Yesterday, the Los Angeles City Council joined New York City in approving legislation banning electronic cigarettes wherever conventional cigarettes are banned. That includes bars, nightclubs, restaurants, beaches, parks, and many workplaces. The Council’s rationale echoes the same argument behind almost all opposition to e-cigarettes: That the devices will compel people, particularly teens, to smoke who would have never smoked otherwise.
“I will not support anything — anything — that might attract one new smoker,” Council President Herb Wesson said during yesterday’s hearing.
That’s a noble position. But are e-cigarettes really a gateway to conventional cigarettes? And if not, has LA just knee-capped a valuable alternative to cigarettes that could help some of the 400,000 Americans who die every year of smoking-related illness?
The most important thing to remember when talking about e-cigarettes is that we are still in the very early days of researching their health and sociological risks. That’s why it’s not helpful to boil the issue down to false binaries like the one used here by the LA Times last January:
Electronic cigarettes are either a potent weapon in the war against tobacco, or they are an insidious menace that threatens to get kids hooked on nicotine and make smoking socially acceptable again.
Why can’t they be both? E-cigarettes may indeed be a “potent weapon” for fighting cancer and “an insidious menace” for attracting teen smokers. Or they could be neither.
Instead of relying on easy talking points and dichotomies, let’s look at what we do know. The early evidence that e-cigarettes are a gateway to conventional cigarettes is flimsy. While a CDC survey found that the percentage of teenagers who had tried e-cigarettes doubled between 2011 and 2012, another survey from the University of Oklahoma Health Sciences Center showed that only 3.3 percent of college students said e-cigarettes were the first form of nicotine they’d tried. Of those, only one respondent later started smoking conventional cigarettes. Conventional smokers are taking up e-cigarettes, not the other way around. Meanwhile, the increase in smoking e-cigarettes or “vaping” among teens between 2011 and 2012 coincided with a larger explosion of e-cigarette sales between 2011 and 2012, from $195 million in annual sales to $500 million.
So the “gateway drug” argument is inconclusive at best. More to the point: Are e-cigarettes healthy?
Whenever assessing the dangers of e-cigarettes, we must confront the fact that these devices have not been around long enough for us to know the long-term effects. I summed up what we do know about the potential health issues posed by e-cigarettes in a post last January:
1. The e-cigarette “smoke” is made up of vaporized propylene glycol and glycerin. The FDA says these are “generally regarded as safe,” however we haven’t had time to study the longterm effects of inhaling it.
2. Yes, there’s still nicotine in e-cigarettes, which increases blood pressure and heart rate at the dosage contained in both conventional and electronic cigarettes. But nicotine’s side effects are minimal compared to the carcinogenic tar and carbon monoxide found in real cigarettes. That’s what causes cancer, not nicotine.
3. Some studies have detected in e-cigarettes some of the same harmful chemicals found in real cigarettes, like formaldehyde. But before you panic, it’s extremely important to note that these chemicals were only produced under “unrealistic” levels of heat, according to Drexel University environmental and occupational health expert Igor Burstyn. Other critics say some of the devices tested came from unreliable sellers in China.
Or if you prefer your e-cigarette knowledge in the form of an R&B song, we’ve got you covered:
Finally, do e-cigarettes help people quit? A study funded by the Health Research Council of New Zealand found that 7.3 percent of smokers achieved complete abstinence from nicotine after six months using e-cigarettes. That may not sound high, but it beat out nicotine patches (5.8 percent) and placebo e-cigarettes (4.1 percent). Furthermore, this study measured the effectiveness of using e-cigarettes to quit nicotine entirely, not their effectiveness at replacing conventional cigarettes.
E-cigarettes are “generally regarded as safe” by the FDA, though there hasn’t been enough time to study the long-term effects.
In any case, without the tar and carbon monoxide found in conventional cigarettes, e-cigarettes are almost certainly healthier than conventional cigarettes.
E-cigarette use has risen among young people, but there’s little evidence to suggest they use e-cigarettes as a gateway to conventional cigarettes.
Finally, as a smoking cessation tool, e-cigarettes are about as effective than nicotine patches.
That’s why Los Angeles and New York’s decisions to treat e-cigarettes like conventional cigarettes is irrational and bad policy. Instead of a blanket ban in public spaces, which is somewhat gratuitous given that the secondhand effects of e-cigarettes are “almost immeasurable compared to the toxins in secondhand cigarette smoke,” we need a different kind of regulation and oversight.
For example, in some states there’s no age limit to buy e-cigarettes, which must change. And as Big Tobacco begins to put its muscle and millions behind e-cigarettes, it’s crucial for federal health and safety officials to monitor what’s goes inside them and how they’re marketed. Over the past fifty years, tobacco companies made numerous changes to the design and makeup of cigarettes to render them more addictive, and more deadly. E-cigarettes may be relatively safe today, but what if the Marlboro Man starts adding ammonia to them?
Smoking is one of the hardest addictions to quit. There have been year-long periods where I barely thought about cigarettes, only to return to them under pressure later. That e-cigarettes can help some kick the habit (I know many of them personally) with minimal proven harm to others or themselves, makes unilaterally banning them a bad decision. Charles D. Connor, former president and CEO of the American Lung Association, agrees: “Such restrictions make sense for traditional tobacco cigarettes. But this proposal is misguided because it would do a public health disservice, discouraging smokers from switching to less-harmful electronic cigarettes that do not combust tobacco and therefore, do not create second-hand smoke.”
So cities of America: let’s cut it out with these bans — especially when the evidence supporting them is often flimsy and panic-driven.
[Illustration by Hallie Bateman for Pando]