University of Michigan School of Public Health’s Ken Warner typified one side of the argument when he said: “The issues that divide the sceptics and enthusiasts are numerous and often very profound. But, the principal concerns driving the opposition to e-cigarettes, that they are gateway products to smoking, that they will re-normalize smoking, and that the nicotine they deliver will harm kids' still-developing brains, are overblown."
Warner noted that the UK has been exceptional in its warm acceptance to vaping when compared to the largely negative response in the United States. Cases in point are the recent gateway studies originating in North America. Warner points out that they were all framed in order to produce certain results: they were all small scale and without any long-term follow up. Nor, he states, did any of them adequately factor in alternative reasons for the initiation of smoking.
Citing the National Institute on Drug Abuse's Monitoring the Future study, Warner pointed out the nonsense in claiming vaping is leading to an increase in teenage smoking: “The decrease in cigarette smoking among young people in recent years has been unprecedented. We have never seen declines so large. I wondered early on whether vaping was essentially going to be a fad for kids. While we don't know that yet, the fact that usage dropped last year [23%] and levelled out in the previous year suggests it is.”
Dartmouth College Institute for Health Policy and Clinical Practice’s Samir Soneji embodies the other side. Devoid of data, failing to cite facts, Soneji said: “The concern that I and others have is that e-cigarettes may renormalise smoking and reduce the stigma of smoking in public.” Unprecedented falling smoking rates and the negative attitude towards vaping it is possible to find on social media points to Soneji being utterly wrong, even if he laughably claims that smoking rates would have fallen “even faster” without electronic cigarettes!
Even though data appears to be favour of tobacco-harm reduction, Amy Fairchild, associate dean of academic affairs at the Texas A&M School of Public Health, and Ronald Bayer, professor of sociomedical sciences at Columbia University’s Mailman School of Public Health still welcomed the “neutral forum for critically debating the emerging evidence”, replicating “an approach taken over the last four years in London.”
“The value of using e-cigarettes as a harm reduction strategy [was] a focus of the inaugural US E-Cigarette Summit,” they wrote. “Unfortunately, the specter of the tobacco industry hovers over any policy choices we make on e-cigarettes… tobacco companies created the very problem they are now trying to ‘help’ reduce.”
Insightfully, they concluded: “Rejecting e-cigarettes because the tobacco industry will profit from them has the virtue of being uncompromising. But it also means rejecting the evidence and accepting the predictable, deadly toll of cigarette smoking. That’s a virtue, we argue, the world can no longer afford.”
The speakers’ PowerPoint presentations are available to be read here.
Overall, the debate was described as “fierce” by a number of commentators: “I will not soon forget the cheers and boos in the crowd as people stood up to state their opinions and present their research.” What is pleasing is that some anti-vape activists attended – it is just a shame the most vociferous ones (and the biggest liars) stayed away.