they desire without the toxic smoke? It’s a simple and brilliant concept.

The pharmaceutical companies developed medical products designed to help smokers quit. They invested heavily, sought and received government approval and began marketing gums and eventually patches and inhalers designed for smoking cessation. While the products worked for some, they fail over 93 percent of the time. Despite the high failure rate, the products are still highly profitable. People come back to them again and again. And getting government to mandate smoking cessation coverage or include such coverage for government employees across the country, taxpayers ultimately dump cash into the pockets of giant companies for repeated purchases of products that don’t work very well.

Nicotine gums and patches provide nicotine, but it’s not absorbed as effectively as it is when inhaled from a burning cigarette (or as effectively from much safer smokeless tobacco). And we’ve learned (mostly from the introduction of e-cigarettes) that while smokers do seek nicotine, there is more to smoking than simply delivering a plant-derived chemical. Anyone who has been a smoker understands that it’s not just the cigarette delivering nicotine that becomes part of the habit, but also the ritual of smoking. Smokers pack their tobacco, they use lighters and matches, they physically engage their hands and mouths in a daily smoking ritual for years. It’s not only inefficient delivery of nicotine, but also because of the failure to address the physical habit of smoking that gums and patches fail so often.

And then, along comes the electronic cigarette. E-cigarettes or vapor products are not medicines or medical devices designed to treat a medical condition. They are alternative products that surveys demonstrate are used almost exclusively by smokers or former smokers. Tobacco control groups fail to acknowledge that smoking provides pleasure and enjoyment for those who do it. Through different devices, liquids, and flavors, vapers can come close to replicating and even exceed the pleasure they got from smoking. If getting smokers to quit is your true mission, that’s a fabulous thing. It’s also contradicts the narrative of anti-tobacco zealots that seem to have a real problem with people enjoying smoking or those who quit because they enjoy vaping even more.

It’s a fundamental distinction that their ideology obscures for them. Gums and patches are just tolerable enough to treat what they see as a medical condition, like a medicine. Vapor products aren’t medicines. They work, often gratuitously, to help smokers quit because people enjoy them, make them a hobby, and develop social networks around them. Vapers are connected online, they travel the country to get together at conventions, meet ups, and “cloud competitions” where they show off their vaping skills. They create and are connected through YouTube channels, online radio shows, podcasts, and Facebook groups.

Smoking can be a very social behavior, especially since tobacco control groups sent CEOs and janitors outside together to smoke in the alley next to the garbage dumpster. No one socializes around gums and patches, but the socialization around vaping contributes significantly to its appeal and its ability to transition smokers away from combustible cigarettes. It works because it’s fun and it responds to the human need to interact with others. No smoker (or vaper) wants to interact with tobacco control nuts who disrespect them and want to use government force to impose their standards upon others.

Tomorrow I’ll talk more about that government force.

This is the first in a three-part series on e-cigarettes. Check tomorrow for Part II.


Brian Fojtik is a Senior Fellow with Reason Foundation.

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Members have made 23 comments.

  1. Profile photo of Instugator Thatcher

    You forgot the study released by the Brits that said encouraging use of Vaping would wipe out 95% of the societal harms that already exist from smoking.

    • #1
    • June 28, 2017 at 7:34 am
    • Like5 likes
  2. Profile photo of 1967mustangman Member

    Great article Brian. You are echoing what I have long thought. I have also long predicted that should it not be regulated to death rates of vaping will go through the roof as people realize they can get nicotine in a relatively innocuous manner. Particularly as people wake up to nicotine’s metabolism enhancing effects.

    • #2
    • June 28, 2017 at 7:44 am
    • Like3 likes
  3. Profile photo of Stina Inactive

    Ì have become increasingly curious about nicotine of late…

    I’m an oddball in that I can genuinely and honestly state I have never smoked or taken recreational drugs. However, I have an addictive personality and food became my drug. With gum, patches, and e-cigs, I have frequently wondered if using a low nicotine product would be beneficial or not.

    But the negativity surrounding it and knowing it is addictive keeps me from actually seeing what its like.

    I think its excellent this exists for smokers.

    • #3
    • June 28, 2017 at 8:09 am
    • Like3 likes
  4. Profile photo of Addiction Is A Choice Member

    Since tobacco taxes are the only thing keeping many governments afloat, instead of shooing smokers outdoors, we should be saying, “Thank you for your service!”

    • #4
    • June 28, 2017 at 8:36 am
    • Like4 likes
  5. Profile photo of RushBabe49 Thatcher

    Follow the money. How many dollars of sales of cigarettes fund all sorts of health programs? If everyone quit smoking and started vaping, how many government programs would have to shut down or find alternate funding? Millions of dollars of tax money from cigarettes would disappear if everyone quit smoking or started vaping, and I’m sure the government does not worry about this. Perhaps they should.

    • #5
    • June 28, 2017 at 9:14 am
    • Like3 likes
  6. Profile photo of Matt Bartle Member

    Stina (View Comment):
    I’m an oddball in that I can genuinely and honestly state I have never smoked or taken recreational drugs.

    I thought I was the only one!

    I grew up around smokers and grew to hate the smell of smoke so much I was never even tempted to try them. (I did smoke a cigar once.) Now I go weeks, maybe even months, without smelling cigarette smoke. I think all the smokers I do know are women.

    It’s better this way, but I agree that treating vaping as if it’s the same thing is ridiculous.

    • #6
    • June 28, 2017 at 9:24 am
    • Like3 likes
  7. Profile photo of Z in MT Member

    I largely agree with this article, but I would disagree that smokeless tobacco is harmless. It is not as bad as cigarettes, and some smokeless tobacco is less harmful than others, but it is not safe. The same could be said of vaping, particularly those that create the great clouds of vapor using special additives.

    Unfortunately, there are a subset of vapers that are more annoying than cigarette smokers, because they use it to draw attention to themselves.

    • #7
    • June 28, 2017 at 11:04 am
    • LikeLike
  8. Profile photo of Judithann Campbell Member

    Z in MT (View Comment):
    I largely agree with this article, but I would disagree that smokeless tobacco is harmless. It is not as bad as cigarettes, and some smokeless tobacco is less harmful than others, but it is not safe. The same could be said of vaping, particularly those that create the great clouds of vapor using special additives.

    Unfortunately, there are a subset of vapers that are more annoying than cigarette smokers, because they use it to draw attention to themselves.

    I am a heavy smoker, who hasn’t gotten around to switching to vaping yet. 🙂 I really hope that vaping is all that some seem to think it is, but have some doubts. It probably is a lot better than smoking cigarettes, but is constantly inhaling steam really totally harmless? I fear that it will turn out in the end that many vapers will also die of a different kind of lung disease than that which affects us smokers. I really do hope that I am wrong.

    • #8
    • June 28, 2017 at 11:13 am
    • LikeLike
  9. Profile photo of Phil Turmel Thatcher

    I have a number of acquaintances who quit smoking thanks to vaping, plus an employee who vapes. Thanks to its safety and the pleasant odor, I allow my employee to vape in both work shop and work truck.

    • #9
    • June 28, 2017 at 11:54 am
    • Like5 likes
  10. Profile photo of iWe Reagan
    iWe

    It drives me crazy that vaping has been vilified. I have seen no coherent argument for why government (or society) should oppose it.

    • #10
    • June 28, 2017 at 1:03 pm
    • Like3 likes
  11. Profile photo of skipsul Moderator

    Vaping got my dad to quit a 50 year smoking habit. Vaping got my brother in law to quit a 20 year smoking habit.

    Vaping helps me relax. I was never a regular smoker, but I like the occasional pipe or cigar. Can’t have those with the wife and kids around, but I can vape, then save the pipe for a cool night out on the deck.

    The never ending attempts to stigmatize vaping are deeply offensive to me, and of the same ilk as the prohibitionism of other stripes – just a bunch of moralistic intolerant do-gooders.

    • #11
    • June 28, 2017 at 1:46 pm
    • Like9 likes
  12. Profile photo of skipsul Moderator

    Judithann Campbell (View Comment):

    Z in MT (View Comment):
    I largely agree with this article, but I would disagree that smokeless tobacco is harmless. It is not as bad as cigarettes, and some smokeless tobacco is less harmful than others, but it is not safe. The same could be said of vaping, particularly those that create the great clouds of vapor using special additives.

    Unfortunately, there are a subset of vapers that are more annoying than cigarette smokers, because they use it to draw attention to themselves.

    I am a heavy smoker, who hasn’t gotten around to switching to vaping yet. 🙂 I really hope that vaping is all that some seem to think it is, but have some doubts. It probably is a lot better than smoking cigarettes, but is constantly inhaling steam really totally harmless? I fear that it will turn out in the end that many vapers will also die of a different kind of lung disease than that which affects us smokers. I really do hope that I am wrong.

    Even if vaping does have long term effects, you could still use it to step down off of cigarettes. My father talked to his vape shop and they sold him a series of fluids at lower and lower nicotine levels – told him to start at the high end (he was a 1 or 2 pack a day person), then when that was gone to go to the lower level, and so on till he was using a zero-nicotine level. At that point it was just the physical habit he needed to work through. One day he forgot his e-cig at home and found he wasn’t ever reaching for it. Then he knew he was done. Took him about 6 months.

    • #12
    • June 28, 2017 at 1:50 pm
    • Like7 likes
  13. Profile photo of Annefy Member

    Z in MT (View Comment):
    I largely agree with this article, but I would disagree that smokeless tobacco is harmless. It is not as bad as cigarettes, and some smokeless tobacco is less harmful than others, but it is not safe. The same could be said of vaping, particularly those that create the great clouds of vapor using special additives.

    Unfortunately, there are a subset of vapers that are more annoying than cigarette smokers, because they use it to draw attention to themselves.

    The guys at my Vape shop say that the annoying vapers are usually people who have never smoked. We who have smoked know the etiquette of where and when you can light up.

    I chewed nicotine gum for years, but after knocking out a couple of fillings, switched to vaping. Works great for me. Not even tempted to light up a cigarette when I’m around smokers, which wasn’t the case with gum.

    • #13
    • June 28, 2017 at 5:06 pm
    • Like4 likes
  14. Profile photo of profdlp Coolidge

    I quit smoking over 25 years ago. I tried quitting cold turkey a few times but it was extremely difficult due to the nicotine addiction component. Then they came out with the prescription nicotine gum. I changed jobs and my new insurance company wouldn’t cover the gum, which in the prescription-only days was quite expensive.. I called them up to protest. (Mainly because I wanted to point out how stupid they were.) I went through a long list of tobacco-related diseases (cancer, emphysema, chronic bronchitis, etc) and asked them if treatments for all of these would be covered. “Oh, yeah, no problem”, they said. “But you won’t cover the daggone gum, which might make all of that unnecessary?” “Yup.”

    So I went and bought a can of Skoal. It was pretty gross, but then I found what are now called Snus. After a little practice I found that I didn’t even need to spit. Haven’t had a cigarette since.

    Now, I know that there is some health risk, but nowhere near what there is from cigarettes. Maybe I’ll quit someday, but for now I am glad to not have had a cigarette since the first Bush was president. If I do quit, I may well give vaping a try. The main draw for me is that nicotine is a great mood regulator. I have gone through periods of depression at times (and still do), but a little trickle of nicotine when I need it helps to smooth out the valleys a little bit.

    • #14
    • June 28, 2017 at 5:11 pm
    • Like4 likes
  15. Profile photo of skipsul Moderator

    The way I heard a doctor put it once was this:

    Nicotine is actually a good drug. It just has had a horrible delivery system.

    • #15
    • June 28, 2017 at 5:51 pm
    • Like9 likes
  16. Profile photo of Annefy Member

    profdlp (View Comment):
    I quit smoking over 25 years ago. I tried quitting cold turkey a few times but it was extremely difficult due to the nicotine addiction component. Then they came out with the prescription nicotine gum. I changed jobs and my new insurance company wouldn’t cover the gum, which in the prescription-only days was quite expensive.. I called them up to protest. (Mainly because I wanted to point out how stupid they were.) I went through a long list of tobacco-related diseases (cancer, emphysema, chronic bronchitis, etc) and asked them if treatments for all of these would be covered. “Oh, yeah, no problem”, they said. “But you won’t cover the daggone gum, which might make all of that unnecessary?” “Yup.”

    So I went and bought a can of Skoal. It was pretty gross, but then I found what are now called Snus. After a little practice I found that I didn’t even need to spit. Haven’t had a cigarette since.

    Now, I know that there is some health risk, but nowhere near what there is from cigarettes. Maybe I’ll quit someday, but for now I am glad to not have had a cigarette since the first Bush was president. If I do quit, I may well give vaping a try. The main draw for me is that nicotine is a great mood regulator. I have gone through periods of depression at times (and still do), but a little trickle of nicotine when I need it helps to smooth out the valleys a little bit.

    Surely I am not the only one who has noticed the use of anti-depressants has increased as smoking has decreased?

    • #16
    • June 29, 2017 at 6:24 am
    • Like4 likes
  17. Profile photo of Kozak Member

    Brian Fojtik: Years ago, they decided that their noble ends justified any means and they deliberately misrepresented the health risks associated with smokeless tobacco, just as they are doing with e-cigarettes now.

    You forgot the terrible science they used in the “secondhand smoke” jihad.

    • #17
    • June 29, 2017 at 7:00 am
    • Like3 likes
  18. Profile photo of bill.deweese Coolidge

    I’m fifty years old and I’ve never smoked, apart from messing with tobacco for a bit as far back as middle school. I deeply dislike cigarettes and their effects and if someone is fifty feet from me and lights up, I’m instantly putting an additional fifty feet between us. I don’t say any of that to do my superiority dance, but to give perspective when I say that from a second hand perspective it has been a boon as well.

    I was trapped in a open stadium setting a year or so ago at an event, when someone promptly “lit up” an E-Cig immediately down in front. I immediately groaned, thinking what next, some antisocial conflict or get up (with family) and abandon the event.

    Despite puffing like a locomotive, then and later during the event, it was not intrusive or obnoxious at all. So I would only add, not only would the socialization aspects within smokers improve from eliminating the false dichotomy and transference of evils of tobacco onto the E-Cig, it might move to significantly reduce the separating the sheep from the goats in the general community as well.

    • #18
    • June 29, 2017 at 7:44 am
    • Like2 likes
  19. Profile photo of Ontheleftcoast Inactive

    Judithann Campbell (View Comment):
    I am a heavy smoker, who hasn’t gotten around to switching to vaping yet. 🙂 I really hope that vaping is all that some seem to think it is, but have some doubts. It probably is a lot better than smoking cigarettes, but is constantly inhaling steam really totally harmless? I fear that it will turn out in the end that many vapers will also die of a different kind of lung disease than that which affects us smokers. I really do hope that I am wrong.

    It certainly looks as though propylene glycol does harm the lungs and possibly more. However, it’s also dead certain that on a population basis, and certain that for almost all individuals, the harm done by the vaping aerosol (it’s not steam, which relies on heat rather than ultrasound to transform liquid water into a vapor) is much less than the harm done by smoking.

    Furthermore, vaping as a drug delivery system is much more amenable to technological improvement to further lessen the risk than cigarettes.

    Note that “harm reduction” and not “harm elimination” is the rationale behind schemes to administer opioids under controlled circumstances to current addicts, as well as needle exchange programs for users of illegal injectable drugs.

    Vaping is a lot more innocuous than that, and I’m willing to have to deal with yet another trigger for the impulse to kick a few more annoying teenagers (after all, I remember when I was one) and hipsters if it means more people don’t have to suffer the consequences of smoking.

    Nicotine is

    1. highly addictive
    2. probably an effective self-medication for some depression
    3. Historically used by means of really bad delivery systems
    4. such a good nootropic for some people that if it was a new drug it would be very trendy right now

    Is #1 alone enough reason to ban its use via vaping?

    • #19
    • June 29, 2017 at 8:52 am
    • Like2 likes
  20. Profile photo of Judithann Campbell Member

    Ontheleftcoast (View Comment):
    Is #1 alone enough reason to ban its use via vaping?

    I do not believe that vaping, or any type of smoking should be banned. Sorry if I didn’t make that clear 🙂

    • #20
    • June 29, 2017 at 9:11 am
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  21. Profile photo of Ontheleftcoast Inactive

    Judithann Campbell (View Comment):

    Ontheleftcoast (View Comment):
    Is #1 alone enough reason to ban its use via vaping?

    I do not believe that vaping, or any type of smoking should be banned. Sorry if I didn’t make that clear 🙂

    My apologies for writing as if you did think that; you gave no reason to think you did.

    • #21
    • June 29, 2017 at 11:40 am
    • LikeLike
  22. Profile photo of Addiction Is A Choice Member

    It is, as Thomas Sowell might put it, a conflict of visions: Non-smokers look at cigarettes and see death; smokers look at cigarettes and see life. When smokers smoke they aren’t dying, they are living! Taking it all in!

    • #22
    • June 29, 2017 at 12:23 pm
    • LikeLike
  23. Profile photo of Judithann Campbell Member

    Ontheleftcoast (View Comment):

    Judithann Campbell (View Comment):

    Ontheleftcoast (View Comment):
    Is #1 alone enough reason to ban its use via vaping?

    I do not believe that vaping, or any type of smoking should be banned. Sorry if I didn’t make that clear 🙂

    My apologies for writing as if you did think that; you gave no reason to think you did.

    No worries 😃

    • #23
    • June 29, 2017 at 12:27 pm
    • LikeLike