E-cigarettes shouldn't be banned

Fairbanks Daily News-Miner community perspective: 

The University of Alaska Board of Regents recently voted to ban smoking and electronic cigarette use on campus. It seems likely their real concern was marijuana, but in any case, the reflexive inclusion of electronic cigarettes in this ban was a huge mistake.

The electronic cigarette is not a gimmick. It’s potentially the single most cost-effective life-saving innovation in the world. It’s probably also the greatest single potential life-saver regardless of cost.

It’s easy to see why. Smoking results in about 440,000 deaths per year (DPY) in the U.S. and almost 6 million DPY worldwide. Cigarette use shortens life expectancy by about 10 years, resulting in 5.1 million years of potential life lost (YPLL) per year in the US, and about 58 million YPLL per year worldwide.

Cigarettes cause an equivalent number of deaths to those lost in World War II every 10 years. Worldwide, the death rate per capita is still increasing. If universally adopted, e-cigarettes would prevent almost all of this staggering loss at negligible cost.

So the main questions are: how easily can the smoking population switch to e-cigarettes, and what can we as a society do to accelerate the process? Smokers could switch fairly easily, and we as a society should help them do so by avoiding or minimizing e-cigarette bans and refraining from taxing e-cigarettes like conventional tobacco products.

From the smoker’s perspective, e-cigarettes are eminently adoptable. Compared to other non-tobacco nicotine delivery systems, the e-cigarette is preferable from the nicotine addict’s point of view. The addict directly controls the dose, which is delivered immediately by inhalation (the route which delivers the desired effects most quickly). Competing cigarette substitutes aren’t as good: patches can’t deliver user-controlled dosage spikes, and nicotine gum and other oral delivery systems respond less quickly to user dose manipulation than inhalation. Revealingly, the most recent pharmaceutical smoking cessation offerings are nicotine inhalers, which differ only slightly from e-cigarettes.

E-cigarettes are safer for bystanders for the same reason they are safer for smokers: they don’t make smoke. They do emit some nicotine, but not nearly as much as conventional cigarettes. E-cigs generate no so-called “sidestream vapor”: only re-exhaled nicotine makes its way into the local atmosphere, not the continual stream of nicotine produced by the combustion of conventional cigarettes. The aerosol nicotine concentration produced by an e-cigarette is about a tenth the amount produced by a conventional cigarette. 

Exactly how dangerous is nicotine? This question is currently the subject of intensive study and debate, but scientists agree it isn’t nearly as dangerous as conventional cigarette smoke. The reflexive urge to ban e-cigarettes needs to be reconsidered. 

It’s probably too much to expect non-smokers to altruistically welcome electronic cigarettes back into restaurants in an effort to save smoker’s lives. Why should they? However small the risks associated with secondhand nicotine exposure, they probably aren’t zero. However, if you’re headed out for a pleasant evening’s soak in alcohol, the additional damage done by nearby e-cigarettes likely is negligible.

The other big issue is taxation. Cigarette taxes as currently implemented are less effective at discouraging smoking than you might think. The demand for cigarettes among existing smokers is fairly inelastic, and inasmuch as it is not, the black market tends to make up the difference. States can spend the sums collected however they want, and they choose to spend an average of only 1.9 percent of them on anti-tobacco programs. Spending more on prevention actually might stop people from smoking, which would in turn deprive cash-strapped states of a significant source of revenue.

Taxing e-cigarettes like conventional cigarettes, as many states would like to do, is insane. No conceivable use of the funds obtained this way could possibly benefit the public as much as the comparative advantage conferred on e-cigarettes by not taxing them. Teenagers, who constitute the most price-sensitive group of nicotine consumers and also the only group vulnerable to new nicotine addiction, are particularly likely to be pushed into the e-cigarette camp by a price differential. That differential would make the existing taxes on conventional cigarettes dramatically more useful for public health.

According to Dr. David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the anti-smoking advocacy group Legacy, “There is absolutely no evidence that using e-cigarettes makes (teens) more likely to use cigarettes.” 

In fact, smoking among teenagers appears to have declined recently even as e-cigarette use has increased. 

E-cigarettes are far safer than conventional cigarettes, fairly easy for smokers to adopt, and seem unlikely to cause new conventional cigarette addiction. They have the potential to save a staggering number of lives. Lets not mess things up by banning, stigmatizing or taxing them.

Britton Kerin is a Fairbanks resident and a web developer for the Alaska Volcano Observatory.

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