Response: '4 Reasons This Article About E-Cigarettes Is Bad'

Dieter Holger

Last week, I wrote a list called "7 Reasons E-Cigarettes Are Bad," which brought me a ton of backlash. Often, we hear that e-cigarettes are safe in comparison to smoking, so I set out to present a counter-narrative which scrutinized the health effects of e-cigarettes.

Hours after I posted the list, my Twitter account blew up. I was getting hundreds of Tweets that were attacking me and my piece. A quick scan of my critics revealed them to be mostly vapers, e-cig advocates, and others associated with the e-cigarette industry. It shouldn't be hard to see an obvious bias here.

Some went so far to accuse me of killing people. They felt my list was turning away smokers from life-saving e-cigarettes. I would even be harassed on Facebook by one of these e-cigarette fanatics, who thought it appropriate to lambast me in a profile picture comment around 3 a.m. in the morning.

And today, Jacob Sullum, a Senior Editor at Reason, picked up my story and wrote a list mockingly titled "4 Reasons This Article About E-Cigarettes Is Bad." I'm thrilled an award-winning journalist like Sullum took the time to write about my piece, so I feel obligated to write back.

"Start with the title: '7 Reasons E-Cigarettes Are Bad.' Compared to what? Since the relevant comparison is conventional cigarettes, which are indisputably much more dangerous, the title is an empty distraction. Holger continues to dodge the central issue in his introduction:"

"'Are e-cigarettes really any better than smoking a cigarette? Here are seven reasons e-cigarettes pose dangers to our health.'"

"'Are e-cigarettes really any better than smoking a cigarette? Here are seven reasons e-cigarettes pose dangers to our health.'"

My article wasn't primarily concerned with comparing whether e-cigarettes are safer or more dangerous than cigarettes. My article presented health dangers of e-cigarettes. I never said that e-cigarettes were more harmful -- or equally harmful -- as cigarettes anywhere.

Of course, people are interested in this comparison, so I raised the question, "Are e-cigarettes really any better than smoking a cigarette?" A question to be mindful of, but a question which remains to be answered by scientific consensus. Sullum is right that I had no intention of answering this question. I don't have the answer because the jury is still out. It could potentially take decades of research before we know the long-term effects of e-cigarettes compared to smoking.

This is important, because most of my critics haven't gone so far to say e-cigarettes are safe. Instead, they criticize me on the grounds that e-cigarettes are safer than cigarettes.

"Holger is determined not to answer the question he poses, so he follows it with a non sequitur. Even if 'e-cigarettes pose dangers to our health,' of course, that does not mean they are just as hazardous as conventional cigarettes. In fact, as Public Health England (PHE) emphasizes in a recent report, they are something like 95 percent safer."
"Holger avers that "e-cigarettes contain plenty of cancerous chemicals" and "their fair share of toxic chemicals," statements that are utterly uninformative in this context. How much, after all, is "plenty" or "their fair share"? As the PHE report notes, "most of the chemicals causing smoking-related disease are absent and the chemicals which are present pose limited danger" because they are typically present at very low levels."
"Holger is clearly wrong when he states that "e-cigarettes might create the equivalent of secondhand smoke."
"Similarly, citing evidence of short-term changes in airway resistance during vaping, Holger warns that 'e-cigarettes have negative effects on lungs.' But as Siegel notes, these effects are far less serious than the respiratory damage caused by smoking, and smokers who switch to vaping 'experience an immediate improvement in their respiratory symptoms and lung function.'"
"Holger asserts that 'e-cigarettes are just as addictive as smoking tobacco,' based purely on the observation that they contain nicotine. But as Siegel notes, research indicates that vapers score lower than smokers on measures of dependence, possibly because e-cigarettes do not deliver nicotine as efficiently as the conventional kind. More to the point, addiction to cigarettes is a concern mainly because of the harm it causes, and vaping causes much less harm."

Also, I listed a study by the American University of Beirut and the Center for the Study of Tobacco Products which examined how e-cigarettes are equally addictive as tobacco, because they both rely on nicotine.

"Like CDC Director Tom Frieden, Holger warns that 'e-cigarettes could be a gateway into tobacco products for youth.' As the PHE report points out, it's not clear what that means. But assuming it means vaping leads to smoking among people who otherwise never would have tried tobacco, there is no evidence it is happening. To the contrary, smoking among teenagers continues to fall as vaping rises, as Holger implicitly concedes in the very same paragraph."
"Like Ron Chapman, director of the California Department of Public Health, Holger claims 'e-cigarettes won't help you quit.' How can he possibly know that? Thousands of former smokers say otherwise, and the scientific evidence reviewed by PHE indicates that e-cigarettes 'can help people to quit smoking and reduce their cigarette consumption.'"

I'm pleased that my piece has helped spur the debate surrounding the safety of e-cigarettes -- that's exactly what I wanted. There are clearly strong views about e-cigarettes on both sides of the aisle, which is why the story about their effects on our health continues to develop. It should be interesting to see how safe e-cigarettes will really turn out to be.

UPDATE: An earlier version of this post stated The Guardian has reported the PHE is "under fire" due to funding connections to the tobacco industry. This statement was meant to articulate how the PHE report cites a paper that has funding connections to the tobacco industry. The statement has been corrected.

[Image via Flickr/Mike Mozart]