Testimony of Carl V. Phillips, PhD, Consumer Advocates for Smoke-free Alternatives Association (CASAA)
to the Philadelphia City Council
regarding e-cigarettes (in opposition to Bill No. 14009500 and in opposition unless amended to Bill No. 14009600)
11 March 2014
My name is Carl V Phillips, PhD. I currently live in xxx, New Hampshire, but have close ties to Philadelphia and until a few months ago I was a resident of the Philadelphia suburbs and was affiliated with Drexel University. I am the Scientific Director of CASAA, The Consumer Advocates for Smoke-free Alternatives Association, and also work as a private consultant. I am testifying on behalf of CASAA, which is a public health non-governmental organization (NGO) and consumer representative, not an industry group. CASAA is the leading consumer representative of users of e-cigarettes and other low-risk alternatives to smoking. CASAA is a nonprofit volunteer organization and I am not being compensated for providing this testimony.
I am a public health scientist and award-winning epidemiologist. I spent most of my career as a professor of public health, and most of that focusing on tobacco harm reduction. I have been doing research on smoke-free alternatives to smoking, including e-cigarettes, for longer than almost any other researcher in the world and have published numerous journal articles and other writings on the topic.
CASAA supports prohibiting sales of e-cigarettes to minors at the city, state, and national levels. There is really no honest opposition to such policies, with merchants and industry joining us, the consumer advocates, in supporting them. Indeed, reputable merchants already enforce such restrictions even when they are not mandated by law. The only opposition to such restrictions comes from so-called public health groups, who are apparently attempting to increase e-cigarette usage by children so they can use it as an excuse to restrict adult access.
However, we cannot support Bill No. 14009600 as currently written and ask that it be amended. First, it defines e-cigarettes as “electronic smoking devices” which they are most certainly not. There is no smoke produced, and referring to e-cigarette use as smoking is misleading, inflammatory, and potentially harmful since it might dissuade smokers from switching to this healthier alternative. The Bill further uses the phrase “unauthorized nicotine delivery products”, which is both inflammatory and rather cryptic (are cigarettes authorized?). Pennsylvania is currently considering SB 1055, which would impose similar restrictions on sales to minors, and uses the term “alternative nicotine product”. We urge you to amend the language to match that of the Commonwealth’s bill or at least to choose some alterative phrase that, like theirs, is appropriately non-judgmental and technically accurate. Second, SB 1055 would require different signage than you are currently considering. In order to avoid imposing contradictory requirements on merchants, we ask that you change the wording of the required signage to match that of the Commonwealth’s bill.
There is little more to say about that, so the remainder of my testimony focuses on the proposed ban of e-cigarette use where smoking is banned.
The key observation is that the environmental exposure from e-cigarettes is not at all similar to smoking. A recent review of all the available science on the vapor from e-cigarettes by Prof. Igor Burstyn of Drexel University concluded that the exposure to chemicals to the user, both intended ingredients and contaminants, was far below the level that would create any health concern. That is to the user himself. The conclusion was that the exposure to any bystanders is 100 or 1000 or 10,000 times less than that quantity which was already shown to be inconsequential. Since Prof. Burstyn is expected to testify at the hearing on this Bill, I will defer to him on further details.
Moreover, as you have probably heard, vaping is about 99% less risky than smoking, and hundreds of thousands of American smokers who would not have otherwise quit have switched to e-cigarettes, thus reducing their health risks almost as much as if they had quit cold turkey. Anything that discourages such switching is thus bad for public health. You might be inclined to say “better safe than sorry” about the environmental exposure issue, but sometimes “safe” is very costly. In this case, it is very costly to public health. Being able to use an e-cigarette in a bar or one’s office, rather than having to trudge outside to smoke, is a big draw: Come for the convenience, stay for the 99% reduction in health risk. Take away that convenience and you are going to be responsible for causing many people who would have quit to just keep smoking because they feel like they might as well. This will kill people. This is hardly “erring on the side of caution”.
Another argument that is sometimes made in favor of bans is to prevent children from seeing people using e-cigarettes. The goal is dubious in itself. Kids see adults doing a lot of things that they are not allowed to do – that is just part of life. Moreover, seeing people ostentatiously not smoking, and seeing them seeking a substitute because they find that quitting cold turkey is not an option, seems like a good message to send to the kids. But even if we assume that this is a legitimate goal, how does making smokers step out of bars and private offices onto the street further this goal? This seems like it would make e-cigarettes more visible, not less. Yes, there are stories – probably mostly apocryphal – about teachers vaping in front of their pupils. But if that is the concern, it is easy enough to prevent that and similar specific concerns without imposing an unjustified, burdensome, and anti-public-health blanket restriction.
You have no doubt heard so-called public health organizations urging you to enact these restrictions, and wonder why they would be making such claims given that there is no scientific or public health justification for them. The reason is, quite simply, that they are not motivated by genuine health concerns. They will claim that there is a risk to bystanders or that we just don’t know enough, both of which are false. If someone you hear from does not know that, it is only because he has avoided reading the scientific literature on the topic before presuming to opine to you about it. They will claim that there are unknown risks to the user herself, but that is not relevant. If there really were great risks to the user – and there is overwhelming evidence that there are not – we would be talking about a ban, not an environmental restriction.
The reality is that these organizations are not worried about protecting bystanders or even product users themselves. They are not really concerned about children, as evidenced by their opposition to minor sales bans (perhaps not the one you are considering, but many others in other jurisdictions). They are frustrated that this solution to the public health scourge of smoking is happening in spite of their dismally ineffective efforts to eradicate all tobacco use, rather than because of them. These organizations have lost touch with their original goal of eliminating the health impacts from smoking – something that e-cigarettes do almost as well as quitting cold turkey – and have become an industry in themselves that is devoted to the hopeless dream of eliminating all tobacco product use. They are hostile toward e-cigarettes not because they are a threat to public health, but because they will achieve the public health goal in a way that they simply find morally objectionable.