NEW YORK --The recent Wells Fargo E-Cig Forum featured two panels of public health experts: one on public health itself, one on emerging regulatory issues. Not surprisingly, both panels centered on the role of communicating the potential reduced risk of electronic cigarettes to the public.
In theory, the burden of educating consumers about new products should fall to the manufacturers; however, requirements of the Tobacco Control Act dictate that manufacturers must go through an incredibly lengthy (and expensive) process in order to gain approval to make any kind of reduced-harm or modified-risk claim.
"It's a very complicated area for manufacturers," said Saul Shiffman, a research professor at the University of Pittsburgh. "Even for a claim of reduced exposure, they have to show consumers aren't interpreting that as reduced harm. It's not just about the facts you put out, but how consumers interpret them."
"The inability to communicate reduced risk is actually causing damage to public health," added Gal Cohen, head of scientific and regulatory affairs for the San Francisco-based e-cigarette manufacturer Ploom.
As such, Shiffman and others argued that it currently falls to public health officials to communicate the potential health benefits of e-cigarettes. The problem is, despite the scientific evidence supporting the new segment, many public health advocates are getting caught up in the "new Big Tobacco" fervor.
"The debate in the public health community is loud rather than robust," Shiffman said. "Attention goes to the people who yell the loudest, rather than the actual data. We're not doing our job as well as we should."
Clive Bates, director of Counterfactual, a public-interest consulting and advocacy group, described such voices as an "unholy trinity working together: bureaucratic regulators, predatory companies and public health's 'useful idiots'" who "cherry pick" only specific data that supports their case to weave anti-e-cig propaganda.
It is an "unholy trinity" that, unfortunately, is proving to be quite effective at swaying consumers' opinions on vaping.
"The truly awful thing is not only do people not understand reduced risk, but their understanding is going in the wrong direction," Bates said. "The number of people in the United States who think e-cigarettes are less harmful than combustibles is declining. It's a terrible indictment of the public communication of risk."
Bates specifically called out the Centers for Disease Control and Prevention (CDC) for, among other things, highlighting the rise in e-cigarette use by youths but refusing to acknowledge its potential link to the rapid decline in youth combustible cigarette usage.
"The CDC has a responsibility to acknowledge reduced-risk potential and stop what they're currently doing, which is using the an immense amount of creativity to find any possible problem with e-vapor that it can," said Bates. "They try to talk about gateway effects that simply aren't there."
Opponents of e-cigs would argue that there's not yet enough data to concretely deem electronic cigarettes as safe; however, Shiffman said that's not what's needed to declare them as reduced harm products.
"The logic of harm reduction is that you want to choose the lesser of two evils," he said. "Are e-cigs safe? We don't have enough data; but that shouldn't be the question. The question is not whether e-cigs are safe, but safer than combustible cigarettes."
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