It’s early, but it sure looks as if the e-cigarette is going to turn out to be every bit as odious as its forebear, the paper and tobacco cigarette.
Yet in a wondrous twirl of Don Draper magic, the e-cigarette has positioned itself as the St. Patrick of the 21st century, driving a carton of menthols out of our lives instead of snakes. Ad blitz aside, the e-cig is a problematic, likely toxic, surely untested, and unregulated battery-operated gizmo that delivers flavored nicotine mist to its sanctimonious users. These users have the assurances of the tobacco companies that are behind the e-cig that their new product, unlike their old product, which, oh well, turned out to be a little dangerous, is totally safe. And if you can’t believe the promises of Big Tobacco, well, hey, who can you trust?
The screws tightened on the e-cigarette racket a tiny amount this week, with a modest study conducted on agar plates that seemed to suggest that the juice, including nicotine, that constitutes the pre-battery buzzed liquid of the e-cigarette might have something in it that promotes the growth of last decade’s public enemy No. 1, MRSA, a resistant and sometimes fatal bacteria. A group presenting a paper at the annual meeting of lung specialists took a famously harsh strain of MRSA, dubbed USA 300, and placed it into various concentrations of e-cig vapor. They studied the consequences and found some changes in the bacteria itself and in its propensity to hide in a self-protective and sometimes impervious slime called the biofilm, alterations that indeed might make the bacteria harder to kill.
Might. It is a mega-leap from the agar and test-tube finding to real patients and their delicate lungs. Though I am certainly no fan of the e-cigarette—and have come to hate its ad campaign and fake glow with almost as much piquancy as I have hated cigarettes these many decades—this study seems like entrapment to me: scientists looking for new ways and reasons to hate the new e-product but with no clear hypothesis other than the likelihood that the dragnet will yield a juicy (read: newsworthy) finding.
The e-cigarette needs no additional evidence that it is a ringer. More than a ringer, it is yet another manifestation of the American genius at finding loopholes. Imagine the glee that entered the cigarette-maker marketplace as tobacco leaders envisioned more and longer life on the tit of yet another addictive nicotine product with a shady health record that seemed likely to lie outside the reach of the FDA at least for a few profit-glorious years. As a reminder, the FDA was not allowed to regulate tobacco (not a food and technically not a drug, as if) until 2009, with the passage of the Family Smoking Prevention and Tobacco Control Act. Thankfully, though, elections have consequences.
The e-cigarette likely will prove to be as slippery to grab and regulate as a greased pig, if I may borrow a faux-country saying from my Oklahoma youth, relevant here since Oklahoma appears to lead the country in its blind, headlong embrace of the e-cigarette. The state likely will lead in the countervailing lawsuits when (insert a horrid disease here) is found to be linked to e-puffing.
The only problem with studies about how bacteria in the e-cigarette are gonna lap up that nicotine juice and go all Schwarzenegger on us is that they distract from the central problem. The original sin is the deliberate, heartless, sinister dishonesty from Big Tobacco as it pretends to be a public health advocate, all the while running as long as it can and as far as it can with a new product it knows can only harm. It’s only a question of how much.
And the argument that e-cigarettes aren’t great, but hey, they aren’t as bad as real cigarettes, holds no water. E-cigarettes have never been studied, but inhaling really hot mist into the lung probably will have consequences. Women’s mascara is subjected to more scrutiny that this. Who knows what the e-cig will cause? Sure, the FDA recently tried to sink some teeth into the e-cig con game, but its efforts may fall short, given the ever -more Southern, ever more “Don’t Regulate on Me” tone of the U.S. Senate.
So we are left running yet another unapproved study without informed consent where a few million people will be exposed to something, and we’ll wait a few years and see if any of them die. In the world of medicine, this is called malpractice and fraud. In the world of commerce, it’s called a shrewd business plan.