Electronic Cigarette: KY E-cigarettes

Anti-Smoking Groups Argue that E-Cigarette Use Leads to More Smoking by Sidetracking Smokers Who Would Otherwise Quit

September 10, 2009
By Michael Siegel
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Anti-smoking groups are now arguing that e-cigarette use sidetracks smokers who would otherwise quit smoking completely, thus leading to more smokers.

According to a Public News Service article: “Health advocates think Kentucky should follow Oregon’s lead in stamping out electronic cigarettes. Oregon was the first to ban the sale of the new products, also called “e-cigarettes,” but they are still available elsewhere, including in Kentucky. … Ellen Hahn, director of the Kentucky Center for Smoke-Free Policy, says e-cigarettes could actually end up creating new customers for tobacco in a state where adult and youth smoking rates are at epidemic levels. ‘They’re mistakenly marketing them as a safe alternative to cigarettes, where there are no age restrictions, and so the way they are marketed really does appeal to children.’ … She says it would be a bad idea for Kentucky smokers, who are trying to quit their habit, to get hooked on alternatives to smoking. ‘The thing that scares me most in Kentucky particularly is because we have so many tobacco-dependent people. These products, e-cigarettes and other products, really will derail smokers who actually want to quit and instead they may switch to these products.'”

The Rest of the Story

Once again, the logic of this argument by anti-smoking groups eludes me: If a person switches from cigarettes to electronic cigarettes, he or she is no longer a tobacco-dependent person.
He is no longer a smoker. So e-cigarette use doesn’t increase smoking, it decreases it. It doesn’t create new customers for tobacco, it reduces tobacco use.

This is the classic abstinence only argument and just as it fails with regards to arguing against sex education in schools, methadone maintenance programs, and needle exchange programs, it also fails with respect to electronic cigarettes.

The argument being used by the Kentucky Center for Smoke-Free Policy is tantamount to arguing that we should not promote methadone maintenance programs because they are going to increase heroin use.

Even if we accept the argument that people who would otherwise quit smoking completely are going to be sidetracked into vaping instead, it is demonstrably false that this increases the number of smokers or brings new users to tobacco products. By definition, it lowers the number of tobacco users. It takes people away from smoking. While it would be legitimate to argue that e-cigarettes create more people who continue to be addicted to nicotine rather than being nicotine-free, it is false that this method of smoking cessation creates new smokers.

What would create new smokers in Kentucky is precisely the policy for which the Center for Smoke-Free Policy is arguing: banning e-cigarettes in the state. Doing so would instantly create thousands of new smokers. Without a doubt, thousands of vapers in Kentucky — ex-smokers — would return to cigarette smoking and the use of tobacco products if e-cigarettes were banned in the state. If you want to do anything to create new tobacco users in Kentucky, banning e-cigarettes would actually be the most effective way to accomplish that objective.

What strikes me is that these health officials in Kentucky are arguing for a policy that will have the effect of accomplishing exactly the opposite of what they say they are trying to achieve. If the goal is to reduce the number of tobacco-dependent people in Kentucky, then the last thing in the world you want to do is ban e-cigarettes, and force thousands of Kentuckians to return to cigarette smoking.

We can debate about whether or not people who quit smoking by switching to e-cigarettes are people who would have quit nicotine use completely, but it is demonstrably false to assert that by switching to e-cigarettes, they are continuing to be smokers or tobacco users. They are not. Thy are ex-smokers. They are ex-tobacco users.

It boggles my mind that anti-smoking groups can’t seem to recognize this fact. They seem obsessed with the idea that if someone is vaping, they are still smoking cigarettes and still using tobacco. This is false. They are actually ex-smokers who are no longer using a tobacco product. Of course, there is an issue about their continued addiction to nicotine (just as methadone users continue to be addicted to opiates), but the amount of harm reduction achieved by the switch from smoking to vaping is immense.

It seems that the fact that vapers are going through a behavioral act that is akin to smoking is what is important to anti-smoking groups, rather than the actual health effects – or relative health effects – of the behavior. I thought we were trying to save lives. But it appears that we are instead trying to prevent people from going through the motions of bringing a device to their mouth and inhaling.

Keep in mind, also, that nicotine-free electronic cigarette cartridges are available. Many vapers are using such products, or trying to wean themselves down to nicotine-free cartridges, and the surprising finding is that even without the nicotine, e-cigarettes are a viable alternative for many smokers.

Now, as far as the argument that people who quit smoking and start vaping are people who would otherwise quit using nicotine completely, there is simply no evidence to support such a position. There is, however, vast evidence that the people who are choosing to switch to e-cigarettes are people who feel that they cannot quit smoking and so they welcome the alternative that vaping provides. These are largely individuals who have already tried to quit – unsuccessfully. Thus, they are not people who would quit smoking were only e-cigarettes banned. They are people who would return to their Marlboros if e-cigarettes were banned.

Finally, the argument that e-cigarettes appeal to children and are being marketed as such is merely a hypothetical one, for which there is – again – no evidence. The product is clearly being marketed for use by existing smokers. Moreover, there is no evidence that any kids are using the product. At $80 to $120 a pop, it is difficult to argue that e-cigarettes are being marketed to children.

If Kentucky is concerned about kids starting to vape, then it is certainly reasonable for the state to enact a law prohibiting the sale of e-cigarettes to minors. But to ban e-cigarettes completely because of this concern makes absolutely no sense. Why create thousands of new smokers in Kentucky overnight? Why add to the already high burden of tobacco-related disease and death in the Bluegrass state?

Once again, it appears that the abstinence only mentality – with its ideological rather than science- or health-based underpinnings – is getting in the way of protection of the public’s health. We went down the wrong road for so long with abstinence-only education, limitations on needle exchange programs, and restrictions on methadone maintenance programs. It’s a shame to see tobacco control headed down that same road.