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Vapor War

By William Saletan
Originally Posted on Slate Magazine Wednesday, June 3, 2009, at 10:44 AM ET

Our irrational hostility toward electronic cigarettes.

First there was smoked tobacco. Then there was smokeless tobacco. Now there’s something in between.

It’s vaporized nicotine, aka “vaping.” It isn’t quite tobacco, and it isn’t quite smoking. Should we ban it, since it’s sort of like smoking? Or should we tolerate it, since it’s different in important respects? Does the war on smoking require total victory, or can we accept a peace deal that lets the industry, in some form, escape?

Let’s start with a bit of background. Vaporized nicotine has been around in various forms for at least two decades. Lately, it’s been spreading across the world in the form of “electronic cigarettes.” Two months ago, Slate’s Emily Yoffe tried them out and reported:

The e-cigarette contains no tobacco and produces no smoke. Instead, it is an ingenious electronic device. … The “filter” is a receptacle for nicotine suspended in propylene glycol—the main ingredient in deodorant sticks and artificial smoke machines. … When the user sucks on the filter, a nicotine-laced vapor is produced, satisfying a smoker’s cravings. … [One product] allows you to choose filter cartridges with different levels of nicotine. I selected “none,” which meant my e-cig was the buzz-free equivalent of nonalcoholic beer. The cigarette came in flavors such as tobacco, vanilla, mint, and apple. … Fortunately, as bad as the mist tasted, there was no noticeable odor, and it dissipated almost immediately, and thus didn’t create a secondhand vapor problem.

Yesterday’s Wall Street Journal and New York Times followed up with similar reports. “The vapor can be inhaled and then exhaled, creating a cloud that resembles cigarette smoke but dissipates more quickly and doesn’t have the lingering odor,” says the Journal. The Times described an e-cigarette that “delivered an odorless dose of nicotine and flavoring without cigarette tar or additives, and produced a vapor mist nearly identical in appearance to tobacco smoke.”

So is vaping smoking? Let’s run the checklist. Cigarette? Yes. Smoke? No. Cloud? Yes. Odor? No. Tar? No. Nicotine? Optional.

Good luck sorting this one out.

The first practical question is whether you can vape in places where smoking is now forbidden. Yoffe tried this and got a mixture of technical tolerance and social disapproval. The Journal adds:

Users have had varied experiences vaping in public, ranging from indifference to odd glances. On a recent day, Shai Shloush, 25, from Knoxville, Tenn., huddled in the back of a movie theater to watch the new Star Trek movie. He powered up his e-cigarette and puffed away. “I was covering the LED part so people wouldn’t notice,” said Mr. Shloush, a former smoker. “Every once in a while I’d be really sneaky about letting out the smoke.”

The Times claims that “because they produce no smoke, they can be used in workplaces, restaurants and airports.” One user, for example, reports that “when everyone was smoking outside in the cold, I just stood in the warm bar, smoking.”

The next question is whether we should officially regulate them like cigarettes. According to the Journal,

The American Lung Association, along with the American Cancer Society Cancer Action Network, the American Heart Association and the Campaign for Tobacco-Free Kids, recently called for e-cigarettes to be removed from the market. The groups say e-cigarettes have yet to be proven safe and that kids may be attracted to the products, some of which come in flavors like chocolate and strawberry. “Nobody knows what the consumers are actually inhaling,” says Erika Sward, director of national advocacy at the American Lung Association.

Governments seem to be buying this view. The FDA has officially barred importation of e-cigarettes. “These appear to be unapproved drug device products,” a spokeswoman tells the Times, “and as unapproved products they can’t enter the United States.” Australia and Hong Kong have also prohibited the devices.

That’s a pretty awkward position. We restricted smoking, tobacco sales, and advertising based on decades of evidence that smoking was harmful to smokers and bystanders. Now we’re treating electronic cigarettes the same way based on … what? That “nobody knows” how bad they might be? The elements of smoking that justified our war on tobacco—carcinogens, combustion, secondhand smoke, even nicotine—have been removed or made optional. Is it really logical to ignore these differences?

And why should we presume that vaping is as dangerous as smoking, when research on vaporized marijuana suggests the opposite? Here are two such reports quoted last week in the Human Nature blog. First, a 2007 paper in Clinical Pharmacology & Therapeutics:

Whereas smoking marijuana increased CO [carbon monoxide] levels as expected for inhalation of a combustion product, there was little if any increase in CO after inhalation of THC from the vaporizer. This indicates little or no exposure to gaseous combustion toxins. Combustion products are harmful to health and reflect a major concern about the use of marijuana cigarettes for medical therapy as expressed by the Institute of Medicine.

And second, a 2007 study in the Harm Reduction Journal, which found

that respiratory symptoms like cough, phlegm, and tightness in the chest increase with cigarette use and cannabis use, but are less severe among users of a vaporizer. … The odds ratio suggests that vaporizer users are only 40% as likely to report respiratory symptoms as users who do not vaporize, even when age, sex, cigarette use, and amount of cannabis consumed are controlled.

Let’s be blunt about what’s going on here. We tolerated smoking until science proved it was harmful to nonsmokers. As momentum grew, the war on smoking became cultural, with disapproval and ostracism of anyone who lit up. Electronic cigarettes have removed the war’s scientific basis, but our cultural revulsion persists. Therefore, so does our prohibition and condemnation.

Maybe what we need is a convergence of the tobacco debate with the marijuana debate. In each case, vaporization is dissolving the categories and grounds that warranted prohibition. Liberals can see this, but only in the case of pot. Conservatives can see it, but only in the case of tobacco. Go talk to one another. The engineering and re-engineering of drugs will only get more complicated as technology improves. We’d better start thinking rationally about it.

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