Popularity of Electronic Cigarettes drives Fear

The other day I reported on a new study published in the American Journal of Preventative Medicine, "Tracking the Rise in Popularity of Electronic Nicotine Delivery Systems ("Electronic Cigarettes") Using Search Query Surveillance" which showed that between 2008 and 2010 Internet searches for electronic cigarettes rapidly surpassed those for nicotine replacement therapies and for drugs like Chantix on the order of "several-hundred-fold". Now, for those of us in the know this is not really news, but it did get me to thinking about some things, particularly how the popularity of electronic cigarettes might be driving the increase in fear mongering and state level lobbying by anti smoking groups and drug companies.

The authors of this article are doctors who monitor the Internet for signs of public health trends. All three of the authors are established experts in using "Internet surveillance" to spot health trends and infectious disease outbreaks, and at least one, Kurt M. Ribisl PhD has published many articles, studies and speeches about tobacco control and the Internet. You would expect these guys to be looking at Internet trends for ecigs. But what they found shows that perhaps they are not the only ones.

Google's search data is public. Anyone can see how often search terms are searched and I'm sure companies like Pfizer, maker of Chantix, as well as the makers of NRTs (nicotine replacement therapies) carefully monitor the search data regarding their products and their competition. I'm sure Pfizer isn't too happy with these results that ecigarette related searches outnumber those for their drug Chantix by 300%.

A common theme in the Anti Smoking and particularly the Anti Vaping, or Anti Electronic Cigarette lobbying efforts which has been noted many times by myself and others is the funding (in the millions of dollars) by drug companies, particularly Pfizer, to the organizations like Action on Smoking and Health, the American Cancer Society, the American Lung Association and the rest who oppose electronic cigarettes and lobby politicians and the press to gain support for legislation to ban their sale until they are approved by the FDA, as the wording for the proposed NY ban says, as "TOBACCO USE CESSATION OR HARM REDUCTION PRODUCTS OR FOR OTHER MEDICAL PURPOSES AND ARE BEING MARKETED AND SOLD SOLELY FOR THAT APPROVED PURPOSE".

I've been noticing more and more the use of this particular phraseology in proposed legislation and lobbying. It's become some variation of: "until recognized and approved by the FDA as a smoking cessation product". This is something new. Until recently these groups opposed all sales of ecigs, claiming any use of nicotine is dangerous and Action on Smoking and Health has many times tried to make the argument that second hand vapor from ecigs might actually be more dangerous than second hand smoke, and that ecigs may pose some sort of unknown danger that after five years on the market has yet to materialize, of course, without any scientific data to back it up other that "we just don't know!!". See Scientists examine ASH smoking claims.

Now, the FDA has been told twice by federal judges that they can't regulate ecigs as a drug delivery device. Judge Leon said very clearly in his first opinion which was recently affirmed by the three judge panel of the appellate court:

While FDA's interest in protecting public health and safety is, in the abstract, paramount to plaintiffs' purely economic interests, given the particular facts and circumstances of  this case, I am not convinced that the threat to the public interest in general or to third parties in particular is as great as FDA suggests. Together, both Smoking Everywhere and NJOY have already sold hundreds of thousands of electronic cigarettes, yet FDA cites no evidence that those electronic cigarettes have endangered anyone. Nor has FDA cited any evidence that electronic cigarettes are any more an immediate threat to public health and safety than traditional cigarettes, which are readily available to the public. Furthermore, now that FDA has regulatory power over electronic cigarettes through the Tobacco Act, any harm to the public interest or to third parties caused by an injunction that merely forbids FDA from regulating electronic cigarettes as a drug-device combination is greatly diminished. Id, at 30-31.

So why this new push to propose state level legislation that seems to circumvent a federal judges opinion and invite more litigation? If the FDA can't regulate them as drug delivery devices, how can a state ban their sale until such time as they are regulated as a drug delivery / smoking cessation product?

My personal feeling is that Pfizer is already well on their way to introducing their own version of the electronic cigarette. They have the means and the resources to get them approved as a smoking cessation device, they have the means and the resources to engage in a massive lobbying effort to establish a monopoly on the product and I think that's exactly what is going on with the anti smoking groups Pfizer supports that are encouraging states and municipalities to ban their sale until there is an FDA approved smoking cessation device version available.

And this study seems to support that Pfizer and the anti smoking groups have much to fear from the popularity of electronic cigarettes and are aware of exactly how much more popular ecigs are becoming over their "safe and effective" NRT and drug options.

Pfizer has been watching as closely, if not more so than these three doctors. They know very well that electronic cigarettes seem to be a far more popular option than their dangerous drug Chantix, which recently topped the list of drugs with disproportionally reported cases of violence. Chantix was found to be 18 times more likely to be associated with violence than other drugs with over 11,393 adverse reaction reports, 408 of them identified as violent. "We identified any case report indicating homicide, homicidal ideation, physical assault, physical abuse or violence-related symptoms" said the report published in the journal PloS One. And Chantix, a stop smoking aid, topped their list?

Is it any wonder people are searching for an alternative that doesn't include the risk of homicide or suicide?

Is it any wonder people are searching for electronic cigarettes with their hundreds of thousands of very vocal supporters over NRT options like the patch and the gum with dismal success rates as low as 5%? A recent study by the Boston University School of Public Health applauded ecigs over NRTs because "No non-tobacco nicotine product has heretofore elicited such dedication among its users, suggesting the rare promise of the electronic cigarette as a smoking cessation tool" and went on to point out that electronic cigarettes are ‘exactly what the tobacco companies have been afraid of all these years’.

I'm going to go one step further and state that electronic cigarettes are exactly what manufacturers of ineffective nicotine replacement therapies and dangerous drugs like Chantix have been afraid of all these years too. Ecigarettes literally scare the pants off them. And thats driving their fear campaign, their lobbying and I'm sure their product development.

But the good news is if you look at the numbers in this study you will see that people see through the hype, the misinformation and the drug company funded fear campaign lobbying. As Boston University noted, there are no other smoking alternatives or nicotine replacement therapies with such a devout and vocal following as ecigs.

As the search report points out, "Stronger tobacco control, created by clean indoor air laws, cigarette taxes, and anti-smoking populations, were associated with consistently higher levels of ENDS searches" and then concludes "The online popularity of ENDS has surpassed that of snus and NRTs, which have been on the market for far longer, and is quickly outpacing Chantix or Champix. In part, the association between ENDS’s popularity and stronger tobacco control suggests ENDS are used to bypass, or quit in response to, smoking restrictions."

And that my friends is the problem. That's the fear of anti smoking groups and companies like Pfizer. Ecigarettes might be used to circumvent tobacco control, cut into the profits of dangerous but "safe" FDA approved drugs like chantix and the scariest part of all... may actually encourage people to "quit in response to, smoking restrictions."

The fact is, and the fear is, tobacco control, taxes, smoking bans and societal engineering towards a more anti tobacco population is driving people to quit using tobacco, which was the goal of all the anti smoking groups all along, but as this study shows, we just are not using the products they thought we would to do it.

And that scares the pants off them.