E-Cigarettes Might Be the Best Addiction to Have?

On Jan. 11, 1964, Dr. Luther Terry released the first report of the Surgeon General’s Advisory Committee on Smoking and Health. The report concluded that there was not merely an association between smoking and cancer, but a causal relationship.

It was a watershed moment. When my own grandfather, a UCLA ophthalmologist and a daily smoker from his Army days during World War II, saw the data that lead to the report’s conclusions, he quit cold turkey. A year after it was published, all cigarette packages were required by law to prominently display the now iconic “surgeon general’s warning.” The effort to decrease smoking in the United States has been one of the great epidemiological successes of modern medicine.

So, when it was announced that current Surgeon General Dr. Vivek Murthy was to unveil the first-ever report from the Office of the Surgeon General on e-cigarette use among youth and young adults, I anticipated a compendium of data that could deliver a welcome and possibly fatal blow to the flourishing nontraditional nicotine industry. As a physician, and simply as a person living in the world, I find the increasing pervasiveness of e-cigarettes in otherwise smoke-free environments to be, at a minimum, a nuisance. I also assumed that since e-cigarettes and other similar products contain nicotine mixed with many other additives, they would probably turn out to be almost as harmful as traditional cigarettes or chewing tobacco. Hoping that the report would represent a possible bon voyage to vaping, I decided to take the time to actually read the thing (vast swaths of it, anyway—it is nearly 300 pages).

To my surprise, it is not the kiss of death I had imagined. After reading it, I concluded that e-cigarettes are nowhere nearly as harmful for most people as traditional cigarettes or chewing tobacco—both of which clearly cause cancer and a host of other long-term serious medical problems. E-cigarettes (and other similar products) so far, according to this report that clearly was created while adhering to the highest standards of research methodology, do not appear to.

Sure, any level of nicotine exposure to youths and young adults is unsafe. But that’s not the whole story.
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