Experts say vaping alarm is overdone

By Sabrina Tavernise, New York Times News Service

Wednesday, Nov. 2, 2016 | 1:02 a.m.

WASHINGTON — A decade after electronic cigarettes were introduced in the United States, use has flattened, sales have slowed and, this fall, NJoy, once one of the country’s biggest e-cigarette manufacturers, filed for bankruptcy.

It is quite a reversal for an invention once billed as the biggest chance to end smoking as we know it and take aim at the country’s largest cause of preventable death. Use of the devices is slumping because they are not as good as cigarettes at giving a hit of nicotine. Dealing another strike against them, the country’s top public health authorities have sent an unwavering message: Vaping is dangerous.

The warning is meant to stop people who have never smoked — particularly children — from starting to vape. But a growing number of scientists and policymakers say the relentless portrayal of e-cigarettes as a public health menace, however well intentioned, is a profound disservice to the 40 million U.S. smokers who could benefit from the devices. Smoking kills more than 480,000 Americans a year.

“We may well have missed, or are missing, the greatest opportunity in a century,” said David B. Abrams, senior scientist at the Truth Initiative, an anti-smoking group. “The unintended consequence is more lives are going to be lost.”

U.S. public health experts, led by the Centers for Disease Control and Prevention, have long been suspicious of e-cigarettes. The possible risks of vaping are vast, officials warn, including the potential to open a dangerous new door to addiction for youth. Scientists will not know the full effect for years, so for now, they caution, be wary.

But mounting evidence suggests vaping is far less dangerous than smoking, a fact that is rarely pointed out to the U.S. public. Britain, a country with about the same share of smokers, has come to the opposite conclusion from the United States. This year, a prestigious doctors’ organization told the public that e-cigarettes were 95 percent less harmful than cigarettes. British health officials are encouraging smokers to switch.

The U.S. approach “is the same as asking, ‘What are the relative risks of jumping out a fourth-story window versus taking the stairs?'” said David Sweanor, a lawyer with the Center for Health Law, Policy and Ethics at the University of Ottawa. “These guys are saying: ‘Look, these stairs, people could slip, they could get mugged. We just don’t know yet.'”

E-cigarettes are much less harmful because they do not have the deadly tar found in regular cigarettes. They instead provide the nicotine fix smokers crave through a liquid that is heated into vapor and inhaled. There is no long-term data yet, but evidence does not show the vapor to be particularly harmful in the short term.

That e-cigarettes are less harmful is a message U.S. smokers rarely hear, partly because U.S. regulation prevents it. Companies are banned from making such claims unless they go through a long process to prove it, and so far, no e-cigarette maker has done so. More states are passing laws that lump e-cigarettes in with traditional cigarettes, levying taxes on them and banning their use as part of local smoke-free rules.

“When they are regulated just like tobacco, people draw the conclusion that they are just as dangerous,” said Daniel I. Wikler, an ethicist at the Harvard School of Public Health. “You didn’t say it, but you didn’t have to. People make that assumption, and you don’t try to disabuse them of it.”

Last week, Georgia State University published a report finding that the percentage of Americans who thought e-cigarettes were as bad as cigarettes or worse than them had tripled, to 40 percent in 2015 from 13 percent in 2012.

If smokers have tried everything else, and use an e-cigarette to quit completely, “that’s a good thing,”