BOSTON -- Dr. Michael Siegel has spent most of his career fighting for stricter tobacco regulations, including two years conducting research on secondhand smoke and cigarette advertising at the Center for Disease Control & Prevention's (CDC) Office on Smoking and Health and later testifying in the Engle v. Liggett lawsuit. Yet, as a professor at Boston University's School of Public Health and author of the Tobacco Analyses blog, Siegel now finds himself in the unlikely role of advocating against taxes or regulations on a new, rapidly-growing tobacco segment with the potential to positively impact public health.
"Electronic cigarettes are the first smoking cessation product that addresses both the pharmacologic and behavioral aspects of the smoking addiction," Siegel told Tobacco E-News. "Not only do they provide nicotine, but they simulate cigarette smoking. Thus, unlike nicotine patches or nicotine gum or other drugs, they address all of the behavioral, physical, and even social aspects of the smoking addiction."
And though no large-scale or long-term trials have been conducted on electronic cigarettes, Siegel believes there is already ample scientific evidence that supports the reduced harm potential of electronic cigarettes.
"There are numerous studies of the chemical constituents of the e-cigarette vapor," he said, adding that such studied confirm a limited number of chemicals--and an even more limited number of potentially harmful chemicals--in e-cig vapor. "In addition, there is scientific evidence that the cytotoxicity of electronic cigarettes is much lower than regular cigarettes, that they do not produce acute cardiovascular effects like regular cigarettes, and that they do not acutely affect lung function."
Siegel's avid support of electronic cigarettes puts him at odds with the views of his former employer: A recent CDC National Youth Tobacco Survey said that the percentage of high school students who had tried electronic cigarettes doubled between 2011 and 2012, prompting CDC director Tom Frieden to speak out against the products.
"The increased use of e-cigarettes by teens is deeply troubling," Frieden said in a press release. "Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes."
While the CDC study did show a doubling in the number of youths who had ever tried e-cigarettes, Siegel was quick to point out that the study also estimated that the number of youths actually using e-cigarettes has not substantially increased and is holding at approximately 0.5%. Additionally, the study did not actually track the relationship between teens who tried e-cigarettes and those who went on to consume traditional tobacco cigarettes.
"The science does not support their claims that these products are not helpful for smoking cessation or that youths are using these as a gateway to smoking," Siegel said. "The recent CDC survey actually found very few nonsmoking youth who regularly use e-cigarettes, and there is no evidence that these products serve as a gateway to smoking, despite the contrary assertions of many policy makers."
Still, numerous anti-smoking groups and lawmakers have called for strict regulations, taxes or outright bans of e-cigarettes, all in the name of public health.
"This is one of the most baffling observations in my entire public health career," Siegel said. "The only explanation I can think of is that the ideology is so strong that these groups cannot bring themselves to endorse any activity that even looks like smoking. I think it is an example of ideology triumphing over science."
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