Should E-Cigarettes Be Treated Like Cigarettes?
April 7, 2014 1:17 p.m.
Jeff Stier, is a Senior Fellow at the National Center for Public Policy Research a conservative think tank. He has presented on the benefits of e- cigarettes at conferences and public meetings across the country.
John Pierce, Ph.D. of the UCSD Moores Cancer Center. This year he was awarded the 2013-14 American Association of Cancer Research outstanding researcher in cancer prevention.
Related Story: Should E-Cigarettes Be Treated Like Cigarettes?
MAUREEN CAVANAUGH: This is KPBS Midday Edition, I am Maureen Cavanaugh. The introduction of e-cigarettes is depending on who you talk to, either an appealing alternative to help addicted at current smokers to give up tobacco or a gateway devices for the new generation of tobacco smokers. Sims East areas have banned the cigarettes and now the city of San Diego is considering a band. This week in San Diego at the annual meeting of the American Association for Cancer research, doctors are hearing cases for and against the service. I would like to welcome my guests, just iron and John Pierce. Thank you for coming in, welcome. Jeff, there seems to be a growing amount of concern among public policymakers about e-cigarette, many cities want to ban them in the same way that they banned the use of tobacco products, what is wrong with that in your opinion?
JEFF STIER: It would actually be harmful because we get in the way for all the people who are real public health heroes, real heroes who live quit smoking using e-cigarette then it would make it difficult and send the message that e-cigarette are just as dangerous or more dangerous than cigarettes, and that is just not the case.
MAUREEN CAVANAUGH: None of the cities that I've read about and actually made e-cigarette illegal, they are just regulating where they can be used like tobacco products, what would be wrong with regulating them in that way?
JEFF STIER: I am in favor of regulation and I think immediately they should ban the use of the cigarettes for minors, there should be safety precautions and product standards but he suggesting that they should be regulated the same way as the deck tobacco products and suggest they carry the same risk is a falsehood, I think even public health committees are beginning to recognize that e-cigarette serve dramatically less harmful than cigarettes and we ought to allow people in more places to use them rather than treating them the same way.
MAUREEN CAVANAUGH: Let me ask you though, just remind us how using e-cigarette differs from smoking tobacco.
JEFF STIER: Think we all know the serious health consequences of smoking cigarettes and the danger is not from nicotine which makes them at the hip, is from the burning tobacco and inhaling it, and you get anything close to that kind of risk from e-cigarette, yes there is more data that we need a we know that there is no combustion or tobacco, they are dramatically less harmful.
MAUREEN CAVANAUGH: The chemical makeup as Jeff says of burning tobacco, that causes most of the dangers of smoking and all the concerns are also in secondhand smoke?
JOHN PIERCE: The chemical makeup is the 4000 constituents in tar that he is restricting that to combusted tobacco, And the issue is there's only one paper that is really looked at indoor air concentrations following a number of people ever rising at the same time, vaporizing at the same time and what they found was a critical component thing that is big enough to lodge in your Linux, at 2.5, the guidelines from EPA for that is that you should not be exposed to more than 35 mcg/m≥, these were five times that.
MAUREEN CAVANAUGH: In your estimation, is that enough for public health concern involving e-cigarette?
JOHN PIERCE: It's not just the particulate matter, the other concern is the expired or exhaled nitric oxide, and asthmatics or potential asthmatics are going to be exposed to a lot of nitric oxide in the vaporizing as well, so the question of how other people are exposed is not answered, there are significant concerns in the literature that have come about, which means that at the moment, we should do is come keep these restrictions in place and secondhand exposure is not safe until demonstrated, and not safe just because the company said it.
MAUREEN CAVANAUGH: Let me pose questions to both of you that I opened within my opening statement if you would, John, many of this year's surgeon general's report on smoking makes the distinction between tobacco and e-cigarettes as a nicotine delivery system? The report does say that it could help tobacco smokers quit, could not help smokers who are you addicted to nicotine avoid the risks involved in tobacco smoke?
JOHN PIERCE: There is no question that if the only thing that happened was heavy smoke converted and used e-cigarette instead of cigarettes, their own health would be significantly improved, there's no question about that, the weather they can quit or not and whether quitting means using nicotine or not, you can stay in nicotine addict using these products, that is neither here nor there. The issue is, whether you putting anyone else at risk when you smoke and the issues kids, I not just came in on kids because what is happening with kids, as you saw last week from the poison information, you're getting something like 100 calls for kids getting poisoned every week in his growing exponentially, because kids are picking up and vaporizing themselves, and they are having toxic nicotine, it's not a harmless ingredient, speak to the poisoning cases were not examples of people who are vaporizing, you know better than that.
MAUREEN CAVANAUGH: Gentlemen, let me stop you right there, I want to go to Jeff about this gateway argument about how kids and not children, kids who are not addicted to nicotine will be using e-cigarette and can get themselves addicted to nicotine, which we know is possible, and therefore will begin smoking tobacco cigarettes, as the gateway argument, what would you say to that?
JEFF STIER: So far evidence does not support that, in fact it supports the opposite. Nobody adult smokers but some minors using them, must the data so far shows that people using e-cigarettes are smokers, not that e-cigarettes are a gateway to smoking, the cigarettes are a gateway away from smoking but because of the concern though use useful for using them, I strongly and immediately encourage a ban on the sale of e-cigarette to minors and in fact, all of the reputable retailers will not sell e-cigarette to minors and the law should be very clear about that, and we can do that immediately, and we are hearing things like e-cigarettes are poisoning people from using them, the poisoning cases have been examples of when people actually ingesting them. And that is why we should have regulation immediately that has phonics safety standards and reasonable regulation with a light touch.
MAUREEN CAVANAUGH: You just turn that on its head, the American Association of pediatrics say that kids that use the e-cigarette's are more likely to smoke cigarettes, are you saying that they started smoking cigarettes and is now smoking e-cigarette?
JEFF STIER: The problem is the association. The media says sometimes it causes people to smoke and there's an important scientific difference, association causation are different, it's more likely that there is that association, but is not from people using e-cigarette to smoking, it's the other way around.
JOHN PIERCE: I have to disagree with that completely. The data is not in on this yet and first of all, the Surgeon General's report and the director of the CDC came out and made the point that middle and high school students using the e-cigarettes has doubled in the last year and the advertising budget aimed at these people has gone skyhigh, And some of the ads are actually offensive, and we have to come back to this one about the poison, which is significant issue, so in the first two weeks of January, we heard that there are 200 calls for poison and 50% of them from four to five year olds, most were from toxic installations in other words, kids are using them, are also a lot of concerns with eye and skin exposure, this is adults having them and moving them around in the young kids are picking them up and using them, from what we can gather.
MAUREEN CAVANAUGH: Couldn't the same thing be said about alcohol?
JOHN PIERCE: It can and drugs as well.
JEFF STIER: That's why we should regulate e-cigarette and product standards is unnecessarily from kids vaporizing them, it is also coming from the liquid being out with the droppers and there is no control over them, that is why I think we immediately need activation with a light touch to make sure there are fields that we kids can't get accidentally exposed to them.
JOHN PIERCE: Or so kids can put marijuana in them.
JEFF STIER: That's scare mongering. This is a serious issue.
JOHN PIERCE: I beg your pardon?
JEFF STIER: This is a serious issue.
MAUREEN CAVANAUGH: I think the reason that educators are still pushing this argument is because another aspect of this year's report that cigarette smoking is apparently become becoming more deadly and were talking about tobacco cigarette smoke, John can you tell us about that?
JOHN PIERCE: Even more deadly, what is happened is with the change in way they make cigarettes and despite of all of the nicotine, the changing structure of the cigarette in the last thirty years, people have been smoking, there been higher rates of lung cancer from that and a different type of lung cancer as well, from what there was these on the 950s and 60s, there's been a change of that and however we can, however we cut it, it smoking cigarettes for forty or fifty years is going to give you a tenfold increase, it is way up there. The best thing is to prevent the inhalation of combustible projects. Everyone will agree that if smokers can not smoke cigarettes, even if they continue to use nicotine, that their health will be better.
MAUREEN CAVANAUGH: Are you surprised to hear John say this that everyone agrees that e-cigarette's, some sort of nicotine delivery system is better than continuing to smoke tobacco?
JEFF STIER: Etiquette represents [ CHECK AUDIO ] significant progress in the discussion and I will come those kinds of comments from everyone to the FDA and we think we're in the right direction.
MAUREEN CAVANAUGH: I think one of the concerns that you have, John that the push for e-cigarette is actually being conducted in some way by the cigarette companies, is that right?
JOHN PIERCE: Featuring the money is coming from cigarette companies, no question. Every counsel that is been on this has had huge representation, which is unheard of and I was heavily involved in all of the tobacco advertising as you might know with Joe Camel, and a lot of that went on at city councils, nothing like the attendance that we get now on e-cigarette, since the company started buying products themselves. The advertising is egregious. We have ads now that you wonder why can be put on air, and it's back on television, and clearly marketed targets our kids, young kids. The marketing is going on and we have the attempts to break down the clean indoor air that we have and that in the evidence to say, it's a significant political push, that is what I have trouble with.
MAUREEN CAVANAUGH: Jeff, you have a chance for the response.
JEFF STIER: I think that marketing to adults is a fantastic thing here, your private companies not owned by tobacco companies, they believe in putting an end to cigarettes and I think all agree on that as well and it via way to do that is by advertising, there was a Super Bowl ad which encouraged people to quit, those ads or were a friend offered his buddy and e-cigarette would be more effective than the government-funded ad. These are private sector adds aimed at adults and I think we should have private we should have regulation to make sure there's not advertising to children, but it's not the same, this is a rhetorical device that advocates who oppose e-cigarette used to say this just like smoking, the only difference it's not smoking. They say that e-cigarette normally smoking, and normalized not smoking.
MAUREEN CAVANAUGH: Let me ask you, in conclusion, Jeff, what kind of e-cigarette regulation would you support?
JEFF STIER: I support immediate ban the sale to advertising and selling to minors, and product safety regulations to make sure there are no accidental poisoning.
MAUREEN CAVANAUGH: And John, what kind of research would you like to see?
JOHN PIERCE: There's a lot of research currently underway in the national surveys and continuous or phrase of the current population, we're probably a couple of years out from getting a very good handle on e-cigarette, and what it looks like is, they will be helpful in quitting smoking, the evidence does not say that. With better products, which is what we expect, expects this situation to reduce the number of products in the next two years. I think will happen is, the availability of all of the liquids is going to go way, and they're going to be standardized by a container with so you can't tamper with it, and you can trinket or anything else, I think those things will happen to make safer products as the go forward, and so the question then is, where can people use them? And how do you prevent young people from this huge increase?
MAUREEN CAVANAUGH: I have to end it there, I appreciate you both so much. Jeff Stier and John Pierce, thank you both very much.