Researchers based in North Carolina have discovered that if you lie to smokers about the amount of harmful chemicals in e-cigarettes compared to traditional cigarettes you will put them off using the products. In a study entitled 'How hearing about harmful chemicals affects smokers' interest in dual use of cigarettes and e-cigarettes', Pepper et al present smokers with four scenarios and then analyse their attitude towards dual use of the products with smoking. The four scenarios were:
That cigarettes and e-cigarettes had the same amount of harmful chemicals
That cigarettes contained 10x more harmful chemicals than e-cigarettes
That cigarettes contained 100x more harmful chemicals than e-cigarettes
That cigarettes contained harmful chemicals and e-cigarettes contained none
Unsurprisingly, in the scenarios where e-cigarettes contained less or no harmful chemicals participants indicated that they would be more likely to initiate or increase dual use of cigarettes and e-cigarettes.
What isn't immediately obvious from the publicly available abstract, but is noted in the limitations section of the full paper hidden behind a paywall, is the fact that the study concentrated on those smokers who said they would start or increase their use of e-cigarettes without stopping smoking. So smokers who indicated that they would completely switch to the safer product were excluded.
Astonishingly, the authors concluded that this apparent encouragement of dual use created by giving smokers accurate information on the relative numbers of harmful chemicals in the products would lead to a harmful continuation of smoking, and that therefore e-cigarettes "may not be able to be approved as a modified risk tobacco product on the basis of reduced chemical exposure alone because the public views information about lower chemical amounts as inherently related to reduced health harms". Paracelsus must be turning in his grave. The underlying suggestion in the conclusion to this study is that the FDA should consider hiding the the fact that e-cigarettes contain vastly reduced numbers and amounts of harmful chemicals when compared to smoking combustible cigarettes.
It is deeply concerning, but unfortunately not surprising to those of us who regularly read the bilge coming out of certain parts of the world, that researchers should feel comfortable suggesting that lying to smokers about the relative risk of products would be a viable public health policy. The obvious consequence of such a policy is that some people who might otherwise have switched to a safer alternative will continue to smoke. It is unfortunate that these researchers appear to have completely ignored them. Whatever happened to ethics?