On March 15 Tom Dennis authored a sensible editorial about e-cigarettes in the Grand Forks Herald. He wrote that “vaping is best thought of as a method of quitting smoking. As such, it can be a public-health tool. Because while e-cigarettes are not ‘safe,’ meaning zero risk, they’re proving to be both dramatically safer than regular cigarettes and effective at helping people cut back on or quit smoking. The public-health benefits of this latter achievement are huge.”
The Herald’s advice to regulators, “avoid heavy-handed rules that target vaping simply because the activity looks like smoking,” was practical and scientifically credible. No human activity is perfectly safe, but vapor is “dramatically safer” than smoke, and there is growing evidence that e-cigs are helping smokers quit.
On March 19 the Herald published an opposing commentary by Dr. Eric Johnson. The editors deserve credit for being balanced and fair, but Dr. Johnson misleads and misinforms North Dakota smokers, starting with his opening claim: “Vaping is smoking.” That is patently untrue. No credible health authority has ever equated inhaling a vapor of water, propylene glycol, nicotine and flavors with inhaling smoke containing thousands of toxic agents.
Speaking of toxins, Johnson falsely ties e-cig liquid to antifreeze, and he incorrectly claims that e-cigs have “problems with contamination from toxins such as heavy metals and aldehyde compounds.” He doesn’t report that these contaminants are present in foods and beverages that are considered “safe” – at vanishingly small levels that have no measurable impact on human health. For example, roasted coffee contains thousands of chemicals in addition to addictive caffeine, and at least 21 of them are known carcinogens. While not absolutely harmless, coffee is quite safe to consume. Under close scrutiny, exaggerated claims of e-cig toxins vanish as quickly as e-cig vapor.
Dr. Johnson inexplicably claims there is “no significant data…that e-cigs help stop smoking.” Apparently he is not aware of several clinical studies documenting that e-cigs work (here, here, here and here). In fact, the evidence has reached a sufficient size that a meta-analysis was presented by University of Melbourne (Australia) investigators at an American Heart Association meeting. The Consumer Advocates for Smoke-Free Alternatives Association maintains a webpage linking to over 2,000 testimonials from successful switchers.
Dr. Johnson promotes “FDA-approved cessation products that actually have data for how well they work.” But he doesn’t mention “how well they work.” In fact, nicotine medicines are successful for only about 7% of smokers who try them. This dismal statistic may impress the FDA and Dr. Johnson, but smokers are not comforted. What other medicines with a 93% failure rate have FDA approval and physician endorsement? There aren’t any.
North Dakotans deserve truthful information about smoke-free tobacco products, and I am committed to providing it. Last month I urged Fargo city officials to correct grossly misleading claims about smokeless tobacco in a local media story. In 2013 I testified at North Dakota legislative hearings on safer tobacco products. While in Bismarck, I was interviewed by Dale Wetzel on his radio show, “The Legislature Today.” He asked challenging questions that generated a lively discussion.
That discussion about lifesaving options for smokers needs to continue in North Dakota. I invite public health and government officials, the media and other interested organizations to debate and discuss the risks and benefits of safer smoke-free tobacco products with me in public meetings and events anywhere in the state. Dr. Johnson and other tobacco control activists may be perfectly content to “wait for more data, and see if e-cigarettes actually work without promoting nicotine addiction.” But waiting will not help the 400,000+ Americans, including almost 900 in North Dakota, who will die this year from smoke.