If you imagined an e-cigarette conference full of policymakers at a Marriott in Washington would be a tame event, you would be wrong. I suppose I shouldn’t be surprised that e-cigarettes could a polarizing topic, but I will not soon forget the cheers and boos in the crowd as people stood up to state their opinions and present their research at the first E-Cigarette Summit here in Washington.

A running theme of this conference came down to the existential question: are you a skeptic or are you an enthusiast? Are e-cigarettes addictive products designed to hook teenagers or should they be marketed to current smokers as a quitting tool?

It’s important to understand that e-cigarettes are much safer than combustible cigarettes. Every panelist—including professors, physicians, economists and industry folks—agreed with reports that e-cigarettes are at least 95 percent safer than traditional cigarettes. What is not so easily understood is how best to use e-cigarettes to promote a healthier society.

We’ve seen debates like this before. Will needle-exchange sites keep injection users free from infectious disease or will they tacitly encourage people to try heroin? Does condom distribution in high schools prevent teen pregnancy or lead to a breakdown of morals? There are valid points in support of either argument, but whichever way we as a society land will have long-lasting effects.

The truth is there are a lot of specific questions that need to be answered before people will feel comfortable with novel devices. When it comes to e-cigarettes, there needs to be a balance between consumer protection, trust and the application of science, so that sound policy can best direct public health goals. Some of the discussions at this forum centered on questions for which we don’t yet have definitive answers:

  • Does a standalone nicotine product at the concentrations found in e-cigarettes (with the absence of other chemicals that are present in tobacco) produce changes in the brain consistent with addiction?
  • What environmental or product factors are predictors of successful transition from combustibles to e-cigarettes?

As we move forward in our research and advocacy endeavors, the answers to these questions will help shape both tobacco and e-cigarette policy and will form a foundation for U.S. harm-reduction policy.

Some of the more contentious issues created even more forceful debates. While e-cigarettes are effective smoking-cessation tools, physicians are reluctant to recommend them over medications, gum or the patch. Although teen smoking rates are at historic lows, the rise in experimentation of e-cigarettes is concerning (it is noteworthy that daily use of e-cigarettes among teens is 2 percent). While it is unethical to perpetuate the myth that e-cigarettes are nearly as harmful as traditional cigarettes, some suggest there might be an ethical dilemma in marketing e-cigarettes to recreational users.

It is fair to say that more information is better to avoid hooking a new generation on cigarettes, but it is more important to use the tools we have now to encourage smokers to switch to safer products. We cannot forget that, just today, more than 1,300 people will die from smoking in the United States alone. Getting people to stop smoking combustible cigarettes should be our No. 1 priority and there is now a product to make that happen.


Image by LezinAV