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The technology exists — they’re called electronic cigarettes, or e-cigarettes for short. For the uninitiated, e-cigarettes are devices that heat up a flavoured liquid, often containing nicotine, producing a water vapour that simulates smoking, without the need to inhale combusted plant matter.
Many public-health advocates champion the devices as a means of reducing the harms associated with smoking — with the potential to save millions of lives worldwide. Yet Health Canada maintains a ban on nicotine-containing liquid that was put in place in 2009. With the federal government collecting $20.4-billion in tobacco taxes between 2001 and 2008, there appears to be little impetus for regulators to do further research on the potential benefits of e-cigarettes.
The debate over their use was reignited recently when, to commemorate National Non-Smoking Week, the Canadian Lung Association put out a press release urging people “to avoid gimmicky unproven methods” of quitting smoking, “like electronic cigarettes.” This coincided with a conference on e-cigarettes in Toronto held by anti-smoking advocates and a number of attacks on the devices in the Canadian media.
The common argument against the smokeless devices — cited by the Lung Association and others — is an old U.S. Food and Drug Administration (FDA) test, which found carcinogens and a chemical used in anti-freeze in a sample of e-cigarettes. This, however, is misleading.
The tests performed by the FDA were very small, only 18 samples were tested, none of the samples contained more than trace levels of carcinogens — no more than are found in other nicotine-replacement products, such as patches or gum. Only one sample contained the chemical used in anti-freeze. That was likely a result of a manufacturing defect, as it is an ingredient used in producing plastic. It has not been found in any tests since — suggesting manufacturers have taken steps to improve safety and quality control.
Appearing on CBC Radio’s The Current last week, Melodie Tilson, policy director with the Non-Smokers’ Rights Association, admitted there’s “virtually no chance an e-cigarette could be as harmful as a tobacco cigarette to the individual using the product.” But this fact, which should be the most important consideration for anyone interested in reducing the number of deaths caused by smoking, is not enough for people who don’t just hate cigarettes — they hate anything that resembles them.
“We need to look at the bigger picture and their impact on overall smoking rates,” Tilson continued. “If the widespread promotion of these products, and availability, causes young people to use them and then transition to actual cigarettes, that’s an increase in harm.”
No one wants to see teenagers start smoking. Even fake cigarettes are better left untouched. Yet, according to researchers at the Canadian organization TobaccoHarmReduction.org, there “is no real evidence that anyone who otherwise would not have smoked starts because of ST [smokeless tobacco] use.”
It is also extremely hard to believe that anyone would go from using a product that comes in a variety of flavours and switch to something that tastes like burnt tobacco. It’s like arguing that rum and Coke is a “gateway drug” that will get youth to start shooting heroin.
Both Health Canada and the Lung Association urge smokers looking to quit to use approved smoking-cessation products, such as lozenges or nicotine inhalers. But a 2011 study published in the journal Addiction found that the vast majority of e-cigarette users already had tried other methods of quitting and failed. Furthermore, 79% of those using the devices were able to fully replace their cigarette habit.
A literature review, published in the Sept. 2012 edition of the same journal, posits that “removing e-cigarettes from the market or discouraging their use could harm public health by depriving smokers of a potentially important option for smoking cessation.” It would “seem misguided,” the authors argue, “to ask people to discontinue an approach that is working in favour of an approach that has already been ineffective for them.”
By dismissing this technology outright, the anti-smoking crowd is showing their true colours. Their actions show a deep-seated antipathy toward smokers and anything that resembles a cigarette, rather than a concern for overall public health.
Health Canada also needs to end its ban on nicotine liquid. Perhaps there is room for regulations over quality control and steps that can be taken to prevent minors from buying the devices. But policy-markers must realize that, as a harm-reduction technology, e-cigarettes have the potential to save many lives. And, ultimately, adults who choose to use them should be free to make their own decisions.