Thursday, November 21, 2013

Tobacco Company Claims that Cigarette Smoking May Not Be Any More Harmful than Vaping

Yesterday, a U.S. tobacco company issued a press release claiming that its products may not be any more harmful than electronic cigarettes, citing several government and non-government public health agencies to back up its assertion.

Since it's not clear that electronic cigarettes have killed any vapers, the company argued, it's not clear that tobacco cigarettes are any where near the health threat that they have previously been made out to be. However, the company insisted that the opinion it is expressing is not its own, but that it is merely reiterating what public health officials have stated publicly.

Excerpts from the press release follow:

"Electronic cigarettes are battery-operated devices that heat a solution of nicotine and propylene glycol in order to vaporize the nicotine and deliver it as an aerosol. There is no tobacco in these products, and there is no combustion. Studies have found that the levels of tobacco-specific nitrosamines (a carcinogen) in electronic cigarettes are up to 1,000 times lower than in our products. Nevertheless, numerous public health agencies have declared that our products may not be any more hazardous than using these non-tobacco, non-combustion products that contain only trace levels of tobacco-specific nitrosamines, similar to what one is exposed to in nicotine gum or nicotine patches."

"Reputable public health sources have stated that it is not clear whether cigarette smoking is any more hazardous than electronic cigarette use."

"For example:
  • The CDC publicly stated that "There is insufficient evidence to determine whether ... electronic cigarettes ... reduce individual ... health risks." 
  • The FDA stated that it is not known "if there are any benefits associated with using these products [electronic cigarettes]."
  • The FDA also stated that: "There may be a perception that electronic cigarettes...are safer alternatives to conventional tobacco products. ... However, FDA is not aware of any scientific data to support those perceptions."
  • An article by public health researchers from the University of Kentucky states that: "no scientific basis currently exists for making claims of ... reduced harm ... for e-cigarettes."
  • The American Legacy Foundation stated: "Electronic cigarettes are designed to give you an experience that’s like smoking but without any smoke. Since they don’t burn tobacco, they’re marketed as less harmful than regular cigarettes. But so far, there’s no evidence to prove that claim."
  • An American Cancer Society official stated: "The truth is, we don’t have the research to tell us these e-cigarettes are helping people stop smoking or that they aren’t as dangerous as regular cigarettes. We just don’t know."
  • A tobacco expert from the Wake Forest School of Medicine stated: "People perceive them [electronic cigarettes] as safer, but we do not yet know if that is true."
  • The American Lung Association stated that: "There is no scientific evidence that e-cigarettes are safer for consumers than regular tobacco products."
  • Researchers from the University of Athens stated: "We do not yet know whether unapproved nicotine delivery products, such as e-cigarettes, are safer than normal cigarettes, despite marketing claims that they are less harmful."
  • An article in the prestigious British Medical Journal concluded: "More rigorous chemical analyses are needed, followed by extensive research involving animal studies and, finally, clinical trials in humans. Until these crucial implementation stages are completed, physicians and other healthcare professionals must inform consumers of the probable fallaciousness of the claims of manufacturers of e-cigarettes [that they are safer than tobacco cigarettes]."
  • A Stanford pulmonary expert stated, referring to vaping:  "We can't say yet whether it's less harmful than tobacco."
"We urge consumers to rely upon these statements of prominent public health agencies, experts, and officials. According to these reputable sources, our products may pose no more risk than electronic cigarettes."

"As a responsible tobacco company, we are committed to providing consumers with accurate health information. We have long acknowledged the dangers inherent in using our products and we are committed to providing information so that consumers can make informed decisions about whether or not to use our products. Given these recent statements of public health officials, it appears that we may have been overly cautious in warning our customers about the hazards of cigarette use. It now appears that our products may be no more harmful than electronic cigarettes. Notably, there have been no reported deaths from electronic cigarettes, despite at least seven years of widespread use. We urge consumers to look to the statements of public health officials and agencies for the most trustworthy guidance on the relative health risks of various consumer products. These officials and agencies have made it clear: our products may compare favorably or equivalent to fake cigarettes that contain no tobacco in terms of health risks. We hope that consumers will take these public health statements into account when making a decision about whether to use our products."

The Rest of the Story

In my opinion, this tobacco company is making a fraudulent health claim. There is abundant evidence that cigarette smoking is much more harmful than vaping. While electronic cigarettes are not "safe" in absolute terms, there is little question that they are much safer than smoking tobacco cigarettes. The contention that nicotine plus tens of thousands of other chemicals including 60 known carcinogens is more dangerous than nicotine vaporized from a propylene glycol/glycerin solution does not require rocket science.

The evidence simply does not support the claim. While cigarette smoke contains more than 60 carcinogens at relatively high levels, there have been only three carcinogens found in electronic cigarettes and they are present only at low levels. In fact, the levels of tobacco-specific nitrosamines (which are present because the nicotine is extracted from tobacco) are more than 1,000 times lower than those of the same carcinogens in tobacco cigarettes. Moreover, there are more than 20 laboratory studies of the constituents of electronic cigarettes and none have identified any chemicals at levels which would warrant serious concern that vaping poses any where near the level of risk as cigarette smoking.

How can a tobacco company go out publicly and state that there is no evidence that electronic cigarettes are any safer than what we already know is the most dangerous and toxic consumer product on the market, which we know kills hundreds of thousands of Americans each year? How can this company ignore the available data which clearly show that the levels of carcinogens in electronic cigarettes are orders of magnitude lower than in regular cigarettes, and mislead the American public so blatantly?

It seems to me that the Department of Justice should investigate this tobacco company for making fraudulent statements to the American public about the safety of a consumer product. At the very least, public health and tobacco control organizations should expose these fraudulent statements and publicly criticize this company for spreading false information to the public.

The dissemination of this false information is problematic not only because it violates basic ethics, but because it could be damaging to the public's health. The statement that this company is making undermines more than 5 decades of public health efforts to convince the public of the very serious health hazards of cigarette smoking. It is even possible that the company's statement might cause many smokers to continue smoking rather than to quit smoking using a product like electronic cigarettes. It is even possible that this company's statement could cause many ex-smokers who quit using electronic cigarettes to return to cigarette smoking. After all, why continue using electronic cigarettes if they may be just as bad as tobacco cigarettes?

Given the significant amount of damage that could be done because of this company's public statements, I would hope that public health and tobacco control organizations would promptly and vigorously attack this company for making these fraudulent health claims, and demand that it immediately retract and correct these statements and issue a public apology.

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