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The attached study appeared in the June 30, 2014 edition of the Food and Drug Law Institute’s Food and Drug Policy Forum.

Electronic cigarettes, commonly referred to as “e-cigarettes,” are devices that enable the user to inhale nicotine-containing vapor without the witches’ brew of toxic chemicals found in cigarette smoke. They have proven to be extremely popular among smokers who have been unable or unwilling to quit smoking and appear to be very effective in enabling users to cut down or quit cigarettes entirely. They are seen by tobacco control advocates as an unproven and unregulated gimmick developed by tobacco companies to addict another generation of children, teens and young adults and, by that means, to unravel the progress we have made in tobacco control over the past half century.

The so-called e-cigarette debate is based on advocates promoting the benefits of e-cigarettes and opponents arguing either that no such benefits exist, or that, even if they do, that harms are sure to outweigh benefits given the corrupting influence of the tobacco industry. The major potential harm referenced by almost all tobacco control advocates is the potential that e-cigarettes will recruit large numbers of teen non-smokers to nicotine use and eventually, many will transition to tobacco cigarettes.

In this policy forum I assert that the case in favor of e-cigarettes is so substantial that a tobacco harm reduction (THR) initiative using e-cigarettes is the only feasible policy alternative that would enable us to substantially reduce tobacco-attributable illness and death in the United States over the next 20 years. This could be done while further reducing teen initiation of nicotine use. I find much of the case against e-cigarettes to be biologically implausible, biased, deeply flawed and frequently in conflict with scientific evidence.