A current Minneapolis proposal to ban sales of flavored electronic cigarettes in convenience stores is contrary to the principles of good public health policy, ignores scientific evidence and could have the unintended consequence of keeping current smokers smoking — and dying.
Combustion tobacco cigarettes will prematurely kill 480,000 Americans this year. This annual death toll is projected to continue for decades, and 100 million premature smoking-related deaths are projected for the 21st century in this country alone.
Electronic cigarettes and other vapor products deliver nicotine without all of the toxic chemicals created by the burning of tobacco. Current nicotine-replacement products like patches and gums also deliver nicotine. However, electronic cigarettes have the added benefit of also providing smokers with satisfaction for the “hand-to-mouth” and other physical rituals of their smoking habit. These products have the potential to help end smoking, and noted public health experts believe they could save hundreds of millions of lives worldwide if smokers make a full conversion and do not continue to also smoke.
Many electronic cigarettes and vaping products, such as nicotine gums, are available in nontraditional flavors, including fruit and other sweet flavorings. The emerging scientific evidence tells us that flavored versions of these products are an important part of the success story for adult smokers who are able to completely switch from combustion cigarettes. This seems to be so for two reasons: The sweet flavors are more satisfying than the tobacco and menthol flavors of regular cigarettes, and these new flavors move smokers farther away from ones they associate with their old smoking habit. It is therefore critical that flavored e-cigarettes be just as accessible to adult smokers as their regular cigarettes. Unwisely, the Minneapolis proposal would dramatically limit the availability to adult smokers of electronic alternatives to traditional cigarettes, in the very places they go to buy their regular cigarettes and where they are most in need of being exposed to alternatives.
As the 17th surgeon general of the United States, I know well the current literature on the public health benefits and potential drawbacks of electronic cigarettes and vaping products. I also pay close attention to the concerns expressed by many that irresponsibly marketed flavored electronic cigarettes and vaping devices could encourage minors to develop nicotine habits.
Yet I am confident that the Food and Drug Administration, which will start regulating these products this year, will sensibly and scientifically regulate these products to limit youth appeal while maintaining attractiveness to adult smokers. This is a balance that, as a society, we need to get right. To those who sound the alarm about youth appeal, we should not forget that, according to the surgeon general, nearly 6 million children living today will die early from tobacco cigarette smoking if present trends continue. Electronic cigarettes are capable of reversing those trends — allowing our children to grow up in a world without combustion smoking.
Encouraging the 42 million U.S. smokers to leave smoking would transform our nation’s health and provide our children with a brighter future. That lofty goal is one we should all support.
Dr. Richard Carmona, a physician and public-health expert, was the author of the 2006 surgeon general’s report on the dangers of secondhand smoke. He serves on the board of NJOY, an independent electronic cigarette company that has the corporate objective of rendering the tobacco cigarette obsolete.