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Advarer mot e-sigaretter  (prof. Stanton A. Glantz)

Prof. Stanton A. Glantz  -  en av verdens fremste faglige autoriteter ang tobakk/ tobakksindustrien

Stanton A. Glantz is a professor of medicine at the University of California at San Francisco and the American Legacy Foundation's distinguished professor of tobacco control.

Opinion: The smoke behind e-cigarettes

By Stanton A. Glantz

January 15, 2014

Electronic cigarettes are designed to look, feel and taste like cigarettes and are being aggressively promoted as a safe alternative to smoking cigarettes that doesn't produce secondhand smoke. It is true that, because e-cigarettes deliver nicotine — the addictive drug in cigarettes — with a heated aerosol of propylene glycol and other chemicals rather than by burning tobacco, a puff on an e-cigarette delivers fewer toxic chemicals than a puff on a cigarette.

The problem is that almost all "vapers" keep smoking cigarettes at the same time, which makes this fact all but moot. The heart disease risks of smoking occur at very low levels of consumption and the cancer risks depend more on how long you smoke than how much you smoke.

And vapers pollute the air around them. Far from just exhaling "harmless water vapor," as many e-cigarette ads proclaim, vapers pollute the air with nicotine, ultrafine particles, volatile organic compounds and even metals. That's why more than 100 cities, including New York City, and three states now sensibly include e-cigarettes in their clean indoor air laws.

Such a plan that would treat e-cigarettes like other tobacco products is moving through the Chicago City Council now; it deserves speedy enactment.

E-cigarettes are sold as a way to quit smoking. Twitter and other social media are filled with testimonials from people who claim anecdotally that e-cigarettes saved their lives by helping them quit cigarettes. And, no doubt, there are some people who believe that e-cigarettes helped them stop smoking. However, population-level statistics tell a different story. Studies that have followed smokers over time show that e-cigarette users are, on average, less likely to stop smoking. In practical terms, this means that for every person e-cigarettes helped to quit smoking, there is at least one person whom e-cigarettes kept from quitting.

It is telling that not a single e-cigarette company has submitted evidence to the U.S. Food and Drug Administration backing up claims that e-cigarettes help people quit smoking.

Indeed, when the FDA tried to regulate e-cigarettes as a drug (nicotine) delivery device, e-cigarette companies sued and blocked the FDA in court. When, eventually, the FDA tries to regulate e-cigarettes as tobacco products (what the companies claimed in their first lawsuit), e-cigarette companies will sue again, which will delay any federal regulation for more years.

In the meantime, for the first time in 42 years, nicotine addiction advertising is back on television. Today's e-cigarette ads resemble cigarette ads from the 1950s and 1960s: sex, glamour and rebellion, with celebrities — even doctors — endorsing them.

Fueled by marketing tactics borrowed from cigarette-company playbooks of the past (which is not surprising since many e-cigarette companies are owned by tobacco companies) and the addition of kid-friendly flavors now banned in cigarettes, sales are doubling every year, with the current market estimated to reach $2 billion annually.

Not surprisingly, kids are responding to these ads. The U.S. Centers for Disease Control and Prevention recently reported that e-cigarette use among middle and high school kids doubled between 2011 and 2012. And they are not just "vaping," or smoking an e-cigarette. Eighty percent of these kids are smoking cigarettes at the same time, a double win for Big Tobacco.

On the eve of the release of a new surgeon general's report on the 50th anniversary of the first surgeon general's report linking tobacco with disease, we are hearing the same false statements extolling the virtues of the next generation of nicotine addiction products that we heard about cigarettes and smokeless tobacco products in times past. That's why Chicago — and communities everywhere — should ban the sale of e-cigarettes in kid-friendly places and, most important, include e-cigarettes in clean indoor air laws.

Stanton A. Glantz is a professor of medicine at the University of California at San Francisco and the American Legacy Foundation's distinguished professor of tobacco control.

Various e-cigarette products for sale are seen at the Henley Vaporium in New York City. (Mike Segar Reuters, / January 14, 2014)

Chicago Tribune



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