Stages of trying to understand the opposition to e-cigarettes

Its not uncommon to have difficulty understanding why other people don’t hold the same positions you do about things. I will never quite comprehend the mindset of Stephen Harper or for that matter the conservative mindset. I guess we are who we are.

But when it comes to health and the public good, I have a really difficult time understanding how people who hold the same general assumptions about what constitute healthier behaviors that I do depart so radically when it comes to smoking and e-cigarettes.

Just about everyone, and just about every part of the health establishment is pro harm reduction. It is agreed that if something that people do is unhealthy and there is a healthier alternative (even if it is not much healthier) then we agree that it is the right thing to promote the healthier alternative.

Yet when it comes to nicotine related issues, the principles that even apply to illegal and socially destructive substances like heroin, are discarded without even an attempt to argue that they are somehow a special case. It is simply assumed that centuries of medical tradition do not exist.

So to get to the point, I do understand when people who do not see the big picture rail against e-cigarettes but I do not understand how doctors and anyone working for public health can do anything but regard e-cigarettes as part of the solution to smoking related disease.

In the tradition of the stages of moving through grief I present the stages of reacting to the anti-vaping sentiments coming from health authorities.

1. They are not aware of the evidence.

They certainly claim as many popular articles do that “The jury is still out on whether smoking electronic cigarettes is a safer alternative..” Not so.

Not being aware can only arise from not reading the literature which they have access to. While tobacco control papers are often behind a paywall very few e-cigarette studies are hidden from interested readers.

2. They don’t understand the evidence.

Again, not so. Even if they act the part they are not stupid people. Many of these people have spent years evaluating evidence for best practices and outside of tobacco have advocated safer alternatives.

3. They are liars.

This is what you really end up with. As Carl Phillips propounds almost on a daily basis there is no other conclusion to come to.

And if they are liars and work in public health then..

4. They must be compromised.

When you can promote a drug that causes suicidal ideation as a reasonable alternative to smoking, or therapies that have success rates as low as 4%, when e-cigarettes have been such an easy solution for so many smokers (with no reports of ill effects) then the only reasonable conclusion is that money is pulling the strings.

There is a variation on this though..

They don’t really care about health.

In the case of some of these larger associations like Health Canada  I believe that it is the case of the bureaucratic imperative overriding any desire to do good.  We assume people that work for these organization are motivated toward the public good.  Whereas I do think that many people do become doctors and nurses out of a desire to improve health, governmental organizations are by their nature regulatory rather than pragmatic.  And in the case of advocate organizations like the Canadian Cancer Association, the ranks are infested with prohibitionary elements.

So where does that leave us in terms of effecting any change?

1. Support your domestic e-cigarette infrastructure.

Buying e-cigarettes in Canada will influence Canadian conditions much more strongly than outsourcing them. And by continuing to vape you will influence other nicotine users around you to switch to e-cigarettes.  There is safety in numbers.  We might not be entirely safe from prohibition but it makes it harder to maintain for any length of time.

2. Write to power.

Commenting on articles is good and politicians do notice these things but even better is to write directly to your representatives.  Health Canada is a tool of the government; representatives can influence how that tool is used.

It would be great if it were only the case that evidence would rule the day but if history is any judge it only happens some of the time. We’ll just have to power this one through.

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