In Defense of E-Cigarettes

They’re already stigmatized out of all proportion to their health effects — and yes, they can help you quit smoking.
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They’re already stigmatized out of all proportion to their health effects — and yes, they can help you quit smoking.
TRY VAPING! Chalkboard outside Gone With the Smoke Vapor Lounge in San Francisco.

TRY VAPING! Chalkboard outside Gone With the Smoke Vapor Lounge in San Francisco.

If you want to get a dirty look anywhere in America, don’t light a cigarette — instead, take a drag from an e-cigarette, let loose a plume of nicotinized water vapor, and await your neighbor’s bottomless scorn.

I get it: Vaping is exquisitely hateable. Where cigarettes represent an unlovely but familiar vice, e-cigarettes are often treated as a showy technology accessory, like the latest phablet (except scented with coconut). Vaping also had the misfortune of going mainstream after a boom in all things artisanal or boutique, and aficionados promptly emerged to create the illusion of a luxury market. At one particularly snobbish e-liquid brewery in Santa Barbara, California, I was recently upbraided for asking about the nicotine content. “Nicotine interferes with our flavors,” the proprietor told me, like a sommelier telling a patron that Château Margaux doesn’t pair with a chili dog. “And we don’t allow anything to interfere with our flavors.”

The whole scene is pretty nauseous. As if the vape-artisans hadn’t sufficiently tarnished the reputation of e-cigs, you can find a whole self-identified “vape community” online, a prickly consortium that gathers under hashtags such as #VapeLife to rebut their critics. (Critics: “Is vaping the douchebag mating call??? Vape community: “No!”) Some members of the community, troubled by vape-hate and seeking to broker a peace, have begun to offer etiquette advice on YouTube. One gentleman strokes a cat while enjoining viewers “not to be a vape douche”:

Americans object to e-cigarettes on more than aesthetic grounds, and the stigma extends into the debate over public health, where anti-vape orthodoxy prevails. On Thursday, the Food and Drug Administration published a federal rule that will finally open e-cigarette manufacturers to regulation, ban all sales to minors, and require warning labels on e-cig products. In an accompanying news release, the FDA heralded the new regulations as a “milestone in consumer protection.”

An admission: By certain standards, I am a vape douche—if only because I use a vape pen daily (and usually in private). I also have no desire to give vapes to children. I also live in California, where Governor Jerry Brown just signed a quite-strict set of laws designed to hound e-smokers out of respectable society. This poses no problems for my way of life, but it does reinforce an irrational stigma that could prevent some smokers from quitting.

Kids are picking up e-cigarettes faster, but they’re also picking up real cigarettes more slowly.

In a raft of new legislation that Brown signed on Wednesday, California will raise its smoking age from 18 to 21 while re-classifying vaporizers and electronic cigarettes as tobacco products and banning them in most public spaces. Elements of the legislation go into effect as early as June 9, and will make California the second state after Hawaii where you must be 21 to buy nicotine products. (Under pressure from fellow California lawmakers, State Senator Ed Hernandez emended the bill to exempt active military from the new age restriction.)

Brown also signed legislation that bans e-cigarettes in workplaces and public establishments and exerts more stringent rules on marketing and advertising. The e-cig ban extends even to smokers’ more secluded redoubts: warehouses, motels, covered parking lots, and a host of other semi-public but quite-discreet areas that have served so long as havens for the conscientious vaper.

California’s new legislation on e-cigarettes is based, in large part, on concern for children and teenagers, who anti-smoking advocates say are being lured to e-cigs and their candy-like flavors — bubblegum, gummy bears, and passionfruit among them. Those fears are not groundless. As Kate Wheeling reported for Pacific Standard, 2014 was the first year when e-cigarette use among teens overtook traditional cigarette use. But demonizing e-cigs might not be the answer. Wheeling goes on to note that traditional anti-smoking campaigns, ones that depend on stigmatizing individual behavior, will frequently backfire: According to a growing body of research, “the more young students are exposed to anti-smoking messaging, the more likely they are to want to smoke.” (The most reliable method of dissuasion is to show teens the declining rates of smoking among their peers.)

As early as 2013, the Centers for Disease Control and Prevention had noted an uptick in e-cig use among secondary-school students, along with an accompanying drop in tobacco use:

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Kids, in short, are picking up e-cigarettes faster, but they’re also picking up real cigarettes more slowly. Meanwhile, among adults, there’s evidence indicating that e-cigarettes can serve as an effective smoking-cessation technique. A year-long study at Cochrane UK found data “suggest[ing] that electronic cigarettes can be helpful [for] stopping smoking and reducing cigarette consumption,” as the authors wrote in 2014. David Shultzsummarizes their findings in Science:

After one year, trial participants who used the devices were more than twice as likely (four percent versus nine percent) to successfully quit compared with those who used a nicotine-free placebo vaporizer. Another 36 percent of e-cigarette users were able to reduce the number of traditional cigarettes they smoked by 50 percent or more. But 28 percent of placebo users also reduced their cigarette consumption by at least 50 percent, suggesting that some of the e-cigarette’s quitting power may be derived from the mere act of “smoking” it…. For those already addicted to nicotine, e-cigarettes may be the lesser of two evils.

Such was my experience. After smoking tobacco daily for several years, and staggering through clean months here and there with nicotine gum as a crutch, I bought a cheap vape and haven’t touched a cigarette since. (Closing on two years.) To those who quit smoking by simply stopping, I tip my cap. For many of us — call it moral weakness, late-capitalist decadence, whatever — a clean quit didn’t work. The vaporizer, though I refused ever to smoke it in public, did.

In August of last year, the Department of Health in the United Kingdom declared that e-cigarettes represented a sound mode of quitting and “have the potential to make a significant contribution to the endgame for tobacco.” (In its report, Public Health England actually estimated that e-cigs were “95 percent safer” than real ones, an optimistic and widely disputed number.) Things stateside have tended to move in the opposite direction, as we see now in California, and this trend represents a missed opportunity. As Michael Siegel of Boston University toldRolling Stone shortly after Public Health England released its report: “All conclusive evidence shows that these [e-cigs] are safer … why aren’t we encouraging [American] smokers to make the shift? If we did, we’d be saving millions of lives and talking about the greatest public health moment of our generation.”

Without multiple longitudinal studies among regular e-smokers, none of us can be sure whether or not e-cigarettes are truly safe. What we do know is that cigarettes were designed by Satan’s minions to destroy every living fiber of the human body. As a civilian, I’m comfortable accepting the hypothetical risks of e-juice if they help me avoid the horrid effects of tobacco.

More to the point, I worry a bit about amplifying the stigma around e-cigs—not for myself, but for smokers who might otherwise have been persuaded to downgrade that cigarette to a vape pen. Addiction management—conscious moderation rather than clean-slate recovery—is gaining more and more favor in therapeutic circles, and positioning e-cigs as almost certainly way less harmful than cigarettes could be a useful gambit among smokers who keep failing to quit cold.

Much as one hates to agree with the lobbying arm of a for-profit industry, the Smoke-Free Alternatives Trade Association basically nails this problem in its response to Wednesday’s legislation:

California took a step backwards today by reclassifying vapor products as tobacco. Stigmatizing vapor products, which contain no tobacco, and treating them the same as combustible tobacco while actively seeking to economically penalize smokers attempting to switch is counterproductive to public health.

E-cigs are stigmatized sufficiently already—in policy spheres, online, and in the streets. I am sympathetic to anti-vape prejudice, which is why I rarely afflict my friends or co-workers with e-clouds. #VapeLife is super lame! But you know what’s lamer? #CigaretteDeath. For this reason, I will now step into our covered parking garage and vape, a daily ritual I will observe until June 9, when my governor tells me to stop.

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