Politics & Policy

Andrew Cuomo’s Unscientific War on E-Cigarettes

New York Times:

Electronic cigarettes, the popular vapor substitute to traditional tobacco cigarettes, will soon be banned from public indoor spaces in New York State — just like the real thing. Gov. Andrew M. Cuomo on Monday signed a bill to ban vaping anywhere cigarettes are already prohibited, like workplaces, restaurants and bars. The ban goes into effect in 30 days…

“These products are marketed as a healthier alternative to cigarettes, but the reality is they also carry long-term risks to the health of users and those around them,” Mr. Cuomo said in a statement. “This measure closes another dangerous loophole in the law, creating a stronger, healthier New York for all.”

Cuomo appears unwilling to admit that some risks are greater than others. E-cigarettes do, of course, come with a degree of risk (what doesn’t?), but it is a very small one compared with smoking the real thing. What’s more, there is strong evidence to suggest that e-cigarettes are seen by potential or actual smokers as an alternative to smoking. E-cigarettes are more likely to operate as an exit ramp away from tobacco than a gateway to it.

And quite how Cuomo is able to assert with such confidence that e-cigarettes carry (presumably material) “long-term risks to the health of users” when e-cigarettes have been around for a relatively short time escapes me. As to the risk to those hanging around e-smokers, well, let’s turn to Britain’s Royal College of Physicians (my emphasis added):

Users of e-cigarettes exhale the vapour, which may therefore be inhaled by others, leading to passive exposure to nicotine. There is, so far, no direct evidence that such passive exposure is likely to cause significant harm, although one study has reported levels of polycyclic aromatic hydrocarbons that were outside defined safe-exposure limits. It is clear that passive exposure will vary according to fluid, device and the manner in which it is used. Nicotine from exhaled vapour can be deposited on surfaces, but at such low levels that there is no plausible mechanism by which such deposits could enter the body at doses that would cause physical harm.

Governor Cuomo quite clearly doesn’t do #science. He’s not, however, a stupid man. What’s going on here is blend of virtue-signaling, puritan bossiness and, I suspect, a sharp eye on the tax revenues that tobacco brings in.

Same old, same old, you might say, except that in this case it is likely to cost lives.

Back to the Royal College of Physicians (again, my emphasis added):

In 2007 the RCP published a report promoting the principle of harm reduction in nicotine addiction,18 arguing that, as most of the harm caused by smoking arises not from nicotine but from other components of tobacco smoke, the health and life expectancy of today’s smokers could be radically improved by encouraging as many as possible to switch to a smoke-free source of nicotine. While recognizing the primacy of complete cessation of all tobacco and nicotine use as the ultimate goal to prevent harm from smoking, the report argued that promoting widespread substitution of cigarettes and other tobacco combustion products would, for smokers who made the change, achieve much the same thing. Harm reduction, as a complement to conventional tobacco control policies, could therefore offer a means to prevent millions of deaths among tobacco smokers in the UK alone….

E-cigarettes, which appeared in the UK at around the time the 2007 report was published, have transformed this market, becoming the most popular choice of product for smokers hoping to quit or cut down on their smoking.

The RCP is not claiming that e-cigarettes are without risk, although, more cautious than Dr. Cuomo; it warns that “as with all new products, however, long-term or rare adverse effects will remain uncertain until e-cigarettes have been in widespread use for several decades”.

You can find a detailed discussion of these devices’ ‘safety profile’ in pages 79-87 of the RCP report. But the key point to consider is how much safer e-cigarettes appear to be than conventional cigarettes:

An analysis based on expert opinion quantified the likely harm to health and society of e-cigarettes at about 5% of the burden caused by tobacco smoking,and a recent report by Public Health England supported this conclusion.

And a word from the RCP on nasty old nicotine (again, my emphasis added):

Nicotine is not, however, in itself, a highly hazardous drug. It increases heart rate and blood pressure, and has a range of local irritant effects, but is not a carcinogen. Of the three main causes of mortality from smoking, lung cancer arises primarily from direct exposure of the lungs to carcinogens in tobacco smoke, COPD from the irritant and proinflammatory effects of smoke, and cardiovascular disease from the effects of smoke on vascular coagulation and blood vessel walls. None is caused primarily by nicotine. For practical purposes, as argued by Mike Russell in the 1970s, ‘smokers smoke for nicotine but are killed by tar’. Although the nature and extent of any long-term health hazard from inhaling nicotine remain uncertain, because there is no experience of such use other than from cigarettes, it is inherently unlikely that nicotine inhalation itself contributes significantly to the mortality or morbidity caused by smoking. The main culprit is smoke and, if nicotine could be delivered effectively and acceptably to smokers without smoke, most if not all of the harm of smoking could probably be avoided.

Not if Andrew Cuomo gets his way.