Hints About Smokers Quitting with E-Cigarettes in National Cancer Institute Survey

 

The National Cancer Institute (NCI) released a Health Information National Trends Survey (HINTS 7, 2024) earlier this spring.  I previously used this survey to illustrate the extensive damage caused by mainstream medicine’s campaign against e-cigarettes, which has resulted in American smokers’ misperception about the relative safety of vaping vs. smoking (here and here).  HINTS 7 does not ask about harm perception, but it does ask if participants “believe that any of the following tobacco products can help people quit smoking cigarettes? - Electronic nicotine devices (ENDS), like e-cigarettes.” 

The results for smokers, described in the table and the following chart, are fascinating. 

It is striking, though not unexpected, that current vapers have the strongest belief that e-cigarettes can help people quit smoking, even though the only group over 50% is “former” smokers.  Still, even among “former” vapers, the belief was 22% to 47%.  

Tragically, only 5% of “current” smokers who had never used e-cigarettes believed they would aid quitting.  This is proof that the erroneous message promoted by the American Medical Association and other prohibitionists (discussed last week here) is working, when, in fact, we have population evidence that smokers are switching (here and here), and two smoking cessation trials reported in the New England Journal of Medicine in 2019 and 2024 clearly demonstrate that vapor products help smokers quit.

The HINTS survey tells us how many Americans were smokers and vapers in 2024 (see Note).  The following chart shows that there are fewer than a million 18-24 year-olds who only smoke, and vaping is popular among the majority of 25-34 year-olds.  However, 18.7 million of the 21.8 million exclusive smokers in this survey are age 35 and older.  These are the smokers who desperately need truthful information about the relative safety of vapes and their usefulness for quitting, in order to avoid untimely morbidity and mortality.   

 

Note: Although the HINTS survey is not used to count smokers and vapers, I compared these findings with numbers from the 2023 National Health Interview Survey, the instrument the CDC uses.  The numbers were comparable in all age categories.

 

E-Cigarette Falsehoods from the President of the American Medical Association

 

American Medical Association President Bruce A. Scott, M.D., authored an article, posted on the AMA website today, “Flavored e-cigarettes pose dire threat to youth and public health,” that includes the following: “Tobacco products cause cancer. Overwhelming evidence demonstrates that multiple types of cancer are linked to tobacco products, including e-cigarettes”

This is grossly incorrect, as Dr. Scott intentionally conflates the risks of tobacco use with those of smoking. He provides links to another AMA article that discusses youth and E-cigarette and vaping associated lung injuries (EVALI), but cancer is not mentioned there.

In today’s piece, Dr. Scott writes, “The use of tobacco in various forms remains the nation’s leading cause of preventable death.  According to the Centers for Disease Control and Prevention (CDC), it claims the lives of 1,300 Americans every day, or about one in every five deaths annually. As an ear, nose and throat surgeon in Louisville for more than 30 years, I’ve seen up close the devastating damage that cigarettes and e-cigarettes cause—mouth and throat cancers that too often change lives forever or end lives prematurely.” (emphasis added) The article linked here by Dr. Scott discusses smoking only.

Conflation of tobacco and smoking is a common practice among prohibitionists, as I have noted before (here, here, here), but it is beyond the pale for the president of the AMA to treat “tobacco use” as a synonym for “smoking”, and worse, to unequivocally claim that he has “seen up close” that e-cigarettes cause mouth and throat cancer.

 

The American Medical Association Only Promotes and Protects Doctors, Not Public Health

 

Dr. Gerald E. Harmon, president of the American Medical Association (AMA), authored a commentary November 19 claiming that the “FDA made the wrong choice in allowing Vuse marketing.”

Dr. Harmon said that the FDA’s decision “is wrong on many levels,” but I will show that his commentary better fits that description.

Harmon says that the FDA’s “gravest error is to frame its action as ‘appropriate for the protection of the public health.’”  Gravest error?  Harmon tells his readers in the next paragraph that the FDA had no choice: Congress dictated that precise standard in legislation giving FDA regulatory authority over tobacco in 2009 (here).

Next, Harmon claims that “the role that e-cigarettes may play in smoking cessation strategies is unclear.”  That may be true – for someone who has never looked at federal surveys (here, here and here), never read the scientific literature (here, here and here) and/or never met a former smoker (also called an “anecdote”) (here).    

Incredibly, Harmon cites a recent study from the University of California San Diego involving “smokers who turned to e-cigarettes as a cessation device.”  No.  They.  Didn’t.  As I recently explained in a critique on that study (here and here). 

Then he gets to the core of his commentary: “The AMA has specifically recognized the use of e-cigarettes and vaping as an urgent public health epidemic and has called for a total ban on all e-cigarette and vaping products that do not meet FDA approval standards as cessation tools.” (emphasis added)  In other words, the AMA wants prohibition if the FDA doesn’t regulate e-cigarettes as harshly as it regulates cancer chemotherapy.

Harmon comes up with a claim that will make ever smokers laugh out loud: “Data has shown that using FDA-approved cessation medicine can double a persons [sic] chance of quitting smoking successfully.” 

Double what?  Every year only 5% of smokers quit, so doubling that number makes 10%.  Does Harmon care about the other 90% of smokers who couldn’t quit the AMA way?  I don’t think so.

A lot of Harmon’s rant about Vuse was devoted to “fruit- and candy-flavored” products.  This is strange.  The only Vuse products the FDA authorized are tobacco-flavored.

Why does the AMA, one of the most influential organizations in American medicine, take such a prohibitionist position when 480,000 American smokers are dying prematurely every year?  Well, its influence derives not from its commitment to public health, but from its power as a trade organization.  And trade organizations’ first and foremost goals are to advance the interests of its members.  According to blogger Matthew Yglesias, the AMA actively makes the number of doctors in the U.S. scarce, by blocking increased scope of practice for nurses, making it hard for foreign-trained doctors to practice in the United States, and historically pushing to train too few doctors here at home.  This results in big salaries for doctors and dismal, expensive access to medical care for Americans compared to many other developed countries (see chart below). 

The AMA protects and promotes doctors, it doesn’t care about American smokers.