Gateway Claims Aimed at E-Cigarettes: Counterfeit, Déjà Vu

In their war against e-cigarettes, government officials often claim that the devices are a gateway to smoking.  CDC director Dr. Tom Frieden asserted (here) that “…many kids are starting out with e-cigarettes and then going on to smoke conventional cigarettes.”  The National Cancer Institute last March promoted (here) Dr. Stanton Glantz’s tortured analysis of youth e-cigarette use (discussed here and here).  While his data failed to support a gateway effect, his employer, the University of California San Francisco, made the claim anyway (here).     

Politicians also have a penchant for yelling “fire” about smoke-free devices.  U.S. Senator Richard Durbin and Democratic colleagues in the House and Senate issued a report in April titled “Gateway to Addiction” (here).  The term “gateway”, obviously used as an attention-grabber on the cover, appeared only once in the text -- as a nonspecific example of how e-cigarettes “could also increase public health risks” for non-smokers.

The marijuana gateway claim didn’t gain currency until the 1950s.  Back in the 1930s, Harry Anslinger, the first commissioner of the Federal Bureau of Narcotics (here) and the driving force behind the prohibitive Marijuana Tax Act of 1937, denied a gateway claim during Congressional hearings.  According to the excellent history of marijuana prohibition by Richard Bonnie and Charles Whitebread (here), Representative John Dingell asked Anslinger “whether the marihuana addict graduates into a heroin, an opium or cocaine user.”  The Commissioner replied unequivocally, “No sir; I have not heard of a case of that kind. I think it is an entirely different class. The marihuana addict does not go in that direction.”

By 1951, Anslinger changed course while testifying in favor of the Boggs Act, which increased federal penalties for narcotics and marijuana.  Endorsing marijuana’s new reputation as a treacherous gateway drug, he said: “The danger is this: Over 50 percent of those young addicts started on marijuana smoking. They started there and graduated to heroin; they took the needle when the thrill of marijuana was gone.”

So began marijuana gateway scaremongering, which Dr. James Anthony, professor of epidemiology and biostatistics at Michigan State, labels as “…‘vapors’ that emerged from a political cauldron during the middle of the 20th century when it was very difficult to find definitive and convincing evidence of harmful effects of cannabis use – over and above (1) the sometimes extremely severe consequences of criminal penalties for simple cannabis possession and use, and (2) adverse effects on mouth, nose, throat, and lung.” (abstract here)   

This should sound strikingly familiar to vapers (e-cigarette users) and tobacco harm reduction advocates.  As they did with marijuana, prohibitionists make the gateway claim against e-cigarettes in the near-total absence of “definitive and convincing evidence” of harm.