How the electronic cigarette debate reveals lack of concern for the lives of smokers
Fifty years ago the Surgeon General issued a report revealing the extreme dangers of smoking. Since that time, the smoking rate in the US has been cut in half. Public health officials and anti-tobacco activists have fought tirelessly to reduce smoking related death and disease, and to keep kids from becoming trapped in a lifetime of addiction to deadly cigarettes. Unfortunately, after years of hard fought battles against smoking, many have become unable to differentiate between fighting against smoking and fighting against smokers. Smokers have become the enemy.
In recent years, as the decline in smoking has slowed, tobacco control strategies have relied more and more on stigmatization. Framing smoking as an ‘anti-social’ behavior is a cornerstone of the movement. And it’s working.
A 2011 Gallup poll revealed that one in four Americans automatically have less respect for a person that smokes. Some employers openly state that they will not hire smokers. Non-smokers, who now greatly outnumber smokers in the US, seem to share the sentiment of the UK’s Chief Medical Officer, Sally Davies that “smokers should just grow a backbone.”
The problem with this sentiment is that smokers don’t continue to smoke despite the overwhelming risk because they are stupid, lazy or weak. They do it because they are powerfully addicted. Research tells us that if someone begins smoking as a teen they will likely be addicted for life. This is especially alarming considering 88% of current smokers picked up the habit before their 18th birthday, when they were most vulnerable to predatory marketing tactics.
According to numbers from the CDC, 68% of smokers want to quit and over half try to quit each year. Only 6% are successful. More quit attempts are made in younger smokers than older, indicating that older smokers may have just given up on the idea of quitting altogether after many unsuccessful attempts.
Public health groups simultaneously send two messages. One is that tobacco companies aggressively exploit vulnerable youth, luring them into addiction to protect future cigarette sales. The other is that adult smokers are ‘anti-social’ pariahs that need to be shamed into quitting. So are smokers victims or are they villains? At what age are we supposed to stop having compassion for those addicted to cigarettes?
Electronic cigarettes provide a unique lifeline to smokers, whose average lifespan is ten years less than that of non-smokers. The battery-powered devices deliver nicotine, the most addictive chemical in cigarettes, while eliminating combustion, which produces the majority of the danger. Unlike traditional nicotine replacement therapies, they also address the behavioral side of addiction by mimicking the act of smoking. Additionally, former smokers report that the variety of flavors available helps break the connection between smoking and nicotine, reducing or eliminating their desire to return to cigarettes. Public health officials and activists should be thrilled by such a promising opportunity to reduce smoking related illness and death.
Shockingly, public health groups are among the most outspoken opponents to electronic cigarettes, adopting what harm reduction advocates call a ‘quit or die’ mentality. A smoker must either stop using nicotine altogether or suffer the disease and death that comes from smoking. Continuing to get nicotine, even from a much safer delivery method is unacceptable. Especially, if it involves enjoyable flavors and rituals similar to smoking.
The fear is that electronic cigarettes will ‘renormalize’ smoking; threatening the stigma that the tobacco control movement has worked so hard to cultivate. While the directors of both the CDC and the FDA have conceded that, for an individual, electronic cigarettes are safer than smoking, they continue to warn against them.
After years of working to stigmatize smoking it seems that many public health leaders have drank their own Koolaid. As a result, the goal of the tobacco control movement has shifted from convincing young people not to take up cigarettes while trying to save the lives of current smokers, to a single-minded pursuit of completely eliminating nicotine addiction. Even if it means discrediting safer alternatives like electronic cigarettes and simply waiting for currently addicted smokers to die.