A basic principle of public health ethics is that we don’t lie to people. Telling the truth is a critical component of the public health code of ethics. It is important not only because it is unethical to lie, but also because we greatly risk losing credibility and the public’s trust if we are found to be lying. And once that public trust is lost, it is extremely difficult, if not impossible, to gain back.
Therefore, it pains me today to have to report that the Pennsylvania Department of Health is urging parents to lie to their kids about e-cigarettes in order to dissuade them from vaping. In addition, the Pennsylvania Department of Health is lying to the public about the dangers of e-cigarettes and tobacco cigarettes as well.
The Pennsylvania Department of Health put out a tweet that read: “E-cigarettes, e-cigs, e-hookahs, mods, vape pens or vapes—whatever you call them, they are NOT safer than other tobacco products. Learn how you can help protect you child’s health by talking about the dangers of vaping → http://bit.ly/2RuVOev
On its web site, the Pennsylvania Department of Health informs the public that: “E-cigarettes, also known as e-cigs, e-hookahs, mods, vape pens, vapes or ENDS, are not safer than other tobacco products for youth.”
The Rest of the Story
It is simply not true that e-cigarettes are as dangerous as tobacco cigarettes, or that vaping is as dangerous as smoking. At this point, there is abundant scientific evidence that vaping is much safer than smoking. In fact, smokers who switch to e-cigarettes experience dramatic improvement in their respiratory symptoms and lung function.
The Royal College of Physicians concluded that vaping is at least 95% safer than smoking, but even if you don’t agree that the risk difference can be quantified, the evidence demonstrates that e-cigarettes are a much safer product than real tobacco cigarettes. The reason for this is that e-cigarettes contain no tobacco and involve no combustion. While tobacco smoke contains more than 10,000 chemicals including more than 60 known human carcinogens, e-cigarette aerosol, at worst, contains more like 20 chemicals and perhaps 1 or 2 carcinogens. And this is only the case for e-cigarette brands that do not properly regulate the temperature of the heating coil. Studies of the aerosol of brands that have proper temperature regulation have not detected significant levels of any hazardous chemicals.
There is no question that e-cigarettes are much safer than cigarettes in terms of lung damage and in terms of cancer risk. E-cigarettes have been on the market now for 12 years and have been used by millions without any identified health effects (other than some mild respiratory irritation).
So what the Pennsylvania Department of Health is doing is lying to the public by telling us that vaping is no safer than smoking. Or, put another way, these health officials are asserting that cigarette smoking is no more hazardous than vaping.
Were a tobacco company to make the same statement, it would be rightly accused of fraud and deception. So why can a state health department make that statement with immunity?
The reason, I believe, is that most tobacco control groups no longer care about the truth and about scientific accuracy. They are more concerned with creating hysteria about vaping and scaring the public. While the ultimate goal – reducing youth vaping – may be considered to be laudable, the ends do not justify the means. Lying to kids to discourage them from engaging in a particular behavior is not the way to go. And it is not something that we condone in public health.
The Department of Health’s message is also deceptive because it instructs parents that by preventing their kids from vaping, they can keep their kids tobacco-free. This is highly deceptive because it implies that a youth who vapes is using tobacco. That simply isn’t true as there is no tobacco in an e-cigarette. In fact, the very thing that distinguishes an e-cigarette from a real cigarette or from a heat-not-burn tobacco product is the absence of tobacco. If an e-cigarette actually contained tobacco, then it would not be an e-cigarette. It would be a heat-not-burn tobacco product.
A youth who vapes is tobacco-free. They are not nicotine-free (unless they use an e-liquid that does not contain nicotine), but they are smoke-free and they are tobacco-free.
I believe that one of the reasons why public health groups have been so ineffective in reaching youth with anti-vaping messages is that the kids are seeing right through these lies. Kids are not stupid. They can see with their own eyes that when someone lights up a cigarette, the health effects are immediately apparent. Smokers cough, they are typically short of breath upon exertion, they are more prone to pneumonia and upper respiratory infections, etc. But kids see plenty of other kids vaping and Juuling without any visible health effects. Today’s kids are just not going to buy the lies that the Pennsylvania Department of Health and other anti-nicotine groups are selling them.
Ultimately, I believe that the credibility and reputation of public health groups and agencies is going to be seriously undermined by the widespread lying and deception that is taking place regarding the relative risks of vaping compared to smoking. Disseminating false facts like this is unethical, it specifically violates the public health code of ethics, it puts the reputation of public health itself at risk, and at the end of the day, it doesn’t even accomplish its intended objective of discouraging kids from vaping.
If you’re going to tarnish the image of public health and violate our ethical code, at least do it in a way that accomplishes some great public health objective. Lying about vaping is doing plenty of tarnishing, but nothing to protect the public’s health.
The rest of the story is that lying to kids isn’t justified even if it did prevent them from vaping. But it is doing just the opposite, as kids see through the lies and in some ways, it makes vaping more attractive.