What’s Not to Like?

Michael Siegel is a professor in the Department of Community Health Sciences at the Boston University School of Public Health. He also writes a tobacco policy blog called “The Rest of the Story.”

August 20, 2013

Many anti-smoking advocates have argued that electronic cigarettes don’t help smokers quit but merely prolong their addiction to nicotine. In other words, the hundreds of thousands of electronic cigarette users in the United States are smokers who, if only they stopped using e-cigarettes, would successfully quit smoking.

This is a ridiculous argument and those advancing it are not living in reality. The truth is that only 3 percent of smokers who want to quit will do so successfully in any given year. Thus, the vast majority of smokers who try to quit using electronic cigarettes are people who would not have otherwise quit.

Many anti-smoking groups oppose e-cigarettes because they find it difficult to endorse a behavior that looks like smoking, even though it is saving people’s lives.

In fact, the overwhelming majority of smokers who try electronic cigarettes are smokers who have been unable to quit using other available methods, such as nicotine replacement and other drugs that anti-smoking groups are recommending over e-cigarettes. Since they haven’t found other ways to stop smoking, it is clear that these are not people who would have suddenly been able to quit if only they had not tried e-cigarettes.

Available scientific research confirms that electronic cigarettes are an effective smoking cessation and reduction strategy for many smokers. There is abundant clinical and survey evidence, and recently – clinical trial evidence – that literally hundreds of thousands of U.S. smokers have successfully quit or cut down substantially on the amount they smoke thanks to electronic cigarettes.

In spite of this supportive scientific data, many anti-smoking groups oppose these products because they are blinded by ideology: they find it difficult, if not impossible, to endorse a behavior that looks like smoking, even though it is literally saving people’s lives.

Electronic cigarettes also have the benefit of eliminating exposure to toxic secondhand smoke. They are helping to reduce disease among smokers and nonsmokers alike. What’s not to like?

The F.D.A. should embrace electronic cigarettes as legitimate harm reduction products that provide an alternative to millions of smokers who simply have not succeeded to quit using available methods. Regulation is needed to ensure that these products are as safe as possible and that they are manufactured with appropriate quality control standards. If the F.D.A. acts wisely, these products have the potential to substantially reduce cigarette consumption and reduce the toll of cigarette-related disease.

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