During the last few years, electronic cigarettes have quietly become the most effective smoking cessation method available. As e-cig use — "vaping" — has increased, smoking prevalence has decreased nationally from 21 percent in 2005 to 17 percent this year, which translates into millions of former smokers.
This is the fastest decrease in smoking rates we've ever seen, and it is true both for youngsters and adults of all ages. We can all — except the tobacco corporations — celebrate this significant reduction in harm to the health of many people. Other nicotine delivery systems — gum, lozenges and patches — are only 2 percent more effective than placebo for smoking cessation.
But wait, how can this be? E-cigs cannot be marketed as a tool for smoking cessation, because the tobacco industry convinced the FDA to regulate e-cigs in 2009 as a "tobacco product." If e-cigs had become known by any other name — "vaporizers, atomizers, inhalers" — perhaps municipal officials would not be so inclined to conflate vaping and smoking.
The Bloomington City Council recently overreached by prohibiting vapers from vaping in vape stores, thus protecting vapers from vapor. Perhaps Minneapolis and state officials will be wiser.
The vast majority — probably well over 90 percent — of vapers are adult former smokers, and most e-cig stores actively discourage nonsmokers from trying e-cigs on their site. Naturally, some minors will experiment with vaping because, being adolescents, they will try anything that makes them feel "cool" and look older, especially if it's not legally accessible, which makes it all the more fun.
I am only one of the millions who have stopped smoking thanks to e-cigs. I smoked a pack a day for 55 years, which adds up to hundreds of thousands of cigarettes, and I enjoyed every single one. I am neither proud nor ashamed of this — it was what it was.
I started smoking as a teenager because it was, or so we thought, mature, sophisticated and oh-so-cool. But as the research came in decades later, I tried to quit many times — cold turkey, with nicotine gum and lozenges, and with Zyban (identical to the antidepressant Welbutrin, found during clinical trials to reduce urges to smoke).
All my efforts failed.
I was hooked, and until last year, I had resigned myself to continue smoking until my last breath.
But since May 2013, resignation has turned to relief. I quit smoking and have zero desire ever to smoke again. Both my lungs (no congestion) and my nicotine receptors are happy.
E-cigs are not for everyone, but for me and many others they are an elegant solution. As one who loved to smoke, I can testify that they work better than other nicotine delivery systems precisely because they mimic the smoking experience — holding them, drawing, inhaling, feeling the throat hit and watching the exhaled water vapor, which looks like exhaled smoke.
Ah, there's the rub — vaping looks like smoking. But things are not always as they appear.
First, e-cigs have no combustion, no smelly first- or secondhand smoke, no tobacco and no tar. The exhaled water vapor is just that — vapor. At worst it may contain trace amounts of residual nicotine, which is harmless to bystanders according to research to date. Second, tobacco cigarettes contain about 4,000 ingredients, many of which are carcinogenic, added over the decades to increase addictiveness and enhance taste. By contrast, e-cigs contain just four basic ingredients: vegetable or aqueous glycerin, propylene glycol, nicotine (which is flavorless), and flavoring.
But what about nicotine, in and of itself? Like caffeine, nicotine is a mild stimulant, definitely addictive but not especially harmful and not carcinogenic. It has a temporary, mild constricting effect on blood vessels and therefore may raise blood pressure slightly. But if nicotine per se were severely harmful, it would not be available over the counter, unprescribed, in gum and lozenge forms.
So in this big, messy, imperfect and complicated world, we do what we can. This issue is not about a perfectionistic, absolute, zero tolerance for nicotine addiction. It is about harm reduction — like seat belts, air bags, condoms and vaccinations.
There are degrees of harm, and sometimes all we can do is to take what we know to be true, trust the unbiased science, weigh the costs and benefits, and then go with whatever works to massage the odds in a healthy direction, at least until something better comes along. It is both fair and accurate to say that vaping is a much less harmful alternative to smoking, even though nothing that we put into our bodies is 100 percent risk-free.
Recalling the old days when ashtrays were ubiquitous and nonsmokers had to tolerate the stinky smell of tobacco smoke, I applaud the Clean Indoor Air Act. But water vapor is not smoke, and to send vapers outdoors to freeze in Minnesota winters is overkill.
But even if e-cigs are overly restricted by alarmist but well-meaning city councils or state legislatures who lump them together with tobacco cigarettes, they will continue to play their unadvertised but undeniably leading role in reducing the known harm of smoking.
John McClay lives in Bloomington.
