American Cancer Society’s Confused Position

In somewhat of a surprising move, the American Cancer Society has quietly updated its position statement on electronic cigarettes. I say quietly because there is no mention of this update on any of the social media channels, nor was there any special press release or blog post on their website.

Naturally, doing that makes me a tad suspicious.

Considering that, earlier this year they issued a press release in response to the National Academies of Science Engineering and Medicine (NASEM) report – which I still need to write about. You would, therefore, think that, given that the report likely spurred this position update, they would issue something to herald it. But no.

Based on currently available evidence, using current generation e-cigarettes is less harmful than smoking cigarettes, but the health effects of long-term use are not known.

Well, no shit Sherlock! However, I would disagree about the effects of long-term use. The products have been around, and in use, since at least 2007. In some areas, it is likely earlier and, let’s face it, the early products were – compared to what we have now – pretty dire. Not only is there a broader array of options, almost everything about the product is easier. There is still a long way to go, of course, but in the relatively short time of the industry, great strides have been made.

To help smokers quit, the ACS recommends that clinicians advise their patients to use FDA-approved cessation aids that have been proven to support successful quit attempts. Many smokers choose to quit smoking without the assistance of a clinician and some opt to use e-cigarettes to accomplish this goal.

Here we go. The American Cancer Society is now lending tacit approval to e-cig use for cessation only. Where have we come across that before?

The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes.

Unsurprisingly, the long-term aim is for abstinence from nicotine entirely. No thought at all given to the pleasure principle.

Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation mediations. These individuals should be encouraged to switch to the least harmful form of tobacco product possible.

We know where this is going to end up, don’t we? Recently, Public Health England repeated the mistakes of 2015 by suggesting e-cigs could be offered by the NHS. A tactic that blew up in their face in 2015, and again this year.

Smokers are not sick, they don’t require medicines to “get better”, in most cases they simply want to be left alone. Those that do want to stop smoking should have the broadest array of options available. It could be that an individual chooses to use snus over cigarettes, or iQOS (other brands are, of course, available), or e-cigarettes.

What the American Cancer Society is saying here is precisely what PHE have been saying. “If you can’t quit smoking by ‘normal’ means, switch to e-cigs”. Basically, using e-cigs as a stick to beat on smokers.

Sorry but, fuck off. If someone wants to switch, then fine. If someone wants to use snus instead, that’s fine too. Let the user make the decision based on their needs, not on yours.

switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products. Of course, these individuals should be regularly advised to completely quit using all tobacco products.

Further enforcement of ACS wanting to dictate to a group of individuals about their choices.

The ACS strongly discourages the concurrent (or “dual”) use of e-cigarettes and combustible cigarettes, a behavior that is far more detrimental to a person’s health compared to the substantial health benefit of quitting smoking.

Oh, do behave yourselves you swivel-eyed loons. The use of two products; such as cigarettes and e-cigarettes is absolutely fine. For many it is their preference for any number of reasons – they’ve yet to find their “ideal” setup as a primer. Some just don’t feel that e-cigs give them everything they want right now, but might in the future, in this case, the switch is a transition (per the Markov Theory) and it doesn’t really matter how long that transition takes. It could take hours, days, weeks, months, or years.

The American Cancer Society recommends implementing polices and public health measures known to prevent the initiation and use of all tobacco products, including appropriate taxation, retail policies (e.g., raising the minimum age of purchase to 21), tobacco and e-cigarette aerosol-free policies and funding of evidence-based prevention and cessation programs.

The ‘goal’ of the e-cigarette industry is to ‘make a better cigarette’ which can only happen with innovation. The industry is, after all, a consumer-driven industry created by smokers for smokers. Implementing policies that hamper innovation, the American Cancer Society is effectively removing a viable market choice and denying consumers.

The ACS encourages the FDA to regulate all tobacco products, including e-cigarettes, to the full extent of its authority.

Given that the FDA regulations will still remove a significant portion of available products from the market, it is unthinkable that ACS isn’t aware of the impact this will have. They know exactly what will happen. This is, to coin a phrase, virtue signalling.

Furthermore, the FDA should use its authorities to reduce the toxicity, addictiveness and appeal of tobacco products currently on the market.

This doesn’t need much explanation, does it?

As noted by Oliver Kershaw earlier, and in various posts on this blog, if the FDA plan to follow through with their proposals regarding flavours, e-cigs become akin to medicines. As I noted here, it seems as though the FDA is keeping a possible option for an actual medicalised device. Given the rabid insistence on reducing nicotine levels in combustible tobacco products, and coupled with the inevitable proposals on flavour bans, that’s exactly what will happen.

The American Cancer Society hasn’t really changed, they’re still fully behind the FDA and its proposals, which equates to some very bad news for US vapers.

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