Letter to Senator Lautenburg
Stop Your Opposition to The Electronic Cigarette Says Senior Doctor
In this letter, which is in the public domain, Dr Joel Nitzkin, Chair of the Tobacco Control Task Force for the American Association of Public Health Physicians, asks Senator Lautenburg to reconsider his proposal to withdraw the electronic cigarette from sale. The full text of the fax can be seen below.
American Association of Public Health Physicians
The voice of public health physicians, guardians of the public's health
Tobacco Control Task Force
March 27, 2009
To: Senator Lautenberg
Fax: 202 228 4054
Subject: Please Cancel Opposition to Electronic Cigarettes
Honorable Senator Lautenberg:
In my capacity as Chair of the Tobacco Control Task Force of the American
Association of Public Health Physicians, I must vigorously oppose your
proposal that FDA ban electronic cigarettes.
Among the many manufacturers and vendors of electronic cigarettes there
appear to be some that make unjustified claims of health benefits. While it
would be appropriate for FDA to address those manufacturers and vendors
relative to their specific claims, banning all electronic cigarettes would
not benefit the health of the public.
Conventional cigarettes kill about 400,000 adult American Smokers each yearfrom cigarette-related illness. Over the next 20 years this will total 8 million deaths among current adult smokers, most of which are now over 35 years of age. Cigarettes kill about 30% of consistent adult cigarette
Smoking cessation rates among these smokers are abysmal - about 3% per year. Pharmaceutical products with counseling, quit lines, etc, are little better - resulting in quit rates no greater than 5% (as measured at 12 months post-intervention) among those willing to try these modalities. In other words, current approaches fail 95% of smokers using them.
Adult American smokers are health conscious, as evidenced by the fact that
about 85% of them have switched to light and low-tar cigarettes, believing
(incorrectly) that they pose less health risk.
Research to date has clearly demonstrated that smokers smoke because they
are addicted to nicotine. This same research also shows that the illness
and death due to cigarettes is not due to the nicotine, but due to products
of combustion and, to a lesser degree, toxins in the cigarette tobacco.
Alternative nicotine delivery devices, including, but not limited to electronic cigarettes, have no products of combustion and none of the toxins in cigarette tobacco. On at least a theoretical basis, they could and should be seen as generic equivalents of the pharmaceutical nicotine products. As best we can tell, on the basis of currently available research data, these products promise a risk of illness and death well under 1% of
the risk posed by cigarettes.
Stated another way - simply informing current adult smokers that they could
dramatically reduce their risk of tobacco related illness and death by
switching to alternative near-zero-risk nicotine delivery products could
possibly save 4 million or more of the 8 million current smokers who will
otherwise die of a tobacco-related illness over the next 20 years.
Both houses of Congress now seem poised to pass an FDA/Tobacco bill
(H.R.1256 in the House). This bill, if passed in its current form will
provide, at least on an interim basis, the FDA seal of approval on
currently marketed cigarettes. That being the case, the safety standard
that should be used for other tobacco products, and for alternative
non-pharmaceutical nicotine delivery devices, should the hazard posed by
cigarettes, not a pharmaceutical safety guideline.
All tobacco and nicotine delivery devices should be held to the same safety
guideline. Exempting cigarettes, while holding alternative nicotine
delivery devices to an impossibly stringent safety guideline, will not
protect current American smokers. It will only protect Altria/Philip
Morris cigarette sales and profits.
On behalf of the Tobacco Control Task Force of the American Association of
Public Health Physicians, I therefore urge to consider the following:
1. Withdraw your proposal to ban electronic cigarettes.
2. Urge amendment of the proposed FDA/Tobacco bill to encourage the
development and marketing of safer alternatives to cigarettes, under strict
but fair FDA oversight, and with marketing restrictions in place to reduce
the numbers of adolescents who initiate use of cigarettes and other
nicotine delivery products.
The amendments we think will achieve these goals, and the results of our
analyses and literature reviews, are posted on the tobacco issues page of
our www.aaphp.org web site.
Joel L. Nitzkin, MD, MPH, DPA, FACPM
Chair, Tobacco Control Task Force
American Association of Public Health Physicians
c/o JLN, MD Associates LLC
office phone 504 899 7893
fax 504 899 7557
cell phone 504 606 7043
see www.aaphp.org, "tobacco issues"
JLN:jln 20090327TobFarLottenbergECig .doc