Vaper Strain

National Review, September 2, 2013

As I write, I am vaping — yes, that’s the word — inhaling an odorless 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 glows as I inhale. 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.”

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 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, to quote John Britton, who leads the tobacco advisory group for Britain’s Royal College of Physicians, is it 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 confined to abroad. A growing number of America’s politicians, bureaucrats, and other nuisances are on the offensive against e-cigarettes, including — if recent reports are true — New York’s nanny-in-chief, Michael Bloomberg. And he won’t be the last.

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, but such worries are best addressed by prohibiting sales to minors. 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 re-glamorize smoking — are feeble stuff. This suggests that the real agenda is driven by the precautionary principle run amok, or, ominously, by something darker still.

Cynics might point to the loss of valuable tax revenues as the motive, but there’s much more to it 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 might be about to find out.