Editor’s note: This commentary is by Adam Tredwell, who works at Vermont Vapor Inc. The views expressed are his own and do not necessarily represent the views of his employer.
In the past, Vermont has embraced humane harm reduction policies when it comes to sex education and, more recently, when dealing with illegal drugs like heroin. However, when it comes to smoking and the 80,000 Vermont adults who are still using cigarettes, public health activists are quick to embrace ideological positions backed not by evidence but by special interest groups.
Case in point: vapor products and electronic cigarettes. These smoke-free and tobacco-free devices are helping smokers all across the country quit smoking. Indeed, in September the CDC released results of a groundbreaking survey that found that among smokers who had quit in the past year, nearly one quarter of them were using vapor products. This likely makes vaping the most commonly used quit smoking tool in the United States.
Activists are apt to point out that vapor products are not FDA approved. There’s a good reason why — estimates put the cost to gain FDA approval for a single new drug at $500 million or more. The small company that I work for in Castleton, Vermont Vapor, cannot afford to apply for one application, let alone the over 100 applications that would be necessary to get our full product line approved. The multi-billion dollar cost of pursuing these applications would likely exceed the GDP of the entire state of Vermont. I don’t believe Vermonters really need another “FDA approved drug” that costs thousands of dollars per month when they can buy the same product now for $20-$40 per month.
In a recent commentary on VTDigger, Dr. Jan Carney claimed that it is a myth that e-cigarettes help people quit smoking. This is a perplexing claim considering there is a vast body of evidence showing that e-cigarettes are just as, if not much more, effective than products made by the pharmaceutical industry like the nicotine patch and gum. A peer reviewed study in 2014 found that among a population of smokers making quit attempts, approximately 20 percent of those using vapor products quit successfully, while just 10 percent of those who used the nicotine gum managing to get away from smoking. Another study published in the American Journal of Preventative Medicine found a 70 percent quit rate among those who used e-cigarettes more than 20 times per day.
Far from “supporting adults’ decisions to quit smoking,” as Dr. Carney claims, H.171 would force e-cigarette users who have quit smoking years ago to breathe in secondhand smoke.
For those activists who oppose harm reduction by adult smokers, merely stating that alternative products don’t work is never enough. In her commentary, Dr. Carney argues that e-cigarettes may contain a host of different chemicals. Nowhere, however, does she mention the amount of substances found in e-cigarette vapor or if those levels would be harmful. This tactic has been used for decades by those looking to confuse the public about “chemicals.” For example, municipal water (a chemical) used by Vermont families may contain arsenic and mercury – indeed, it is quite common. The question isn’t whether a particular chemical is present, but whether the specific amount of the chemical present is dangerous.
For several centuries, the principle tenet of toxicology has been, “The dose makes the poison.” In fact, toxicologist Dr. Igor Burstyn of the Drexel University School of Public Health analyzed thousands of observations of e-cigarette liquid and vapor for a paper that was published in BMC Public Health. Dr. Burstyn, whose expertise is in the effects of chemicals on pregnant women, found that “(t)here was no evidence of potential for exposures of e-cigarette users to contaminants that are associated with risk to health at a level that would warrant attention if it were an involuntary workplace exposures.” He concluded that because secondhand exposure is so much less than what is inhaled by the user, vapor products “pose no apparent concern” to those who are around someone using a vapor product.
Unfortunately, in the field of vapor products, bad studies never go away. Dr. Carney cites a widely discredited letter to the editor of the New England Journal of Medicine on the presence of formaldehyde in e-cigarette vapor. However, the results produced by those researchers were the result of vapor products being tested by a machine in an improper manner that caused combustion. One byproduct of incomplete combustion is formaldehyde. E-cigarettes are designed to heat the liquid inside (a type of alcohol) to its boiling point; not to set it on fire. No human could withstand the burning and acrid taste produced by this, yet with no humans involved in the study, the machine just kept puffing. This should be common sense. Indeed, it is analogous to maple sap: heated to the right temperature, it is quite tasty and reasonably healthy. But if you let it boil too long it will light on fire and smoke and dangerous byproducts like formaldehyde are produced. The New York Times’ Joe Nocera rightfully tore into this study last year, declaring that the study was deeply flawed and seemed to be designed to scare smokers into continuing to smoke. Other studies have found that when used properly, e-cigarette vapor contains less formaldehyde than plain human breath.
Far from “supporting adults’ decisions to quit smoking,” as Dr. Carney claims, H.171 would force e-cigarette users who have quit smoking years ago to breathe in secondhand smoke. It would also send the wrong message to smokers: It’s better to keep smoking. With no evidence of harm to bystanders or users, and plenty to the contrary, the state should butt out and allow Vermont smokers to quit in peace.