A Case Of The Vapers

National Review Online, December 26, 2013

What was it again that Mencken once wrote? Google, enter, click. Ah yes, it was this: “Puritanism: The haunting fear that someone, somewhere, may be happy.”

On Thursday, the New York City Council made room in its legislative agenda — it was also busy commissioning a study on polystyrene foam — to pass by a vote of 43–8 (that lopsided majority an indicator of idiocy afoot) a measure that will, once Mayor Bloomberg signs it (oh, he will) shortly prohibit the vaping (that’s the word) of e-cigarettes anyplace where smoking is now banned in Gotham, bars, restaurants, offices, parks, the beach, you name it. Technically speaking, the ban will take effect as an amendment to the city’s Smoke-Free Air Act. That e-cigarettes do not emit any smoke was an irrelevance.

To vape is to inhale a vapor from a plastic facsimile of a cigarette, battery-powered, bought for $10 at a local store, and good, it is claimed, for 400 puffs. The business end is fashioned to look like a filter. In another nod to nostalgia, the tip typically glows as the user inhales. It’s not the real thing, nothing like. Plastic is neither leaf nor paper. It holds no memories of that old bar down on the Lower East Side, that conversation once upon when. There’s no tobacco, no combustion, none of the warmth, none of the evocative transience, none of the mouth-feel of cigarette or cigar, and it looks just a bit dumb. Walk into Rick’s with an e-cigarette and Rick would laugh. Then again, Bogie died at 57.

Whatever the aesthetics of e-cigarettes, as nicotine-delivery systems go, they are a lot safer than the cancer sticks of old. There’s no carbon monoxide, no tar, very little, in fact, of tobacco smoking’s carcinogenic stew. To be sure, the Food and Drug Administration has detected tobacco-specific nitrosamines (a carcinogen) in the e-cigarette cartridges that contain the treats to come. A 2009 study revealed about the same quantity of TSNAs in cartridges as might be found in a nicotine patch, a total about one-nine-hundredth of the level found inside Joe Camel. The vaper (I know, I know) will inhale an even smaller portion, a tiny fraction of a minuscule amount. Furthermore, TSNAs were the only carcinogens detected in this study. Boston University’s Dr. Michael Siegel, a 25-year veteran of tobacco-control work (and a Centers for Disease Control alumnus), has noted that smokers of conventional cigarettes may inhale maybe 40 other carcinogens, not to speak of “thousands of [other] chemicals.”

It is true that at the end of November a study by Holland’s National Institute for National Health (RIVM) triggered a few headlines like “Dutch sound alarm about possible risks of e-cigarettes” (Reuters), but within the body of that Reuters story there was this: “The institute said it was concerned about a lack of evidence on the possible health effects of e-cigarettes…”

As a reminder: Don’t know is not the same as know.

The RIVM did note that the dread nicotine was involved and referred to reports of nausea and throat irritation by some users. Indeed, it recommended (Reuters writes) that “as a precaution [e-cigarettes] should not be used by pregnant women or in the vicinity of children.” For a health warning nowadays, this is on the mild side. The scientific concerns it reflects are not enough to justify a heavy-handed ban of the type now headed New York City’s way.

But what about the antifreeze? This substance, more happily associated with autos than lungs, has seeped into the e-cigarette debate, setting up a scare or 50. The truth is that the FDA found some diethylene glycol — an important ingredient in antifreeze — in just one of the cartridges surveyed in the 2009 study, a dismaying result but almost certainly a rogue finding. E-cigarettes generally do contain, however, a base of propylene glycol to “hold” the nicotine and any added flavoring. Propylene glycol is used in antifreeze, but as a kinder, gentler alternative to its rough diethylene cousin, particularly when there is any danger of contact with food. As is explained in the compound’s Agency for Toxic Substances and Disease Registry toxicological profile (September 1997), “the [FDA] has classified propylene glycol as ‘generally recognized as safe,’ which means that it is acceptable for use in flavorings, drugs, and cosmetics, and as a direct food additive.” Move along, there’s nothing to see here.

As an alternative to propylene glycol, some e-cigarettes use vegetable glycerin as their base. This common food additive will affect their taste, but not your health.

And so far as the ingredients lurking in an e-cigarette are concerned, that ought to be about it. This is not, of course, a reason for arguing that research on these products should cease, or that stricter quality control should be opposed. Nor is it a claim that e-cigarettes are risk-free. They may, for example, inhibit lung capacity, at least temporarily. Beyond that and those pesky TSNAs, there is also the matter that most e-cigarettes will (as the astute folk at the RIVM had noticed) be used to deliver nicotine, a potentially addictive substance — albeit one that has been given up by tens of millions. Then again, much of nicotine’s famously powerful addictiveness can be attributed to the fact that it is being delivered via tobacco, a medium with naturally occurring monoamine oxidase inhibitors that seem to have a great deal to do (it’s a long story) with the difficulty of quitting smoking. Divorced from its leafy accomplice, nicotine is not that addictive, nor under those circumstances is it, to quote John Britton, who leads the tobacco advisory group for Britain’s Royal College of Physicians, even a “particularly hazardous” drug.

What about secondhand smoke, butcher of innocents, enricher of laundries? E-cigarettes give off little or no odor, and, although the research is still at an early stage, the health risks of secondhand vaping likely rest somewhere between zero and infinitesimal.

Considering all this (Dr. Britton has been quoted as saying that if everyone switched over to e-cigarettes it could save “millions” of lives), the medical world ought to be cheering the swift rise of a hugely safer alternative to demon tobacco. E-cigarettes are, so to speak, catching fire. In the U.S., sales are expected to hit $1 billion in 2013, twice the total of a year ago. That’s still only about 1 percent of the total spent on tobacco products, but it says something that Altria Group Inc. (parent company of Philip Morris USA), Reynolds American Inc., and Lorillard Inc. (which paid $135 million for blu eCigs in 2012) have all entered this market. Non-U.S. e-cigarette sales have been expanding rapidly too, reaching an estimated $2 billion in 2012.

But e-cigarettes have given tobacco’s fiercer foes, well, the vapors. Brazil, Norway, and Singapore have banned them. Others have imposed strict controls, including the prohibition of vaping in public places. Some British railway companies have exiled vapers from their carriages on the carefully considered grounds that they make other passengers “uneasy.” Such stupidities are not, as New Yorkers now know, confined to abroad. Their city is by no means alone. A growing number of America’s politicians, bureaucrats, and other nuisances are on the offensive against e-cigarettes. Thus bans similar to that now looming over New York City have already been introduced in New Jersey and Utah, states that would not normally agree on very much.

There are some legitimate concerns. There is a wide range of e-flavors, some of which, cherry crush, say, or chocolate (I’m not sure — on many grounds — about maple bacon), might appeal to a younger set. Meanwhile the anxious RIVM frets (according to Reuters) that e-cigarettes “might be attractive to young people because of bright colors, flashing lights and jewelry-like appearance.” Dutch e-cigarette design must have taken an exotic turn.

Such worries could be addressed by prohibiting the sale of e-cigarettes to minors, but that would not have been enough for New York councilman James Gennaro, a key promoter of the ban (and also a sponsor of legislation that recently increased the minimum age for buying tobacco in New York City to 21), who wants us all — of course he does — to think of the children. He worried (the New York Times reported) “that children who could not differentiate between regular and electronic smoking were getting the message that smoking is socially acceptable.” Combine the RIVM with Gennaro and the message is clear. E-cigarettes are a menace when they look like cigarettes. And they are a menace when they do not.

Other objections — that e-cigarettes might act as a gateway to the real thing (in reality, they are more likely to represent an exit from it) or that they might reglamorize smoking — are feeble stuff. This suggests that the real agenda is driven by the precautionary principle run amok, or, ominously, by something darker still.

And that something is not the prospect of the loss of valuable tobacco tax revenues (although that will not have gone unnoticed by some of those looking to bring vaping to heel). What is at work here is, at least in part, altogether more profound, and more disturbing, than that. The campaign against tobacco began with the best of intentions, but it has long since degenerated into an instrument for its activists both to order others around and to display their own virtue. And with that comes an insistence on a rejection of tobacco so absolute, so pure, that it has become detached from any logic other than the logic of control, the classic hallmark of a cult. So mighty is the supposed power of this anathematized leaf that anything — even when tobacco-free — that looks like a cigarette or provides any approximation of its pleasures is suspect.

It’s too much, of course, to expect any respect these days for the principle that adults should be left to decide such things for themselves, but the chance that the e-cigarette could save an impressive number of lives should count for something. Europe’s sad snus saga suggests that that might not necessarily be so. For generations Swedes have taken a form of oral tobacco, a snuff known as “snus,” cured in a way that sharply reduces its TSNA content. Snus is available in the U.S., land of dip and chaw, but, within the EU, where no such tradition exists, it can be sold only in Sweden. Taking snus is not without risk, but it’s far less harmful than smoking. Its popularity in Sweden, especially with the guys, goes a long way to explaining why that country has Europe’s lowest incidence of lung cancer among men. It has been estimated that introducing snus elsewhere in the EU could save some 90,000 lives a year, but the EU’s capnophobic leadership has rejected the idea. Anti-tobacco jihadists are quite content, you see, to accept that the perfect can be the enemy of the good.

As America’s vapers are now finding out.

Note: This article updates “Vaper Strain,” an article that appeared in the September 2, 2013 issue of National Review.