Both the New York Times and the Wall Street Journal carried front-page stories today (in the Journal, atop the Marketplace section rather than p. A1) on “e-cigarettes,” something most of us never heard of until the past few weeks or not until today. Most e-cigarettes come from China. They have been around for a couple of years but only recently reached the $100 million mark in annual sales. In a sense, e-cigarettes are the latest chapter in the continuing debate over smokeless tobacco, which deliver nicotine from tobacco but eliminate the smoke, which is the source of practically all the harms from cigarette smoking. E-cigarettes are the ultimate smokeless product because they don’t actually involve tobacco at all. They typically contain nicotine, water, some flavorings and scents, and propylene glycol (which the Times explains is common in hand sanitizers)—plus a battery and a miniature atomizer so that when the user takes a puff, he or she receives a nicotine-laced flavored mist.
The leading public health antismoking organizations like the American Cancer Society, American Heart Association, and the Campaign for Tobacco-Free Kids (supported by litigation-induced taxes on smokers) are furious about these unregulated products. They want proof of safety and efficacy, and they want the Food and Drug Administration to force e-cigarettes off the market. That is exactly what the FDA is prepared to do, on the grounds that e-cigarettes are obviously designed to help smokers quit, which is a recognized medical use and therefore renders these products subject to FDA rules about the testing and approval of new drugs.
It is hard to believe that e-cigarettes pose even a tiny percentage of the risks of smoking. Remember, there is no smoke, and the dangers of nicotine itself resemble those of caffeine. The antismoking groups are intent upon perpetuating their reckless gamble that smokers can be induced to quit and that in the meantime, virtually harmless substitutes should be kept off the market unless they go through rigorous FDA testing with all its expense and narrow focus on how products are used.
All of which leads to the totally weird observation that e-cigarettes would be free of all this controversy if only they were more dangerous (by putting real smoke in the lungs, for example) and if they didn’t seem to help people quit smoking cigarettes. In today’s strange public health regulatory environment, cigarettes are OK and smokeless substitutes are not.
And now, what about FDA regulation of tobacco products? Well, that’s another story for another time (really soon).