Professor Michael Siegel
The Rest of the Story
In an op-ed published in the Arizona Republic, the Southwest chapter of the American Lung Association has called for a federal ban on the television advertising of electronic cigarettes, protesting against an ad that appeared in the Phoenix area during the Super Bowl and urging the FDA to ban such ads in the future.
The American Lung Association writes: “We were stunned to see that twice during the nation’s largest televised sporting events, the CBS affiliate in Phoenix aired a commercial that touted the use of e-cigarettes. … Costs were not spared in the creation of this polished and professionally produced television commercial to deliver a misleading message to the public. Ironically, the commercial promoted this e-cigarette as the first with “a look, feel and flavor of the real thing.” We would say that it has a whole lot in common with real cigarettes.”
“The U.S. Food and Drug Administration has found e-cigarette cartridges labeled as nicotine-free often have traceable levels of nicotine. That means a smoker using e-cigarettes hoping to slowly break his nicotine habit is really exacerbating his addiction to the drug. To make matters worse, FDA tests have found detectable levels of carcinogens and toxic chemicals, including an ingredient used in antifreeze, in some e-cigarettes. … E-cigarette companies sometimes say this product can help people stop smoking. Going well beyond views and studies of the American Lung Association in Arizona, the World Health Organization knows of no evidentiary basis for the marketers’ claims that the electronic cigarette helps people quit smoking. The American Lung Association in Arizona believes nicotine use, whether it is a regular cigarette or an e-cigarette, is still an addiction.”
The American Lung Association was also quoted in a separate Arizona Republic article as protesting against the electronic cigarette ad because it is promoting cigarettes and falsely claiming that these products can help people quit smoking: ““Whenever I see any kind of (cigarette) advertising that seems out of place, I am certainly sensitive to it,” said Bill Pfeifer, president and CEO of the American Lung Association chapter of the Southwest. “We are trying to encourage people to quit smoking, and there is no scientific evidence that these products help people kick their habit.””
Just about everything that the American Lung Association said about electronic cigarettes could also be said about nicotine replacement therapy (NRT), but the ALA – curiously – is not calling for a ban on NRT advertising on television.
Like electronic cigarettes, NRT represents a nicotine delivery system. If the ALA truly believes that “nicotine use, whether it is a regular cigarette or an e-cigarette, is still an addiction,” then certainly NRT is also addictive and should not be promoted on television.
The ALA also complains that electronic cigarettes contain “detectable levels of carcinogens.” Well so do NRT products. So certainly, NRT advertising should also be banned on television. Why would we want to allow the advertising on television of a product that has detectable levels of carcinogens? How can the ALA possibly justify that stance?
The third prong of the ALA’s argument is that electronic cigarette advertising should not be allowed on television because there is no evidence that it is helpful in smoking cessation. As I’ll show below, that statement is a lie. The truth, in fact, is that the current evidence suggests that electronic cigarettes are actually more effective than NRT in smoking cessation.
The truth is that the NRT products which the ALA is promoting are a dismal failure. They work only about 8% of the time. They fail in the overwhelming majority of cases. So why should NRT ads – which are far more deceptive than electronic cigarette ads – be allowed on television?
The real deception here is not in the electronic cigarette company’s ad, but in the American Lung Association’s statement.
It is the American Lung Association that is lying when it states that there is no scientific evidence that e-cigarettes are an an effective cessation tool. Actually, there is abundant evidence that literally thousands (if not tens of thousands) of electronic cigarette users have successfully used these products to either quit smoking or to cut down substantially on the amount that they smoke. A clinical trial has demonstrated that among smokers who were not motivated to quit, 54% were able to quit completely or to cut down by at least half on the amount they smoke. And substantial evidence from the real-life use of these products by thousands of vapers documents that they can be effective in smoking cessation. In fact, the evidence for the effectiveness of electronic cigarettes in real-life settings (outside of clinical trials) is far stronger than that for NRT.
In light of the existing evidence, how can the ALA deceive the public by asserting that there is no evidence for the potential of electronic cigarettes in smoking cessation? To do so is to completely ignore the results of the clinical trial evidence, as well as to ignore the multitude of anecdotal evidence based on personal reports of ex-smokers. Perhaps the ALA has simply not reviewed the scientific evidence, but if that’s the case, it is irresponsible to be putting out a statement like this in ignorance of the science on the issue.
If the ALA had asserted that the effectiveness of electronic cigarettes in smoking cessation has not been definitively proven, that would be fine. But to claim that there is no evidence that electronic cigarettes may be helpful in smoking cessation is simply a lie.
The worst part of this story is that at the end of the day, the American Lung Association is protesting against ads which are promoting smoking cessation. The reason why most electronic cigarette users try these products is because they want to protect their health by quitting smoking, and e-cigarettes are a viable alternative for smokers who have failed to quit using NRT or other drugs.
The rest of the story is that the American Lung Association has become blinded by ideology and has unfortunately lost its vision of protecting the public’s health. Smokers must quit in the way the ALA prescribes, or else their quitting is invalid. Better that smokers should keep smoking and die then successfully quit using a product that the ALA does not endorse because it looks like smoking. Shame on the ALA, both for lying to the public and for standing in the way of smoking cessation for tens of thousands of smokers across the country.